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  • yesterday i was officially diagnosed as hypothyroid...

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    Old 11-12-2008, 02:11 AM   #1
    Masta
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    Unhappy yesterday i was officially diagnosed as hypothyroid...

    i went to the only endocrinologist in my county yesterday,it took 2 mths to get in. she is a 50yr + women who cannot read labs properly, she gets the dates all mixed up. she gets medical data messed up so I'm wondering if i can trust my health in her hands.

    I know AACE ranges have dropped since 2002. I'm glad this endo knew about it. every other doctor I've seen doesn't have a clue. i have not come across a doctor yet who trusts in prescribing Armour.

    i was given 50mcg of synthroid and was sent home.

    My labs have been:
    11/10/08 - TSH 3.40 (range 0.45-4.67) Free T4 0.94
    10/14/08 - Free T3 is 2.4 (range 2.4-4.2). Free T4 is 0.82(range 0.71-1.85). TPO Ab is 0.3 (range 0-3.9). TgAb is 0.0. DHEA 150
    10/07/08 - TSH was 2.83. Total T3 96 (range 58-159)
    09/10/08 - TSH was 4.58. T3 was 96
    07/26/07 - TSH was 3.23.
    08/21/06 - TSH was 3.38
    07/09/03 - TSH was 2.87. DHEA was 171
    06/13/02 - TSH was 2.60
    08/23/00 - TSH was 2.73

    I think i have an adrenal problem but the endo didn't want to address that because I'm on steroids for my asthma. i did a 24hr urine collection the tests came back saying my numbers show that i have low levels of cortisol and it may be consistent with adrenal insufficiency. i have no idea why the endo did not address this problem.

    i also suffer from metabolic x syndrome (insulin resistance) & pcos (just taking metformin 500mg twice a day).

    i also suffer from Vitamin D deficiency. endo told me to take OTC vit D pills.

    i have tried to read up on all of this but its all very confusing and i have no idea if my TSH, free T3 and Free T4 are ok or what? because i have a high TSH does that mean i have a pituitary problem and not a thyroid problem? sounds like my whole endo system is totally messed up!

    i have been diagnosed with fibromyalgia (coz i have hypothyroid symptoms)

    I'm wondering how long does it take to start feeling better once you are on thyroid meds?

    Last edited by Masta; 11-12-2008 at 02:12 AM.

     
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    Old 11-13-2008, 03:46 AM   #2
    calail
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    Re: yesterday i was officially diagnosed as hypothyroid...

    hello Masta! i don't think i'm educated enough to answer your question, but since there's been no replies yet, i'll give it a whirl.

    the time it takes for your body to adjust to the medicine can vary greatly by person. i've been on levoxyl for over a month now, and seem to have had no changes in my symptoms - i'm going to an endocrinologist next week and i'm guessing my meds aren't strong enough but we'll see.

    i've read that it can take several months, but i don't know if during that time you would see modest improvement.

    hang in there!

     
    Old 11-13-2008, 04:55 AM   #3
    memawof3
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    Re: yesterday i was officially diagnosed as hypothyroid...

    hi masta!
    it dose take awhile!
    my endo changed my dosage about a month ago from 100mcg synthroid to 112 mcg synthroid, im hypo too also fibro, i lost alot of hair, and sufferd with muscle pain too!
    iam getting better, its slow, but you will be ok!
    hang in there!!!
    its going to be alright!
    bren

     
    Old 11-13-2008, 10:39 AM   #4
    mkgb
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    Re: yesterday i was officially diagnosed as hypothyroid...

    Masta,
    First congratulations and welcome to our thyroid dysfunctional family.

    I went to the only endocrinologist in my county yesterday,it took 2 mths to get in. she is a 50yr + women who cannot read labs properly, she gets the dates all mixed up. she gets medical data messed up so I'm wondering if i can trust my health in her hands. I know AACE ranges have dropped since 2002. I'm glad this endo knew about it. every other doctor I've seen doesn't have a clue. i have not come across a doctor yet who trusts in prescribing Armour.
    Score one for reading her A A C E recommendation update memos!

    I was given 50mcg of synthroid and was sent home.
    Were the November readings on T4 supplementation?

    My labs have been:
    11/10/08 -
    TSH 3.40 (range 0.45-4.67)
    Free T4 0.94(was this the range here too - range 0.71-1.85?).
    20.175% of normal range
    10/14/08 -
    Free T3 is 2.4 (range 2.4-4.2).
    You are 0% of normal range here.
    Free T4 is 0.82(range 0.71-1.85).
    You are 9.6% of normal range here. This is definitely suboptimal in range and in need of supplementation.

