← The Thyroid (and Hormone) Fixer Podcast: Thyropause, Menopause, Metabolism and How to Fix It
The Thyroid (and Hormone) Fixer Podcast: Thyropause, Menopause, Metabolism and How to Fix It
636. How to Titrate Up Your T3 the RIGHT Way
00:31:35
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The important thing is to also remember that progress is not linear. You might get better and then get worse and then get better and then have a step back. And you're not going to know what actually is going on. You're going to think that you're failing. You're going to think that the treatment isn't doing what it's supposed to do, but it actually is. Because that is the progression to thyroid optimization. Welcome to the Thyroid and Hormone Fixer podcast. If you've been told everything is fine, but you're gaining weight despite doing all the right things, struggling with brain fog, mood swings, low libido, or feeling like a stranger in your own body, you're in the right place. I'm Dr. Amy, the thyroid Fixer. And I want you to know right now, I see you, I believe you, and you don't have to figure this out alone anymore. We're going to do this together. But I'm also not here to play nice with bad medicine or empty promises. This show is meant to disrupt the entire health space. We're going to challenge the status quo, connect all the dots other providers miss, and give you real, practical science back. Tools you can use today. You're not going to get any more recycled biohacking advice, just truth, strategy, and hope. Let's get you back to feeling like the badass human you're meant to be. Do you want to burn fat while just sitting around? Do you have extra weight to lose? Do you want less inflammation? Do you want to reduce your oxidative stress? Do you want to improve your lipid panel? Maybe become more insulin sensitive? And once again, burn fat while you're sitting there at rest at your desk or on your couch watching Netflix. Well, now you can, with the power of tea 2 that is in thyroid Fixer. Now, Thyroid Fixer is not just for those with a thyroid problem. It's for anyone looking to lose body fat to improve their metabolism to have better energy. Thyroid Fixer actually works at your mitochondrial level, so it is stimulating your metabolism. It's also activating ATP, which gives you more energy, nice and steady through the day. Here's the other really cool thing that Thyroid Fixer does. It turns on a gene that prevents fat from accumulating all over your body. So that means, yeah, if you slip up and you have the Oreo cookie or the sweet potato fries, which are my two favorite, they're my downfalls, that is not going to put extra fat on your butt, your hips, your thighs, and your abs. Oh, and your arms. You don't want those jiggly arms. So why don't you just improve your fat burning potential and actually turn on a gene that prevents fat from accumulating on your body with the power of Thyroid Fixer. So as a listener of the Thyroid Fixer podcast, your first time purchase, you can use the code LISTEN20L I S T E N2 0 we'll put that down in the show notes and if you've already purchased it but you just want to save a little something something extra then use the code listen 10 L I s t e n 10 and grab some thyroid fixer. Stock up today because it will help you burn extra body fat and who doesn't want that? If you are exhausted, gaining weight, you have brain fog, you just feel off and you're tired of doctor hopping and wasting money. Listen closely. So many women bounce from provider to provider trying supplements, protocols and then functional approaches that never truly address the thyroid. Months turn into years and you're still stuck feeling like garbage, wasting your precious life. So this is why we offer a thyroid and hormone solution call. It's not a lab review. It's not treatment. It's clarity and strategy to determine whether you're a good fit for working with our clinic. We specialize in thyroid optimization and hormone optimization together because they go hand in hand. You can't do one without the other. You have to do them both. We prescribe in all 50 states and if you become a patient, we take care of you from start to finish. Testing, treatment, optimization and ongoing support. You don't have months or years to waste feeling this way. And you shouldn't have to keep throwing money at people who don't truly understand the thyroid and hormones. So if you're ready for real help, go to doctorami.com that's D R A M I E dot com and click book a call in the top, top right corner to schedule your thyroid and hormone solution call and just let us help you get your life back and be that badass human that you are meant to be. That you deserve to be. This is a question I get asked all the time. And really, this episode should be secretly hidden for patients only. But for you, I'm kind of opening up the vault so the patients will get access to this. But if you're listening to it, then you're very, very special because you also get access to my secrets of increasing your T3 or titrating it the right way. So before we dive into the how to, let's just talk about the medications in general containing T3. So if you are on natural desiccated thyroid, so this could be Armour Thyroid, NP Thyroid, REN Thyroid, a