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  #1   ^
Old Wed, Jan-11-12, 23:19
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 25,843
 
Plan: DDF
Stats: 202/185.4/179 Female 67
BF:
Progress: 72%
Location: San Diego, CA
Default I could use some advice... Pam?

Okay, here's my pickle. I've been on Armour for over a year. I had RAI for Graves 20 or so years ago, so I have no functioning thyroid.

I felt like pooh on T4 only. I was starting to get a TSH into the 4+ range on 125mcg but on 137mcg I started get palps.

So I switched to Armour and I was on 120mg but the palps got worse. I've had all the iron tests recommended by thyroid experts at STM (I think it was) and I had a 24 hour cortisol. My cortisol is a little wonky, but not by a huge amount. My ND didn't think it was an issue. My iron is fine.

I'm perimenopasal. Still menstruating sporadically. I now can't seem to tolerate more than 90mg of Armour and sometimes not even 90mg. I'll get bad heart palpitations after taking it for a week or so and I have to back off to 60mg for awhile. Then I'll feel hypothyroid after a week or so.

It just seems like 60 and 90 mg are tiny doses for me. I should be taking at least 120mg, but I get truly hyperthyroid on that big of a dose with worsening palps, insomnia and so on.

I've thought about going back to T4 with just a small amount of cytomel. I'm one of those folks with lots of RT3 and low free T3.

I have tried T3 only and it was great for a few weeks and then I started feeling like death... I mean, it was scary how quickly my health deteriorated. I got weak, felt both hyper and hypo. Hideous.

Any suggestions? Am I just someone who needs a small dose of Armour for some reason? I'm not a tiny person... 5'7", 170 pds.

I actually feel reasonably good most of the time... but I feel like I'm teetering on a fine line between hypo and hyper and I seem to shift from one to the other easily.

Any advice would be welcome!
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  #2   ^
Old Fri, Jan-13-12, 23:20
heirloom10 heirloom10 is offline
Senior Member
Posts: 177
 
Plan: Kwasniewski
Stats: 120/132/115 Female 5'5"
BF:
Progress: -240%
Location: canada
Default

a quick post - i've had some thyroid problems for the past 4 months and i learned if you have high reverse t3 you should not take anything with t4 in it. t4 creates rt3, which blocks your receptors for t3, the main thyroid hormone.

in order to clear your receptors of rt3 you need to take only t3, aka cytomel. http://www.thyroid-rt3.com/

after you clear your receptors you can think about going back on other thyroid medications. but until you stop taking anything containing t4 you're hypothyroidism will only get worse.

in order to do well on t3 only you need to have very good iron and stabilize your adrenals. both of these factors control the uptake of t3. there is a protocol to follow in which you monitor your adrenals and slowly build up your t3 medication until you clear, which is described on the website. it is a controlled and delicate process. i strongly suggest you read the whole t3 website and join the rt3 yahoo group. the moderators are very knowledgable and kind.

good luck!
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  #3   ^
Old Sun, Jan-15-12, 13:38
bertiedog bertiedog is offline
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Plan: protein power
Stats: 145/135/135 Female 65 inches
BF:
Progress:
Default

Hi Nancy

I think Heirloom gave you some good advice. Not sure if I am the Pam you mean but I would say that I didn't do great on T3 alone and I am positive you need strong adrenals in order to do well on it.

