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Old 08-27-2011, 05:40 PM   #1
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Tell me I'm on the right path...advice?

Previous frequent poster here having another rough time. Obviously things were going pretty well for me as I have not posted here for awhile. I guess I am just looking for confirmation I am on the right track or looking for any words of wisdom (Midwest you out there?)...

Let me start by saying that 3 or 4 weeks ago a friend of mine that has been battling colon cancer was told he only has weeks left to live. Hard news to hear about a dear friend. About a week after that I began to have anxiety attacks. I also have weakened adrenals so I chalked that up to my adrenals freaking out from the stress of what is happening with my friend. And that same night had severe insomnia where I could not fall asleep before 4:30 am when most nights I can't stay awake past 9:00 or 10:00. And then about a week later I started having the lightheadedness/dizzy feeling and brain fog and just feeling 'off'. Went to the doctor and kind of had an anxiety attack on my way there and my BP was through the roof. (I always have issues with white coat hypertension but never that high.) My doc wanted me to start 5HTP which helps increase the serotonin and she thought would help with the anxiety attacks as well as insomnia. She had asked me to take that a couple years ago when my mom passed away and I was dealing with issues with my dad too and I don't remember the effect it had on me but I thought it probably helped. She also told me to add Benicar HCT to my BP meds to bring my blood pressure down but I did that the first day and the next day it was really low so I've just been monitoring it day by day and it has been normal or just slightly elevated so I am not taking the extra BP meds.

Anyways here are my blood test results (while taking 125 mcg Synthroid and 20 mg of Cytomel):

08/18/2011
TSH: .03 (.40-4.5)
FT4: 1.3 (.8-1.8) 50%
FT3: 4.6 (2.3-4.2) 121.05%

Initially my doc said I should try to bump back my Cytomel to see if that helps with the anxiety but she said my numbers did not seem that far off from where I've been before and felt OK. Looking at my records I have noted where I really remember feeling really good at one point and my FT4 was at 70% one time and 90% the other. So I asked if we could lower my Cytomel to 10 mg and raise my Synthroid to 135 mcg and she agreed. Does this seem like a good decision to the rest of you? I've also heard people talk about FT3 and FT4 ratios and how its best to keep them closer together but I don't know much about that.

So today is the first day on my new dosage and I started off not too bad but then I started to feel horrible. (Just remind me that is to be expected when dosage adjustments are made.) Lightheaded to the point I feel like I could pass out (which causes more anxiety) and also I've had issues with diarrhea. I do normally have stomach issues too when my thryoid is off but usually my disgestive system slows down, but I also had some questionable ham yesterday so it might not even be thyroid related. BP has been at 135/84 which is not bad for a day when I am feeling like crap.

Guess i am just looking for some reassurance and some company while I wallow in my pity party.

Thanks for reading!

Last edited by Heckofagal; 08-27-2011 at 05:51 PM.

 
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Old 08-27-2011, 09:07 PM   #2
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Re: Tell me I'm on the right path...advice?

Heckofagal,

I'm certainly not an expert with this thyroid stuff, and I'm learning as I go along, but I've dealt with the anxiety that my thyroid triggered and completely understand how you are feeling. We lost a very dear friend two years ago to cancer and events in my life that are high stressors can definitely have an impact on how I sleep and feel overall. My blood pressure goes up when I'm dealing with stress at times as well and I've had to learn to recognize it. I certainly don't do a perfect job when it comes to dealing with it all the time, but I've learned over the years how to minimize them. Take care and yours isn't a "pitty party". You're simply someone who is sharing what they're going through and I've done this myself.
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Old 08-28-2011, 08:18 AM   #3
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Re: Tell me I'm on the right path...advice?

Quote:
Originally Posted by Heckofagal View Post
So I asked if we could lower my Cytomel to 10 mg and raise my Synthroid to 135 mcg and she agreed. Does this seem like a good decision to the rest of you?
To me this sounds like a good plan. Hope you get adjusted to it soon

 
Old 08-29-2011, 03:27 PM   #4
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Re: Tell me I'm on the right path...advice?

Thanks for reading guys. Still feeling poorly but I know it takes a while to get through this.

 
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Old 08-30-2011, 07:38 AM   #5
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Re: Tell me I'm on the right path...advice?

I concur with Finnmaid. I would also like to recommend another cortisol check for you. With weak adrenals you do not produce the cortisol to handle stress. You have been under a lot of it. In tines of increased stress you need to increase your hydrocortisone treatment to compensate. Dialing the T3 back is a good start. But if you need added cortisol supplementation then a 24 hour blood saliva test and 8 am blood cortisol draw will help iddntify that need. You are not alone. I hope that we have been of some help. My deepest sympathy for you and your friend.

