More Wonky Thyroid Questions - T3 Medication Side Effects?

KnitOrMiss

So, to give a little background, my PCP diagnosed me as hypothyroid some years back. We tried Armour, it did squat for me, because we didn't titrate up to therapeutic dosage levels. Went to an endocrinologist who basically told me until I lost weight, I was so fat that thyroid meds wouldn't help me. Dropped him like a hot potato, but stopped the meds.

Fast forward a few years, end up on generic of Synthroid (a T4 only med) after my PCP gets concerned about my levels nearly doubling in less than a year. Start to feel some relief. Add in Iodoral (iodine/iodide combo), get assigned endocrinologist, and start treatment for PCOS, discover I'm insulin resistant, etc.

After that time, about every 6 months, my endo was increasing my T4 medication. We do some more testing, and decide to add a T3 medication (started about 4 weeks ago). Well, I've been fighting way harder against the sugar demon who lives in my head lately, and losing more than winning, but not really gaining more than 2-3 pounds total. After a "MUST EAT SOMETHING SWEET NOW" reaction - more mental than actually physical, but that overwhelming thought process that I've gotten rid of in the 18+ months I've been low carb, and to be honest, it freaked me out.

So, I look up side effects of the medication. No indications for sugar issues. Might affect BCP though - yeah that was a fun read. That being said, it does say something about if you are diabetic and on meds or not, it might become difficult to control your blood sugars - but no reason given unto why. Called pharmacy to ask about side effects. Pharmacist indicated that it's likely just from the changes it gives to your metabolism, but monitor blood sugar (have had lows previous as medication side effect, this feeling definitely was NOT that) and talk with my doctor if continued issue. I've had my insulin levels go wonky before triggering weirdness in this general subject area, but never like this. I do have somewhat of a sharpish energy drop right at the 3-4 hour mark after taking this medication both times I take it daily.

---

So long story short - has anyone added a T3 medication and had sugar cravings, blood sugar issues, insulin issues, hard crashes after? I know that I can look into a compounded sustained release form, but the cost and procurement will be a problem. My pharmacist recommended that I monitor my blood sugars, cut any carb creep I had back down further, and go back to my doctor if this continues. I'm currently feeling way too *special* with this side effect, and I'd love to hear from anyone who's had this side effect or others.

Thanks in advance, all.

LauraCoth

I just started my time-release compounded T3 medication today and my reaction was so totally whoa am I flying! that I didn't take my afternoon Erfa dose. I'm supposed to be taking this 2.5 mcg dose in the morning in addition to my 90 mcg dose of Erfa (I take 60 in the morning and 30 in the afternoon). I think I'll try to ease into the total dose over a week so I don't shock my system.

Of course it's too early to tell how this will ultimately affect me, but I'll keep you posted. What I do know from previous experience is that T3 is a VERY powerful substance and can have a profound effect on the body.

nvmomketo

I started Erfa's Thyroid around the same time that I developed my insulin resistance, but I was also on steroids at the time. If there is any medication link to my IR my guess would be the steroids and not the T3/T4.

I dont remember a boost in carb cravings but I was not low carb back then. There could have been but I wasn't trying to avoid carbs then so I would have just eaten it. I'm no help there.

I take 150 mcg of Erfa every day. I take 60 at bed and 60 when I wake up around 7am. I then take the last 30mcg in the late morning. I've never noticed a buzz or coming down feeling from it except when I was taking 180mcg and ran a bit hyper - I got a bit jittery and felt like I was on fast forward a bit.

My worst side affect when switching to Erfa was hair loss. I lost a lot of hair then... I bough a lot of hats until it eventually came back.

LauraCoth

I find it interesting that you can take the Erfa at night and still sleep. I'm leery of taking my second dose later than around 2:00 in the afternoon because of my chronic sleep problems. That's why my ND put me on the time-release T3 -- I get a small dose over a long time, which no doubt helps with the crash and burn I get when I take it all in the morning.

I think it's helping me. It's very early days since this is really only day 3 -- I stopped after my first dose last week because it made me very hyper and then I started again without incident this week. I don't feel as jumpy. I noticed this effect last year when I started the Erfa -- a feeling of deep internal calm. Synthroid always made me feel as though I was on the ragged edge of hysteria.

I definitely had far fewer joint pains when I got to my current dose of Erfa.