It always felt like something was missing when on T3 and I did feel a bit better when I added back just 25 mcg T4. AFter 3 months I gradually put back Nature Thyroid but cannot tolerate more than 1 or 1 1/4 grains each day and now take that plus 12.5 mcg T3 at lunchtime. The 25 mcg T4 I take with the NT around 5.30 am together with my steroid dose. I am also not very large and weigh around 133 lbs and am 10 years post menopause. I also use just one pump daily of Estrogel (no progesterone because I have a naturally highish level of it and don't do well on it at all),

Did your doctor also test your DHEA levels as well as cortisol because they can tell you a lot. You can have a situation like I had where cortisol looked within range but not high and yet DHEA was above range. My doctor said that as I was having symptoms at these times my body was asking for more cortisol but the adrenals couldn't produce it and instead was throwing out lots of DHEA which I think comes from a different part of the adrenals (I might be wrong about that). Anyway he was happy to treat me with low dose hydrocortisone and when retested the DHEA went back into range except at night and I still had bad symptoms at night so he switched me to Prednisolone which is longer acting and the DHEA has been normal ever since.

My temperature has never gone up to normal, the highest I ever see is in the afternoon and it would be around 36.6 but Dr Lowe has said that in some people their temperature never gets normal even if overmedicated and I am definitely like that. However I feel warm most of the time.

Good Luck

Pam
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  #4   ^
Old Mon, Jan-16-12, 09:25
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Plan: DDF
Stats: 202/185.4/179 Female 67
BF:
Progress: 72%
Location: San Diego, CA
Default

In my original post I addressed the T3 only thing:
Quote:
I have tried T3 only and it was great for a few weeks and then I started feeling like death... I mean, it was scary how quickly my health deteriorated. I got weak, felt both hyper and hypo. Hideous.

I suspect it might work out okay for those with functioning thyroids who are still making some T4, but for me, probably not. Your body does use some T4 directly, which I suspect is my issue when I finally used up all my existing T4.

I did do the protocol on the rt3 group. It just didn't work at all. Maybe it is adrenals, but my ND doesn't seem to think it is. I might need to look around for one that is more interested in looking at that.
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  #5   ^
Old Mon, Jan-16-12, 10:20
*bookish*'s Avatar
*bookish* *bookish* is offline
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Posts: 153
 
Plan: <50g a day, gluten-free
Stats: 202.8/180.6/145 Female 5'7
BF:
Progress: 38%
Location: Toronto
Default

Hi Nancy - I have Hashimoto's and switched from .137mcg synthroid (levels at dose: TSH 39.48 (!), T3 3.2, T4 18) to NTH in June, when I started low-carbing as well on recommendation of my doctor. I had been on T4 meds for 10 years before the switch and I am 31.

You say
Quote:
I switched to Armour and I was on 120mg but the palps got worse.
Did you plunge right in at 120mg? It takes a while for the spectrum of thyroid hormones in Armour (or whichever NTH you were on) to build up in your body, so if you were getting that extra t3 from the NTH it could release in a rush and give you those palps. Perhaps if you started at a lower dose (1 grain, 60mcg) and stayed there for a couple of weeks, then upped by a 1/2 grain when your hypo symptoms re-emerged, stay at that dose for a week or two (or however long it takes until you feel hypo again) and then up accordingly? Going up too fast is scary - palps suck - but staying too low is demoralizing because you're in perma-hypo mode.

What supplements are you taking? Iodine is something you may want to try out since it's a building block of your thyroid hormones. Google "Lugol's and hypothyroidism" and you'll get a lot of information. I can get my Lugol's OTC in Canada, but I think in the US it's a but trickier - maybe someone else on here could comment on that? Selenium is also supposed to help clear rT3 and I was taking 100 mcg daily until the fall once things were stable with my thyroid, so that could be worth a shot too?

I hope this helps and I hope you find the right medication(s) to better your thyroid - I fully get how frustrating it is to visit doctor after doctor toeing the Synthroid line. You're lucky to have found an open-minded practitioner but like everything else on this forum YMMV, so you'll probably have to continue to experiment a bit before you find the right balance for you. Especially if you're going through the hormonal changes of peri-menopause to boot.

One final Q: did you get your thyroid antibodies tested at your last blood panel? Especially if you're Hashimoto's there may be some underlying allergies (food or otherwise) that are messing you up - mine were over 4000 (the highest my doctor had seen in his 25+ years of practice) until I went GF. I'm getting tested again in March so hopefully they've come down significantly by then.

