FORGIVE the whopper post please. Thank you in advance of course!
I just got off the phone with the endo. She had my latest lab results, which are as follows: TSH 110, T4F .024 (.7-1.8) and T3F 0.7 (2.3-5.0). They are WAY, WAY out of line. The T's are far too low, and the TSH is way too high. She guessed correctly that I stopped taking the thyroid med. Prior to making the decision to curtial the meds, it was evident I was way overmedicated with hyper symptoms and high pulse rate at 114.
The pulse rate has been headed down gradually every day, but it every time I tried periodically to take even a quarter grain of Armour, it would shoot up (123 at one point) again, and I would go hyper again. Now, its three weeks since I stopped taking the meds every day and the pulse is STILL hitting 90 in the morning sometimes. Even so, this is THE BEST I have felt since starting the replacement meds following the full T in April. (I have endured five debilitating agonizing months).
Now, here's the riddle: The labs have looked much more in line when I felt like hell, but now when they are crazy looking, I feel well. Doc says she has never seen anything like it. Instead she emphasizes, I should not be feeling as well as I am right now with my labs looking the way they do. She says I'm in danger of getting toxic and sick so I had better start taking the med again.
Problem is, I don't know what would make more sense. My plan had been to start taking 1/4 grain of Armour and work my way up W/ADJUSTMENTS EVERY THREE WEEKS to a dose that would bring the labs, pulse, and health in line and stablized. Whatever adjustments were necessary after that, I figure separate T3 or T4 pills could be supplemented. She says she prefers the Sythroid over the Armour and believes the high pulse rates are likely the result of the Armour because it contains T3.
She says 150 micrograms of Sythroid daily would probably be a good fit. Now, to reach back, I did take 100 micrograms for a month in the begining of my treatment and didn't feel good at all --hypo-- (although the labs were more in keeping to what the doctors want, the TSH was not as suppressed at they wanted at 4.95). It was right after that, that I switched to Armour.
I never took consistant doses, so I never felt well except when I scaled back the Armour before and skipped a few days of doses a couple months back. This means, so far there is no baseline to go by. I, of course, didn't grasp the importance of this, until I gathered enough research and got yelled at by nasty doctors who didn't know what to tell me about my lab readings.
The question is, what do you think is going on here with these latest results and what do you recommend?
~S
PS. Only recent doctor visits tell me I had a follicular variant and are recommending a scan?! Are my labs currently in line with the optimum for the procedure?
Last edited by softcrush; 09-02-2004 at 06:09 PM.
Reason: fixes and additional question
I just got off the phone with the endo. She had my latest lab results, which are as follows: TSH 110, T4F .024 (.7-1.8) and T3F 0.7 (2.3-5.0). They are WAY, WAY out of line. The T's are far too low, and the TSH is way too high. She guessed correctly that I stopped taking the thyroid med.
Your labs indicate EXTREME hypothyroidism. You should be on some kind of meds and should be glad that are going to the doctor. Both T3 and T4 are dangerously low in my opinion, and I am sure most docs would agree, as does your doc. You are likely bordering on Myxedema Coma.
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Prior to making the decision to curtial the meds, it was evident I was way overmedicated with hyper symptoms and high pulse rate at 114.
The pulse rate has been headed down gradually every day, but it every time I tried periodically to take even a quarter grain of Armour, it would shoot up (123 at one point) again, and I would go hyper again. Now, its three weeks since I stopped taking the meds every day and the pulse is STILL hitting 90 in the morning sometimes. Even so, this is THE BEST I have felt since starting the replacement meds following the full T in April. (I have endured five debilitating agonizing months).
Pulse fluctuaions are often seen as an adjustment to a new dose and dose changes should be made VERY slowly.. Also, if you have adrenal fatigue, you WILL have very strong reactiuons to dose changes. All changes in dose should be very slow and small to avoid problems, and if you have adrenal problems they MUST be treated to avoid dangerous reactions to thyroid meds. If you read the prescription insert (written for doctors and pharmacists to better understand the medication) it clearly states that adrenal issues should be addressed first. Here's a quote from the insert for Synthroid:
Quote:
Levothyroxine sodium is...contraindicated in the patients with uncorrected adrenal insufficiency, as thyroid hormones increase tissue demands, for adrenocortical hormones and may thereby precipitate acute adrenal crisis
Adrenal crisis is characterized by many of the same symptoms of hyperthyroidism, you need to look it up and know how to treat it yourself, because most doctors won't touch it unless you are on your deathbed.
