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Old 12-01-2004, 09:05 AM   #1
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Question Meep..Question about something you said - Please Help Me!

Meep...you were responding to Taram's question about TSH. I STILL don't know how to work the quote function so I've cut and pasted - here is your quote:

Meep:
"TSH has NO direct correlation with symptoms. Symptoms are tied to T3 and T4 levels, so your Free T3 and Free T4 levels are far more telling as to what is going on in your body."

Meep, I spoke w/my doctor yesterday - she FINALLY called me AFTER I got the info I was trying to get. But since I had her on the phone, I explained that while I didn't have the brain fog anylonger, (still on 5mgs cytomel) and have been feeling overall better, I'm STILL having muscle spasms (has subsided some) and lots of stiffness in my joints. I didn't mention to fact that I still havne't lost any weight inspite of my continued exercise. I'm beginning to believe all that I've read - many docs just think you're fat because you're not REALLY trying to lose weight and I KNOW that isn't the case for me so I chose to leave out that concern for now. However, it IS still a concern for me. Unfortunately, one that is more bothersome to me than the muscle spasms and joint pains, although I want all my symptoms in remission! Anyway, I am not scheduled see my doc until mid December - next labs due week prior to visit with her. I'm still on the Levoxyl and cytomel (levox 200 mcg and 5mg of Cytomel). I asked her if she prescribes Armour as I've been thinking of switching. She said she does and would consider it if I'm still not feeling better BUT that she doesn't think Armour works as well because it's from pigs and we're humans Yeah...I know that, but from everything I've read....I mean...I've heard wonderful success stories on hear...including your own. Meep, I'm getting so confused again Sometimes I think the more I learn, the less I really know! All I want is to feel my very best again...like again. AND to be able to once again lose the extra weight healthy and safely. My doc also stated during that conversation that the TSH is the BEST indication of what's going on with my thyroid...I asked her why, because isn't they TSH a hormone from the pituatary gland? (I felt soooo smart by asking that question!..hehehe)...she said yes but for my "type" of Graves Disease, the TSH is the best indication. Now what does that mean??? I didn't ask because I was at work and didn't have much time to talk. Meep....help me please!! I've reposted my labs below from last month (November)...do you really feel that my Free t3 and Free t4 is the best indication of what's going on in my body? If so, what can you tell from mine? What should I do? Please help me try to make the best decision cuz' honestly, I just don't know anymore!
Thanks
LucyPearl

TSH = 1.30 (0.40-5.50)
T3 Total = 141 (60-181
T3 Uptake = 32 (22-35)
T4, Free = 1.8 (0.8 - 1.8)
T3, Free = 341 (230-420
T-4 (Thyroxine), Total = 13.7 (4.5-12.5) - *out of range
Free T4 Index (T7) = 4.4 (1.4 -3.8) - *out of range

 
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Old 12-01-2004, 09:52 AM   #2
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Re: Meep..Question about something you said - Please Help Me!

Meep...
By the way...I don't feel "hyper" at all. No heart palps, hand tremors...nothing like that. I remember from my early days of Graves/hyper, what those felt like. My levels may indicate hyper, but I really don't feel it. I confused! My endo read my latest results (I had my pcp run those labs that I posted above) and endo says "wow, you're responding really fast...we MAY have to make some adjustments when you come back in" Adjustments to what? I was on 175mcg levox when I went to see her initially back in late October and she took my labs and my TSH was 12...that's why she increased my levox to 200...what in the world is going on??

 
Old 12-01-2004, 12:26 PM   #3
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Re: Meep..Question about something you said - Please Help Me!

Just bumping me up so I don't get lost

 
Old 12-01-2004, 04:22 PM   #4
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softcrush HB User
Re: Meep..Question about something you said - Please Help Me!

Meep:

I'd be interested to hear the input too. I have been told repeatedly that when TSH is not rock bottom....it can be the cause of muslce aches, spasms so forth.

I have also heard, from you, that it could be related to certain mineral/vitamin deficiencies.

