Hypothyroid/sleep apnoea, anyone help pls?

[Denice45]

Sorry all, I guess you've all read similar pleas for help, but I am SO damned confused, can anyone please help?

I was diagnosed hypo 3 years ago; Thyroxine (synthetic, I'm in the UK) helped a little; not a lot.  Endo put me on Armour.  Better, particularly helped with hair loss.  Then discovered to be toxic on T4 (slow & erratic heart rate for weeks and weeks and tons of other symptoms)- I have no idea why, when I'd done pretty well on the Armour for many months.

I currently take 75mcg of Cytomel only - no T4.  Again, okay for some months then bang! three months ago, return of symptoms; hair falling out, extreme fatigue... sure I don't need to tell anyone here the rest of the symptoms.

Last two months I look and feel like nothing on Earth; suitcased sized bags under my eyes and feeling like I hadn't slept in a week - put that down to thyroid prob.  However, became aware of very likely sleep apnoea (just waiting for a referral re that) - had two night of waking up choking for breath; constant severe headaches on waking; constant sore throat and have now become aware that I am constantly (almost) waking with a constricted throat and a big 'gasp'.

Can anyone tell me... is sleep apnoea a symptom of hypothyroidism and, if so, why?  I am so totally fed up of being unwell and very confused... I seem to go several months feeling I've got on top of it with the right medication/dosage.... only to fall to pieces several months later with a return of symptoms or yet something else, as with the apnoea.  I'm sorry for the disjointed ramble.  Cany anyone please help?

[Mark Lupo, M.D.]

Sleep apnea can be aggravated by hypo.  The cytomel dose is unusual.  This needs to be doses 2x/day (that may be part of the problem if it is once a day) and usually cytomel is given with synthroid to provide at least some T4.  75mcg of cytomel is like 300mcg of synthroid -- ie, a large dose.

I'm not sure why the armour was stopped -- it may be worth re-discussing with the doc & changing back to armour at a lower dose -- dividing the dose into 2 times/day.

[mshypo]

yes, sleep apnea is associated with hypothyroidism.  search the terms together and you'll come up with some info.  

the only people I know who have not done well on Armour are those with low functioning adrenals and/or low Ferritin.  You said you were "toxic" on Armour but the symptoms you mentioned were not necessarily ones that are hyper related...and it sounds like you do have continuing hypo symptoms now.  I'd want to know my Free T4 and my Free t3 to see if they're over the midpoint - that would give some good information.

[mshypo]

in reading your post over, I'm thinking that maybe you weren't on enough Armour.  Armour has a little quirk about it in that when you first start it, you feel better...then as your body adjusts to that first dosage, you have symptoms arise again...and you then raise another 1/2 grain...and so forth and so on...and most folks seems to get rid of their hypo symptoms between 3 and 4 grains.  Just a thought...and of course most docs will dose by TSH and not let the patient's body tell them when to raise.  Docs who use Armour exclusively seem to know TSH dosing doesn't work well with desiccated thyroid...and it just has to be a gradual increase until hypo symptoms abate. After 3 grains, it is wise to just increase by 1/4 grain as that is nearing full replacement dosage and one would want to avoid going hyper...so slow and steady wins that race.  I'm not a doctor, just studied the docs who use Armour Thyroid.  

[Denice45]

Thank you both.  Crikey, at most I only ever took 2 grains of Armour.  I have had a very strong feeling all along that my dosages were never high enough; I have never returned to the good health I experienced prior to being diagnosed hypo.  Part of the problem, for me anyway, is that I was so ill for such a long time that you forget what 'normal' feels like... you take your meds and any improvement feels wonderful, but as I say, with hindsight I can see that I still far from well.

I just wish I could get the balance right on these medications, I seem to have been 'playing around' with them from the start.  Then I begin to worry over the dreadful palpitations I get (oddly enough, only ever when I get into bed at night).  I checked my heart rate two nights ago and it was 122bpm; I get hot and sweaty at night too and cannot sleep... yet otherwise I do not have a SINGLE hypER symptom; all other symptoms are completely hyPO.

My last lot of thyroid tests came back showing as 'abnormal' showing very low T4 and TSH (I think TSH anyway) but very high T3.  I'm assuming that's because I take Cytomel only?  Is that okay, having very high T3 ?  I'm in the UK and anyone else who is too will know what a major mental block most gp's have on thyroid problems and I only get to see my specialist once in a while; mostly because I have to pay for my own private medical care :(

[mshypo]

are you taking all that cytomel at once?  or even splitting it...that's a bunch of T3 to be putting in your system at one time. I would have palpitations too on that much T3 in a day. wow.

I take 4 grains of armour a day (dosed 3x a day)and that's about half of what you're taking in regards to straight T3.  yea, it sounds like to me that your problem before was just not enough Armour.

[Denice45]

Thank you.  I'm sorry for more questions, but I really need to try and understand this.  If the equivalent dose of Cytomel I've been taking is high - too high maybe - why do I still have so many hypo symptoms?  In the last year (on the Cytomel) I haven't lost an ounce of the 30lbs I've put on since being diagnosed (and I eat healthily) I still have the fatigue, muscle and joint pain, hair loss has returned, puffy/droopy eyelids, a tummy that makes me look 9 months pregant... and so on...

Again, I do apologise what I'm sure are a load of dumb questions; I have been 'doctorless' for a while but am due to see a new thyriod specialist doctor who was recommended by a thyroid support group in the UK.

[mshypo]

great question...i'd love to see you post it to dr. mark to get his response.  a guess would be that your body isn't using all that T3 and is turning it into reverse T3, unuseable.  the body has some mechanisms  for getting rid of too much at one time.  

also, I think it's the T2 in Armour that perhaps can really help with the weight loss...do some research on T2 and you'll see the benefit of that thyroid hormone.