    Now I wouldn't say you have an adrenal issue right of the bat. You are fairly balanced in Ft3 and Ft4 levels. If your cortisol was insufficient for your you FT3 level would be significantly higher than your Ft4 level. Your Endo is doing a decent thing by giving you a 50 mcgs starting dose and waiting to see how your Fts turn out. If you have a lurking adrenal issue. Supplementation may bring out the FT imbalance. In 4-6 weeks after starting your T4 you need to get your Fts checked again. And TSH of course. Depending on those results, further adrenal testing may be warranted. Right now I do not think it is necessary. The urine cortisol testing is not as accurate as the saliva or the ACTH stim test for determining hypoadrenalism.

    TPO Ab is 0.3 (range 0-3.9) and TgAb is 0.0. These show that you are not one of the 80% that have a positive antibody test with Hashimoto's. Thus you most likely do not have Hashimoto's, however there is a 20% chance you may and you are just showing a false negative result.

    DHEA 150 What is the range for this one? It could be significant.

    I am ignoring the other TSH data. It just shows that you are hypothyroid but not your main thyroid hormone deficiency causing the hypothyroidism.

    I think i have an adrenal problem but the endo didn't want to address that because I'm on steroids for my asthma. i did a 24hr urine collection the tests came back saying my numbers show that i have low levels of cortisol and it may be consistent with adrenal insufficiency. i have no idea why the endo did not address this problem.
    What steriods are you taking for your asthma? Depending on the steriod you may be indirectly treating your low cortisol. Your adrenal glands can take and convert certain steriods into cortisol as needed.

    i also suffer from metabolic x syndrome (insulin resistance) & pcos (just taking metformin 500mg twice a day). How is the metformin working for you? I am on 1000 mg of the Metformin XR once a day for PCOS and IR as well as hypoglycemia. Taking Metformin made a big difference, but I was treating my adrenals and hypothyroidism already.

    i also suffer from Vitamin D deficiency. endo told me to take OTC vit D pills.
    ME too! I take 2-3 viactive vita chews a day to get my needed supplementation of Ca, K, and vit D. I was deficient in K and D.

    I have tried to read up on all of this but its all very confusing and i have no idea if my TSH, free T3 and Free T4 are ok or what? I tried to explain this above.

    I have a high TSH does that mean i have a pituitary problem and not a thyroid problem? No. The TSH rising is your pituitaries response to lower that optimal thyroid hormone levels. Because you do not have enough T4 and T3 to meet your physiological needs your pituitary gland is increasing your TSH to get your thyroid to make more. YOUR thyroid is on strike or dead or just too weak to meet these demands and under produces T4 adn T3 for your needs. Leaving this untreated without supplementation of your thyroid hormone insufficiency will make your TSH continue to rise over time. As you supplement your T4 and t3 levels with Synthroid your TSH should lower as your hormonal needs are met and returned to an optimal state.

    sounds like my whole endo system is totally messed up!
    i have been diagnosed with fibromyalgia (coz i have hypothyroid symptoms)
    I am not going to argue with this statement. I agree. I also doubt the new condition and diagnosis of fibromyalgia. I have serious doubts that all these cases are a separate issue versus poorly managed thyroid dysfunction. I would bet AT LEAST 50% of fibro patients are not optimally treated and still hypothyroid. But that is just my opinion on the matter.

    I'm wondering how long does it take to start feeling better once you are on thyroid meds?
    It takes 2 weeks for your body to reach equilibrium on a new medication dose. Then it takes another 2-4 weeks for your body to adjust and say hey still hypoT or i am alright on this dose OR I am hyperT here! 50 mcgs is your starter dose. You may feel worse before getting better. I am certain that in 4 weeks time you will be able to bump to 75 mcgs of T4 as LONG as you do not have an adrenal issue manifest. So you should feel some improvement, but you are not going to be set right after a few days on 50 mcgs given your levels. When do you go back for a level check and medication increase.

    MG
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    Old 11-14-2008, 06:10 AM   #5
    mkgb
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    Re: yesterday i was officially diagnosed as hypothyroid...

    OKAY there are some really annoying things you have to do for optimal adrenal testing. If you do not follow these testing procedures certain adrenal tests will not be valid.

    For adrenal testing you need to be off of hormonal supplements like birth control pills or estrogen/progesterone supplementations for 6-8 weeks. These will interfere with and adrenal testing done.

    For adrenal testing you have to be off of all corticosteriods and mineral steriods that metabolize in the blood. Symbicort dose metabolize and permiate your system it is detectable in your blood stream. You are on the FDA recommended maximum dosage. I am assuming that with your 160/4.5 mcg you follow the 2 inhalations twice daily prescription plan? In patients on this regime, peak plasma concentrations of budesonide (1.2 nmol/L) and formoterol (28 pmol/L) occurred at 21 and 10 minutes, respectively.