More from the prescription insert:
Quote:
Use of levothyroxine sodium in patients with concomitant diabetes mellitus, diabetes insipidus or adrenal cortical insufficiency may aggravate the intensity of their symptoms. Appropriate adjustments of the various therapeutic measures directed at these concomitant endocrine diseases may therefore be required. Treatment of myxedema coma may require simultaneous administration of glucocorticoids.
Glucocorticoids, specifically Cortisol, in this case, are produced by the adrenal glands in response to stress and to control blood sugar levels in times of crisis. IF you have adrenal fatigue, your doc will likely prescrobe cortisol in a low dose to take daily.
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Now, here's the riddle: The labs have looked much more in line when I felt like hell, but now when they are crazy looking, I feel well. Doc says she has never seen anything like it. Instead she emphasizes, I should not be feeling as well as I am right now with my labs looking the way they do. She says I'm in danger of getting toxic and sick so I had better start taking the med again.
I agree with your doc whole-heartedly.
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Problem is, I don't know what would make more sense. My plan had been to start taking 1/4 grain of Armour and work my way up W/ADJUSTMENTS EVERY THREE WEEKS to a dose that would bring the labs, pulse, and health in line and stablized. Whatever adjustments were necessary after that, I figure separate T3 or T4 pills could be supplemented. She says she prefers the Sythroid over the Armour and believes the high pulse rates are likely the result of the Armour because it contains T3.
I agree with you here, but not your doc, this time.
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She says 150 micrograms of Sythroid daily would probably be a good fit.
Your doc is making an estimate, and may be right, BUT I think meds should be prescribe based on a combination of symptoms and lab work to keep things in chek, adn making an estimation liek that is not a good appraoch to treatment. Like you were saying, start on a low dose and move up. This applies to ANY thyroid med.
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Now, to reach back, I did take 100 micrograms for a month in the begining of my treatment and didn't feel good at all --hypo-- (although the labs were more in keeping to what the doctors want, the TSH was not as suppressed at they wanted at 4.95). It was right after that, that I switched to Armour.
Possibly due to adrenal fatigue? Hmmmm....
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I never took consistant doses, so I never felt well except when I scaled back the Armour before and skipped a few days of doses a couple months back.
Insonsistency is a BIG no-no. ALWAYS be consistent. If you have to cut back, cut back, but be consistent, from day to day and over a period of time of at least 6 weeks before having labs done. You seem to know this because you said
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This means, so far there is no baseline to go by. I, of course, didn't grasp the importance of this, until I gathered enough research and got yelled at by nasty doctors who didn't know what to tell me about my lab readings.
I am yelling at you too, but only gently and only because I care enough to make sure you understand the importance of this.
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The question is, what do you think is going on here with these latest results and what do you recommend?
Get on some meds, adn staret slowly at a low dose. Be patient! Do your homework and read up on adreanl fatigue and how you can help yourself. Docotrs are often reluctant to treat adrena; probelms unless you are on your death-bed. A good book to read is Adrenal Fatigue: 21st Century Stress Syndrome Do an internet search for it and buy the book or urge your local library to get a copy.
[quote]PS. Only recent doctor visits tell me I had a follicular variant and are recommending a scan?! Are my labs currently in line with the optimum for the procedure?[QUOTE]
I am not sure here. It will determine if your thyroid gland is taking up iodine and help find nodules that may be producing thyroid hormone on your own, but I dont' have confidence that it will reveal much in your case.
__________________
Danny
I am not a doctor, nor have I ever played one on TV...
...every time I tried periodically to take even a quarter grain of Armour, it would shoot up (123 at one point) again, and I would go hyper again. Now, its three weeks since I stopped taking the meds every day and the pulse is STILL hitting 90 in the morning sometimes.
There's no way to know if you "went hyper" without testing your free T levels. Sure, there are typical hyper symptoms that can happen at any time, but unless your hormones are at or above the top of the range, you aren't hyper. The fact that you still have a racing heart at times pretty much proves it isn't related to the med that you stopped three weeks ago.