KnitOrMiss

I'm so glad to hear all of this. Since my endo increased my dosage, my crashing is less, though on days I get significantly less sleep, it's still kind of rough. I'm working to add MCT oil back in, and that's helping take the edge off, too...

Thanks for continuing to keep an eye on this thread.

The weirdest thing I've noticed so far is a warming effect a bit when taking the med, but indirectly...and that my metabolism seems a bit more forgiving - something that would have normally been a 10 pound gain over several days was like 1 pounds or none...which is totally weird and I don't understand, as it's been a short term thing.

I'm also focused heavily on my stomach acid issue, because without increasing the acid level, I can't absorb the iodine and other minerals to help with my thyroid's function... Increasing to a higher level of D3/K2 this week, too, has definitely helped!

LauraCoth

I certainly haven't noticed an increase in carb cravings or odd blood sugar reactions with the compounded T3. I mean, I'm craving carbs a lot because of the lowered carbs in my diet, but nothing more than that. And I can usually shut those down with an almond butter and coconut oil fat bomb.

I would think that thyroid medication wouldn't have anything to do with IR, given that it improves metabolism. My understanding is that it's carbs that cause it -- the terrible low-fat, high fibre diet that's been ruining people's health for decades. It's probably not that simplistic, I know.

When I started taking the Erfa, after 19 years of Synthroid, my body temperature increased. I used to be cold all the time even when everyone else was warm or even too hot. The other thing I noticed was a sharp decrease in nocturnal foot cramps -- but they were a side effect of Synthroid.

KnitOrMiss

I take magnesium pretty heavily. I wonder if that's why I didn't have a major foot cramp issue? I mean, yes, the toe tendons once in a while, but nothing hugely annoying...

But yes, in the time period maybe 4-8 hours after a dose, any humid heat makes me start sweating moderately, and I find it difficult to get cooled down, even in AC without a fan directly on me... I don't notice it changing all the time, just after a dose...

Since I have IR, I was wondering if speeding up the metabolism when I'm not back fully fat adapted yet would cause me to burn through whatever carbs I am eating more quickly triggering the OMG NO SUGAR?!?!?! reaction, you know? I'm a carb/sugar addict anyway, complete with binging tendencies, so I'm thinking something sparked that trigger, and I faceplanted off and on for a while. It's getting easier, again since the dosage was increased...

ambergem1969

Sadly not out yet but might be an interesting read: https://www.amazon.com/Paleo-Thyroid-Solution-Fatigued-Uninformed/dp/1939563240/ref=sr_1_1?ie=UTF8&qid=1468531204&sr=8-1&keywords=Russ,+Elle

I don't have thyroid issues...at least not at this point (never say never!). The author hosts some of Mark Sissons Primal Solution podcast and there was a long podcast a few months ago on thyroid stuff...admittedly much of it over my head. So not in any way endorsing but would be good to hear from those at the front if there is anything good in there!

LauraCoth

That book looks interesting. I'll keep an eye out for it.

My recent issues with inability to lose weight may be because whenever I've tried low carb, I always seem to rely heavily on dairy products. I might do better on Paleo.

KnitOrMiss

Yeah, I do that, too, @LauraCoth. My main issue was I lost GREAT for a few months, then really just yoyoing since. SO I hit my LOW bacin April of last year, and then again in June.

www.healthfulpursuit.com has a great podcast on why that happens to some thyroid (and adrenal and other) folks on Keto. I do FAB on keto during the day, because I don't crash. I have far less dramatic reactions to carbs at night, so I'm trying to formulate a modified keto/higher PM carbs plan that will still allow me to control hunger, not spike insulin, and all that...

ambergem1969

KnitOrMiss wrote: »

www.healthfulpursuit.com has a great podcast on why that happens to some thyroid (and adrenal and other) folks on Keto. I do FAB on keto during the day, because I don't crash. I have far less dramatic reactions to carbs at night, so I'm trying to formulate a modified keto/higher PM carbs plan that will still allow me to control hunger, not spike insulin, and all that...

I'm just listening to the Sunday podcast on carb-ups. It's making me question things even though I feel fine (I think?) even after a year of strict keto. Lots of great info!

nvmomketo

LauraCoth wrote: »

I find it interesting that you can take the Erfa at night and still sleep. I'm leery of taking my second dose later than around 2:00 in the afternoon because of my chronic sleep problems. That's why my ND put me on the time-release T3 -- I get a small dose over a long time, which no doubt helps with the crash and burn I get when I take it all in the morning.

