Re: update, need help

[Guest guest]

Your ferritin has come up which is good. It looks like you have started to

absorb more T3 because of this. Hence your numbers are a bit lower now. What

about raising thyroid meds?

I am not a mod, but thought i would give you the info as i see it.

>

> I have not posted here in a couple of weeks, as I have been so ill and so

frustrated. This is a summary of my history, as well as my current situation,

with a repeat of all labs:

>

> I have lived with CFS since 1984. No diagnosis was ever made, until one

doctor tested me for Lyme disease in 2000. I had it, but treatment made no

impact on my CFS whatsoever. I was tested for thyroid problems many times over

the years, and all doctors assured me I had no problem, until my current doctor

started treatment based on labs of 12/4/09. I understood here that these labs

indicated severe problems that would explain the CFS, and that treatment should

significantly restore my health. I began treatment in January, 2010, and have

felt consistently worse since then, with a sharp decline beginning in late

March, a week after a series of iron IV's, and the day after increasing HC from

10 mg/day to 20 mg/day.

>

> Treatment has been as follows: I started T3 and HC in January, 2010. I began

with SR T3 but switched to regular T3 after I had a series of 3 iron IV's in

late March to raise ferritin. I gradually increased T3 to a high of 45 mcg/day.

I'd been on 10 mg/day HC starting in January, increased to 20 mg/day on 3/24/10,

and kept increasing throughout April to 25, then 30, then 35. As I felt

increasingly worse throughout that time, I finally started weaning back.

" Worse " means weak spells, extreme fatigue, intermittent high blood pressure,

intermittent severe insomnia, profuse intermittent sweating, and being virtually

incapacitated. All these symptoms were completely new to me except chronic

fatigue, which has also gotten worse during this period.

>

> I continued on T3 and HC throughout this time, always believing that things

would get better. I continued to decline and on 5/10/10 my doctor prescribed

Naturethroid to replace T3. He felt since both my T3 & T4 were very low, I

might benefit from a full-spectrum thyroid replacement instead of T3 only. He

also felt my symptoms were consistent with my low hormone labs, and prescribed

bio-identical estrogen & testosterone, as well as prometrium at 100 mg/day. He

recommended 10 mg/day HC as I hadn't done well at any time on higher doses.

>

> I am currently on 1 grain/day Naturethroid, 10 mg/day HC, bi-est,

testosterone, and 100 mg prometrium. Supplements are: cod liver oil for

vitamin A, B complex, 3 grams/day vitamin C, 5000 IU/day vitamin D, 400 IU/day

vitamin D, calcium, magnesium, CoQ10, 5 htp, digestive enzymes, HCl with each

meal. I have been graphing my temps since mid-January; the graph is completely

up and down, with daily averages 98.0-98.7.

>

> Since my blood pressure went as high as 199/91, my doctor referred me to a

cardiologist, who did a complete workup including testing for an adrenal tumor.

All tests were negative. He told me yesterday that unnecessary HC and thyroid

hormones can cause all of the symptoms I'm having, and that my current problems

are physician-caused. He advised me to wean completely off all HC and thyroid

treatment and to see an endocrinologist. I did see an endo initially back in

February for a second opinion. She told me I had no thyroid problem, all of the

treatment I was receiving was inappropriate, would do harm instead of good, and

advised me to stop treatment. So I am not encouraged about the prospect of

seeing yet another endo, but after almost 5 months of treatment I am in worse

shape than I was when I began. My current doctor is not a thyroid specialist or

an endo--he specializes in treating CFS. This means that yeast problems have

been addressed, and my diet is very high quality. After 5 months of attempting

to treat RT3 & adrenal problems, I am about ready to give up. My quality of

life wasn't great before I started treatment in January, but it's way worse now,

and I just don't know how to proceed with this.