combination of T4 and T3 that's compounded at a pharmacy. Usually those pharmacies are using the porcine based T4 T3 blend. So animal derived porcine thyroid gland or thyroid glandular, it's just dried pig's thyroid gland. That's basically what makes up all natural desiccated thyroid. Now when we are talking about a thyroid glandular supplement, which we don't know as of right now at this recording, we do not know what the FDA is going to do with all natural thyroid medications. You might be listening to this and going, well those aren't in existence anymore. It's possible. Same with the supplements that are derived from bovine or cows thyroid gland. We just dry that up and put it into a capsule. Both porcine and bovine contain T4 and T3. The fallacy that's out there, that really is out there to protect the supplement manufacturers because as we know we're not allowed to sell a prescription in a capsule form. But the reality is when you dry out a cow's thyroid gland, very similar to a pig's, that which is in the natural desiccated thyroid medication or prescription medication, when you dry a cow's thyroid gland out, guess what, the T4 and T3, they're still in there. Now I have other podcasts that cover this all about glandulars, but I just want to give an overview before we dive into the how to. So you have your NDT medication that contains 20% T3. Now if you are time treating up just NDT, just NDT and you are freshly starting or maybe you came from being on T4 only and you're making a transition to using natural desiccated thyroid medication, a great step in the right direction might not be enough, but we'll go over that in a minute. So you're making that transition from however many micrograms of Synthroid, Levo Tyrocent over to the milligram amount of natural desiccated thyroid. So it's a little bit different in the measurement microgram to milligram. But that's because in NDT medication you have T1, T2, T3 and T4, T1 and T2 are in miniscule amounts. I've talked about this before as well, that the T2amount that you actually need to increase your basal metabolic rate is going to be between 150 and 300 micrograms. So that's what's in supplemental form. I talk about this in the book special chapter on T2. That is what is in supplemental form in thyroid fixer and metabolism fixer. So you're not going to get enough T2. I don't want you to get too excited when I say that T1 and T2 are in NDT medication because it's maybe 6 to 9 micrograms in a 60 or 90 milligram tablet. So differences in the measurement, microgram to milligram. But what's important is that when you're looking at the milligram amount, this is a really quick way to do some math. You're looking at, let's say, a 60 milligram tablet of armor. The way to find out approximately. This is just a very raw calculation. The way to find out Approximately how much T3 is in that NDT is to multiply it by 20 or 0.20. So then we get roughly 12ish micrograms of T3 in a 60 milligram dose of armor. Now, of that too, we have to almost take off some because it's not a pure 20% of the total amount of milligrams. Remember, we have fillers in there. We have T1, we have T2. So when we actually look at it, I always back it down a bit and I'll say, okay, I'll take it from 12 to maybe 9. Nine micrograms of T3 is what is present in a 60 milligram dose of Armor Thyroid or Ren or NP, any natural desiccated thyroid. Now, you can do the same for the thyroid glandulars. So let's say you have a thyroid glandular, that's a hundred milligrams. You're getting roughly 20 micrograms of T3 in that. And then we back off a little bit, drop it down from 20 to maybe 15 to 17 micrograms of T3 in that dosing of bovine thyroid glandular in a supplement form. Okay, you're following me, right? So we see T3 spanning natural desiccated thyroid. So as you're starting off, the usual dose is a 30 milligram tablet. Now, if you're very, very sensitive, like sensitive to caffeine, are you sensitive to medications, are you easily stimulated? Then you're going to want to start really low and slow, maybe cutting that 30 milligram tablet in half and dosing it 15 milligrams of twice a day. Why do we say twice a day? Because T3 has a very fast action on the body and a very Short half life. So T3 is essentially in and out of your system within eight hours, peaking at the four hour mark. Now we know that some is left behind because if it was truly all gone, we would never have a T3 level. But it does build up over time and that's why is getting to your cells. You're literally feeding your cells with the thyroid medication or with the thyroid hormone that's required to attach to the receptor the cell. So you want to split dose that 15 and 15 if you're not that sensitive. I would say most people can start with 30 milligrams twice a day. 30 in the morning and 30 in the afternoon. Now we dose that second dose usually between noon and 3pm, 1 and 3pm at a time where you're not eating. If you are eating throughout the day, that's a whole other issue that we have to deal with. But putting your medication on an empty stomach in the afternoon without food, away from lunch, that is when that second dose needs to occur. So now you're breaking it up 30 and 30. So let's say it's time for an increase. You've