Your doctor is right. You're heading for real trouble unless the two of you together can figure out a way to get your treatment on track. I'm a huge fan of Armour, but it might be a factor in your HR problem. Soooo... try the Synthroid or another T4 again. Did you start on 100 mcgs Synthroid? That would be an awfully big starter dose... and that could have been its own problem right there. Starting at 50 would've been better.
And then... there's the inconsistency of all that up, down, on-again, off-again, switch to Armour stuff. Not good.
That's my 2¢ worth. Hope it gives you something to think about.
softcrush...Oh dear! I'm new to the world of TD so can't add any advice except to say that I'm sorry you've gone through such a difficult time.
I truly hope for your sake and the sake of your loved ones that you'll follow through with appropriate treatment...and immediately...this is nothing to mess with!
And please do have your adrenals checked as Meep suggested. My doctor has been working to beef up my adrenals for the last 6 weeks and I won't even be starting my Armour for probably another 2. He made it clear that treating the thyroid before taking care of any adrenal issues would likely cause me problems in the long run.
Thank you for your swift responses. As you might guess this is all so troubling to me, and I just continue to be confused by the entire thing and there never seems to be an end in sight.
I tried looking into the adrenal thing and that only confused me more.
I don't understand how it plays a role here and why it needs to be treated BEFORE I treat the thyroid.
If I need to take the 1/4 grain of Armour shouldn't I take that and drink licorice tea at the same time/different times of day? Yesterday I started the med again, and because I'm so confused, I already took a different dose today and different med.
You see, I can never be consistant because I am so paniced/scared/confused, and I just want to be better.
If I do take the 1/4 Grain and the pulse goes up, should I just keep taking the same dose every day regardless of the symptoms/pulse bounce? Would one expect the pulse will jump and I'll have to endure the symptoms for a few days and the pulse will settle into the 1/4 grain?
Will the licorice tea (if I can even stomache that) really take care of the rapid pulse. All there alternatives to the licorice tea that might agree with my system better? I didn't sleep last night because of worry about this.
I do feel some hypo symptoms, like the leg coldness. I felt very faint earlier when I got up of the couch too fast.
My pulse was 88 just now, and that's down from first thing this morning of 104. Why is it spiking when I first get out of bed in the morning like that? I took 1 synthroid and 1/4 grain of armour yesterday. Why does it drop during the day. It was 76 last night at 10 pm. Is this bad or good? Does it indicate the adrenal fatigue you speak of ?
I just read up that pregnalone can help support the adrenals. I have so of that cream I purchased a maybe a year and a half ago. Would it hurt to give that a try?
[b]softcrush[/b
about your medication questions...what does your doctor recommend?? And what kind of doctor is he/she?
About pregnenolone...I've researched this myself and want to look into it as an additional treatment to help strengthen my adrenals. This is must my humble opinion but personally I highly recommend you ask your doctor first...perhaps even having your levels tested to see if you are low. This is what I'll be doing to determine if I should take it or not.
There are many things available over-the-counter that are still quite powerful and can cause many problems if we self-treat. This is where a DO or Naturopath or "cross-over" M.D. comes in so handy...
.
Last edited by Administrator; 03-01-2005 at 03:41 AM.
Again, this is merely my personal and humble opinion...others may disagree with me...but I would most definitely get your doctor (or a new doctor) to test your adrenals, including a saliva test, so as to determine which would be the best support for your adrenals.
In the meantime, a healthy diet and vitamin supplements are good for most everyone.
There are varying degress of adrenal insufficiency. Some do very well with just diet and supplements to strengthen their adrenals, but for some who may actually need the hormone replacement, diet and supplements alone may not do nearly enough to help their adrenals...and may needlessly prolong their journey to feeling better. Testing one's adrenals, especially with a saliva test, is a good starting point for determining what YOUR adrenals in particular need so that you can get better.
Also, what kind of doctor do you have, softcrush? I really do hope you'll be feeling better soon.
Last edited by Administrator; 03-01-2005 at 03:42 AM.
I'm so silly I didn't even read what you've been writing till just now, since I've had my face surfing through adrenal stuff. My doc is an endocrinologist. I was doctor shopping when I stumbled across and wasn't planning on keeping her, but when I kept going to other doctors they were impatient with me since it was clear I was confused (and hated that I was Armour). My first doctor put me on the synthroid and I couldn't beleive how bad I felt and couldn't get him to test Ft3 levels.