Good luck! Don't stop researching alternatives (and I second the suggestion to join a Yahoo group or two - there's good info on there) and know that you will eventually find something that clicks.

-Susan
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  #6   ^
Old Tue, Jan-17-12, 05:48
inatic's Avatar
inatic inatic is offline
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Posts: 48
 
Plan: leanbodies consulting
Stats: 183/130/130 Female 5'4.5"
BF:lean
Progress: 100%
Location: alpharetta,georgia (n of
Default

Where are those antibodies? Maybe you need to do a block and replace?
Have you had your sex hormones tested? Progesterone?
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  #7   ^
Old Tue, Jan-17-12, 09:38
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 25,843
 
Plan: DDF
Stats: 202/185.4/179 Female 67
BF:
Progress: 72%
Location: San Diego, CA
Default

Everyone assumes I had Hashi's. No, didn't. I had Graves disease, where the thyroid goes hyper. Then I had a radioactive iodine treatment to perma-kill my thyroid. So iodine won't really help my thyroid, since it is dead.

My antibodies would be whatever Graves puts out, they're not the same as hashi's.

I expect my protesterone is probably low. I'm a little nervous about replacing sex hormones. I have a serious genetic condition that can cause blood clots, which can be deadly. I think it's only estrogen I need to be wary of, but that's something I should research.
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  #8   ^
Old Fri, Feb-10-12, 14:41
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Plan: DDF
Stats: 202/185.4/179 Female 67
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Progress: 72%
Location: San Diego, CA
Default

This is so weird. Now I'm doing quite well. No palpitations and I seem able to tolerate 2 grains of Armour just fine. Feel really pretty good.

I just seem to go in and out of this weird state where I can't seem to tolerate Armour.
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  #9   ^
Old Sun, Feb-12-12, 16:25
aeroangie's Avatar
aeroangie aeroangie is offline
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Posts: 1,087
 
Plan: Dr. Eric Westman's/Atkins
Stats: 150/148/132 Female 5'-4"
BF:
Progress: 11%
Location: NC Southern Outer Banks
Default

Nancy.....(long time no see!)......but I wanted to chime in here to tell you I switched from Armour to a compounded T4/T3 made with dextrose instead of cellulose as the filler ingredient. I still haven't managed to quite get up to the dosage I think I need though I can tolerate it much better than the Armour I was on. I also had a Rt3 problem and took small amounts of T3 only and selenium for about 6 months. I wish now I had stayed on that but my new doctor really didn't like it and retested the Rt3 and said my ratios were OK (also, Nigel on the realthyroidhelp forum confirmed his opinion.) Though I have seen some improvements (skin, hair, energy) once again, my weight won't budge!

I am finally going to see one of the Endos on the Top Thyroid Doc's list due to a new cyst found on my ultrasound last week. Have you been able to find one of these docs in your area? I am hoping to get answers to the palps question even though most of the time I feel slightly hypo and also, going to ask about using testosterone cream.

How'd the HCG work for you?
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  #10   ^
Old Mon, Feb-13-12, 15:59
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 25,843
 
Plan: DDF
Stats: 202/185.4/179 Female 67
BF:
Progress: 72%
Location: San Diego, CA
Default

HCG worked great. Lost a lot of weight and kept it off for a longish time. But it all came back, except 10 pounds, because my thyroid hormone issues and menopause, I think.

I tried the T3 only and I felt wonderful... for awhile. Then I started feeling weak, exhausted. I thought I was going to die. I was seriously frightened. So I went back to armour.

Sorry to hear about the cyst. I hope it is nothing to worry over.
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  #11   ^
Old Mon, Feb-13-12, 20:15
Neanderpam's Avatar
Neanderpam Neanderpam is offline
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Posts: 1,388
 
Plan: Ketogenic now
Stats: 277/121/125 Female 61 inches
BF:
Progress: 103%
Location: NE Indiana
Default

What about progesterone? When it 'tanks' you'll get weak, exhausted, etc.

