AM temps rising - good, right?

[Heather123]

I've been taking my temps each morning for a year (in order to track ovulation in attempts to become pregnant).  My temps have always been in the low 97's pre-ovulation (usually 97.1, 97.2).  I've been on Synthroid .1mg for about 2 wks now (TSH was 6.3, then 4.99, have anti-thyroid antibodies).  My temps have stayed above 97.5 since I started meds.  I was reading about AM temps and believe my low 97 temps were too low and probably indicative of hypothyroiditis.  Now that they're staying at 97.6, 97.9, I believe that's good news.  Am I correct to feel optimistic that something good is going on?  I don't feel better yet, though - I do know that can take a while.  
Also, right now I'm seeing my Reproductive Endocrinologist.  Should I be going to a regular endocrinologist and/or an immunologist?  I want to get everything checked out to make sure I'm 100%, as well as to find out if I need other meds or whatever...or maybe I should wait two more wks to see if I feel 100% again and see what my numbers are.  But then, I'd need to get a full thyroid panel done...
????

[Mark Lupo, M.D.]

Patients with positive thyroid antibodies have more difficulty conceiving and keeping the TSH around 1 may be helpful -- while I don't usually follow temps in thyroid patients, in your case this is most likely a good sign.  See an endocrinologist,  not an immunologist.

[ArmourGal]

I'd say yes, it's a good sign that you see an upward trend in temps. Your temps can be an indicator of your body's metabolism and therefore can be low in hypothyroidism.  

There is some good information available on infertility and thyroid disease. Here's one link that you might find helpful to give you a bit more information that was written by Mary Shoman, national thyroid patient advocate.
http://thyroid.about.com/library/weekly/aa050199.htm

[Heather123]

Thanks :c)  I have checked that site out and have a few of her books from the library.

[LowMac]

Hi ladies, I posted today under another heading but wanted to post again because I found something very interesting, just goofing around. I went to Google and put in search: "Thyrotoxicity Confusion" and the first page of articles that pops up, at top page, is one by "SomaticsPlus.com"(I was amazed that "somatics" is referred to, just as I've been doing). I've been mis-spelling "somatics".
This site is kind of an intoduction site to Dr. Lowe's website. The site lists terms of understanding and under the heading "Thyrotoxicity:AKA Hypermetabolism of Thyroid Hormone", the webmaster explains the diff. between thyroid-induced and medication-induced hyperthyroidism.
He/she also states that with thyrotoxicity (med.-induced), the most threatening problems, are "heart problems & bone loss".
I'm simply stating the site's opinion and after defining the terms, they refer readers to Dr. Lowes website.
I just thought it was an interesting page to add to the discussion. It shows that even avid followers of Dr. Lowe, believe thyrotoxicity to be a real danger, including heart and bone. They also state Dr. Lowe as being the best source for thyroid info.. See how someone can agree with most a Dr./person, says but also disagree in specific areas? As Dr. Mark has said completely reliable info., is so very important, before everyone lumps their selves into one catagory and jump into something that could be dangerous for them individually. When there is always conflicting info out there "some patients benifit, some don't", this is why a standard is always reverted back to, it's the only way to treat masses of people safely. On the other hand, Dr.s should be aware of those individuals that have a degree of hormone resistance and need higher than usual dosing. If it's a good Doc, and he's watching closely, he should be able to recognize this. I suspected my problem was hormone resistance but above normal doses for long periods, caused me problems and did not improve symptoms. In my case, I believe mine is due to a degree of adrenal insufficiency (cortical) or possible viral cause, which I'm getting tested for the viral, soon. (symptoms actually better this week!)
People with true adrenal insufficiency (undiagnosed), who increase their thyroid med, are at risk of adrenal-crises and symptoms can be mistaken for hypothyroid ones. I just mention this as another example of increased dosing not always being the answer for every person. Not for argument sake, just for learning purposes, as I learn things from everyone else on here. God Bless.
Jim

[ArmourGal]

For some reason, Doodlebug and I aren't getting the message across to you.  
No one is disputing that if someone has too much thyroid hormone that it is isn't a problem.  It is.  No doubt. Just as hypothyroidism causes problems, so does hyperthyroidism, excess thyroid hormone.  Lots of problems, not just bone and heart problems.  

The dispute is whether a suppressed TSH is indicative of excess thyroid hormone in ALL cases.  I am saying (based on many folks' experiences and also top thyroid docs observations) that it does not.  It that is true, it explains why some folks do not find relief from hypo symptoms when a doc is dosing by the TSH and keeping them in a certain range.  Perhaps they just need more thyroid hormone and would NOT go hyper if their TSH went lower.

Now - a person is free to disagree with those folks who are doing well with a suppressed TSH and NO hyper symptoms and with those physicians who have written about their patients needing enough thyroid hormone, even if it suppresses TSH, to eliminate hypo symptoms.  But if a person does not look at the evidence with an open mind, they miss the opportunity to learn something that might help someone.  And I think that's all I was trying to do...open minds to the fact that TSH is not the "end-all" that many folks think it is because their particular physician told them. so.  Because there are other physicians who say something different.

