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    Old 09-11-2004, 11:59 AM   #1
    prfalken
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    at a loss with some symptoms

    Hello,

    It'd be very nice if somebody could give me a clue about some symptoms that I've had for a long time, since the doctors I've consulted seem to be at a loss.

    The symptoms began all of a sudden, more than two years ago. They are quite annoying, but not incapacitating: some day I began to feel subtly bad (malaise, I think it's called), with moving white dots in my field of vision, bad balance (not vertigo), weakness and acceleration of the heart with small efforts that previously didn't affect my heart rate (even after meals or when urinating). In the first months I even had moderate leg pain when walking and palpitations, which have not ocurred again in the last months. Except for these, I don't feel worse, but I don't feel better either.

    I know this symptoms could suggest anaemia, but my blood tests seem to be normal (however, for motives I'd rather obviate, more than a year had elapsed since the onset of these symptoms when I had my first blood test made). The doctors I've consulted (two at the moment) attribute them to some nervousness or mild depression, but I'm not convinced and, moreover, the treatments they have prescribed have not had effect at the moment. I feel specially weak in the morning, after breakfast. My blood pressure is often around 10/6. A year ago I started to jog 10 or 15 minutes every two or three days to see how my body reacted, but 10 or 12 days later I began to feel so weak that I had to quit it.

    I'd apreciate any suggestion. Thank you.

     
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    Old 09-11-2004, 12:11 PM   #2
    Misty800
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    Re: at a loss with some symptoms

    Is this a typo or for real....bloodpressure 10/6. If this is for real I am surprised you are able to walk around with bp that low.

    It is possible your bloodpressure is too low for you.

     
    Old 09-11-2004, 12:33 PM   #3
    flintrock
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    Re: at a loss with some symptoms

    Don't know reason you put off getting blood work done, but if it's for reason I think....that could be your problem..............

     
    Old 09-11-2004, 12:45 PM   #4
    Gopherhead
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    Re: at a loss with some symptoms

    The symptoms you have described are all present in people with thyroid disease, in particular auto immune hypothyroidism. Have a look at the thyroid disease forum - there is a lot of information there and there are some very helpful people who can give you more advice.

    Feeling weak, dizzy and run down, a racing heart, low blood pressure (which often causes the dizziness), depression and panic attacks (leading to a racing heart rate) are all classic symptoms. Also, if your depression-like symptoms are caused by hypoT taking all the antidepressants in the world won't help - they just won't work.

    Doctors get very little training in how to deal with thyroid disease (about one hour) and many are using old outdated lab ranges for what is considered "normal". Even specialists (endos) aren't great at diagnosing and treating thyroid disorders; they tend to rely on lab results and ignore symptoms. Often naturopaths or osteopaths are much better with this type of illness. Nevertheless, I would hazard that your doctor did not do the right tests (they rarely do), he probably only did one (TSH) - this combined with an old lab range would results in your "normal" result.

    Again, have a look in this board's Thyroid Forum - post your symtoms and if you have that test result post it as well (along with the range).

    Nat
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    Old 09-12-2004, 07:23 AM   #5
    prfalken
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    Re: at a loss with some symptoms

    Thanks everybody, I'll try the Thyroid Forum

     
    Old 09-13-2004, 02:46 AM   #6
    typhoidmary
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    Re: at a loss with some symptoms

    Treating people with non-specific symptoms with thyroid replacement has been studied and found to be no better than placebo.

    PS Physicians get a LOT more than one hour about thyroid problems

     
    Old 09-13-2004, 05:22 AM   #7
    Gopherhead
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    Re: at a loss with some symptoms

    Treating people who are not suffering from hypothyroid disease with T4 or a combination of T4/T3 makes them hyperthyroid.
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    Old 09-13-2004, 05:50 AM   #8
    typhoidmary
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    Re: at a loss with some symptoms

    That is essentially what you are suggesting to try. Some people with good symptomatology for hypothyroidism (classic criteria, none of this low body temperature mumbo-jumbo) with TSH in the high-normal range benefit from thyroid replacement. T3 treatment is dangerous, causing cardiac problems.