>

> Here is my lab history:

> Original saliva labs from 11/08, before I started thyroid/adrenal treatment:

> cortisol, saliva:

> 5.6 at 6:00 a.m. optimal range 7:00 a.m.: 7.0-10 ng/ml

> 2.1 at 11:00 a.m. optimal range noon: 3.0-6.0 ng/ml

> 2.6 at 5:00 p.m. optimal range 5:00 p.m.: 2.0-4.0 ng/ml

> 1.0 at 10:00 p.m. optimal range 10:00 p.m.: 1.5 ng/ml

>

> Labs from 12/4/09, before starting T3; RT3 ratio 4.8:

> TSH 2.1 (2.0-4.4 pg/mL)

> T3, free, serum 2.1 (2.0-4.4) pg/mL

> RT3 434 ( 90-350) pg/mL

> T4, free (direct) 1.32 (0.82-1.77) ng/dL

> ferritin, serum 15 (10-291)

> B12 926 (211-911)

> TPO <6 (0-34 IU/mL)

> testosterone

> serum 30 (6-82 ng/dL)

> free (direct) <0.2 (0.0-1.8 pg/mL)

> CD3+CD25+Lymphs 29.00 (4.93-25.85)

> IGF-1 113 (75-212 ng/mL)

>

> Labs from 2/23/10, after a month on SR T3 at 30 mcg/day, oral iron, HC at 10

mg/day. This is before I had the iron IV's; RT3 ratio has risen from 4.8 to

15.6:

> TSH .72 (.04-4.0 uIO/mL0

> T3, free serum 2.7 (2.0-3.5) pg/mL

> RT3 173 (90-350) pg/mL

> T4, free 0.97 (.89-1.76) ng/dL

> ferritin, serum 25.7 (11.1-264.0) ng/mL

> B12 >1000 (193-982 pg/mL)

> folate >24.0 (3.8-17.0 ng/mL)

>

> Labs from 4/5/10 (after a series of 3 iron IV's):

> TSH : 0.769 (0.450-4.500)

> Free T3 : 3.4 (2.0-4.4)

> Free T4: 0.90 (.82-1.77)

> Reverse T3: 196 (90-350)

> Ferritin, serum : 191 (10-291)

> Aldosterone/ Renin Ratio: 48.0 (0-30) high

> potassium: 4.6 (range 3.6-5.0)

>

> Labs from 4/27/10:

> thyroid:

> T4, free, direct .56 (.82-1.77)--a month ago it was .90,

same reference range

> TSH 0.105 (0.450-4.500)--a month ago it was

..769, same reference range

> T3, free, serum 2.3 (2.0-4.4)--a month ago it was 3.4, same

reference range

> reverse T3 129 (90-350)--a month ago it was 196, same

reference range

> ratio 17.83 a month ago it was 17.34

>

> Iron panel:

> TIBC 250 (250-450)

> UIBC 150 (150-375)

> iron, serum 100 (35-155)

> iron saturation 40 (15-55)

> ferritin 113 (13-150)--a month ago it was 191,

range 10-291

>

[Guest guest]

I'm no expert, but have you tried increasing the T3 dose. Your Free T3 seems to

be on the very low range.

I'm male on my 5th week of T3 only and up to 150+ mcg daily. At times, I have

increased the dose up to 225 without any notisable side effects.

Read " How much T3 do i need? " at: http://thyroid-rt3.com/dosing.htm

Hope it helps!

>

> I'm sorry you're feeling so poorly. :-( Unfortunately, sometimes we do have a

lot of ups and downs on this journey to get things right.

>

> > Treatment has been as follows: I started T3 and HC in January, 2010. I

began with SR T3 but switched to regular T3 after I had a series of 3 iron IV's

in late March to raise ferritin. I gradually increased T3 to a high of 45

mcg/day. I'd been on 10 mg/day HC starting in January, increased to 20 mg/day

on 3/24/10, and kept increasing throughout April to 25, then 30, then 35. As I

felt increasingly worse throughout that time, I finally started weaning back.