Sincerely,
MG
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Old 08-30-2011, 10:00 AM   #6
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Re: Tell me I'm on the right path...advice?

Quote:
Originally Posted by mkgbrook View Post
I concur with Finnmaid. I would also like to recommend another cortisol check for you. With weak adrenals you do not produce the cortisol to handle stress. You have been under a lot of it. In tines of increased stress you need to increase your hydrocortisone treatment to compensate. Dialing the T3 back is a good start. But if you need added cortisol supplementation then a 24 hour blood saliva test and 8 am blood cortisol draw will help iddntify that need. You are not alone. I hope that we have been of some help. My deepest sympathy for you and your friend.

Sincerely,
MG
Mkgbrook,

I've considered having my adrenals tested and the 24 hour saliva test consists of dropping off samples several times correct?

I appreciate your thoughts regarding my loss and this board is always helpful. I'm constantly learning new things and thanks again.

 
Old 08-30-2011, 10:22 AM   #7
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Re: Tell me I'm on the right path...advice?

The adrenal testing is just one drop off. You are given 4 vials that you spit into. You have to clean your mouth and wait an hour before each sample collection. They often fail to tell you that one. You want to collect these samples at 8 am, 12 pm, btwn 6-8pm, and at 12 am. You will record your collection times on a sheet or slot on the vial. Store collected samples in your fridge. At least kids will not mistake the vials for lemonade unlike the 24 HR urine cortisol collection... My son was 4... Back on track now. When all samples are collected drop them off to your MD or respective lab service. I just carry mine in a xiploc with a disposable cold pack to the office.

It is a 24 hour blood cortisol draw that they make you come in and put out blood at the key times I listed above. Cortisol levels and production change through out the day. We should be highest at 8 am and lowest at 12 am. These rhythms tend to get messed up in long term undertreated hypoT patients. Resulting in adrenal fatigue or flat out Hypoadrenalism. I am hypoadrenal and have to take 20 mg of hydrocortisone tablets on a normal day. During stressfull periods my MD supplements me with OTC DHEA and sometimes an added 5 mg tablet of HC.

It is amazing how complex our bodily functions are... Flashes of potty training memories with that phrasing... But back to the point the thyroid is involved in two major endocrine loops and even more minor ones. One is the hypothalamus-pituitary-thyroid loop often referred to as HPT and the other is the Adrenal-HPT LOOP. it is very important to keep an eye on the communication between these glands it helps isolate the source of issues when issues arise.

I wish you the best.
MG
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Old 08-30-2011, 02:35 PM   #8
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Re: Tell me I'm on the right path...advice?

Quote:
Originally Posted by mkgbrook View Post
The adrenal testing is just one drop off. You are given 4 vials that you spit into. You have to clean your mouth and wait an hour before each sample collection. They often fail to tell you that one. You want to collect these samples at 8 am, 12 pm, btwn 6-8pm, and at 12 am. You will record your collection times on a sheet or slot on the vial. Store collected samples in your fridge. At least kids will not mistake the vials for lemonade unlike the 24 HR urine cortisol collection... My son was 4... Back on track now. When all samples are collected drop them off to your MD or respective lab service. I just carry mine in a xiploc with a disposable cold pack to the office.

It is a 24 hour blood cortisol draw that they make you come in and put out blood at the key times I listed above. Cortisol levels and production change through out the day. We should be highest at 8 am and lowest at 12 am. These rhythms tend to get messed up in long term undertreated hypoT patients. Resulting in adrenal fatigue or flat out Hypoadrenalism. I am hypoadrenal and have to take 20 mg of hydrocortisone tablets on a normal day. During stressfull periods my MD supplements me with OTC DHEA and sometimes an added 5 mg tablet of HC.

It is amazing how complex our bodily functions are... Flashes of potty training memories with that phrasing... But back to the point the thyroid is involved in two major endocrine loops and even more minor ones. One is the hypothalamus-pituitary-thyroid loop often referred to as HPT and the other is the Adrenal-HPT LOOP. it is very important to keep an eye on the communication between these glands it helps isolate the source of issues when issues arise.

I wish you the best.
MG
Mkgbrook,

I will definitely look into this and thanks for all the advice.

 
Old 08-30-2011, 04:37 PM   #9
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Re: Tell me I'm on the right path...advice?

Thanks MG - I've been on a dose of Hydrocortisone in the past and did not fair too well. Will just stick with my adrenal supplements and try to be kind to my adrenals!

 
Old 08-30-2011, 05:12 PM   #10
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Re: Tell me I'm on the right path...advice?

Some times HC is too harsh. Most that need it can handle it. It is weaker and more gentle than prednisone. DHEA can be converted into cortisol in a round about way. It may work for you. If testing shows you need it.

MG
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