Additional Tests?

[drick008]

I was diagnosed Hypothyroid with TSH 6.22 (0.4 - 5.50) last May 29, 2007 and started taking 25mcg Levothyroxine.
Six weeks later (July 24th), my Lab results:
TSH 1.45 (0.4 - 5.50)
Free-T4 1.5 (0.8 - 1.8)
T4 -Total 10.7 (4.5 - 12.5)
T3-Uptake 34.8 (22 - 35)
My doctor told me I'm fine, but I insisted I'm not feeling better, especially Brain Fog, fatigue and tingling/numbing at hands and feet. She recommends trying Armour and I did tried it 30mg which helped a lot; I don't have Brain fog, tingling/numbing hands and feet come and goes.
I did another blood test two weeks after taking Armour (August 21):
TSH 1.65 (0.4 - 5.50)
Free-T4 1.0 (0.8 - 1.8)
T4-Total 7.1 (4.5 - 12.5)
T3-Uptake 32.0 (22 - 35)
My questions are:
1) Do I still need to be tested for Antibodies?
2) I have good days (I fell normal with lots of energy) and I have Bad Days (Weak, neurophatry and felt cold). Could this cause of under medication?
3) Are there additional tests you think I need?
Thanks you in advance,
Rick

[Mark Lupo, M.D.]

The antibodies will confirm the likely diagnosis of hashimoto's.

Your levels look okay at this point, the good/bad days are tough to sort out as many people have this pattern and usually if the dose needs increase/change there is a consistent (not intermittent) pattern of good vs bad.

[cheshire]

The right labs are listed below. I don't get why your dr is running Totals and Uptakes? -- these show nothing!

Also, check to see that B12 is above 600 (I wish I could underline that); tingling in hands and feet is a symptom of pernicious anemia. make sure you look at your results yourself. If the bottom of the range is 150 and your result is 151, your dr may tell you it is "normal" so be careful because low B12 is dangerous!

* TSH But this lab is only for diagnosis of hypopituitary, NOT to diagnose or dose your hypo by.
* Free T4 and Free T3 (note the word “free”)
* Thyroid Antibodies (anti-TPO and TgAb. YOU NEED BOTH.)
* Ferritin (and do stress FERRITIN, not just RBC -- this should be above 60)
* Adrenals Cortisol levels (but strongly recommend saliva tests, not the one time blood test your doctor will do.)
* B-12 (you want this above 600),
testosterone, DHEA
* Reverse T3

My memory was non-existant on Synthroid, and I had to sleep half the day, even though my Free T4 was at the TOP of the range. My Free T3 was actually at the BOTTOM of the range, and I was still hypo. Before I was taking synthroid, but now I'm on 4 and a half grains of Armour, and for a while I had to take iron and Cortef for adrenal problems. But feeling great now, with no hypo symptoms.

[msfergy]

So you also have a adenal problem? Did that come before or after your thyroid?  I was practualy adrenal dead before they figured that part out, 5 months of suffering everyday. I take sublingo B12 5000mcg everyday, i use to get the injections a couple of times.

[cheshire]

I believe I developed adrenal disfunction after 10 years of hypo without treatment, and one horrible year on synthroid. Have you treated your low cortisol with HC, and are you still on Cortef? And how much?

FYI: do you know that 30mg is a starting dose of Armour? You should be raising by 30 mgs every two weeks until your reach 3 grains (180mgs). At this point you should hold this dose for four weeks and then run Free T4 and Free T3. You want to see your Free T4 above midrange and Free T3 at the top of the range and not have any symptoms. looking at your labs, you have a long way to go!

Make sure you do not still have "dead adrenals" or low ferritin when treating with Armour or you will not get better, and not be able to tolerate thyroid hormone.

For example, when i was on 125 synthroid my labs were:
Free T4 21 (range 9-23)
Free T3 3.7 (range 3.5-6.5)
Ferritin 11 (range 20-30)
Cortisol: dead in the water.

Now on 265 mgs of Armour:
Free t4 17 (range 9-23)
Free T3 6.3 (range 3.5-6.5)
Ferritin 65 (range 20-30)
Adrenals normal after eight months of treatment.

And forget about dosing by the TSH on Armour. You have to go by SYMPTOMS and use the Free Ts as a tool. My TSH is next to nothing and that's where I want it on Armour.

[cheshire]

Sorry msenergy, part of that answer was for you!

