BUMP - confused about how to deal with RT3 as I'm dealing with HC

[Guest guest]

Hi there.

I'm having confusing results, partly good, but totally confusing!

My temp was 98.2 on WAKING yesterday and have been getting up to 98.6 in the

afternoons. Crazy!! Then at 3:30pm and I had more energy (good, grounded

energy) at that time than I've had in five years, no exaggeration, but it's

confusing because while I was feeling relatively good temp was 97.9 and my hands

and feet and nose were freezing, as usual, still brain fogged, but thinking is

less taxing. By the time I'd finished writing the email (this is a BUMP), my

temps had dropped to 96.95. (Temp was 97.9 this morning on waking and last

night I took only 1/2 HC and tried to divide a 1/2 grain of T3 to see if it made

a difference .)

My temps had definitely started going up in the last few of days, I'm sure of

starting I HC on 10 January, which I went on after RT3/T3 test (ratio: 11) not

being able to raise T3 (and seeing low cort. labs). But now they're going back

down.

Time machine back to November: I started trying Cytomel on 4 November (thought

it was SR I took 7.5mcg 3x/day, totaling 22.5). Then on 4 December I tried

mult-dosing with Cytomel 37.5mcg and going off NT, titrating appropriately and

dosing correctly with the help of this list. Experience was HORRIFIC. Could not

function. Missed over a week of work. I mention this because I've been now on

some sort of T3 since early Nov. - around at least 20mcg. And when I did my labs

in late Oct. my RT3/T3 ratio was 11 this was after changing from 1 grain of

Armour to 2 grains of NT. On just one grain of Armour my ratio was 17. And my T3

went from lowest normal number, up a bit. But, when I raised the Armour I felt

awful, too.

Fastforward to now: So, I haven't even gotten my adrenals totally stable so I

can do a T3 regimen to clear RT3, but my temps are going up and I'm feeling,

albeit, not consistently, like my body might be getting what it needs like I am

getting the chemicals to think. Well, until late yesterday. As I said, I'm only

on 25mcg T3 and ½ grain NT (both Nick and Val have said I probably have some

resistance (or was it a conversion issue, which I've always suspected before I

knew there was such a thing, or both?) and was living off the T2 in the NT,

which is going on T3 alone was an unmitigated disaster. So, I'm staying on a bit

of NT.

QUESTION: Could it be that somehow my receptors weren't damaged enough or

somehow some of the cortisol is helping a bit to get the T3 through NOW, or the

fact that I've been doing cytomel in some way since early Nov is helping

somewhat? Though, imperfectly, since now my temps are fluctuating.

QUESTION: I'm also super confused as to whether the T3 is making my adrenals

crash, or, Nick, I read you said front loading HC for you can make you hypo all

day. I know we're all different, but it's like I need a decision tree or

something! (If this happens, think of x, y, z. And if that happens, think of

j,k,z) (I've read the helpful RT3 site, have the STTM book, researched my

eyeballs off, too!) I know I'm not on a high dose of T3, but am wondering if I

should reduce to help my adrenals, since I was only on 1 grain of armour forever

( I'd previous to that: levoxyl, lev/cytomel combo platter, etc. etc.) (Agggh,

me and my labs showed I was hypo for all those years and my doc said I was

" fine " !) Or, should I try to go up on the HC? - though I'm already on 27.5 and

don't want to shut down my ACTH. I tend to have the atypical reaction, and

except for little waves, I haven't gotten hyper or certainly haven't gotten

sweaty or gotten edema, etc. How do I think about RT3 in all of this?

Ex: in the time it took me to write this original email yesterday, either

writing and/or taking my T3 increased my brain fog a LOT and I became literally

too foggy to reread to see if I was making any sense. So either, 1. I crashed my

adrenals by using up cortisol to think! (sounds hokey, but I think it has

happened for years) 2. Used up my T3 by same mechanism, 3. Took my T3 before

writing this (though I took less) and it is the T3 that is crashing me/my

adrenals currently 4. I'm just not on enough cortisol, period, or I'm dosing

wrong. Not so much energy-wise, but brain fog-wise. So confused on teasing this

out, and my temp doesn't always mesh with my sxs.

I know this post is a disjointed mess. It's amazing how much my brain can crash.

It's never good varies from about 50% at best these days, to 20%, I'd say. (HC

is giving me a glimmer of hope, though!)

Thanks so much, Nick and Val (and all!) ~ Carol

FYI:

Vitals: Pulse remains steady at 60! Past avg: 57. BP is weird now: old avg:

87/47, better on fludro, but now it's: 117/57. Yay for systolic going up, but

the diastolic won't budge. Doc says maybe it's Vit. B issue. (????)

Ferritin: was 6, did IVs, up to 130, down now to 88, so in range, but I'm not

holding it. Will take another test tomorrow.

Medications:

Cortef: 27.5mg/day in divided dose (10mg on waking, 7.5mg 3 hours later, 5mg 3

hours, 2.5mg 3 hours, 2.5 at bed)

Fludrocortisone: .1mg, in divided dose (½ on waking, ½ at 2pm)

7-Keto DHEA: ~15mg on waking (doc wants me to stay on it as my DHEA was only

normal in labs while being on it)

Cytomel: 25mg/day in divided dose (6.25mg on waking, 6.25mg at 12am, 6.25mg at

4pm, 6.25 at bed) just changed this from 3 hour intervals to 4

NatureThroid: ½ grain in divided dose (¼ grain on waking, ¼ grain at 2pm)

Progesterone: 100mg at bed (bio-identical micronized capsule)

Estrogen: transdermal diestrogen (estriol, estradiol) 2.5GM tube (1 gram per

day)

also taking C, B, omega 3, potassium for the fludro, 1/2 tsp salt in morning.

etc.

12/23/09 saliva testing

Cortisol

o 6-8am: 24 (range: 13-24)

o 11-noon: 2 (range: 5-10)

o 4-5: 1 (range: 3-8)

o 10-midnight: 2 (range: 1-4)

Cortisol burden: 29 (range: 23-42)

DHEA: 7 (range: 3-10) (supp'ing 7-keto, prior to that 15mg DHEA since last test)

10/09 serum on 2 grains NT

FT3: 331 (range: 230-420)

FT4: 1.1 (range: 0.8-1.8)

RT3: 28 (range: 11-32)

FT3/RT3 ratio: 11 (optimal: 20)

TSH: .06 (range: .40 4.50)

6/09 serum on 1 grain NT

FT3: 279 (range: 230-420)

FT4: 0.8 (range: 0.8-1.8)

RT3: 16 (range: 11-32)

FT3/RT3 ratio: 17 (optimal: 20)