I think it's helping me. It's very early days since this is really only day 3 -- I stopped after my first dose last week because it made me very hyper and then I started again without incident this week. I don't feel as jumpy. I noticed this effect last year when I started the Erfa -- a feeling of deep internal calm. Synthroid always made me feel as though I was on the ragged edge of hysteria.

I definitely had far fewer joint pains when I got to my current dose of Erfa.

I'm lucky. I am one of those people who can sleep anytime. It doesn't seem to wake me up. I started out taking it at 2am (bathroom) because I believe T3 is highest in the early morning hours. I started sleeping through the night more and missed my doses so I just take it at bed now.

LauraCoth

I've never tried taking it at night -- too chicken. One of these days I will, though I'm sure I know what will happen. Could be wrong, though.

My ND is hoping that the T3 (as well as going grain-free) will help me lost the weight that seems to be stuck on my chest and stomach. Feel like I'm carting around a couple of bowling balls on my chest. Not fun.

nvmomketo

I hope it works for you too. I was pretty happy with the difference I that I experienced. It was subtle but positive. I hope you get the same.

LauraCoth

So far, so good. No hyper symptoms. In fact, quite the opposite. I feel wonderful today -- and I've slept four nights in a row. Maybe my thyroid numbers will finally be in the zone! And maybe, just maybe, I'll be able to chisel off some of this weight now.

toadqueen

KnitORMiss - I started taking T3 last year, adding to the T4 I had been taking and totally fell off eating keto. I attributed it to a change in lifestyle (new boyfriend, eating out) but it is possible that the T3 triggered my change. After 1 year and 60 lbs of regained weight, I am trying to eat LCHF once again. It's just been a couple of weeks and I am really struggling with sugar cravings. I've been diagnosed with Hashimoto's Thyroiditis and am also IR. I was diabetic from 199? - 2009 and beat that when I first started eating LCHF. My most recent A1C was 6.5, up from 5.8 the previous year before T3. I have 3 month to get it down before I retest.

I never feel any different with the thyroid medications. I am on low doses of each: T4 25 mcg; T3 5 mcg. My thyroid number look good although my antibodies are still climbing.

Very interesting discussion. I'm inspired to try harder to resist the sugar cravings. I'm already grain-free, but will try to eliminate dairy (cheese) and see if that helps.

LauraCoth

toadqueen, do you know what your test numbers are, or are you just taking your doctor's word for it that your numbers are good? It you have them, post here and I'll take a look. Often doctors get this wrong, unfortunately.

toadqueen

Thyroid Peroxidase AB = 728 (higher than before)
TSH = 3.38 (I think that is too high)
T4, free = .9
T3 Uptake = 27
T3 Total = 83
T3, free = 2.3
Vitamin D = 36 (I am now supplementing to raise this)

Did you want any of the others? These were taken in May, before I began eating LCHF again a couple of weeks ago.

KnitOrMiss

toadqueen wrote: »

Thyroid Peroxidase AB = 728 (higher than before)
TSH = 3.38 (I think that is too high)
T4, free = .9
T3 Uptake = 27
T3 Total = 83
T3, free = 2.3
Vitamin D = 36 (I am now supplementing to raise this)

Did you want any of the others? These were taken in May, before I began eating LCHF again a couple of weeks ago.

OMG, @toadqueen, not to freak you out, but my endo told me that the older we get, the lower our TSH should be. He told me absolutely that at 40 years old, mine should not be over 2!!!!! With you being slightly older than me, I'd be upset. Mine level was like 2.05 or something in April, and he moved my med from 88 mcg to 100 mcg...and to top that off with the T3 crap I had going on, he added the T3 on top of that!!!

I'm going to look at the other numbers compared to mine and respond directly... I just had to jump in because that TSH makes me wanna slap your doctor telling you you're fine... OMG...

KnitOrMiss

How odd?!?! I can't find any documents to support why my doc told me that about the level...based on age. No charts will tell you... Annoying. They won't tell you anything about age/gender breakdown...