Also, are you splitting the incoming dosage?? Half in am...or if you are doing 90mg. take 60mg. am, the rest about six hours later.

What do your FT's look like when you take ONE grain of Armour then have the blood taken EXACTLY at the five hour mark after?

I had heart palps when my progesterone finally tanked out. No matter how much/little thyroid. I got a Rx.'d compounded transdermal 100mg. and used it right before bedtime. Did the trick!

Actually, blood clots with BIOIDENTICAL HRT used transdermally/topically gel with estradiol ONLY with a doc doing blood work and keeping up to date should be ok as long as YOU have not had blood clots or phlebitis YOURSELF. And do not smoke. And have BP checked a lot. Usually the only background for bioidentical estradiol transdermal genetically where you'd want to forego it is if YOU, yourSELF have had cancer, OR have genetic testing for breast cancer markers yourself.

But, yeah, heart palps can also be caused by very low estrogen...you can use estradiol compounded (or get Rx. for brand name) vaginally with barely any type of risk (not Premarin, I'm talking bioidentical vaginal cream..or a 'pill' type...many different ones to chose from).
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  #12   ^
Old Tue, Feb-14-12, 18:16
aeroangie's Avatar
aeroangie aeroangie is offline
Senior Member
Posts: 1,087
 
Plan: Dr. Eric Westman's/Atkins
Stats: 150/148/132 Female 5'-4"
BF:
Progress: 11%
Location: NC Southern Outer Banks
Default

Good info Pam. It really is hard (for me anyway) to even begin to figure out thyroid hormones but when you factor in how they all are supposed work in symphony, it is easy to see how we can get soooo wacked out!

Also....quick question...if my FT-4 is below range after missing an a.m. dose, should I assume if I had taken it that morning before the blood draw that it would have been in range?

Not trying to hijack your thread Nancy! I have been referred to an ENT with the new cyst and then I am going to get a second opinion before anyone cuts on me! As soon as they started talking about removing it or even my thyroid, I got right on the "top Thyroid Docs" list and made an appt. with a highly recommended Endo in Raleigh. It's definitely very hard to get in to see anyone on this list but I finally feel like I am "getting somewhere" with this Hashi's mess! I am seriously considering the Hcg though current doctor didn't like the idea, said that he didn't believe the drops or shots we the "real stuff" and that is was the 500 calorie diet that made this appear to work magic. I am glad to hear you did lose easily on it......please do tell me how the hunger was and if the HcG did help with that.
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  #13   ^
Old Wed, Feb-15-12, 07:40
Neanderpam's Avatar
Neanderpam Neanderpam is offline
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Posts: 1,388
 
Plan: Ketogenic now
Stats: 277/121/125 Female 61 inches
BF:
Progress: 103%
Location: NE Indiana
Default

T4 has a HUGE half life in regards to T3. The T4 you took today...is working sometime next week. (Like asking hubby to take out the garbage before guests arrive, isn't it?...lol).

Free T4 test in a NORMAL person who's thyroid works GREAT is about half the range. Yep. HALF the range. Yet doctors who ONLY Rx T4 get used to seeing it higher...and if it's not, they just throw more T4 at ya. ??? Why bother?

Free T3 testing...in that same NORMAL *lucky' person is around 2/3 to alllll the way to top of range.

So, there ya are...with T4...and it's not very high in range (and shouldn't be, mine is slightly below MIDWAY of my range, and I'm talking Free T tests NOT TOTALS) yet my FT3 is about 3/4 of it's range. I feel good here.

Two years ago I knew NO ONE doing the HCG. Out of the 67 people (real life!) that did it lost TREMENDOUSLY!!! OMG!! they did GREAT!!!!

