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    Old 04-19-2013, 06:41 AM   #1
    noodlesandbeans
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    Need help with numbers

    Hi--I'm new here, though I've been utilizing these boards for info sometimes.
    I was diagnosed as "subclinical" hypothyroid in January after a trip to the ER from multiple runs of bigeminy (PVC)'s that had been ongoing for a year. I'm sure stress made them worse.

    Anyway, I am seeing a holistic GYNO who had ordered bloodwork and decided she wanted to treat me with Armour.

    My numbers at the time were:
    (at the hospital)
    tsh: 3.6 (.300-3.000)
    t4 free: .91 (.76-1.46)

    (bloodwork drawn by doc)
    tsh 4.56 (.35-4.94)
    free t3 2.76 (1.71-3.71
    free t4 .93 (.70-1.48)

    She started me on 30 mg armour

    6 weeks later in February:

    tsh: 2.65 (.45-4.50)
    free t3 : 2.7 (2.0-4.4)
    free t4: .87 (.82-1.77)


    She upped my dosage to 60 mg armour

    My most recent labs as of today are:

    tsh: 1.83 (.45-4.50)
    free t3: 2.5 (2.0-4.4)
    free t4:.76 (.82-1.77)


    So my t4 has actually gone down and my t3 has basically stayed the same.

    She will probably up my dosage because she said she wanted me to be under 1.5 for the tsh and to see the other numbers in the upper range.

    I'm just trying to understand why those numbers would go down. Overall, I actually do feel better.

    Symptomatically i never lost hair or gained weight. (ETA: Although I recently noticed i have no arm hair anymore...and I used to have quite a bit) I have four children and after my youngest was born in 2011 most of my annoying symptoms started happening....major morning fatigue--difficult to get out of bed. Low heart rate, low basal temperature, cold hands and feet, anxiety and panic, allergies dizzy feeling at times and brain fog...difficult to get motivated. All of that has improved considerably in the last few weeks. I originally went to the gyno because I assumed I had a hormonal imbalance. My PMS was getting very bad.

    When the doc asked me if I was tired I said yes, but I assumed that was normal for a mother of four who homeschools and bedshares and has been pregnant and/or nursing for 10 years straight. Now I'm beginning to think I've been hypo (if at least slightly) for most of my adult life. I have a history of endometriosis (surgery before kids). I have never had a lot of exercise tolerence (actually since I was a kid) and anxiety hit me pretty hard after my 2nd daughter was born.

    Any help/advice anyone can give would be much appreciated.

    Last edited by noodlesandbeans; 04-19-2013 at 06:42 AM.

     
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    Old 04-19-2013, 10:22 AM   #2
    midwest1
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    Re: Need help with numbers

    The small doses of Armour are sometimes barely enough to lower TSH, which in turn reduces your gland's struggling ability to make enough hormone (T4 and T3). In turn, that small amount of med isn't enough to replace both the original deficit plus the one it has created from reducing the gland output.

    Your doctor's goal of getting TSH into the 1.5 range is worrisome. We know for fact that for most people taking an optimal Armour or other natural dessicated thyroid product dose, TSH will be suppressed. If your TSH gets to the 1.5 area but your symptoms aren't relieved, please understand that it means your dose is not high enough yet despite the "normal" TSH. The goal of treatment should not be to lower TSH; it should be to raise free T4 and free T3.

    I take an Armour-like replacement med. My own TSH hasn't been higher than .02 in the last 10 years. This does NOT mean I'm overmedicated or hyperthyroid, because my free Ts have never been excessively high. My MD understands this is what happens, as do most Armour-prescribers. I tell you this to warn you what you might be up against if your MD's treatment plan doesn't work for you as you hope.

    As for your somewhat atypical symptoms... Mine were too. There are literally dozens of things a thyroid deficit might cause, because every single bodily system uses thyroid hormone in some way. Not everyone gets every symptom, so the liklihood that you have your own particular set of them isn't surprising.

    I hope your treatment goes smoothly and that it will work out well for you. If it doesn't, do not assume that's as good as it can get. With optimal - not merely adequate - treatment, you can feel your healthiest best again.
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    Last edited by midwest1; 04-19-2013 at 10:23 AM.

     
    Old 04-19-2013, 05:38 PM   #3
    noodlesandbeans
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    Re: Need help with numbers

    Thank you, Midwest1! Your explanation makes a lot of sense. I appreciate that. I guess I'm still trying to wrap my head around the fact I'll be on medication the rest of my life. I've eshewed any sort of unnatural prescription and am pretty down about it. My antibody numbers were negative, but I'm not convinced this is not autoimmune in nature.

    I really think this doc is not just concerned with tsh numbers. She has told me that she will treat my symptoms and definitely looks at the numbers. Her first question after the second labs was "how do you feel?"

    I see her Wednesday. I was just mostly concerned about that t4 number dropping...worried that it wasn't just a thyroid issue but a pituitary one. Your explanation makes perfect sense.