" Worse " means weak spells, extreme fatigue, intermittent high blood pressure,

intermittent severe insomnia, profuse intermittent sweating, and being virtually

incapacitated. All these symptoms were completely new to me except chronic

fatigue, which has also gotten worse during this period.

>

> Some of these symptoms, like sweatng and weakness and even the insomnia, sound

like high cortisol. It could be you went too high on HC, which makes you feel

much more hypo. I have often made the mistake of thinking my symptoms were low

HC when in fact they were low t3. For example, I used to think feeling very

run-down was low HC and it CAN be, but for me, it's actually often a sign of

needing more t3.

>

>

> > I continued on T3 and HC throughout this time, always believing that things

would get better. I continued to decline and on 5/10/10 my doctor prescribed

Naturethroid to replace T3. He felt since both my T3 & T4 were very low, I

might benefit from a full-spectrum thyroid replacement instead of T3 only. He

also felt my symptoms were consistent with my low hormone labs, and prescribed

bio-identical estrogen & testosterone, as well as prometrium at 100 mg/day. He

recommended 10 mg/day HC as I hadn't done well at any time on higher doses.

>

> If you have a rt3 problem, the NatureThroid isn't likely to help you. Nor is

taking only 10 HC. Because of the HPA axis feedback loop, you will be even lower

in cortisol than if you took none. 20 is probably a better choice. The testo and

PG are probably good.

>

> > I am currently on 1 grain/day Naturethroid, 10 mg/day HC, bi-est,

testosterone, and 100 mg prometrium. Supplements are: cod liver oil for

vitamin A, B complex, 3 grams/day vitamin C, 5000 IU/day vitamin D, 400 IU/day

vitamin D, calcium, magnesium, CoQ10, 5 htp, digestive enzymes, HCl with each

meal. I have been graphing my temps since mid-January; the graph is completely

up and down, with daily averages 98.0-98.7.

>

>

> > Since my blood pressure went as high as 199/91, my doctor referred me to a

cardiologist, who did a complete workup including testing for an adrenal tumor.

All tests were negative. He told me yesterday that unnecessary HC and thyroid

hormones can cause all of the symptoms I'm having, and that my current problems

are physician-caused. He advised me to wean completely off all HC and thyroid

treatment and to see an endocrinologist.

>

> Your high BP could very well be too much HC as you were on 35. It could ALSO

be low sodium, low potassium or low t3! Based on your labs, I don't think you

were taking either HC or t3 unnecessarily.

>

>

> > Here is my lab history:

> > Original saliva labs from 11/08, before I started thyroid/adrenal treatment:

> > cortisol, saliva:

> > 5.6 at 6:00 a.m. optimal range 7:00 a.m.: 7.0-10 ng/ml

> > 2.1 at 11:00 a.m. optimal range noon: 3.0-6.0 ng/ml

> > 2.6 at 5:00 p.m. optimal range 5:00 p.m.: 2.0-4.0 ng/ml

> > 1.0 at 10:00 p.m. optimal range 10:00 p.m.: 1.5 ng/ml

>

> Looks like you NEED the HC. But i am not qualified to say how much or how to

does. Please ask in the adrenal group.

>

> > Labs from 12/4/09, before starting T3; RT3 ratio 4.8:

> > TSH 2.1 (2.0-4.4 pg/mL)

> > T3, free, serum 2.1 (2.0-4.4) pg/mL

> > RT3 434 ( 90-350) pg/mL

> > T4, free (direct) 1.32 (0.82-1.77) ng/dL

> > ferritin, serum 15 (10-291)

> > B12 926 (211-911)

> > TPO <6 (0-34 IU/mL)

> > testosterone

> > serum 30 (6-82 ng/dL)

> > free (direct) <0.2 (0.0-1.8 pg/mL)

> > CD3+CD25+Lymphs 29.00 (4.93-25.85)

> > IGF-1 113 (75-212 ng/mL)

>

> The endo who said you had no thyroid problem based on these labs is NUTS. You

have classic mid-range ft4 and low ft3, which means rt3 problem. Probably due to

your low ferritin and low cortisol.