Um...fast forward. They obviously did NOT follow through with the lowcarb for life diet. AND get this: out of those....22 of those women (yes, all women, sorry) actually never DID the HCG drops or anything..just the 500 calorie diet. Hmmmm.

So, NO, if your FT4 level is below range (what's your FT3 level? Oh..you're in the Carolina's ...that's a rough place to even GET T3 at ALL) than you are just under replaced most likely. sorry.
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  #14   ^
Old Wed, Feb-15-12, 11:07
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 25,843
 
Plan: DDF
Stats: 202/185.4/179 Female 67
BF:
Progress: 72%
Location: San Diego, CA
Default

Quote:
Originally Posted by Neanderpam
Actually, blood clots with BIOIDENTICAL HRT used transdermally/topically gel with estradiol ONLY with a doc doing blood work and keeping up to date should be ok as long as YOU have not had blood clots or phlebitis YOURSELF.

That's just it, I've got the gene that predisposes me to them. 30% risk... it's a huge risk. It is the Leiden Factor V mutation.
Quote:
Women with factor V Leiden have a substantially increased risk of clotting in pregnancy (and on estrogen-containing birth control pills or hormone replacement) in the form of deep vein thrombosis and pulmonary embolism.


I suspect the palps are a meno symptom for me. I had them on T4 when my TSH was nearly 5 and when it was closer to 1. They just get worse when I'm taking T3. My period restarted after going AWOL for almost a year and now the palps are gone too. Maybe I'll look into the progesterone. I don't think I'd consider estradiol unless I investigate it thoroughly in terms of my genetic mutation and clotting risk.

Yes, I divide my dose. I'm scheduled to have a new blood draw in a month or two. Is the 5 hour advice for after taking a full dose of Armour of just half a dose? Divided as I normally do?
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  #15   ^
Old Wed, Feb-15-12, 16:57
Neanderpam's Avatar
Neanderpam Neanderpam is offline
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Posts: 1,388
 
Plan: Ketogenic now
Stats: 277/121/125 Female 61 inches
BF:
Progress: 103%
Location: NE Indiana
Default

Nancy, I'm talking BIOIDENTICAL transdermal. "Hormone replacement' means 'synthetic' or conjugated, and there are NO estrogen containing birth control pills on the planet. NONE. It's all test tube synthetic.

I know a SLEW of doctors who know how to adjust bioidentical.

Do you not use any plant products? Do you not take any EPO (Evening primrose oil)? cuz that's what they basically make the topical biodentical from. Plants.

I'm a three time survivor of cancer...and I used bioidentical HRT. Specifically compounded for ME. (YES it WAS expensive, in case anyone wants to know).

We women need to realize when you see "HRT" or 'Estrogen in birth control' it means synthetic or conjugated.

I have a SIL who have the same V Leiden and she is now 56 and having compounded transdermal vaginal estradiol (not estrOGEN) and using progesterone and doing fine. And, of course, she is having blood work done every three months.

BUT if you are not sure, etc. than if I were YOU, I'd not TOUCH EPO or anyother 'natural oil or product' that has lignans in it. (Oh, flaxseed would be worse than vag. estradiol actually....it has lignans GALORE).

My doctor (and many others) have you take HALF your dose of either T3 (if you are on synthetic) or half your daily dose of Armour...but you need to make sure your doctor is 'up on that'. Or you'll freak 'em out and might be at risk of having your Armour lowered.

But there have been times I've SWORN I wasn't getting 'enough' Armour and then I'd go and do the half my daily dose, blood drawn five hour mark and there it was....FT3 WAY over range!!! LOL The symptoms of hyper and hypo are SO similar sometimes! I get very very tired, and lethargic, and moody, and depressed when I'm OVER range and heading hyper.

The 'very very good' thyroid docs on my lists use progesterone (transdermal, compounded, not the OTC soy crap) after testing at night to quell the heart palps and give good sleep...and it works REALLY well!!!
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