In October last year, before I took some time off low carbing, I'd stopped losing weight, and in 6 months, my TSH had gone from 2.699 uIU/mL to 3.979 uIU/mL... (before that it was at 1.640 uIU/mL in October 2014. For reference, I went low carb in January of 2015, but I hit a full on wall with my weight loss stopping suddenly at the end of March/beginning of April 2015. Some podcasts and such I've seen indicated that strict keto might have hit on an underlying adrenal issue that was "holding steady" but not really allowing anything to work well. I'm working on a new plan right now...). Here are my numbers in that time frame.

Thyroid Stimulating Hormone (TSH)
Date -- Result -- Reference Range -- Flag
15-Apr-16 / 2.04 uIU/ML -- 0.36-3.740 -- none
13-Oct-15 / 3.979 uIU/ML -- 0.358-3.740 -- H
20-Apr-15 / 2.699 uIU/ML -- 0.358-3.740 -- none
27-Oct-14 / 1.640 uIU/ML -- 0.358-3.740 -- none


Free Thyroxine (T4)
Date -- Result -- Reference Range -- Flag
15-Apr-16 -- 1.28 ng/DL -- 0.76-1.46 ng/DL -- none
13-Oct-15 -- 1.27 ng/dl -- 0.76-1.46 -- none
20-Apr-15 -- 1.16 ng/dl -- 0.76-1.46 -- none
27-Oct-14 -- 1.48 ng/dl -- 0.76-1.46 -- H

Free Thyroxine (T4) Index
Date -- Result -- Reference Range -- Flag
21-Apr-14 -- 5.2 -- 1.5-4.4 -- H

Total Thyroxine (T4)
Date -- Result -- Reference Range -- Flag
16-May-14 -- 16.8 UG/ML -- 4.8-13.9 -- H
21-Apr-14 -- 17.3 UG/ML -- 4.8-13.9 -- H


Triiodothyronine (T3) Uptake
Date -- Result -- Reference Range -- Flag
21-Apr-14 -- 30% -- 30-39 -- none

Free Triiodothyronine (T3)
Date -- Result -- Reference Range -- Flag
31-May-16 -- 2.9 pg/mL -- 2.3-4.2 pg/mL -- none
15-Apr-16 -- 2.67 pg/DL -- 2.18 -3.98 pg/DL -- none
21-Apr-15 -- 2.9 pg/mL -- 2.3-4.2 -- none
21-Apr-15 -- 2.7 pg/mL -- 2.3-4.2 -- none
28-Oct-14 -- 3.0 pg/mL -- 2.3-4.2 -- none
17-May-14 -- 3.2 pg/mL -- 2.3-4.2 -- none

Reverse Triiodothyronine (T3)
Date -- Result -- Reference Range -- Flag
31-May-16 -- 26 ng/dL -- 8-25 ng/dL -- H
25-Apr-15 -- 20 ng/dL -- 8-25 ng/dL -- none


Antibodies Tests
Date -- Test -- -- -- Result -- Range
31-May-16 -- Anti-Thyroglobulin Antibody -- <1 IU/mL -- < or = 1 IU/mL
31-May-16 -- Thyroid Peroxidase Antibodies -- 1 IU/mL -- <9 IU/mL


Basically, my end said with my T3 being lowish and my T4 being high, it seemed like I wasn't converting (which low stomach acid/no gallbladder is a HUGE part of it, other stuff contributes), which is what our body is supposed to do. Both my thyroid antibodies tests came back negative, so that was a good thing for me, but definitely something for me to watch. Also, he said that my TSH coming down, but my T4 still being high told him I wasn't converting either. My T3 levels still being low. Me feeling like crap, all of it was part of deciding to add the T3 in. As far as I know, I won't retest until October at my next appt. Just wanted to share my numbers during the same timeframe for reference.

LauraCoth

toadqueen wrote: »

Thyroid Peroxidase AB = 728 (higher than before)
TSH = 3.38 (I think that is too high)

You're right. That is far too high.

Most people feel best when their TSH is between around 0.5 and 1.5, Free T4 in the upper half of the normal range, and Free T3 in the upper third of the normal range (over 75% may be too high for some).

Majcolorado

Following this. Just had my first labs showing high TSH with low T4 and T3 (3.49, 1.0, 2.8). Started Iodine Synergy today and trying to learn all I can. Good luck to everyone.