been doing that for a while. I always advise beware of baby doses of T3, beware baby doses of NDT as they can do more harm than good. They can actually send that negative feedback signal to your hypothalamus and your pituitary, which will essentially tell your thyroid gland to just stop producing thyroid, thyroid hormone altogether. That's fine if your thyroid gland isn't really working that well to begin with. But here's where the issue comes in. When you shut down production, what little production is actually happening. I always say it's like firing a lazy employee. You're not really losing anything by getting rid of them, but you're going to need to bring in better employees or a better employee at some point in time, very, very quickly to do the job that you just needed to boot the lazy employee for. So same thing. Your thyroid gland's not working that well anyways. We don't really care about the shutdown. However, we want to make sure that there's enough thyroid hormone, IET3 on board to fuel your cells and to give you life. Remember, from head to toe, the thyroid runs the show. So we need to fuel every single cell with that active thyroid hormone. Then we need to make sure that you are properly converting that 80% of T4 in the NDT medication over to T3, because that's what should happen to T4. I don't care if you're on Levo Synthroid tier sent, which is straight up T4. Or if you are taking NDT medication which is 80% T4, you have to do all the things to make sure that that converts over and becomes T3. Now that has nothing to do with titrating up your T3. That's a side note PSA for you in that you better make sure that you're converting. So you always, always, always want to check the reverse T3. I know, I say that all the time. Can't hurt to repeat, right? Can't hurt to hear it again. So we check that reverse T3 and if reverse T3 is high, consider possibly adjusting your dose down again, whether it's NDT medication or T4 medication. When reverse T3 is above a 12, that's when we need to reduce the T4 medication. Now I'll get into Thai training upper T3 in a moment, but we want to check that reverse before we go up any further. So if we are at 30 and 30 of NDT and let's say we go to 45 and 45 and then we go to 60 and 60, we need to be checking reverse T3 because with every step up in natural desiccated thyroid medication, you're stepping up the T4 by 80%. Yes, you're stepping up the T3 in that 20 box that it's in, but you're also increasing the T4 in the NDT. Now, when we are titrating up whether it's NDT medication or straight up T3 medication, which I'll get to in a minute, we are always listening to our body, listening to signs, signals, symptoms of going a little bit too fast. These are the hyper thyroid symptoms. And these can occur not because you've moved into a graves disease state or a hyperthyroid state, but these can occur simply because you went up too quickly in your T3. There was a non patient, she was actually in the Just Fixture thyroid Facebook group. She made a post wondering why she feels so horrible when she finally got to start T3 medication by her doctor. Well, her doctor who was uneducated on how to properly titrate up T3 started her at 25 micrograms twice a day. That is way too high to start. When we start the titration of straight T3L cytomel. When we start that, we start at 5 micrograms twice a day and go up from there. But the same thing can occur with natural desiccated thyroid medication in that that NDT can also jack you up a little bit, make you feel speedy, make you feel like you're a little bit. I call it icky and sticky. When you get that icky and sticky feeling, you need to back down. So let's say you went 30 and 30, then you went 45 and 45. Then you win 60 and 60. And at that point you're like, oh, no, wait, something is wrong. I feel that icky and sticky. I feel jittery, I feel anxious, I can't sleep, I'm sweaty, I'm a little bit hot. What's happening? Well, your metabolism is kicking in, that is true. But you also just added maybe too much T3 for you. Maybe you did that too quickly. Now, when we do that increase, let me back up to the timing of that increase. This is very individualized. So if you are on ndt, we could certainly tell you, okay, you're going to increase by, you're going to start at the 30 and 30. You're going to increase by 15 micrograms at each dose every five to seven days. Well, that is an in general rule. And then it comes down to how do you actually respond to that? So let's just say you go up by 15 and 15, you're at that 45 and 45 mark 45 in the morning, 45 in the afternoon, and then you climb to 60 and 60. You don't feel well. Maybe what you do first is back down on that afternoon dose, take it back down to where you were before. Just leave in the 15 extra micrograms in the morning. So have 60 in the morning and then 45 in the afternoon. If that doesn't do it, you pull it back again, back down to the 45 and 45. You hang out there maybe for two, three weeks until you start to stabilize again, until your body can get used to that T3 at that point of time. Then you try again. But you only try with that 15. You only pull that morning lever and add the 15 in the morning. So you can monitor how you feel by adding just 15 milligrams to that dose. So that is NDT. Now this applies to further increases as well. 60, 60, 90, 90, whatever your dose is that you're moving to, you always want to follow the same rules of listening to your body titrating up slowly. Some people can titrate up. I call it like the double ladder step where we're adding an extra dose to each one to the morning and the afternoon one at the same time. You're stepping up that ladder. But sometimes we need to climb the single ladder like wrongs. So that's where we go up just in the morning, hold for a while, go up just in the afternoon, hold there, then increase the morning hold, then increase the afternoon again hold. 