[LowMac]

Hi,
If it has been a misunderstanding I believe it is because something this important needs more than just superficial explanations. Don't get me wrong, I'm not saying this is what you have been doing, what I am saying is that even several fairly detailed, consecutive posts, sometimes will not get a point across. If I misunderstood, so did Dr.Mark.
I think the concern was that others could misunderstand and attempt to self-medicate as I did because as you know, VERY FEW Dr.s would agree with a patient wanting to exceed the normal ranges on ANY hormone level, as an experiement to see if it will work or possibly drop them over the edge into thyrotoxicity.
Let me say again; Extra dosing DOES work for certain individuals and I'm sure they are saying "hallelujah" and I say God Bless them for their success! Others would not have the same results but could have very negative ones, so needs to be done under careful supervision.
Nothing I've said actually takes away from your points made and nothing you have said, takes away from my points but a little more did need to be added to both views, which are actually similar, just different in specifics and in consideration of  patient individuality.
Don't get frustrated about it, I'm sure not. I think this has all helped in getting more perspective and gives other patients reading, more to think about. In this sense we have provided a good service in my opinion.
Keep expressing but allow opposing (specifics) to be expressed, to help bring balance, unless they amount to personal attacks, in which case I can understand someone getting upset.
I believe your research and expression skills are very good. Let's learn together.
Sincerely, Jim

[doodlebug1]

Hi Heather123! I used to be on Synthroid like you, and I never ever was able to get my temps where I learned they should be. I did a lot of reading, and found it suggested that the morning before-rising temp should be 97.8 - 98.2, and the mid-afternoon temp should be 98.6 (using a mercury thermometer). I think it's Dr. Rind who recommended it first, and others have followed. It's only when I switched to Armour, which is natural dessicated pig thyroid, did I achieve those temps, plus SO MANY benefits that I NEVER got on Synthroid.

You mentioned a thyroid panel--I have noticed that there are docs who are moving away from a thyroid panel, and who are instead doing simply the free T3 and free T4, plus the TSH because the latter is simply old standard.  The typical thyroid panel tends not to do the free's, and in my opinion, and apparently in the opinion of others, you miss out on crucial information! If you read a lot, you will find that the free T3 is important info as to whether your thyroid treatment is optimal. In my case, and in the case of apparently thousands of others, getting the free T3 towards the top of the range is crucial for adequate thyroid treatment. And that can be achieved, according to literature and experience, when someone is on a med which gives them direct T3, as Armour does.

In my opinion, I have found that Endo's are often not the best docs to go to get good thyroid treatment. Granted, there may be a few out there who know about Armour, and some are very nice folks, but generally, they tend to dose only with Synthroid, and treat only by the TSH and T4 only. I found a Nurse Practitioner who knew about Armour and dosing, and my life turned around 360 degrees. If this information all interests you, perhaps you could go to a large pharmacy and ask what docs prescribe Armour in your area. That's how I found my doc (NP, in my case.)

Hope that helps.

[doodlebug1]

Hi Jim! I hate to keep this string going, because I know in time, you'll get it as we all did. But, I did want to emphasize that I have watched hundreds and hundreds of folks in the groups I belong to, and not ONE has ever had symptoms of thyrotoxity. Of course, Jim, that does not mean that someone won't have it. But the point is--I have not seen it a major issue when someone is dosing with Armour by symptoms, by temps, and by the free T3.

When you mentioned heart problems and bone loss, unfortunately, I have also noticed that docs who aren't very well versed in Armour tend to proclaim that these two issues are HUGE PROBLEMS with Armour and/or by dosing by temps, free T3 and symptoms. But experiences with Armour are NOT showing these to be the case.

As far as your statement "When there is always conflicting info out there "some patients benifit, some don't", this is why a standard is always reverted back to, it's the only way to treat masses of people safely.": I'm don't observe that docs are treating patients the way they are because of conflicting info. I observe that docs are prescribing Synthroid and relying too heavily on the TSH because THAT IS THE WAY THEY ARE TRAINED, and because they feel they have to go by the guidelines of the governing body to stay in business!!

But patient's experiences are going AGAINST how they are trained, and I don't see docs paying attention.. If you are trained that the TSH is a reliable way to dose a hypo patient, yet your patient has screaming hypo symptoms, perhaps it is time to re-evaluate how one is trained!! Also, if folks like me and a HUGE growing body of other folks who got on Armour, are showing that treatment with Armour IS working better, docs need to LISTEN. Because the movement of folks who are getting on Armour, and ARE doing MUCH better, is huge and growing...........and WE are becoming more knowledgeable than docs are about good thyroid treatment.

