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Old 08-20-2003, 01:24 PM   #1
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Post Hashi's and meds

I'm coming to realize how much I don't really know about Hashi's and how confused I am by what I do know. For instance, I know that Hashi's causes TSH levels to fluctuate all over the place. I seem to experience this on a daily basis. What confuses me is that I'm being medicated (2 gr. Armour) but if I'm hyper sometimes and hypo others, how the heck is the Armour supposed to help me? It seems like I'll either be overmedicated or undermedicated at any given point in the day depending on how psycho my thyroid feels like being.

I'm really frustrated right now and my symptoms seem like they go away for a while and then come right back. I would love any help anyone can give me!

 
Old 08-21-2003, 05:05 AM   #2
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Bumping up because this is a great question! I'd love to know the answer myself.
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Old 08-29-2003, 10:14 AM   #3
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TTT

I would think that, once our thyroids are correctly medicated, fluctuations would go unnoticed. I am no expert, though.

 
Old 08-29-2003, 05:56 PM   #4
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First of all, TSH fluctuating isn't the problem. TSH is fluctuating for two main reasons:

1) Your hypothalamus an pituitary are trying to make sense of the rising and falling thyroid levels and are slow to respond compared to what the antibodies are causing.

2) TSH varies DAILY anyways. It is not released at a steady rate, but in a series of pulses, usually around what your body thinks is bedtime. Most people have a peak in TSH between 9pm and 2am. and it falls steadily throughout the day until the next series of pulses.

Now, the REAL problem is that your T3 and T4 are fluctuating. These are what are causing your symptoms. What causes them to fluctuate? The antibodies.

Thyroid Peroxydase (TPO) Antibodies attack the thyroid gland's ability to manufacture thyroid hormones. If you have theses antibodies, when they are most active, they are causing your thyroid gland to be very inefficient. Subsequently, your T4 level will drop. To compensate, your body may try to convert as much T4 to T3 as possible, causing your T4 to drop even more, but your T3 level will probably stay in the vicinity the middle of the lab range.

Anti-Thyroglobulin Antibodies attack the protein that binds most of your thyroid hormone in your blood. When you get a Total T4 test done, it measures the total amount of T4 that is in your blood, including that bound by proteins such as Thyroglobulin. A Free T4 test measures T4 that is NOT bound by this protein and is ready to be immediately used by your tissues. When attacking, this antibody destroys Thyroglobulin, causing a rise in Free T4 levels While causing Total T4 to stay the same. (remember, Total T4 include ALL T4, free and bound to proteins.) This is one reason why a Total T4 test is not a good choice to screen or monitor someone who has Anti Thyroglobulin antibodies and a Free T4 test is better, because while the antibodies are attacking, you might be hyper on T4 (due to elevated Free T4), but might have "normal" Total T4. Thyroglobulin ALSO binds to T3, so your Free T3 level might (and probably will) rise as well, following a similar pattern.

How can thyroid meds help with this? Here are a few ways:

1) by lowering your TSH so that your thyroid gland has to do less work and you rely on the thyroid meds, you are gaining more control over your thyroid levels--at least against the TPO Antibodies.

2) when the thyroid gland has to work less, it shrinks some and there is less for the antibodies to attack, thus lowering the level of antibodies.

The best help that I know of is to make sure you are getting plenty of Selenium. Selenium helps to lower the antibody count and, if you are not converting T4 to T3 well, it helps there, too. If you are already converting T4 to T3 well, or are taking a med with T3 in it, like Armour, then The Selenium won't hurt because you will only convert T4 to T3 if you need it.

Hope this helps!

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[This message has been edited by Meep (edited 08-29-2003).]
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Old 08-29-2003, 08:36 PM   #5
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It has helped my understanding a lot, Meep, thank you. I'm saving this to my file. I've already read it several times over. I want to get the facts down pat.

I understand TPO ABs pretty well, but I'm confused about thyroglobulin and its ABs. Please correct me if I'm wrong... The TG is necessary to carry the hormones to the receptor sites on the cells, isn't it? If that's so, I can see why TG ABs are a bad thing... But I don't understand the statement that "bound" T4 and T3 aren't usable, if they must be bound in the first place.

Each step in the whole complex thyroid process is so dependent on the others, I can see why getting dosages adjusted to just the right balance is so tricky. When you think about it, it's really no wonder so many dox have trouble with it... I just wish they'd try a little harder!

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Old 08-29-2003, 11:33 PM   #6
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This question has probably been asked before so bear with me. What happens to the antibodies when you have your thyroid removed or have RAI. Do they continue to attack other things. I read something about the antibodies changing about six years after RAI to something different, but I didn't understand it. Can you still have symptoms and disease from the antibodies even without a thyroid, i.e. eyes, etc.? Thanks, IWL

 
Old 08-30-2003, 11:42 AM   #7
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Quote:
Originally posted by midwest1:
I understand TPO ABs pretty well, but I'm confused about thyroglobulin and its ABs. Please correct me if I'm wrong... The TG is necessary to carry the hormones to the receptor sites on the cells, isn't it? ... But I don't understand the statement that "bound" T4 and T3 aren't usable, if they must be bound in the first place.
Actually, Free T3 and Free T4 are the hormones that are available to attach to the receptor sites. Teh ones bound to proteins can't attach, because the part that attaches to the receptor site is covered up by the protein. It is like trying to plug an electrical appliance into an outlet that has one of those toddler-proof covers on it. You can't plug it in until you remove the cover.

Another more complex analogy that might make it more understandable is this:

Thyroglobulin is like a trucking/warehouse company. The Thyroglobulin stores thyroid hormones in your thyroid gland after they are made, AND carries a great deal of it around in your blood stream (the ones in your blood are the trucks). Blood vessels are the highways. The blood itself is like the shelves at the store. The consumer (your receptor sites) can't use a product that is still on the truck or in the warehouse, but the consumer CAN pull it off the shelf at the store, when needed, and buy it to use.

Thyroglobulin antibodies cause the warehouse and trucks to be unloaded too quickly, and the shelves overflow with too much product. The receptor sites then get overloaded by "buying" too much thyroid hormone "off the shelf" and then you have hyper symptoms.

[This message has been edited by Meep (edited 08-30-2003).]
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Old 08-30-2003, 09:23 PM   #8
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OK, now I see.
Such a good explanation obviously took some time, Meep. I appreciate your spending it for those of us who crave understanding.
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Old 08-31-2003, 09:07 AM   #9
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I feel I fluctuate within hours also...for example...being ice cold when I go to bed, needing jammies and blankets, then a few hours later, I am sweating...lol....no, I am not menopausal..YET

I also have hyper symptoms when hypo, like heart palps....oh joy!

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