There is a compounding lab that will do saliva tests. I'll check to see if they do adrenal checks if the endo doesn't want to get involved. The endo did say she thought there was something else going on if my pulse was so sensitive to the t-med. She pointed to the Armout, but perhaps she'll be open to testing the adrenals.
You recommend to saliva test over the other ways, blood or urine?
Last edited by Administrator; 03-01-2005 at 03:43 AM.
I have now taken the Synthroid for three days. I took 50mcg. The muscle-spasm- ladden-fatigue has returned and now I'm bolted to the sofa.
Last night and again today I drank some O.J., ate some brown rice, an egg, and popped some vitamins, including zinc and Coq10, to support adrenals until I can get the doc's ear on Tuesday.
The pulse checked in this morning was 83 (not bad).
As predicted, the renewed fatigue from taking the medicine has brought along with it spaciness, headache, muscle pain, and a hopeless outlook. The med seems to spark off a flurry of nightmarish dreams during fitfilled sleep.
If I can argue the doc into testing the adrenals, how do I know which tests to get her to order, how to interpret them, and then how to get her to prescribe something that adressed the problem without causing me more problems?
How long is it likely to take to get the adrenals out of their weakened state if that is even what is wrong with me, considering I'm taking the adrenal stressing T-med?
Please help, any input would be appreciated. You guys are all I have.
Just bumping this up so you'll maybe get a quicker answer on a Sun. afternoon. I'm very interested, have some of the same symptoms, bad muscle and/or tendon/ligament/blood pain in one arm, low temp for decades, even on dosage of Levothroid 300.
I went to an endo once, and he didn't even do a saliva test, or thyroid, tho' he knew I was on thyroid meds, just wrote a confusing letter thanking my regular doctor for a referral my Dr. didn't make, and I didn't say he did, was only thinking of himself and showing off a bit, GUESSING w/out any tests that I might be hyper from too much med for my WT, or hypo from not taking my thyroid at least an hour before anything else in the morning. Do not ever let any of your doctors start trying to communicate with each other, is my advice.
After that, three doctors I saw about the arm pain all gravitated to the thyroid issue as if they'd heard of the letter, trying to fix what wasn't broken, one hinting about gov't, and I found at another forum there'd been some gov't interest, probably not FDA but the agency that has been sued a lot (?) When we've been treated for hypothyroidism for nearly half a century, we know a few things, they try to change around backwards and upside down, claiming need for thyroid decreases. Truth is just the opposite. My arm pain may have been because I was hypo in spite of high dosage, in fact.
While my dose was temporarily lowered, also many other hypo patients' at another forum, probably all archived now, I almost lost my vision, everything smokey like in a huge house fire, brain-fog big time, thyroid gland swelled, GOITER, and I even had a small car accident.
I'm just now getting some of my gumption back but not all of it, after more than 6 wks back on my usual meds. The several doctors evidently thought a 68-yr-old person's own thyroid gland would come to life again if deprived of medication support, when all other hormones are already shut down too. Two thought I should still have, I guess, sex hormones. I've been diabetic nearly 20 yrs, hypothyroid nearly all my life, never any hyper symptoms, you'd think they would realize I would recognize if I had them. Hyper is worse than hypo, though you can die from hypo.
Most grocery stores and pharmacies now have a b.p. machine, you know, where you can test yourself. I haven't had any noticeable heart rate increases while experimenting for proper T4 dose, so guess I don't have adrenal fatigue, have read symptoms at these forums and haven't had them.
The endo told the OTHER DOCTOR there was one more test he could do. So why didn't he instead of just talking about it, while I was there? I don't really want to go back. Because I'd have to pay again, and/or just showing off?
All kinds of malpractices have happened to all kinds of people, so I'm not just being grumpy.
Hope someone can help you more than I can. Your problem is educational for us as well as for yourself so don't apologize! That and the confusion and lack of confidence I believe is a typical hypo symptom. Please keep us posted about the muscles, big problem for me. Good luck.
I'm better in the evening. I shouldn't post early on in the day when my mood is the whiniest. You are right to point out confusion on guilt/ridden anxiety is one of the more insidious hypo symptoms.