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So to join the gut health revolution and take control of your health Today, visit Just Thrive.com and save 20 on your first 90 day bottle of Just Thrive Probiotic with the promo code Dr. Amy D R A M I E. So don't forget to check out all their other natural clinically proven products too, like their newest product, digestive bitters. Focus and memory. Gluten away and more. So that's Just Thrive. J U S T T H R I V E Health H E A L T H.com promo code Dr. Amy D R A M I E It all depends on your unique biochemistry and how you respond to T3. There might not be a way to know how you're going to respond or how fast you have to titrate up. The only thing we really have to go on, and what I see consistent across the board with patients is that those people, those individuals who are very sensitive to caffeine, sensitive to any kind of stimulant, maybe even green tea, makes you a little bit jittery. There is a stimulating effect of T3. So in that subset of the population, you're probably going to need to go very, very low and slow. Okay, now speaking of very, very low and slow, let's move over to T3. This is Cytomel lyothyonine. It could be a slow release compounded T3, but slowly slow release. We don't really have to break up, we don't have to double dose it and we don't really have to baby step up. Unless you're working with a practitioner, you're working with my team that specifically says, okay, Sally, we're going to start you on 5 micrograms of slow release compound at T3 and then maybe we'll add in another 5 micrograms of slow release compounded T3 to that same morning dose because it's slowly released out of the body. Maybe we'll do that in like another two to four weeks. So very, very, very slow and very, very, very slow titration up. Like length of time increases between the increased dose, whereas again, the, I would say the average patient that is on immediate release T3, they can do either the double ladder or the climbing. When we start T3, whether we are doing T3 only to bring down an elevator, reverse T3, whether we are adding T3 to your Synthroid levothyroxine or Tyent dose, your synthetic biosynthetic T4 only dose, or whether we are adding T3 to your natural desiccated thyroid medication dose to change that 80:20 ratio. Because when we add in straight up T3 to something that is 80T4 and 20T3, we have now changed the ratio. So now we're, we're adding it in and we're tweaking it to maybe be 60, 40, maybe 40, 60, maybe 3070, maybe we want more T3 than T4. So we can do that with the addition of lyothyrene and cytomel when we start Lyon thyronine and or Cytomil. Well, or cytomil. It'd be one or the other. Lyothyonine is the generic, T3. C is the brand T3. Whenever we start that again for the first time ever, like you have never been on this medication before, this thyroid hormone replacement before. And again, this is the biosynthetic T3. We are going to start low and slow. Now, most of the time we can start at 5 and 5. We're adding in 5 micrograms in the morning, adding in 5 micrograms in THE afternoon. Now, nothing changes with the other medication that you're on. If this is T3 only that we're doing to lower your reverse, that's one thing. But if we're adding it in addition to the T4 or the NDT that you're on, those stay the same unless directed by your practitioner, because maybe they want to lower it based on your reverse T3. But in general, for the purpose of this talk, we are only. We're assuming that you're static on your T4, your NDT dose that remains the same. Maybe you're split dosing the NDT. Maybe you're just taking the T4 in the morning, that remains the same. The only thing that changes is we're adding in the T3. So we'll go 5 micrograms twice a day. Then we'll go maybe 10 in the morning, 5 in the afternoon, we're doing the climbing of the ladder. Then we'll go 10 in the morning, 10 in the afternoon. Then we'll go 15 in the morning, 10 in the Afternoon. Then we'll go 15 in THE morning, 15 in THE afternoon. Then we'll go 20 in THE morning, 15 in THE Afternoon. Then we'll go 20 in the morning, 20 in THE Afternoon. So you can see how we are climbing the ladder. Individuals that react to nothing. This would be me very steep handful of my patients. I would say they're just rock solid is the only way to describe it. Like, nothing moves them, nothing affects them. They're not sensitive to anything they can go up like the double ladder. So even though we're adding in straight T3, we can go 5, 5, 10, 10, 15, 15, 20, 20. Sometimes that happens over the course of four weeks. A