In Lucy's case...could she be lacking an optimum dose of T3?

I ask...because as a former ARMOUR tryer myself, I didn't get rid of those muscles aches at all....but the weight sure came off. Of course with a resting heart rate or 123...I probably couldn't have avoided it. LOL

I was just curious because I share the muscle/ache challenge.

~S

 
Old 12-01-2004, 04:35 PM   #5
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Re: Meep..Question about something you said - Please Help Me!

Hey Soft...
Are you having muscle spasms also? And you said you're a "former" Armour user...why'd you stop? Do I understand you to say that while on Armour you lost weight? I'm thinking of trying Armour - I've heard more positive than negative and at this point I'm just trying to get better! What are you taking now? It doesn't look as though Meep is online right now but I'm sure when he is he'll repond. When you say I may not be getting the optimum dose of T3, do you mean the t3 from the cytomel? I'm on the lowest dose I think...just 5mg. I'll be off and on computer tonight so I'll check back in later or definately tomorrow a.m. from work...in the meantime, be well!
LucyPearl

 
Old 12-01-2004, 07:31 PM   #6
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softcrush HB User
Re: Meep..Question about something you said - Please Help Me!

I stopped Armour for several reasons.

1. I took too much and went VERY hyper. The t3 ratio overshot the t4 and THAT my friend is KILLER. Your heart gets wired...and you shake like a junky.

I decided to go back and create a solid baseline with the t4. WE know you need that...and we know the pig ratio is bad (80/20)...but we know pigs are good. So we must find a solution (fix the ratio).

THINK outside the box...for hack phrase.

Don't take what I say as gospel...I'm still learning myself. I think there is some logic to the science though that contains some real commen sense.

You actually look like you may be in a great postion to just jack up a bit more T3. Look at your 3Tfree...It could go higherby a smidge. You might also find that if you are not hyper, you could even use a scrap more T4. MAYBE that is all you need to get going with the weight thing. Maybe your not HYPO per se...but "sublcinical." You got to go with how you feel...and get a physiological dosage...not pharmacologic. Not all based on labs.

The other thing you could do if you have you heart set on the pig stuff, is do a small addition on the end of your t4 of porcine extract. Maybe you want to add 30 milligrams porcine extract...and eliminate the cytomel for now. I would give that a try first.

Tweaking is better. That way you craft what you body needs, instead of looking at it as one way or the other.

Hey..if it didn't work...you could always jump into pigland wholeheartedly in the end anyway. Going back the other way will be much more difficult.

Ya SEE?

~S

 
Old 12-02-2004, 05:11 AM   #7
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Re: Meep..Question about something you said - Please Help Me!

Soft...
I think I understand what you're saying. My endo also suggested that I could add another 5mg of cytomel in the evenings if I wanted to - she said she thought it might help. I haven't yet. I was going to wait and see what my need labs say, but as you say....it's not about the labs as much as it is about how I feel. Porcine Extract....hmmm...well what exactly is that? I promise, my heart is not set on the natural pig hormone...it's only set on getting better by any means necessary! Know what I mean? May I'll add the other 5 mg of cytomel just to see what happens. I'm already on 200mcg of T4...you think I might need to boost that up a bit?? My endo just said she MAY have to adjust...but I think she's talking about lowering it since my TSH came down so quickly.
LucyPearl

 
Old 12-02-2004, 06:47 AM   #8
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Meep HB UserMeep HB UserMeep HB User
Re: Meep..Question about something you said - Please Help Me!

OK, Lucy, here's what I would do, if I were your doctor. If you choose to stay on the T4/T3 meds you are on now, they really are easier to tweak, which is a big advantage over Armour, so I'll start there. I still prefer Armour, though, so I'll do the math and post that if you want, too.