[msfergy]

Ok someone with the same problem, YEAH! I do beleive my adrenal problem came from undercare of the thyroid really. I just called today to see what my last labs were which was in may so i know they need ran again but they want to take my left lobe out first then do them,grrrrr I dunno. Now Questions.
What is Armour? I am on 75mcg of Synthroid, I had to cut back about a month or so ago because i was shaking so I went to 50mcg. But like I said now back to 75 for the past 2 weeks.
I take 20 mg and 10 mg. Hydro a day
xanax as needed
vitamins of course
and they gave me neurotin for pain.

Here were my labs in May I beleive, I am picking up a copy of all the blood ran tomorrow.
FT3  3.56
Ft4   .98
TSH  1.78
T3 Total 176

I am 35 yrs. old
So can you help me with this leveling stuff?
Before all this and they found out what was going on
Ferriten 37
cortisol   4
Magnesium   1.9
triodothyronine t3, free  4.0  (1.5 - 4.1)
tsh  2.22
sodium   138  (135-145)

[msfergy]

Also they told me I have to take the hydrocortizone the rest of my life, are you still on it? If not how long did you take it?

[cheshire]

My adrenal disfunction was not as bad as Addisons -- I had some cortisol in the morning but the rest of the day was depressed. It's possible, if you make NO cortisol, than you will probably have to take HC forever, but not always. If its not Addisons, you may be able to wean off slowly once you have given your adrenals a break, and reached the correct dose of Armour and held it that dose for a couple of months. Right now you are still stressing out your adrenals because you are taking an inferior drug. Armour is a natural form of thyroid hormone, that gives your body what it needs. Have you read through stopthethyroidmadness.com? You will find a lot of great info on it there.

I looked up your location, and searched out a doctor who sounds excellent, and prescribes Armour, and gets people well! If he is too far from you let me know and I'll see if I can find another. I'm in Canada, so I'm just going on maps.

David Berkenbile, Osteopath/DO, St. Marys Westphalia Clinic, 1875 Highway 63, Jefferson City (Westphalia), MO, Ph/Fax: [phone].

Also, your ferritin is too low. You want to take iron until you see it reach 70-90. I had to take 200mgs a day to raise my ferritin. (I increased the amount slowly over a couple weeks as not to get a stomach ache)

When you get you knew labs, post them here, with the ranges included -- I'd like to see your Free t3 and Free t4. I wish I could send you a private message and help you more! There's only so much I can say on this forum.

[msfergy]

Hello, so you were adrenal insuff.? Hmmm I wonder why you only had to take it one morning, and I dont know what the dif. is between synthroid and armour, I guess i need to ask the doc that also do u have yahoo? I am sweetaz72.

[msfergy]

Very interresting site, I dunno where to start though entirely to much, I will have to study it to get a grip on it. Is armour a presciption? I have seen alot of people on it in here.

[cheshire]

Armour is a prescription just like synthroid.

As for HC, i took 10mg in the morn, 5 at noon and 5 before dinner.

Yes, read over that site. Most of the info you need is there for you. Also try realthyroidhelp.com as they can answer questions about Armour.

yahoo? Ah you mean messenger. no i don't use that but i can try it.

[msfergy]

Yes yahoo, i just got back from picking my latest labs up which were done in July. They didnt do a T3 all they did was T4 free 1.3 and TSH 1.85 and other stuff like potassium sodium bun and so on oh and no ferriten,lol. Sodium and potassium are both on low end but normal. Sod. 139 Pot. 3.9

[cheshire]

What range are they using for Free T4?

I urge you to read up on adrenals, to find out if you are taking enough for your condition. Do some research on Armour while you are at it, as from my experience you won't be getting better without it.

Also, call a good doctor, maybe the one I listed above, as sure sounds like you have a lot going on, and need someone to prescribe Armour.

If you have been diagnosed with "low b12", did they check you for intrinsic factor and do you have PA. Most folks with low B12, unless there is a good reason for it like being vegan, will need shots monthly for the rest of their lives. Sublinguals are good, but with PA you need shots and possibly supplements as well.

[drick008]

Thank you and I have a question.
I'm attaching your post earlier;
"FYI: do you know that 30mg is a starting dose of Armour? You should be raising by 30 mgs every two weeks until your reach 3 grains (180mgs)."
I think this is good for you since your last syntroid dose was "125". And according to Armour, 3 grains contains 114 mcg T4 and 27 mcg T3. My condition may not be the same. My last Levothyroxine dose was 25 mcg when my TSH and Free-T4 was at range...I know it was still on the low side but adding another 30 mg can cause me to go hyper, is'nt it?