Thankyou for your kind words and encouragement. I'll take strong note of keeping my docs from gossiping about me behind my back. That's all I need. A little paranoia anyone?
You are right, they seem to waste a ton of time sort of guessing their way through, and making up stuff when they don't actually know what to say.
I'm sorry to hear about your dillema. I do hope you get that worked out. Sounds frusterating. Perhaps a Meep and Midwest and John's babe are really onto something here about the adrenals. If those little glands get blown out through starting at too high an initial dose of T-meds or overdosing T-meds, one can see how the patient wouldn't feel the benefit of the meds at all....only get a bunch of rotten feeling symptoms which mirror the ones the poor victim is trying to rid herself/himself of.
You would think doctors would really be keeping an eye out for adrenal exhaustion for sure. If they have the power to script you for T-meds, they should take responsibility for the side effects they are laying on the patient. I dunno, they should do SOMETHING for those yaughts and high maitenance lawns they enjoy so much.
I think in my case, if the med MAKES me sick...and actually GIVES me hypo symptoms, you would think SOMETHING weird is going on. I can't help thinking the coma sounds like a much more pleasant option. Hey, at least I'd stop whining.
I'll check in tommorow. Thanks again, for your kind words.
Hi, just now read your post. I was trying to stay off the computer a bit and see if my arm would get better.
You aren't whining and we aren't paranoid, lol. These things have happened to a lot of people. A gov't agency has been sued a lot, and have you ever heard of dentists, maybe the immigrant ones, pretending they can't understand enough English when you're pointing out a cavity, until you lose the tooth, and they think they'll get some "bridge" business from you?
I frankly don't want any kind of bridge in my mouth, and a 30-yr(?) old one-tooth lower gap hasn't caused my upper teeth to move, like they all threaten. They even have a scare video where your mouth goes all deformed, really fast, and an aged face sort of caves in. It won't look good anyway, no matter what, at that age.
I don't need movie star teeth now! Have enough problems with diabetes, foot ulcers that won't heal for a couple of years, can always come back, and podiatrists are always threatening loss of a toe. I've heard of it happening, to a man. Latest dentist fixed up an estimate of over $6000 ! Wasn't going to tell me an endodontist about 30 yrs ago probably shouldn't have tried a root canal on a tooth with too-short roots. He should have known it would break off, and for some reason Blue Cross doesn't participate with him any more, so I wonder if he does this a lot. He's also got some written pages, charges a lot for even removing old posts, and warning that some cases are more difficult (yeah, right) so his already-too-high prices will have to be increased even more. I don't know why dentists keep sending him patients or how he stays in business. I needed to vent about that, don't like to tell my hubby because he's got enough burdens of his own running a business and probably being terrorized by his childhood rivals, the kind that want to call others losers and whiners, because that's what they are. Once you've read this I may edit it out, too much complaining, but I don't want anyone else to go through the same things.
I've edited my above post a little for clarification, since I had to go back and read it again, couldn't remember what I'd written.
Unn, thanks, but I've "been there, done that". Garlic I was taking for allergy ear and respiratory infections, so as not to build up a resistance to antibiotics, accidentally got me off dyazide I'd been taking for decades for high b.p. It's not generally known that garlic has these powers, so I just wanted to rule out addison's, was tested, so I knew it must have been the garlic.
Endo's can have their quirks like anyone else, so if they want to write a letter to your doctor just to show off, or because they're assuming you needed a referral because of your insurance plan, or maybe want to shame your regular doctor for not referring you, whatever, I'd advise your objecting. You feel used and talked about and it causes lots of confusion.
Saying a patient can be either or hypo or hyper w/out doing any tests, just rambling, making conversation, when your thyroid med has been working for almost a lifetime and you didn't ask anyone to tamper with that, isn't real smart, now is it? There's a knowledgable poster at one of these forums who always signs off as "Endophobia", must have had some bad experiences.
There's an old saying, "If it ain't broke, don't fix it," but several doctors I saw one time, who couldn't explain my arm pain wanted something else to distract me to, noticed on the registration form I guess, that I was on thyroid meds. I'm so mad! Evidently a lot of health forum people also noticed I was at the Addison's forum for a while. Glad I don't have it, would not want to take cortisone of any kind. No heart palpitations or any other symptom. Whew!
Re: Riddle re: meds/labs 
Re: Riddle re: meds/labs 
