Hi Elaine,

I wanted to get your opinion on block and replace with Bugleweed. I was on block and replace for a year and at first TSI kept dropping but then it kind of been flat for the past 12 months. I feel like I have been in the final stretch for over 1.5 tears. I just can't seem to bring down my TSI below 1 and closer to 0.55.

I was taking 1.25mg methemazole with 25-37mcg levo. The methimazole has always given me side effect but I just struggled through it, constant heachache, dry mouth etc.

I have now been on methimazole for 6 years, albeit on low dose(highest dose has 10mg when I first was diagnosed but been taking 1.25mg for the last 2-3 years. I really want to transition to bugleweed. I have read a couple of studies where someone with a mild graves disease like me was able to go into remission using only bugleweed.

What are your thoughts on using bugleweed and levo for block and replace? What should the dosage be for each? Or should I only do bugleweed and lower the dose enough to keep my FT4 high. Any input would be helpful. See blood results below.



11/28/2022
TSH 0.017 (0.45-4.5)
FT4 2.09 (0.82-1.77)
FT3 3.7 (2-4.4)
TSI 1.54 (0-0.55)

1/23/2023
TSH 0.013 (0.45-4.5)
FT4 1.52 (0.82-1.77)
FT3 3 (2-4.4)
Thyrotropin Receptor Ab 1.88 (0-1.75)
TSI 1.11 (0-0.55) Finally breaking new lows!
3/29/2023
TSH 1.06 (0.45-4.5)
FT4 1.2 (0.82-1.77)
FT3 2.8 (2-4.4)
Thyrotropin Receptor Ab 2.05 (0-1.75)
TSI 1.04 (0-0.55)

5/25/2023
TSH 0.105 (0.45-4.5)
FT4 1.43 (0.82-1.77)
FT3 3.2 (2-4.4)
TSI 1.04 (0-0.55)
Vitamin D 97.5 (30-100)
Selenium 206 (100-340)
Iron 71 (38-169)
Ferritin 105 (30-400)

3/29/2023
TSH 0.07 (0.45-4.5)
FT4 1.49 (0.82-1.77)
FT3 3.2 (2-4.4)
Thyrotropin Receptor Ab 1.91 (0-1.75)
TSI 1.06 (0-0.55)

8/10/2023
TSH 0.722 (0.45-4.5)
FT4 1.36 (0.82-1.77)
FT3 2.8 (2-4.4)
Thyrotropin Receptor Ab 2.28 (0-1.75)
TSI 1.22 (0-0.55)

9/15/2023
TSH 0.595 (0.45-4.5)
FT4 1.3 (0.82-1.77)
FT3 2.4 (2-4.4)
Thyrotropin Receptor Ab 2.05 (0-1.75)
TSI 1.23 (0-0.55)

Hi,
any problems with allergies? that definitely causes a rise in TSI, which is why my level never falls. I'm allergic to trees and we live in a forest and to dogs, which we have.
Bugleweed (Lycopus virginicus or officianalis) is great since it's a natural anti-thyroid drug. There are several preparations like Thyrosoothe that contain a few other herbs to reduce hyper symptoms. You can find these products on Amazon and they give a dose for starting out. I would take around 1/3 of the recommended starting dose and then check levels after 5-6 weeks. Your levels now are too low and are preventing remission. Also, check your 25OH vitamin D level if you haven't in a while since low levels are also related to increased thyroid antibodies. Best, Elaine