>

> > Labs from 2/23/10, after a month on SR T3 at 30 mcg/day, oral iron, HC at 10

mg/day. This is before I had the iron IV's; RT3 ratio has risen from 4.8 to

15.6:

> > TSH .72 (.04-4.0 uIO/mL0

> > T3, free serum 2.7 (2.0-3.5) pg/mL

> > RT3 173 (90-350) pg/mL

> > T4, free 0.97 (.89-1.76) ng/dL

> > ferritin, serum 25.7 (11.1-264.0) ng/mL

> > B12 >1000 (193-982 pg/mL)

> > folate >24.0 (3.8-17.0 ng/mL)

> >

> > Labs from 4/5/10 (after a series of 3 iron IV's):

> > TSH : 0.769 (0.450-4.500)

> > Free T3 : 3.4 (2.0-4.4)

> > Free T4: 0.90 (.82-1.77)

> > Reverse T3: 196 (90-350)

> > Ferritin, serum : 191 (10-291)

> > Aldosterone/ Renin Ratio: 48.0 (0-30) high

> > potassium: 4.6 (range 3.6-5.0)

>

> It looks like your ft3 came up a lot with the iron IVs. You didn't feel well,

though? Your ft3 is still too low here and you may have needed more t3 instead

of more HC at this point.

>

> > Labs from 4/27/10:

> > thyroid:

> > T4, free, direct .56 (.82-1.77)--a month ago it was .90,

same reference range

> > TSH 0.105 (0.450-4.500)--a month ago it was

..769, same reference range

> > T3, free, serum 2.3 (2.0-4.4)--a month ago it was 3.4, same

reference range

> > reverse T3 129 (90-350)--a month ago it was 196, same

reference range

> > ratio 17.83 a month ago it was 17.34

> >

> > Iron panel:

> > TIBC 250 (250-450)

> > UIBC 150 (150-375)

> > iron, serum 100 (35-155)

> > iron saturation 40 (15-55)

> > ferritin 113 (13-150)--a month ago it was 191,

range 10-291

>

>

> It looks like your ft4 has lowered a lot, which is what's supposed to happen

on t3 only, but if you didn't increase your t3, then that's probably why your

ft3 fell down. You need to take more t3 as the t4 in your body decreases. does

that make sense?

>

> You may have to sort of start over, but not totally! I would post in the

adrenal group for how much HC and how to dose and then gradually work up on t3.

I think low t3 is the reason you are feeling the way you and possibly you were

on too much HC.

>

> Kathleen

>

[Guest guest]

>T3, free, serum 2.3 (2.0-4.4)--a month ago it was 3.4, same

A long sad saga by the sound of it.

Your initial adrenal labs show you do need HC, the problem is that

very rarely is 10mg enough to make anyone better, it normally makes

them worse. That dose lowers your own production but doesn't add

enough to replace it. The net result is even worse low adrenal

symptoms.

Head over to the adrenal group, post your most recent saliva labs and

see what dose the suggest.

http://health.groups.yahoo.com/group/NaturalThyroidHormonesADRENALS/

Their FAQ Web site is here http://faqhelp.webs.com/

The second question on this page addresses that

http://faqhelp.webs.com/hchydrocortisone.htm

The other problem is not enough T3

The FT3 needs to be top of range or even over on T3 only

Again you started ramping up and ended up making yourself more hypo by

not being on enough, most people need 75 to 125, with your levels of

resistance (as shown by the very bad ratio) you probably needed more

than that.

Did you do the " 3 times a day and take the average " temperature check

to see if you were on enough HC??

The recommendation is to increase HC until average temperature are

stable from day to day to within 0.2F (temperatures taken as per the

link on the site) and then to increase T3 until the average

temperature reaches 98.6.

Nick

--

for more information on RT3 and Thyroid Resistance go to

www.thyroid-rt3.com