person is getting the 20 micrograms twice a day. The sensitive person over four weeks might be at 10 micrograms in the morning and 5 in the afternoon. You just don't know. But there is no one right way to do it. There is no one size fits all to this. This is unique to you. This is not a sprint. This is A marathon. We want to do this the right way. If you sprint with tie training up your T3, you're going to be back down at a lower dose because you're, it's going to catch up to you. You're going to feel icky and sticky, you're going to feel jittery. Unless you are one of those people that you need know. You know nothing moves you, nothing bothers you. I know I am a high hormone individual. I could take higher doses of T3, higher doses of estrogen, higher doses of progesterone. Testosterone is the only thing that I have to keep a little bit lower or else I'll get acne. But everything else, I can go at a much higher dose when it comes to CBD, much higher dose. Even when it comes to Delta 8, much higher dose to get me to sleep. Melatonin, way higher dose. If you are one of those people, then you will most likely be able to titrate up your T3 much quicker. Much quicker. So same rules apply. Listen to your body as you're titrating up that T3, especially if you're adding it to natural desiccated thyroid medication. Remember, you're adding T3 to existing T3. So in that case, you want to pay attention again because the T3 is already on board and a 20% mark. We're adding T3 to that to increase your dose of T3, to bring down your reverse T3, to increase your free T3, to give you the T3 you need for your cells and basically to get you feeling better overall. But again, you have to listen to your body. Now, if you're working with my team, always just be in communication with your nurse practitioner because it takes guidance. And sometimes in that titration, in that climbing of the ladder, you might stop at some point and go, wait, wait, I just really want to check in on this. I just all of a sudden, all of a sudden started feeling X, Y, Z. Now this bears repeating as well. I tell our patients this, I tell my audience this. Thyroid optimization is not linear. So while I am encouraging you to reach out to your practitioner with any questions, even if you're not working with our team, reach out to your practitioner with any questions on how you're feeling as you're tight training up your T3. But the important thing is to also remember that progress is not linear. You might get better and then get worse and then get better and then have a step back and you're not going to know what actually is going on. You're going to think that you're failing. You're going to think that the treatment isn't doing what it's supposed to do, but it actually is because that is the progression to thyroid optimization. You're going to get better at first because initially when you give your body that beautiful thyroid hormone that it needs, it just lights up and smiles. But then over time, it's like a sponge. It's absorbing the water, that dry sponge is absorbing the water. And it's like, wait, I just poured a bunch of water on this dry sponge and now it's dry again. Need more water. So oftentimes people ask, well, I started feeling better and then I, I just felt like I did at the beginning again. Well, we need to do that increase of T3. Maybe that is you adjusting to the T3 medication, T3 uptake or the dosing increase very, very quickly. And you need to increase even faster than the average person. So while Susie Q. Over here might take two months to get to 20 micrograms twice a day, you just got there in three to four weeks. So now you need another increase. This is communication 101 with your prescriber. You communicate, you communicate, you communicate and you ask questions because that's the only way you're going to get to that finish line of optimization. If you are working with someone who knows what they're doing with the thyroid. Okay, so we covered titration of NDT medication, we covered titration of T3 medication even with T3. I do want to mention once again, again, baby doses. If you are working with someone who has a cap basically on the amount of T3 they will give you, then that is a huge problem because what did I just say? Someone who titrates to 20 micrograms twice a day in three to four weeks is going to need more. They might be one of those individuals that needs 100 micrograms twice a day, 75 twice a day, 50 twice a day. We can't put a cap on how much T3 that we're going to prescribe because what if you need more? That is personalized medicine. Not having a block, not having a cap, but yet being open minded to that person in front of you, being a unique biochemistry set, a unique individual that needs your nuanced glasses on to personalize their treatment. The problem with baby doses of T3 and what are baby doses? I would say if you are capped out at 10 to 20 micrograms daily, if your doctor, your clinic says we will not go above 20 micrograms, of T3, we feel like it's dangerous, then what that's going to do, it's going to keep you at a non optimized dose for you and a non optimized dose of T3. And please, especially if, let's say your conventional medicine doctor gave you 5 micrograms of T3 and that's it. I've