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Old 06-29-2012, 06:49 PM   #1
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Hashi needs help with analyzing tests and Meds

Hello! This is my first post and I am hoping someone can shed some light on my situation. I was diagnosed with Hashis last May after trying to live with terrible hives and some fatigue. I went off gluten and the hives decreased by 60% or so. But I still have them everyday. My TSH was 8 and I took 37mg of Synthroid. I didn't really feel much different either way. Most of my fatigue had cleared up with eliminating gluten and I eat only small amounts of sugar. But I continued to take the Synthroid until December when much of my hair was gone. By January, I quit the meds just to let my hair grow back.

Well, May rolled around and I started feeling a bit fatigued again. So I was retested. These are my stats:

TSH 10
Free T4 .7 (.8-1.8)
Free T3 2.6 (2.3-4.2)
Thyroid Peroxidase 534 ( They have been as high as 800)
Vitamin D 37 (total 30-100)
Vitamin B12 701 (200-1100)

I have eliminated iodine. But I went to a MD who wanted to medicate me with Thyrosol ( iodine supplement). I am sure I don't want to do this because he didn't even want to run a test to see where my levels were.

So, I in a quandry. My endo wants to take my thyroid completely out. I am not on board with that either. But larger amounts of Synthroid (over 37) makes me jittery with hot flashes. I feel worse.

So...

either I just live with the hives and don't take meds and am tired

OR

should I take Synthroid - go bald - and stay at a lower dose which keeps me in the 4-5 TSH range (fine with me)

OR

Try Naturethroid, Armour, etc. in hopes that this lowers my TSH, but doesn't leave me bald? I am very concerned though that since my free T3 isn't abnormal, that I would be putting too much T3 in my system.

Any thoughts??

Thank you SO SO much!

Stephanie

 
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Old 06-30-2012, 09:18 AM   #2
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Re: Hashi needs help with analyzing tests and Meds

Your hives are probably due to the TPO antibodies more than gluten. If removing gluten from your diet improved them, it's probably because it reduced the TPO Abs. Have you tried taking an OTC selenium supplement? Se has been shown to reduce TPO Abs by up to 40%. Take 200 mcgs of it for one month, then reduce to 100 mcgs daily. Be sure to factor in the Se content of any multi-vitamins or other supplements you now use, so that you don't overdose on it.

I wonder what the endo thinks would justify removing the gland from a patient who can't tolerate Synthroid? You'd need even larger amounts of it than you've already found to be intolerable. And let me guess.... He won't consider prescribing porcine thyroid, not ever.

As I explained in your other thread, one of the other brands of levothyroxine may agree with you better than Synthroid. Thyroid hormone in and of itself has almost no side effects, because it's hormone, not a chemical physiology-altering drug. Synthroid, though, seems to have the reputation of causing continuing hair loss and/or leg cramps... More so than other brands. So, do give another brand a trial.

Also as I explained, adrenal fatigue causes intolerance to thyroid hormone. You could have it checked. (I'm sorry I can't tell you the best way to do that.) Or, move on to a porcine hormone product.

Your T3 actually is "abnormal". Almost no one can squeak by with either free T level at the basement level. You should aim to increase it to at least mid-range (3.25), but most women need it even higher than that.

Hope that helps you figure out what to do next.
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Old 06-30-2012, 01:31 PM   #3
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Re: Hashi needs help with analyzing tests and Meds

Dear Midwest,

Thank you! The problem with the antibodies is that as I chart them, they make no sense to me. Last year before Synthroid - they were 713. Then on Sythroid 25-37mcg - they were 482, 462. Then off Synthroid - they were 642 and 532. I would think they would continue to climb if my TSH is continuing to go up (although they did climb).

But when I did go off gluten, my hives diminished by 50% or so in duration and intensity. The problem is that I have to tell my doctors what to give me....except my endo who won't give Armour anyway. I do have a doc that will give me the prescription. If I want to start small, what should I ask for?

This doctor is no help. He wanted to start with the equivalent of 75 of Sythroid. I do MUCH better starting slowly with 12 for 2 weeks, 25 for 2-3 weeks, etc.

Lastly, should I pursue another brand of levothyroxine or bite the bullet and get the Armour? If I up my T4, doesn't it look like I convert it well-enough? Could the Armour make me jittery if I convert T3 well-enough?

Also I have been on about 175 selenium for a year, plus extra B12s and some D when I am not in the sun quite a bit.

The MD gave me digestive enzymes? Do you recommend these? Could they help the hives? Or is this just an expensive pill at $50 a bottle? I do take a probiotic.

Blessings,
Stephanie

 
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Old 06-30-2012, 02:34 PM   #4
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Re: Hashi needs help with analyzing tests and Meds

Antibodies do their own tricks. You shouldn't try to correlate their titer to anything else, because even the smartest researchers in the field of autoimmunity don't understand them.

There isn't much way to be sure if you convert, because you have abysmally low levels of both free Ts. There just isn't any FT4 there to convert. Sometimes we see very low FT4 levels and perfectly adequate FT3, but that's because the body senses the low T4 and converts extra to keep the body running on it alone. Doesn't seem to be the case with you, at least not now. Maybe you've already depleted all your stores of hormone, having TSH so high for so long. I think you'd probably do okay with a T4/T3 combo med. I mean... My FT4/3 were pretty well-balanced. I didn't need T3 on the face of it, but I still did fine with the combination.

My MD started me on dessicated very slowly, given my hypersensitive reaction to Synthroid. He considers 30 mgs conservative. I had no trouble with that, so he increased it to 45 mgs after a month. After another 8 weeks, up to 60 mgs, then gradually to 90, and eventually 120. I've been stable on 120 for about 8 years, except for the fiasco that happened when both Armour and Naturethroid reformulated.
People who seem to have palpatations and chest pain related to the onset of T3 may start out even more slowly with 15 mgs to start. If that still seems to be too much, that dose can be split into two parts, one taken in the a.m. and one in the p.m. To soften the effect of T3 even more, the dose could be taken with food, although that will cause an absorption problem with the T4, making that level dip too low. Taking Armour with food will likely necessitate the addition of a levothyroxine product to go with it in order to maintain an adequate T4 level. Then you're back to square one.

Sorry, don't know much about digestive enzymes except -- I was having frequent bouts of heartburn. My MD gave me vegetable enzymes, which I have to admit helped when I remembered to take them before meals. Trouble is, they taste like goldfish flakes smell, and they produce a *burp* to match the smell. yuck I doubt taking them would accomplish anything for your hives or thyroid. I can only say, if you have the cash, see what they might do for you.

I would imagine, although I cannot guarantee, that once you get your free T levels to optimal places, your antibody count would naturally go down. I hope so, anyway!
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