Your T4 levels concern me. They aren't dnagerously high, but you are verging on hyper, and I don't like it. I would drop back on the T4 to 175mcg and test again 6 weeks later. I prefer to see Free T3 higher--around 370 on the range you posted, so I would go ahead and up the Cytomel to 5mcg twice a day. (cytomel is available as a 10mcg pill you could split, which would be less expensive than two 5mcg pills a day if you don't mind splitting pills)

Now, about that TSH. I disagree with your doctor that TSH is the best indicator for anything other than measuring TSH. If TSH is so accurate, then why wasn't your TSH lower to reflect your T4 being over the top of the range? Point out that this concerns you and you would rather optimize your Free T3 and Free T4, shooting for the goals I stated. Look up a Dr. Dommisse on Google or Yahoo. He has a paper on optimal treatment of hypothyroidism that is fantastic. Maybe you could print a copy or fax it to your doctor and ask if you can try his protocol. The things I recommend are based on his approach, though I disagree with him on a few points (he advises taking Armour with food---not a good idea). In his paper he has a section on "Modern Conventional Myths about Diagnosis and Treatment" This myth is one your doc should take note of:
Quote:
The third TSH-myth is that, just because the new ultrasenstive TSH test is a very sensitive and accurate test for measuring the TSH level, this suggests to imply that TSH is always or usually the correct yardstick by which to measure the function of the thyroid hormones, T4 and T3. There is an unconscious, unintentional 'sleight of hand' occurring here. The assumption is that, if TSH is low-normal, adequate amounts of T4 are being converted to T3 in the pituitary receptors; and that, if TSH is below normal, excessive amounts of T3 are being formed from T4 in those receptor cells. There does not appear to be any evidence that the pituitary gland ~ or any organ or tissue, for that matter ~ can convert T4 to T3 at any greater rate than that which is reflected in the serum FT3 level. Anyone who routinely measures the serum FT3 level will observe that the serum FT3 level is often low, even when the TSH level is low-normal or below normal ~ even in the absence of identifiable pituitary or hypothalamic disease. Some of these cases are so-called 'euthyroid sick'/ non-thyroidal illness syndrome cases, some are subtle secondary or tertiary hypothyroid cases without known disease involvement of either the pituitary or the hypothalamus. And some are any combination of these two forms of hypothyroidism, or of non-thyroidal-illness hypothyroidism, or of grade-3 primary hypothyroidism.

The TSH is an indirect gauge of T4 and T3 activity and depends on its own integrity-of-function and not only on the relative heights of the two thyroid hormones. Most realize this truth when there is known hypopituitarism or hypothalamic malfunction, but we don't recognize it is also true in subtle/ occult pituitary and hypothalamic failure, and in the hypothyroidism that is now increasingly recognized as a frequent accompaniment of non-thyroidal illness or the 'euthyroid sick' syndrome (Palazzo & Suter, 1990; Chopra, 1997; DeGroot, 1999). It is incorrect to state that the FT4 and FT3 levels are inconsequential: High or high_normal levels would indicate that the high or high-normal TSH is not even due to hypothyroidism but is due to lab error, stress, or a spurious high TSH, or some other condition. This is another example of why it is always necessary to measure FT4 and FT3. A TSH level can be dispensed with in a patient who over_suppresses the TSH even when FT4 and FT3 are not elevated, but, in our opinion, FT4 and FT3 can never be dispensed with.
__________________
Danny

I am not a doctor, nor have I ever played one on TV...

Last edited by Meep; 12-02-2004 at 06:50 AM.

 
Old 12-02-2004, 08:13 AM   #9
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LucyPearl HB User
Re: Meep..Question about something you said - Please Help Me!

Meep...
All I can say is Thank you so much! Excellent point about my TSH should have been lower to reflect my T4 being over the top of the range! Thank you!! I'm going to ask her that. OK...so I'll increase the T3 to 10mg and drop back to 175mcg on Levox - that MIGHT be what she meant when she stated that she may have to make adjustments I'm printing out your response so I can read it thoroughly - sort of hard to do right now here at work. I thank you so very much for taking the time to help me. I'm going to look up and read article on Dr. Domisse.
LucyPearl

 
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