    I just assumed 60 mg (since it was double what i started on) wasn't necessarily a low dose. It would be amazing to have energy again. One of my biggest complaints is my mood swings or irritability which I usually tie to feeling tired. I don't complain and always push through and HATE going to the doctor so I initially started going to see this alternative clinic for allergy elimination and my palpitations were getting worse and worse and anxiety was getting worse and most of my other symptoms I tended to ignore or brush off (tinnitus, sinus problems, fatigue) so I think I let this go a long time.

    My ferratin is on the low end of normal too...higher than when i was pregnant but could stand to be higher.

     
    Old 04-19-2013, 11:06 PM   #4
    midwest1
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    Re: Need help with numbers

    Thyroid hormone isn't really an "unnatural" prescription. Armour is derived from an extract of dried pig thyroid glands. It's very similar to the hormone your own gland would be making if it could. It doesn't alter the way your body works to achieve its end; it merely replaces the natural hormones that your body is meant to have and needs for good health. Hormones are probably the most "natural" of any prescription drugs on the market. If you think of all the prescription drugs you could take in pursuit of alleviating all the symptoms you have, isn't it smarter to take the one "natural" one that can can fix the root cause of those symptoms?

    The average full replacement dose of Armour in women is 120-150 mgs. Many women need more than that. Thirty to 60 mgs is an average starting dose. You'll most likely need more than you're taking before it's over.

    The T3 contained in Armour often will prevent the blood level of free T4 from rising as high as needed. This isn't a problem for everyone; as long as free T3 is above mid-range, the proportionately lower free T4 isn't an issue for them. For those who do have trouble with lower FT4, a small amount of synthetic T4 can be added to the daily Armour dose. Since you're still early in treatment, don't worry about the falling T4 just yet.

    HypoT is a frequent cause of low ferritin levels. If you want to try boosting it by taking an iron supplement, be sure to take it well apart from your Armour dose. Take the Armour in the morning and the iron at night.

    I'm glad your MD seems focused on getting you well instead of on the lab numbers alone. A really good thyroid doc is half the battle.

    Let us know how you're getting along as you proceed!
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    Old 04-20-2013, 04:18 AM   #5
    noodlesandbeans
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    Re: Need help with numbers

    Thanks.

    To clarify, I know that Armour is about as natural as it can get. I guess I just feel like I'm so disappointed my body stopped producing it well enough on its own. I've always believed in the body's ability to heal itself given the proper tools but knowing I'll be dependent on a med that not everyone needs for the rest of my life just makes me feel down.,

    I want to know why my thyroid is failing! Why are there so many undiagnosed hypoT cases? As far as being on something, you are right...better Armour which is replacing an actual deficiency. My family doc wanted to put me in Zoloft.

    This board is a great resource. Thank you do much for responding!

    Last edited by noodlesandbeans; 04-20-2013 at 04:20 AM.

     
    Old 04-20-2013, 08:05 AM   #6
    midwest1
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    Re: Need help with numbers

    Were you pregnant shortly before your thyroid went south? Times of estrogen flux are very common triggers for hypoT to begin. Autoimmunity is by far the most common cause, and pregnancy triggers the AI response. Once those antibodies kick up, there isn't much that can be done about them.

    There is as yet no identified reason for the AI response. If I were a bettin' woman, I'd say it's environmental. Fluoridated water, CFCs, PVCs, the entire chemical alphabet. Soy foods are terrible for us, no matter what the soybean or medical industry says. It has the potential to shrivel up a thyroid gland.

    It might be worth having tests for TPO and Tg antibodies. It might reveal the reason for your hypoT and help a bit to put your mind to rest. You'll still be hypo, but at least you'll know it wasn't anything you caused yourself.

    Good luck!
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    Old 07-01-2013, 01:43 PM   #7
    noodlesandbeans
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    UPDATE--need more guidance Re: Need help with numbers

    So a few weeks ago I got my next set of labs done.

    They revealed the following:

    TSH: .199 (.45-4.50)
    T4: .86 (.82-1.77
    t3: 3.5 (2.0-4.4)

    Shortly before these numbers were drawn I had symptoms that seem to correlate with Hyper, but were my original symptoms in the first place...intense anxiety, shakiness inside, overwhelming fatigue and a few heart palpitations that had been gone for 8 weeks!)

    I saw my doctor (who incidentally is leaving the state and now I feel completely abandoned) and she took me from 90 mg armour down to 75.

    Within 4 days I started having the awful bigeiminal PVC's again. Today (a week and a half after lowering armour) they are so non stop i want to die.

    My question is two fold:

    1. Was I hyper? or really did I need a dose increase because my symptoms were starting to emerge again.

    2. could symptoms come on that quickly after lowering a dose?

    3. I felt pretty much the best so far on 60 mg. I was still tired but most of my symptoms were gone, specifically these heart palps. They had been gone for a long time. About 4 weeks after starting the 60 and lasted until about 5 weeks after being on 90.

    If anyone could help me figure this out. I was so productive, so happy, so normal again. And now it's back...these overwhelming palpitations I've dealt with since Aug 2011.

     
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