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  • Hypo/Hyper Thyroid Advice needed please! Current meds not working.

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    Old 03-06-2017, 11:59 AM   #1
    melindaFL
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    Hypo/Hyper Thyroid Advice needed please! Current meds not working.

    Hello - I am so frustrated with doctors right now and I'm so glad that I discovered this site in the hopes that someone can assist me with advice.

    I was diagnosed hypoT about 7 years ago and put on Armour 90 mg. I tolerated it well and felt fairly good but had terrible insomnia and a fast heart rate. I finally went to an Endo a few months ago to check things out. My labs were as follows:

    T4 Free - 0.91 (0.82-1.77)
    T3 Total - 158 ng (71-180) (Dr. didn't order a T3 Free test)
    TSH 0.285 (0.450-4.50)
    Thyroid Peroxidase AB - 11 IU (0.34)

    In reading some of the posts I now know that being on Armour can cause the T4 Free to be low and maybe I wasn't actually in the hyper range. Regardless, my Endo wanted me off Armour and put me on Tirosint 125 because it's pure and I'm lactose and gluten intolerant. After 5 weeks I started feeling terrible. No energy (yes, I was definitely sleeping at night!) and a very down feeling - almost apathetic. Constipation and every other symptom that goes with Hypo. I could barely form a sentence due to brain fog. My doctor said to go ahead and get tests done again. Those results were:

    T4 Free - 1.64 (0.82-1.77)
    T3 Total - 92 (71-180)
    T3 Free - 2.3 (2.0-4.4)
    TSH 0.108 (0.450 - 4.50)

    My Endo said I was now hyper and wanted to lower Tirosint to 112 and get labs done in another 6 wks. I said there was no way I could keep feeling this way and that I wanted to go back on Armour. She doesn't want me to and suggested I try Cytomel 5 mcg one time per day (along with Tirosint 112) and if that works I could go to twice a day in 2 weeks. I took the Cytomel for 3 days and couldn't take the nausea. I'm beginning to think that I'm one of the people who might do better on NDT.
    I've actually started taking the Armour again and once I let my Endo know I'm sure I will have to go back to my primary doctor for future prescriptions.

    Do any of you think my original labs were that bad? I was in the upper level for my T3 and I felt better then. It would be nice to not have the rapid heart beat and sleep better but at least I felt good while on Armour. I'm so confused as to what medicine/strength to be on.

    One other issue that I think is connected is that I'm trying to get hormones regulated with hormone pellets and I've had a lot of breakthrough bleeding these past few months. I now think it is definitely connected to my thyroid meds not being right.

    Any advice on the strength and best medicine would be greatly appreciated. I'm losing faith in my doctors .

     
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    Old 03-06-2017, 06:29 PM   #2
    smokeymtnrain
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    Re: Hypo/Hyper Thyroid Advice needed please! Current meds not working.

    Quote:
    Originally Posted by melindaFL View Post
    Hello - I am so frustrated with doctors right now and I'm so glad that I discovered this site in the hopes that someone can assist me with advice.

    I was diagnosed hypoT about 7 years ago and put on Armour 90 mg. I tolerated it well and felt fairly good but had terrible insomnia and a fast heart rate. I finally went to an Endo a few months ago to check things out. My labs were as follows:

    T4 Free - 0.91 (0.82-1.77)
    T3 Total - 158 ng (71-180) (Dr. didn't order a T3 Free test)
    TSH 0.285 (0.450-4.50)
    Thyroid Peroxidase AB - 11 IU (0.34)

    In reading some of the posts I now know that being on Armour can cause the T4 Free to be low and maybe I wasn't actually in the hyper range. Regardless, my Endo wanted me off Armour and put me on Tirosint 125 because it's pure and I'm lactose and gluten intolerant. After 5 weeks I started feeling terrible. No energy (yes, I was definitely sleeping at night!) and a very down feeling - almost apathetic. Constipation and every other symptom that goes with Hypo. I could barely form a sentence due to brain fog. My doctor said to go ahead and get tests done again. Those results were:

    T4 Free - 1.64 (0.82-1.77)
    T3 Total - 92 (71-180)
    T3 Free - 2.3 (2.0-4.4)
    TSH 0.108 (0.450 - 4.50)

    My Endo said I was now hyper and wanted to lower Tirosint to 112 and get labs done in another 6 wks. I said there was no way I could keep feeling this way and that I wanted to go back on Armour. She doesn't want me to and suggested I try Cytomel 5 mcg one time per day (along with Tirosint 112) and if that works I could go to twice a day in 2 weeks. I took the Cytomel for 3 days and couldn't take the nausea. I'm beginning to think that I'm one of the people who might do better on NDT.
    I've actually started taking the Armour again and once I let my Endo know I'm sure I will have to go back to my primary doctor for future prescriptions.