heard that many, many times. Or 5 micrograms twice a day and that is it. Don't you dare come back and ask for more. What that's going to do is the same thing we talked about with ndt. It's going to produce a negative feedback loop to the hypothalamus and the pituitary and you are going to shut down all thyroid production and you will feel worse. And this won't be a progress, isn't linear feel worse. This will be. You're going hypothyroid and you're going to stay there. Unless you jump ship and go to somebody that knows what, what they're doing. Because that baby dose of T3 is making you sick, sicker. Because now you have just enough T3 on board to shut down your own thyroid production. But you do not have enough T3 to feed every single cell in your body from head to toe runs the show from head to toe. You have receptor sites on your head, on your skin, on your heart, on your brain, in your gastrointestinal tract muscles. Everything, every cell has a receptor site on it for T3. So if you don't have enough on board, something is going to suffer. And your body will always prioritize survival. So your body will give that T3 to your heart, to your brain, but not to your hair, not to your metabolism, not to your GI tract. So you're going to remain fat, you're going to lose your hair, and you're not going to be able to poop every day. And that is the hardcore truth. Hardcore truth. And this is why I can't publish this. Because I just said the word fat and somebody will be offended out there. But the reality is, that's what I hear from my patients. That I am fat, frumpy, fatigued, frustrated, all the things I got, foggy brain, all. All of the Fs. I am. I get that. I totally get that. Because I was there. And when my thyroid wasn't optimized, I was fat. There's no two ways. There's no pretty spin on that whatsoever. And in the thyroid fix, you'll actually see a chapter on use of the word fat. And the controversial use. And I fought for it, because the reality is that's how patients feel. They don't come in and say, I'm overweight. They say, I'm fat. When you talk to a woman who is frustrated about not being able to fit into her clothes, what does she say to her girlfriend? I am so freaking fat. That's how we feel. That's what hypothyroidism does. And you know what? It takes even a stronger connotation when we're doing all the things. When we're eating right, when we're exercising, we're doing all the things. So if you don't have enough T3 on board, then you will stay right where you are, and you will not climb that optimization ladder whatsoever. So there are dangers in baby dosing T3, in baby dosing natural desiccated thyroid medication. I don't care about baby dosing T4 because the opposite is true. With that, too much T4 causes a problem because T4 is the only hormone that converts over and becomes reverse T3. That's not a problem whatsoever. In fact, we want to keep T4 a little bit on the lower side. You know, we want to keep it in the mix as your savings account, but we want to keep it on the lower side. But with T3, we want to make sure we hit that optimal range. And that requires you listening to your body and titrating up very, very slowly. And when you do so, and you find your optimized dose, no matter how long that takes, I'm going to remind you again, this is not a sprint. It is a long marathon. And if it takes you six months, if it takes you a year to reach your optimal dose, then who cares? You at least made that first step to get there, to get to the finish line, to get optimized. You said, is enough, is enough. You said that you were done being told that you're normal and everything looks good while you're suffering with symptoms. So you're on the right path. Just be patient. Listen to your body as you're titrating up. Do it the right way, and you will find your optimal dose of T3. Now, I will leave you with this again, repetition. You've heard me say this before, but I'll say it again. When asked, what is my favorite dose of thyroid medication? What's my favorite thyroid medication? What's my favorite dose? What's the average dose of T3? To all of those questions, I say the one that works for you in the combination that works for you. And in the dose that works for you. Make sure you personalize your optimization journey with your thyroid and with your hormones, because that is what is going to make you the badass human that you're meant to be the information shared on the Thyroid Fixer Podcast is intended solely for informational and educational purposes. It is not a substitute for professional medical advice, diagnosis or treatment. Always consult with your physician or other qualified healthcare provider with any questions you may have regarding a medical condition treatment or before making changes to your healthcare regimen, including medications, supplements or other therapies. Use of the information provided in this podcast does not establish a doctor, patient or client provider relationship between you and the host or between you and any other healthcare professionals featured on the show. Any medical opinions or statements made by guests are their own and do not necessarily reflect those of the host or affiliated parties. 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