And your statement: "reverting back to standard treatment is the only way to treat masses of patients "safely""---the standard treatment, Jim, USED TO BE DESSICATED SHEEP OR PIG THHROID, and the standard treatment USED TO BE BY SYMPTOMS PRIMARILY, NOT the TSH. YES, let's see docs go back to treating the masses with a treatment that apparently WORKED, and is proving it by the thousands of us who have returned to that standard treatment, and are getting wonderful benefits! :o)

[Heather123]

I need to talk to my RE and find out what all was tested and what the results were.  They only told me my "TSH and antithyroid antibodies were elevated".  I definitely want to look into all tests, treatments, and meds so that I feel 100% again ASAP.

[LowMac]

Hi, I've also read the articles about how in the early days of treating hypothyroid patients, they fed them raw animal thyroid glands. The patients did very well. Just the fact that toxicity happens (people testify of having it today), is why safegards are in place today. Is the system perfect?, As you and I know, of couse not. When patients don't respond favorably to the standard treatment, Dr.s need to look at every single area of the replacement to see if it can be tweaked even more. If every avenue has been explored, including excceding the optimal dose (agreed on between Dr. & patient), only then, should other causes be looked into.
I am one of those patients that didn't do well on Synthroid, T-4 only med and was switched to Armour and did much better. My mother however has been on Synthroid for 10 years and has done very well. When I mentioned Armour to her several times, asking if she thought she might do even better, she refused because of feeling so well on the Synthroid and didn't want to upset the applecart (so to speak). I have read that some people actually have the opposite happen to them, they have bad reaction to Armour and are switched to synthetic. Some people for example are allergic to porcine products, pork etc.... If Armour was the only one available, what would happen to these hypo people?
Is Armour superior? For some people absolutely and extremely so and this may be true in a majority of cases but synthetic still needs to be available for people who need another option.
Your excitment and pro-activeness is a good thing and you and others like you, may someday help cause reform of those things in regard to treatment that aren't good.
Keep it up, we need compassionate people like you and along the way, be willing to hear other views, that may agree with you, more than it seems at first glance. Keep the string going as long as it needs.
You are appreciated.
Jim

[Mark Lupo, M.D.]

There is nothing wrong with Armour - I have personally seen patients in a-fib/heart failure with armour but also with synthroid/levoxyl/etc -- so over-replacement is real and must be considered.  TSH <0.1 needs to be looked at closely -- A TSH of 0.1 to 0.4 is in the "gray zone" - meaning that otherwise young, healthy patients may do fine if they are not symptomatic.

The important thing to remember is that each individual is different and to extrapolate one person's experience (or for that matter 100s of peoples' testimonies).  The TSH is only part of the assessment - the patient is the most important part.

[Heather123]

Thanks drmark, thanks all :c)

[ArmourGal]

yes...the doc and I agree that TSH is only one part of the assessment.  If only that was the way it happened in the real world, life would be good.

I also think part of this "disagreement" about suppressed TSH is that all these current endocrinology "standards" were based on treatment with T4 synthetic meds.  I wonder if it's true that when a person takes a desiccated thyroid extracts (with all the thyroid hormones), that perhaps that T3 being put into the blood that way orally is enough to just cause pituitary production of TSH to fall downward below the range?  But I do know it is my observation from dozens of thyroid patients on desiccated thyroid extract - that when they rid themselves of all hypo symptoms, their TSH is suppressed.  So this scenario seems likely.

And wouldn't someone on a full replacement dose of desiccated thyroid extract (3-5 grains) naturally have a suppressed TSH?  Full replacement appears to often be what Hashimoto's patients need to stop antibody attack.  It was certainly necessary in my own case, but I am also apparently thyroid resistant from being hypo so long without treatment.


To Low Mac...i've heard your story about one's mother being on Synthroid and doing fine many times. Upon questioning those folks, I have always found that the patient does have either remaining hypo issues (say for example memory problems or overweight) or takes medication for an undertreated hypo problem (say for example cholesterol medication or high blood pressure meds).  Honestly, this happens every single time I have encountered this situation...and yet what is amazing to me is that those Synthroid patients continue to say "I'm doing just fine".  But I guess they just don't realize these things are hypo related.  Like Oprah says (smile), when you know better, you do better.

[doodlebug1]

I couldn't agree more with Armourgal's observations about those on T4-only meds. My sister-in-law is also on them, and she has great energy and says she is doing fine. BUT.....she also takes meds for her high cholesterol, and has chronic problems with joint aches--both common problems related to being on an inferior treatment. SO perhaps she isn't "just fine" at all?

Additionally, a gal I work with is also on T4-only meds, and states she is doing fine. Yet, she is on an anti-depressant/anti-anxiety med, and has skin and hair so dry that she looks like a lizard--both common problems to being on an inferior treatment.

My own mother was on T4-only meds. Oh sure, she lived to be 83 and was fairly healthy her entire life. But, she never had the stamina of others, was on meds for her cholesterol, and dependant on being on an anti-depressant. She wasn't fine, either.

Summary: T4-only meds aren't doing the job. They are just doing a good job of lining the pockets of their makers....