LauraCoth

Majcolorado wrote: »

Following this. Just had my first labs showing high TSH with low T4 and T3 (3.49, 1.0, 2.8). Started Iodine Synergy today and trying to learn all I can. Good luck to everyone.

Are you not going to receive medication for hypothyroidism? I don't think iodine is enough -- and it is controversial.

LauraCoth

I suspect my T3 dose is too high when added to the Erfa Thyroid I already take. Felt quite good for a few days then went hyper one night with a racing heart and blazing heat. I'm going to alternate days to see if I can nudge my Frees to the right spot without going over, at least until I can have my blood test and talk to my ND.

toadqueen

I am being treated by my primary care physician and not an endocrinologist. I have a follow-up with her in Sept or Oct and will discuss this with her. I am retesting before the appointment. She is very caring and responsive. She was the only person who would prescribe T3. I had seen other endocrinologists who were only concerned about diabetes and that my TSH was below 10.

I read that Iodine treatment is not recommended for people with Hashimoto's Thyroiditis. I think I have a lot of studying to do. I definitely need to find out where the thyroid medications are absorbed. I hope it is not the small intestine.

I have not felt my best since April 22, 2011 (last day without inflammation and pain). I would love to learn that lowering my TSH could possibly help me feel better. I do sleep quite well!

My best to everyone too.

kmn118

From this entire thread, I am feeling that even if they find a degree of hypothyroidism, the medication regime cannot ever be optimized.

Majcolorado

LauraCoth wrote: »

Majcolorado wrote: »

Following this. Just had my first labs showing high TSH with low T4 and T3 (3.49, 1.0, 2.8). Started Iodine Synergy today and trying to learn all I can. Good luck to everyone.

Are you not going to receive medication for hypothyroidism? I don't think iodine is enough -- and it is controversial.

I'm recovering from 10 years at two very high stress jobs where I was consuming over 1000 mg of caffeine a day, and not sleeping well or otherwise taking good care of myself. During that time I also dealt with chronic Lyme, leaky gut, adrenal fatigue, and multiple food sensitivity issues. I was a mess!

I am managing to recover from the adrenal problems by cleaning up my diet, changing my priorities and job to reduce stress, getting good rest, and using supplements under the supervision of a functional medicine doc. I'd really like to do the same with my thyroid if I can.

This was my first lab to show thyroid issues, ever. I do have an extensive family history on my mother's side of thyroid issues, but those were all discovered when they were much younger than I am now, so I am trying to be optimistic that I didn't do permanent damage and I didn't inherit those thyroid issues.

We're going to try the iodine for a month and then re-test. If there's no improvement I'll have to look at other options.

KnitOrMiss

toadqueen wrote: »

I am being treated by my primary care physician and not an endocrinologist. I have a follow-up with her in Sept or Oct and will discuss this with her. I am retesting before the appointment. She is very caring and responsive. She was the only person who would prescribe T3. I had seen other endocrinologists who were only concerned about diabetes and that my TSH was below 10.

I read that Iodine treatment is not recommended for people with Hashimoto's Thyroiditis. I think I have a lot of studying to do. I definitely need to find out where the thyroid medications are absorbed. I hope it is not the small intestine.

I have not felt my best since April 22, 2011 (last day without inflammation and pain). I would love to learn that lowering my TSH could possibly help me feel better. I do sleep quite well!

My best to everyone too.

@toadqueen - that is part of why I pushed for the antibodies tests. I felt TONS better while taking the iodine, but I read the same - that excess iodine can cause Hashimoto's to flip chaotically. Apparently all thyroid medications have iodine in them - apparently there are 4 units of iodine in a T4 medication, as it requires 4 units of iodine to convert the thyroid med in it. T3 is a bit of a different bird, as it's the "converted" version of T4 that's actively usable, but I believe it still has a small bit of iodine for usage.

Anyway, if it is the small intestine, which is likely, due to the fact that nearly all nutrients, minerals, and vitamins are absorbed there by the majority after basic breakdowns in the stomach, and you have concerns about absorption, adding apple cider vinegar with the mother (or pills) with each meal and/or digestive enzymes (Super formulas are generally better), your absorptions will increase dramatically. I had absolutely NO idea that stomach acid and such was such an issue here!!

Inflammation and pain are often triggered by and/or contributed to by sugar, wheat, and gluten, so autoimmune elimination diets may be in your future... (AIP)...