I went yesterday to another blood test for TSH, Free-T4 and yes this place has Free-T3 test. I should receive the result next week.

Take care,
Rick

[msfergy]

I do the sublingo and i think they do help, that doc is really far from me. The cotef dose iam on is the normal dose for insuff. but heak who knows, i have alot of pain in my ankles and feet and still think it has to do with that, i thought i read on that site something about adrenals and taking armour not sure what it said i cant never remember what i read, i will have to write down everything step by step.
I am gonna see about doing that salavia test, is that a home test u can order?

[cheshire]

make sure that you don't take Armour before your blood draw or it will be way off. I give it at least 18 hours.

Your dose of Armour is not determined by your dose of synthroid, nor your present weight. They work very differently. Most people need 180-300mgs of Armour to feel right. Less than that and you will probably be hypo, even with your low dose of synthroid. Yu can always stop raising at 2 and a half, and hold it for 1 month, then check labs.

If you are feeling hyper on 60 mgs of Armour, then you must have adrenal fatigue or low ferriitn. I'm suprised you are not dead on that low dose actually.

Make sure they are testing Free t4 and free t3, as the Total and Uptakes don't say anything.

[msfergy]

Ok so u take armour and synthroid both plus cortef? Im a thyroid pateint so be slow with me :)

[drick008]

Currently, at 30 mg of Armour, I'm having headaches, stiff neck, some nausea, and blood pressure is a little higger than before (around 135/78) especially at night time. I feel warn at night but not as cold in the morning.
I'm calling my doctor tomorrow and ask her about these symptoms.

Take care,
Rick

[msfergy]

I heard on another forum here people on armour having heart palps, by i am on synthroid and get them, today when it happened i might of had to much sugar (coffee and icecream). Anyway heard u have to be careful on armour because it raises t3 but again it happens to me with synthroid, i took a xanax to calm mine.

[drick008]

Yes, Armour has T4 and T3. I was on Lexothyroxine for six weeks at 25 mcg and when the results of my blood test showed TSH and Free-T4 at range, I told my doctor that I'm not feeling well at all especially the Brain Fog. I researched and found somewhere that low Free-T3 could cause Brain Fog. So, when my doctor recommends Armour to me, I felt a lot better...no brain fog even on the first day I took Armour.
I also beleive that my head ackes and little elevated BP may be caused of not able to sleep good lately. My brain tends to wonder around even though I'm so sleepy. Stiff neck also tells me I'm stressed out, but with what? I just want to sleep and get better. I might sleep in the living room tonight and see if change in scenery will help me sleep good.
Take care,
Rick

[msfergy]

Oh I have done that, my neck hurts all the time to and even kept going to chiropractors and theropy and it didnt help. Also I just swithched to synthroid as i have heard the generic levothyroxine isnt as good, i just switched a week or so ago so not sure yet as i am still tired. I just ordered the sublingo package it has B12 B6 and folic acic plus u get a free bottle of vitamin E with first purchase it is at Getb12.com check it out and see if it helps you, i heard it is good stuff.

[cheshire]

Heart palps on syntheic T4 or Armour is most likely low cortisol (or low ferritin). You will never be well until you deal with your adrenals and heal them.

I had brain fog until i switched to Armour. I never felt truly okay (able to function) until i was taking 20 mgs of HC and 3 grains of Armour, and from then on life's been good. I had to raise to 265 mgs to feel just right.

Your neck hurting sounds like adrenals.

My insomnia was cured by Armour, by taking HC, and healing my adrenals.

All the vitamin supplements in the world are never going to make up proper thryoid treatment and adrenal disfunction.

Also, I did take synthroid and Armour together for about a month (half my synth dose), until I was on a high enough dose of Armour to let synthroid go completely.

[drick008]

Here's my test result from Sept 5th:
TSH       1.232     (0.35 - 5.50)
Free-T3   3.5        (2.3 - 4.2)
Free-T4  1.28      (0.61 - 1.76)

Take care,
Rick

[msfergy]

Them are all about the same as mine in July but they didnt do a Free-T3 on me. Did they do your cortisone testing? I have heard the one time blood test isnt what you need, they have 24hr saliva test.

[msfergy]

Ok do you know what decreased echogenicity posteriorly is?