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    Old 02-20-2009, 02:55 PM   #1
    keystone206
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    Question Labs Normal after Cortef

    I started taking cortef Feb 4th, and also cut my tapazole down to 1 5 mg a day, while continuing the 25 mcg of synthroid.
    Previously my labs were: 1/22
    T3 Free 2.9 2.0 - 3.5
    T4 Free 0.51 L .58 - 1.64
    TSH 7.31 H .34 - 5.60

    this week 2/18:

    T3 Free 3.4 2.5 - 3.9
    T4 Free 0.8 .06 - 1.1
    TSH 3.24

    quite a change
    My question is this, is it the cortef that is changing things, or the drop in the tapazole or both?
    Thanks!

    PS oh, and my arthritis is kicking in majorly, but only on the right side of my body, mainly in my right hand, any ideas?
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    Last edited by keystone206; 02-20-2009 at 02:57 PM. Reason: Thought of something

     
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    Old 02-23-2009, 06:25 AM   #2
    mkgb
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    Re: Labs Normal after Cortef

    keystone206;

    I started taking cortef Feb 4th, and also cut my tapazole down to 1 5 mg a day, while continuing the 25 mcg of synthroid.

    Previously my labs were: 1/22
    T3 Free 2.9 2.0 - 3.5
    T4 Free 0.51 L .58 - 1.64
    TSH 7.31 H .34 - 5.60

    this week 2/18:

    T3 Free 3.4 2.5 - 3.9
    T4 Free 0.8 .06 - 1.1
    TSH 3.24

    My question is this, is it the cortef that is changing things, or the drop in the tapazole or both?
    Both.

    Reducing the tapazole is going to allow your thyroid to step up and produce more thyroid hormone (T4 and T3 in the normal 80:20 ratio) This will cause an elevation in thyroid hormone levels and thus a decrease in TSH.

    How much cortef are you on? 20 mg or less? Right now you are 40% in your Ft4 levels and 64.3% in your Ft3 levels. This is optimal in range for your FT3, but still suboptimal in your Ft4. Your FT3 is still 24.3% above that of your Ft4..indicating you may still need a smidge more cortisol to slow down the T4 to T3 conversion process. Normal replacement dosage is 20 mg.. but i know some that need 25 and others that are fine on 10-15 mg. It takes time to figure out the right dosage.

    How do you feel at these ranges? What are your main complaints? If I were you I would want a bit more cortisol and then if my Ft3 and Ft4 levels were 50% in range hold and wait to see how I felt.

    PS oh, and my arthritis is kicking in majorly, but only on the right side of my body, mainly in my right hand, any ideas?

    Increasing cortef will help with arthritis effects. SO will Naproxen. I would consult your MD on the arthritis recommendations. I am unsure what would be best to alleviate your pain. My knees and hips have been kicking my tail of late as well. I try to listen to my body good naturally given it was my soccer and track days that have brought about the issues.. but I would love to say ENOUGH already and have the aching and popping quit. I stood up this weekend and my knees crack sharply and loudly. My son shot his head up and pipped, "NO shooting in the house!" I laughed and assured him it was just a backfire in my knees not a gun fight. To which I got the.."Your knees can POOT like an old car?! Cool!" Well I was laughing good and hard for about 30 minutes after that one. Knee poots.. *snort*

    MG
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    Last edited by mkgb; 02-23-2009 at 06:26 AM.

     
    Old 02-23-2009, 02:16 PM   #3
    keystone206
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    Re: Labs Normal after Cortef

    Good one, knee poots... mine poot all the way up the stairs, ha!

    I am on the teeny dose of 10 mg of cortef in the morning and 5 in the afternoon. Sometimes I get some dizziness but that isn't as bad as it once was. I am sleeping like the dead and maintain a level of fatigue but I manage. No appetite, and my sweet tooth is gone. It used to be huge! I can't wait to see what the scale says, my jeans are falling off. (not really a complaint I guess) Some of my muscles are sore an achy and my concentration is off. Oh, and I can be a grouch I think, but I am not sure... but my large cyst in my thyroid may have gone down considerably, at least it doesn't feel as firm.
    I went back over some of your prev notes, so I knew that my T4 is still too low, just was for sure by how much. I had been waiting for the lab to send me my basic panel, so I called them today, and they said "oh we sent you everything we had" So I told them, no it was also marked for a basic medicbolic. "oh? I will pull the original and call you back!" a while later there was a message on my phone that I was right and that since they store the samples for a week, that they would run the panel and send it on to me and the Dr... it pays to pay attention!

    Thanks MG!
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    Old 02-24-2009, 05:54 AM   #4
    mkgb
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    Re: Labs Normal after Cortef

    No problem! It sounds like you may need a bump to the full 20 mg. I was started at 10 of cortef and that didn't dent my fatigue and falling asleep at the drop of a hat. SO they bumped me to 15 mg. This was better but I still felt like a zombie half the day. The added 5 mg at 3-5 pm.. WEEE! That sent me into functional awake and alive mode. Heck my libido even returned enough to make my husband nervous. The first week he said I was looking him over like a box of my favorite chocolate covered caramels. I was looking, but chocolates were not on my mind. I also lost the excess salt and sweet cravings at this point and was less likely to snack. It always pays to check your own results and get a copy of the lab order so that you can make sure all is done. Why? Human error. We create as many problems as we solve.

    MG
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    Old 02-24-2009, 02:15 PM   #5
    keystone206
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    Re: Labs Normal after Cortef

    Really ?? a Libido?? OMG, lol! That would certainly be something Well, I see the Doc tomorrow so we shall see what he thinks and I will let you know. Thanks once again!
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    Old 02-25-2009, 03:20 PM   #6
    keystone206
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    Re: Labs Normal after Cortef

    Doc is happy with my metabolic panel and thyroid labs. So am continuing with the same dose of cortef for now. He asked me to cut my tapazole to half a pill, so it will be 2.5 mg, the pill is so tiny it will be difficult. He said he is not sure that I need to be on it at all because my current labs dont indicate hyper thyroid at all. He asked me if I wanted to run a vitamin D since that could contribute to my fatiuge, I told him no, since I knew it had been low a few months ago I would just start taking it again ( I have been taking the chews recently) and he is redoing the labs in 2 months right before I see him again.the first time I saw this Dr he had talked about surgery, this was before I had pointed out the cortisol, and acth, he had indicated today that it was still a possibility if it was still causing me issues in swallowing, but I can honestly saw that I think my cyst has grown a lot smaller and doesn't bother me like that anymore. So, I guess I will make an appointment with my GP to talk about the arthritis and go from here!
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