To be honest, I do not know if I would be willing to go that long without feeling better, but admittedly, if you just added the T3, it might be worth it.

However, part of feeling crummy is likely that dangerously low D3. Make sure you are taking 10,000 I.U. daily with 1000 mcg K2 to absorb it properly, preferably in the morning. My level was coming up slowly, and my endo asked me to take that much twice a day (you can do up to 40,000 I.U. daily with the 4000 mcg K2, according to Dr. Berg, with other supplements in order to declutter and maintain clear arteries and such). Adding in the stomach acids and enzymes I have are making tons of difference (I just switched this weekend to a better enzyme and to pills of ACV instead of Bragg's liquid, though I have that as back up - and let me tell you, the difference is incredible!!!)... B12 is another consideration, though I don't know if you had that tested.

For me, the key mandatory 3 supplements are D3/K2, B12 (with B-Complex to not deplete the other B's), and magnesium (not oxide!!!)... I personally believe that unless you have super high levels of D3/B12 that these are all necessary for life. 90% of the world is deficient in magnesium due to lack of crop rotation, pesticides, and soil depletion - we're getting less than 10% on average of the magnesium in foods that our parents/grandparents were getting in the 50's!!! Getting these things improved will only help with the rest of things - and improving them doesn't hurt the thyroid function in any way - as long as you take your thyroid meds on an empty stomach as indicated, etc.

LauraCoth

kmn118 wrote: »

From this entire thread, I am feeling that even if they find a degree of hypothyroidism, the medication regime cannot ever be optimized.

You know, it can be optimized for many people. I believe that, as with so many things on the Internet, it's the people who have problems that post on line -- though I have a suspicion that those with Hashimoto's don't do as well in general. My older sister, who simply has a sluggish thyroid, takes Synthroid and feels great. My younger sister and I' both of whom have Hashi's, not so much. We both have chronic insomnia, which is a plague that diminishes our lives quite badly.

The other thing that happens to us, especially when we're diagnosed decades after the onset of the condition -- as so many of us are -- is that the rest of our endocrine systems can go on the fritz because they have to compensate for the lack of thyroid function. The problem is that mainstream medicine doesn't recognize this fact and many if not most doctors will scoff at the notion so the problems continue through the years untreated.

I'm fairly certain I have adrenal issues, and that's why it took over a year for me to be comfortable with the desiccated thyroid meds I take. My blood sugar tests fine in the morning, but at night ravenous hunger often wakes me. My female hormones are terribly deficient and even HRT hasn't stopped the night sweats and shakes (though it has minimized them).

The next step for me is a 24-hour urine test that my ND hopes will uncover something that an a.m. blood test has missed. She's been great over the years; done more for me than any doctor ever has. Fingers crossed...

KnitOrMiss

@kmn118 - I agree with @LauraCoth - they can be optimized. It requires getting proper testing, monitoring symptoms, following a proper dietary/exercise program, and all the things we fight so hard against as naturally lazy humans. Personally, I feel like I'm finally heading in a FABULOUS direction with my medications, but much like mental health issues, there aren't hard and fast blood tests that just say at a glance - YES, THIS IS IT.

Once you have an idea which direction to look for thyroid stuff, there are more specialized tests, but many just lead to more questions time and again before you finally get to answers, and honestly, most of us don't push that far, don't have doctors willing to push that far, or can't afford to push that far...

All I can say is keep educating yourself, keep asking questions, if something doesn't feel right - ASK, keep adjusting, keep track of symptoms, all of it!!!

toadqueen

I have been taking 5000IU daily of D-3, but only 45 mcg of K2. I take about 1000 mg a day of magnesium citrate as well as 1000 mg of calcium that also has an additional 800 IU of D-3. I also take a small dose of Selenium.

Absorption is definitely an issue that cannot be fixed because most of my small intestine were surgically removed in 2014 as a result of a car accident. I am not sure about the ACV because of a sensitivity to salicylates (apples, aspirin). I used to add it to everything.

I saw an applied kinesiologist last year who said I had to fix a bunch of stuff before I could address my thyroid issues. This proved very expensive and I never felt better so I went back to allopathic medicine.

Last time my B-12 was tested, it was slightly elevated.

More research need for autoimmune diets. I did well on the first stage of GAPS and still eat boiled chicken/and or broth daily.