finally totally off all T4 and just on T3- but think adrenals are now crashing

[Guest guest]

Hi there.

So, I was posting here for a while and went over to the adrenals list after

realizing that needed to come first. Val worked with me some there (thanks

Val!), but now that I'm on just T3 for my Rt3, so I'm back and could really use

some help. (see labs and meds below)

Backstory (to anticipate questions!):

I have been undertreated for hashi's for since mid-late 90s. My main symptom is

horrible diminished consciousness/brain fog/cognitive problems that have robbed

me of my life. Barely functioning from a very functioning and good life. Had

lots of fatigue before, though that was getting better, now bad again.

I was on 1 grain of armour and my rt3/t3 ratio was 17, and we decided all things

considered it wasn't awful and to stay put in terms of dosing. I then switched

to NT and went up to 2 grains to try and " finally " treat my hypo. I felt AWFUL

- very muddied. Had a lab done and my rt3/t3 had gone down to 11 with the NT

increase, while my T3 did go up. So, I tried to switch to just T3 - making sure

I was doing the correct substitution of T3 with the help of the list - and I

felt even more awful, but in a different way. Missed a week of work. We

wondered if I wasn't super T3 resistant and utilizing the T2 more than most. I

went on 25mcg cytomel on 4 December - can't remember if that was before or after

or at the same time (i could dig up old posts, but my brain is too powered down)

Also, went back to 1 grain NT. I wondered if some of my reactions weren't my

adrenals/cortisol finally going low after years and years of cortisol being

high, so at the end of December I got some adrenal labs back that, sure enough,

showed low - stage 5. (though, all were diagnos-techs). So, after consulting

the adrenals list, I started HC on 10 January. (Though, my morning cortisol

number was great - top number in the range, so I had cortisol reserves, and that

continues to give me pause about being on HC.)

So, I then reduced my NT to 1/2 grain, staying on cytomel (divided morning, and

three hours apart and bed, though I've shifted to not taking it at bed last

couple of days.)

In the last couple of weeks I started getting more crashed in the afternoon,

which used to happen all the time, and some of my old postural hypotension sxs

were coming back, more dizziness and wooziness, too. Though that's been

happening off and on. Then I started getting jittery in the morning and getting

a high pulse (90s - 105) My pulse has been 57-60 for ever because of hypo, not

because of being in good shape (I'm tall and thin. Think Olive Oil on Popeye!).

Thought it might be my progesterone turning into cortisol, so I dropped from

100mg to 50 and that helped some, but I don't at all think that's the main

issue. My temps had been going up since being on HC, but started going down. My

electrolytes were okay (though I continue to have leg cramps). My ferritin is

56. (Was 6, got five rounds of iron IV - up to 189 - too high, but whatever.

Dropped to 89, which could've been self-correcting. Then dropped to 56, so

figured I need to get that up again. Had appt for one IV, but doc had to

reschedule.)

I just got some more thyroid labs last week and even staying on small amount of

NT and a relatively small dose of cytomel (25mcg), my Rt3/t3 ratio went from 11

to 25 and my T4 is suppressed, as is my TSH, but it was suppressed when on 2

grains NT. AND, my T3 went DOWN a few points after starting T3! Val said that

was revealing my true hypo and it was going into the cells, and I need more time

to clear receptor sites. (See labs below.) So, I decided to try and give going

off NT another try, which I've been off of for four days, being sure to add in

the T3 that was in my NT.

This morning I took 12.5mcg and I am so woozy and weird jittery (though not

awful) and while my pulse is higher for me - 80s, not crazy. I know if temps go

high with this its hyper, and if they go low it's cortisol or i need to space

out the dose more or ferritin. Well, my temp went down to 96.5, after this dose

and it hasn't been that low in eons. I didn't take the next dose and then my

temp was up to 98.8, but I was hot in an overly-heated room. My dosing is all

off and I feel atrocious from the morning dose. If it were just one day, it'd

be no biggie, but this has been working up over weeks, and now worse with being

on just the T3.

I feel like I could keel over, I'm so fatigued today. I cannot overexaggerate

how bad my brain is. It's truly hugely hard to think about this history and to

know if I'm making sense. It's like my brain is a computer that is powering

down, but I'm asking it to create an excel spread sheet and to play a video and

just stay up and running! This is how I felt a while back when I was HIGH

CORTISOL. I think I'm crashing my adrenals again. (I was feeling this BEFORE I

went on T3 only in the last couple of weeks with the T3 clearing, I guess it

is.) I can tolerate a LOT, but feel toxic and creepy like I'm medicating myself

incorrectly and damaging myself now. I do NOT think more HC is the answer

(given my labs, I'm wondering if I need to be on LESS.)

Any help would be so greatly appreciated in terms of what might be going on and

what to do. Sorry for the long post, but I think the hx of my labs, etc. are

important to help figure this all out.

labs and meds:

3/01/10 – serum – on ½ grain NT (recently reduced from 1grain), 25mcg Cytomel

• FT3: 327 (range: 230 – 420)

• FT4: 0.5 (range: 0.8-1.8)

• RT3: 13 (range: 11-32)

• FT3/RT3 ratio: 25 (optimal: at least 20)

• TSH: 0.19 (range: .40-4.50)

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: at least 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: at least 20)

1/09 – serum – 1 grain armour

• FT3: 243: (range: 230-420)

• FT4: 1 (range: 0.8-1.8)

• TSH: 2.92 (range: 0.4-4.5)

Medications:

• Cortef: just up to 25mg/day in divided dose (10mg on waking, 5mg 3 hours

later, 5mg 3 hours, 5mg 3 hours, 2.5 at bed. )

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

• Cytomel: 33.75mg/day in divided dose (12.5 on waking, 6.25mg at 11am, 12.5mg

at 2pm, just stopped bed dose)

• Progesterone: 50mg at bed (bio-identical micronized capsule) (stopped,

restarted)

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

day) (stopped, restarted)

some salt supp'ing, D3, Vit E, Omega 3s, B12, liquid multi- B, digestive enzymes

with meals, small amounts (1/4 tab!) of special folic acid for methylation, as

i'm a poor methylator.