Update - Val

[Guest guest]

Just an update for the list. Yesterday, I was determined to go to Mayo in

MN and even made the initial call. As many of you know, I have been going

through an " episode. " An " episode " is defined as

1) Sweats

2) Probable paralysis with the sweats, very rarely and probably after too

much salt.

3) Extreme anxiety

4) BP as high as 210/114

5) Inability to sleep

6) Headache, usually hits when I can get the anxiety to resolve for a while.

7) Muscle contractions. My chiropractor finally told me to stop trying to

lift weights (2 lb) because lifting always sends me into spasms.

8) Weakness. Some days I can't walk 1/2 mile; other days, I can walk and

work.

During an episode in 2005, my ARR was 32.5. From my reading, that is

suggestive of PA but not determinative. CT in 2005 showed nothing

irregular. I had a parathyroid adenoma removed in 1999.

This is where I was last night. I had written Dr. Grim privately and he

suggested I write to the list so all can learn.

As of tonight, I just don't know what to do. I feel almost normal and am

appropriately sleepy (a rare occurrence)! My BP today was 145/80. My pulse

the last few days has decreased from the high 80's to the mid/low 70's. I

had blood tests done today including aldo and renin. I think I'm going to

wait and see what they say.

I am taking tram/HCTZ 37.5-25 as of two weeks ago (HCTZ for five years

before that). Perhaps my calmness is the result of rising K. I'm thinking

I should perhaps try some other BP meds before I give up and go to Mayo.

Perhaps a different med (not a diuretic) would lessen my metabolic syndrome.

I just don't know what to do.

These episodes seem to be precipitated by the substitution of a tiny amount

of T3 (2.25 mcg) for about 25 mcg of T4. The episodes take literally

several months to subside, but I have had major episodes without taking any

T3 nor a diuretic. I want to take T3 because of the heart-event severity of

low T3 and I keep thinking a higher T3 would help me lose weight. I've

always lost a few pounds on that regimen until a big episode starts and I

give it all up. I took Actos for six months for a barely elevated BG - and

gained ten pounds. Then took metformin for a few months, had constant

hypoglycemia and had to eat fruit nearly constantly. I gained seven pounds

on that. I am NOT a food junkie. If I didn't get the shakes, I could

almost live without food. I DASH.

My T3 is always low. Below is an article about " low T3 syndrome. " I have

lipid problems just like my mother. As the years went on, her life was not

quality. I think she was hypothyroid all her life. You probably understand

it all but may be interested in the article.

This morning, I was up at 5 a.m. with the sweats but my BP is down to

129/83. Anxiety level is medium as opposed to extreme.

Val

Low T3 article:

cid:image001.gif@...

Published online before print January 20, 2003,

doi:10.1161/01.CIR.0000048124.64204.3F

(Circulation 2003;107:708.)

A more recent <http://circ.ahajournals.org/cgi/content/short/107/5/708>

version of this article appeared on February 11, 2003

Submitted on September 26, 2002

Accepted on October 17, 2002

Low-T3 Syndrome. A Strong Prognostic Predictor of Death in Patients With

Heart Disease

Giorgio Iervasi MD*, Alessandro Pingitore MD, PhD, Patrizia Landi BSc, Mauro

Raciti BSc, Ripoli PhD, Scarlattini BSc, L'Abbate MD,

and Luigi Donato MD

From C.N.R. Clinical Physiology Institute and Scuola Superiore di Studi

Univeritari S. (A.L.A.), Pisa, Italy.

* To whom correspondence should be addressed. E-mail: iervasi@....

Background--Clinical and experimental data have suggested a potential

negative impact of low-T3 state on the prognosis of cardiac diseases. The

aim of the present prospective study was to assess the role of thyroid

hormones in the prognosis of patient population with heart disease.

Methods and Results--A total of 573 consecutive cardiac patients underwent

thyroid function profile evaluation. They were divided in two subgroups:

group I, 173 patients with low T3, ie, with free T3 (fT3) <3.1 pmol/L, and

group II, 400 patients with normal fT3

(cid:image003.png@... pmol/L). We considered cumulative and

cardiac death events. During the 1-year follow-up, there were 25 cumulative

deaths in group I and 12 in group II (14.4% versus 3%, P<0.0001); cardiac

deaths were 13 in group I and 6 in group II (7.5% versus 1.5%, P=0.0006).

According to the model, fT3 was the most important predictor of

cumulative death (hazard ratio

---

3.582, P<0.0001), followed by

dyslipidemia (HR 2.955, P=0.023), age (HR 1.051, P<0.005), and left

ventricular ejection fraction (HR 1.037, P=0.006). At the logistic

multivariate analysis, fT3 was the highest independent predictor of death

(HR 0.395, P=0.003). A prevalence of low fT3 levels was found in patients

with NYHA class III-IV illness compared with patients with NYHA class I-II

(cid:image004.gif@... 5.65, P=0.019).

Conclusions--Low-T3 syndrome is a strong predictor of death in cardiac

patients and might be directly implicated in the poor prognosis of cardiac

patients.