    Now how does this apply to your adrenals? Budesonide in particular will supplement your adrenals. Yeah! You are treating your adrenals by treating your asthma. Kinda cool, huh? Your Budesonide( I am going to call this Bud for short) component is an anti-inflammatory corticosteroid. So is cortisol. The Bud exhibits potent glucocorticoid activity and weak mineralocorticoid activity, both of these will interfere with aldosterone test results and renin. Cortisol testing will also be biased. SO you will not be able to tell exactly what is going on with out going off your Symbicort. In standard in vitro studies performed on Symbicort by the FDA, budesonide was shown to have ~ 200-fold higher affinity for the glucocorticoid receptor and a ~ 1000-fold higher topical anti-inflammatory potency than cortisol. This is most likely why your thyroid hormones are balanced and your adrenal issues have not become excessive. You would have to be off the Symbicort and any other steriod AT LEAST 4 weeks for accurate test results.

    10/14/08 DHEA: 150 (range for all three tests 75-410 ug/dl) This is low. You can supplement DHEA OTC, HOWEVER!! with PCOS you are going to convert most of the DHEA you take in into testosterone and estrogen. Yeah. It sucks when this happens acne city and the facial hair can be embarassing. I saw no benefit from DHEA supplementation, but my DHEA, estrogen and testosterone are already high. SO I am the token agressive, moody female, that seems to live in a constant state of PMS.. my husband's description of my bad days.

    Have you had an ultrasound of your thyroid? All those inflammation indicators smack of thyroiditis.. in particular Hashimoto's, but your antibody tests were not positive. There is the chancce of a false negative.. or you may have TSI and TRAb and your thyroid has collapsed from over use.. but your symptoms are not as typical of a hyperT case. Then again the inflammation could be an asthma response. I would talk with your pulmonologist about the inflammation indicators. You can also talk with them about getting testing for adrenal issues.

    The cortosol, aldosterone, pregnenolone, progesterone results will all be biased by the Symbicort 160/4.5 use. You can look at you ACTH and see if this is high or low. Low means too much cortisol.. high means not enough.. but this is going to be effected because your symbicort is supplementing your cortisol needs. The DHEA is valid. However supplementation may aggravate your PCOS.

    Are you taking a super B complex and a selenium containing multivitamin? These are tow other factors that can help overall thyroid and adrenal function. Also have you had your ferritin tested. Low ferritin can also suppress your adrenal and thyroid function. Low ferritin is also very common in those that are low vit D and B12. It implies nutrional malabsorption issues are present. Low ferritin also amplifies hypothyroid symptoms or can cause someone with out a thyroid issue to appear hypothyroid. You have to just be amazed at how sensitive and interdependent our biochemistry is...

    Metformin can be prescribed up to 2000 mg. The XR version has less side effects and tends to balance you out better through out the day. My IM and OBs have tried the other versions and much prefer the extended release version taken before dinner. You can increase your dosage by 500 every 2-4 weeks after side effects have settled out until you reach the maximum dosage of 2000. hopefully once you medicate the thyroid the metformin combination will help drop the added weight. My thyroid is far from optimal right now, but taking 1000 of metformin, dieting and exercising is keeping the recent weight explosion in check. I so want to drop 40 pounds. 50 would be great, but I would settle for 40.

    I think a reproductive endocrinologist sounds like a good idea. Make sure you get one that is up to date with the latest thyroid care as well. Good luck and keep us posted on what you find out.

    MG
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    Old 11-18-2008, 07:43 AM   #6
    mkgb
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    Re: yesterday i was officially diagnosed as hypothyroid...

    I have put the optimal TSH and Ft ranges and a lot more in my thyroid care and concerns thread series. Week 2 is the thyroid care and concern series that I set up as the beginner thread.

    I am not an MD. I have them in the family. I am a Chemist/Chemical Engineer/Computational Eng. I have an extensive higher education background. I hope to be a Dr. one day.. but it will be a Ph.D. not an MD.

    We can not trust the MDs to look outside the box or even outside one result in the box. Most fixate on one point of care a session. Heaven forbid they actually spend an HOUR going over everything for you. My MD loves my charts and graphs and symptoms logs. They make my visits quick and thorough. I can cover adrenal, thyroid, hypoglycemia, PCOS and IR in less than 30 minutes. This gets a look over brief discussion, script updates/changes, lab slip request and see you in 4-6 weeks wrapped up nice and neat. I am still amazed at the effciency of my current MD. I am rarely there more than 45 minutes. I used to have to wait 1-2 hours BEFORE seeing my MD. It is great! I can call and get in next day most times as well. You can not beat that kind of efficiency.

    MG
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