Lab Results - Block and Replace?

[Guest guest]

,

It's difficult to assess your TSI after only 2-3 months on B & R.

TSI are IgG antibodies or immunoglobulins. Once they're produced, they hang

around for 2-3 months. So it could be that something triggered TSI production

before you even started the B & R and TSI have not yet started to disintegrate.

Have you been exposed to more stress, estrogens, iodine or other triggers?

But in the event that the TSI rise is from the Armour, and it could be, you

could ask your doctor about trying levothyroxine instead of Armour for your B & R

protocol. Also, if your protocol causes you to become at all hypothryoid,

your gland won't be properly suppressed and you'll produce more antibodies. I

don't recall if you posted labs but you'd want your FT4 and FT3 to be near the

high end of the normal range. Take care, Elaine

[Guest guest]

My recent lab results from August 16:

T3 (my doctor made an error, here): 2.8 (Range 0.6 - 1.8)

FT4 2.2 (Range 0.8 - 1.8)

TSI 730% (YIKES)- That is way up from a reading of 258 on April 3.

TSH: .004 (Range 0.035 to 5.50)

My doctor and I made an adjustment from 120mg of Armour to 60mg of

Armour and dropped the methimazole to 10mg based on the slightly

elevated thyroid hormone numbers. (I wanted to stop cutting up the

pills, so I elected to drop the 2.5mg of the methimazole for that

reason. I appeared that a lot of the pills were lost to dust and

slivers when cut.) My doctor also advised me to take Inderal

regularly instead of as needed for daily heart palpitations. So, my

medication routine is this: 5mg methimazole, 30mg Armour and 20mg of

Inderal at 3:30 a.m. and 3:30 p.m. (I tried three times a day, after

reading about that, here, but I was not able to remember to take the

mid-day dose in the middle of my work day at the right time and had

difficulty remembering the third dose at 7:30 p.m. I am very regular

with twice a day.)

I had decided to drop the Armour completely if my TSI levels had not

improved as I understand from what I have read, here, that expert

help is needed for successful Block and Replace. I haven't been able

to find anyone who has had any experience with it. Also, from what I

have read, here, it sounds as if people are able to adjust their

ATD's up or down, depending on how they feel, when they get to

maintenance doses.

It is apparent from the TSI levels that two months of BRT has not

dropped those.

The trouble with dropping out the Armour from my treatment is that I

have started to feel really good, lately, so I hesitate to change

anything.

I actually don't understand the extremely elevated Thyroid

Stimulating Immuglobin Antibodies. There doesn't seem to be a direct

correlation between the very high TSI and how I feel nor how high the

thyroid hormones are. (It is a bit difficult to tell, though, with

only a Total T3 and not a free T3).

My doctor would not write out a standing lab order for me. I thought

it would save him a lot of time if I could report at the lab when I

thought I needed to see lab results. I think he pictured me running

in for lab tests every two weeks or something. We agreed on FT3 and

FT4 in two months. I am starting to think that I could postpone the

lab tests even more if I don't experience any difficulties.

Am I at a point where I can postpone the labs for three or four or

more months if I continue to feel okay? Can this disease be treated

based on how I feel and use the lab tests only to find out what is

going on if I don't feel good, anymore?

54 years old. Diagnosed August 20, 2003. Tried natural regimen for

three months. Started ATD's December 7 when thyroid hormone levels

were still very high. Started Block and Replace on June 11 in hopes

of moving more rapidly towards remission. (It looks like remission

has moved more rapidly out of reach, actually.)

[Guest guest]

Hello, Elaine,

You asked if there had been any triggers, such as estrogen, iodine,

stress or others. The answer is not to my knowledge about the

estrogen and iodine. I am having more and more success with using

meditation to reduce my stress responses, both at work and at home,

so I feel quite stress-free, right now.

My lab results are:

(R:230-420) (R:.87-1.57) (R:0.8-1.8) <2% R:.035-5.5

DATE FREE T3 FREE T4 T3 TSI TSH

10-11-02 3.86 3.62 <.01

11-30-02 1227 5.49 282

01-02-03 705 2.88 <.01

01-28-03 424 1.56

03-01-03 256 .83

04-03-03 240 .55 258

06-05-03 360 1.30

08-16-03 2.20 2.80 730 <.004

During this time, I took a natural remedy up until December 7 when I

started on 30mg of methimazole. I went gradually down to 17.5 by 03-

01-03, down to 12.5 on 04-03-03 and added in 120mg Armour on 04-11-03

and went down to 10mg methimazole and 60mg Armour on August 23.

I need to make a correction: I started on BRT on April 11, not June

11, so I have been doing BRT for four months, not just two. Sorry.

You said that Armour may have caused the rise in antibodies. Is this

enough of a possibility that it would be worthwhile to switch to

Levothyroxine even if I have started to feel good? My numbers for

the 16th of August don't show hypothyroidism, but I definitely had

the fatigue associate with hypo, at that time.

The numbers for 8-16 don't jive with what I felt at that time. They

reflect more of what I am feeling, now. I have a very simple

criteria for judging how I feel: If I wake up at 3:30 a.m., take my

medication, feed my seven cats, do my exercise routine and fix myself

a good breakfast before leaving for work at 6 a.m., I feel as if

things are definitely looking up! If I wake up, take my medication,

then doze until I only have time for feeding cats and eating

breakfast, things are on a downward slide. LOL For the last three

days, things have been looking up. The previous three weeks,

downward slide.

So, to sum up a very confusing situation, I should focus on the fact

that the antibodies are high, ignore how I feel and switch to

Levothyroxine?

After I do the switch (can I just stop taking Armour and start the

Levothyroxine without tapering down on the Armour?), how long should

I wait before having lab tests done, again? I have decided to tell

my doctor I will pay for the lab tests myself if I need them more

frequently than he is comfortable with.

Thank you, Elaine, for all your input. I have no idea what I would

be doing without this support group.