     
    Old 09-13-2004, 08:19 AM   #9
    Gopherhead
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    Re: at a loss with some symptoms

    Correct dosage of T3 does not cause cardiac problems. And for the record, the range for TSH used by most labs is outdated, the American Association of Clinical Endocrinologists has advised that TSH should be below 2.5.

    Quote:
    That is essentially what you are suggesting to try.
    I suggested that the correct tests were not done and that they should be. Testing for TSH is not enough, especially when dealing with secondary hypothyroidism, and especially if an old lab range is being used. FT4 and FT3 are much better measures.
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    Old 09-13-2004, 09:06 AM   #10
    typhoidmary
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    Re: at a loss with some symptoms

    There is no need to prescribe T3 separately in the vast majority of cases and it will cause cardiac problems - this is the reason why T4 is used.

    TSH can be used as a screening tool. Obviously pre-test probability affects which test is used.

     
    Old 09-13-2004, 09:35 AM   #11
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    Re: at a loss with some symptoms

    Quote:
    Originally Posted by typhoidmary
    There is no need to prescribe T3 separately in the vast majority of cases and it will cause cardiac problems.
    This is simply not true, your information is outdated.
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    Old 09-13-2004, 09:42 AM   #12
    typhoidmary
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    Re: at a loss with some symptoms

    That is your opinion - you have no need to be so dogmatic since my source is very definetely up to date (Royal College of Physicians). T3 causes arrhythmias unlike T4 which is converted peripherally to T3 and avoids cardiac problems.

     
    Old 09-13-2004, 10:05 AM   #13
    typhoidmary
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    Re: at a loss with some symptoms

    A quick browse of websites shows "Liothyronine sodium is contraindicated in patients with cardiovascular disorders or angina of effort"; Dr Wartofsky said of liothyronine "we are making patients mildly thyrotoxic for a while and they feel better. But over a long period of time there are adverse effects on bone and the heart."

     
    Old 09-13-2004, 10:08 AM   #14
    Gopherhead
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    Re: at a loss with some symptoms

    Quote:
    Originally Posted by typhoidmary
    That is your opinion - you have no need to be so dogmatic since my source is very definetely up to date (Royal College of Physicians). T3 causes arrhythmias unlike T4 which is converted peripherally to T3 and avoids cardiac problems.
    Too much T4 can cause cardiac problems. I said:

    Quote:
    Originally Posted by Gopherhead
    Correct dosage of T3 does not cause cardiac problems.
    It is not my opinion, it is, however, the opinion of many endocrinologists in the field:

    Danzi S, Klein I. Thyroid hormone and the cardiovascular system. NYU School of Medicine and North Shore LIJ Research Institute, Manhasset, NY, USA. Minerva Endocrinol. 2004 Sep;29(3):139-50.

    Agid O, Lerer B. Algorithm-based treatment of major depression in an outpatient clinic: clinical correlates of response to a specific serotonin reuptake inhibitor and to triiodothyronine augmentation. Int J Neuropsychopharmacol 2003 Mar;6(1):41-49.

    Bunevicius R, Jakubonien N, Jurkevicius R, Cernicat J, Lasas L, Prange AJ Jr. Thyroxine vs thyroxine plus triiodothyronine in treatment of hypothyroidism after ********ctomy for Graves' disease. Endocrine 2002 Jul;18(2):129-33.

    Woeber KA. Levothyroxine therapy and serum free thyroxine and free triiodothyronine concentrations. J Endocrinol Invest 2002 Feb;25(2):106-9.
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    Old 09-13-2004, 10:12 AM   #15
    typhoidmary
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    Re: at a loss with some symptoms

    Do you take T3? How often do you take it?

     
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