    Do any of you think my original labs were that bad? I was in the upper level for my T3 and I felt better then. It would be nice to not have the rapid heart beat and sleep better but at least I felt good while on Armour. I'm so confused as to what medicine/strength to be on.

    One other issue that I think is connected is that I'm trying to get hormones regulated with hormone pellets and I've had a lot of breakthrough bleeding these past few months. I now think it is definitely connected to my thyroid meds not being right.

    Any advice on the strength and best medicine would be greatly appreciated. I'm losing faith in my doctors .
    Hi,

    I'm confused as to why you are on meds. Everything looked in the normal range with the exception of the Thyroid Peroxidase Antibodies which I have found two different reference ranges which one was 0.0-2.0 IU and the other said less than 35. Yours being at 11 or even 1.0 still fall in range according to these ranges that I found. I'm kind of dealing with the same issue only I'm not on any meds at the moment. The frustrating thing is, every lab is different and numbers aren't set in stone. Its just an average in fact I was told that the new guidelines for TSH were going to change and go lower than 4.5 and some I have seen go to 5.0 because that way, the Pharm and FDA get to prescribe more meds. Its all about money and learning from our Physician friends, what's normal for one is not always normal for another. What's the first med that Dr's usually go to for hypothyroidism? The drug Synthroid or its generic and what they don't understand is being a synthetic drug, it only replaces the T4 which most people can not convert synthetic T4 to T3. The conversion of T3 can be hampered by low selenium, inadequate omega 3 fatty acids, low zinc,environment or stress. So the synthetic T4 will only give you partial improvement and its notoriously hard to prescribe and keep within optimal dosage range as too little won't improve and too much can lead to heart issues, muscle weakness, bone fractures, etc...

    So just throwing a pill at something and not telling the patient exactly what it does or does not do is doing the patient a great dis-service. You have to know your body (which isn't always easy) because you more than anyone will know your body best. Hope this helps!

     
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    Old 03-06-2017, 10:17 PM   #3
    midwest1
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    Re: Hypo/Hyper Thyroid Advice needed please! Current meds not working.

    That doctor will never be your thyroid friend. Do your best to find one who understands the merits of natural desiccated thyroid. Most endos are notoriously anti-NDT. Try to find an internist, GP, or osteopath who will cooperate with your wishes.

    See how your FT4 rose while your T3 fell dramatically between labs? You obviously feel better with a higher T3 level. Tirosint produced very low T3 and excessively raised your FT4. But, you apparently don't convert T4 to T3 very well. There's no point in having adequate FT4 if little of it converts to the active hormone, T3.

    The probable reason you have insomnia and fast heart rate while on Armour is that your T3 was higher than your body needs it. It was about 75% of its lab range; most people have some overmedication signs/symptoms above 70%. Just tweaking that Armour dose downward a tad might have solved the problem. Or... You could have added in just a tad of levothyroxine with the reduced dose of Armour to raise your FT4 which was clearly lacking.

    There are ways to creatively adjust dosing to have better outcomes than forcing patients to take types of med that don't suit them.

    Wishing you luck!
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    Old 03-07-2017, 08:01 AM   #4
    melindaFL
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    Smile Re: Hypo/Hyper Thyroid Advice needed please! Current meds not working.

    Thank you both for the helpful replies. A few months ago I thought it would be worthwhile to get an opinion from an Endo but I see now that they only want to prescribe synthetics and those just clearly don't agree with my body. It makes perfect sense now that I had the insomnia due to the higher level of T3 - thanks for pointing that out! I will ask my endo if she will keep me on Armour and try to tweak my T4 up a bit and if she isn't willing to prescribe NDT I will stay with my primary doctor for treatment. Of course my primary only orders yearly tests for TSH to monitor my thyroid levels so I will need to ask her for additional tests to monitor my own T4/T3. Thank heavens for this board and people who can give us great advice when needed!

    Last edited by melindaFL; 03-07-2017 at 08:02 AM.

     
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