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Barb135 or anyone knowledgeable on thyroid lab results
I have Hashimoto's & am currently taking 105 mg of Armour Thyroid. I've been at this dose now for about 1+ month. Before that, I was on 90 mg for about 2 months. For about the last 2 weeks or so, Ive been feeling as if I'm going into a hyper state but I'm not sure. (This is all confusing to me & I heard you were the best person to come to for help
Just for information, when taking cortisol meds, patients should also be taking an adequate dosage of DHEA to assure optimal levels. The DHEA offsets bad effects from cortisol, like those you mentioned. Having an adequate DHEA level is very important, and it tends to decrease as we get older, requiring supplementation for us to feel our best. So perhaps you needed both.
Barb-Yes, I'm still weaning off the Cortef. I was at 60mg & now I'm down to about 8. I take the Armour around 4:30 am then I take the Cortef either an hour later or whenever I wake up (I've been soooo tired & weak as of late & it's usually around 10am when I wake up) I take the full dose of Armour now. I tried your advice and split the dose but oddly enough, when I did this, I would end up feeling so much more drained. It's like when I took the whole dose in the morning, I would have the energy to get up, get myself & my dogs ready & go walk 2.5-3 miles. If I split it up, I felt so drained & exhausted! I couldn't do anything but stay in bed. I'm having a great deal of trouble going to sleep at night (fall asleep around 1-2am) In a very weird way its like I'm wired & exhausted all at the same time. Yes I still do the b12 shots but I've only been doing them monthly.
2 questions for you...
1.)What's an example of another thyroid med I could/should ask to be placed on?
2.) What is the difference between Magnesium citrate & chelated Magnesium & which should I take? I have had trouble with low magnesium before & several years ago, I went to a vitamin store & this was the type recommended/preferred. Per serving (4 HUMONGOUS horse pills
2 questions for you...
1.)What's an example of another thyroid med I could/should ask to be placed on?
2.) What is the difference between Magnesium citrate & chelated Magnesium & which should I take? I have had trouble with low magnesium before & several years ago, I went to a vitamin store & this was the type recommended/preferred. Per serving (4 HUMONGOUS horse pills
(I added this comment earlier but for some reason it didn't post)
My current labs as of 11:59am on Dec 27:
*currently on @8mg Cortef & 109mg of Armour Thyroid
Cortisol- 8.2 (8am= 8.0-19 & 4pm=4.0-11)
ACTH- 4.4 (7.2-63.3)
Tsh- 0.718 (0.450-4.500)
Free T4- 1.06 (0.82-1.77)
Free T3- 5.7 (2.0-4.4)
Sodium- 140 (134-144)
Magnesium- 1.6 (1.6-2.3)
I'm STILL incredibly EXHAUSTED & wore out (physically & mentally). I'm still very much depressed. My appetite is pretty non existent; eating maybe one healthy meal a day (usually a healthy salad). In spite of the lack of appetite, I continue to struggle with my weight. I've lost about 10 lbs (of the 30 lb weight gain from the steroid use) but that's been a slow go. I thought with as little as I eat, I should've lost a WHOLE lot more than just a measly 10 lbs.
Your thoughts
My current labs as of 11:59am on Dec 27:
*currently on @8mg Cortef & 109mg of Armour Thyroid
Cortisol- 8.2 (8am= 8.0-19 & 4pm=4.0-11)
ACTH- 4.4 (7.2-63.3)
Tsh- 0.718 (0.450-4.500)
Free T4- 1.06 (0.82-1.77)
Free T3- 5.7 (2.0-4.4)
Sodium- 140 (134-144)
Magnesium- 1.6 (1.6-2.3)
I'm STILL incredibly EXHAUSTED & wore out (physically & mentally). I'm still very much depressed. My appetite is pretty non existent; eating maybe one healthy meal a day (usually a healthy salad). In spite of the lack of appetite, I continue to struggle with my weight. I've lost about 10 lbs (of the 30 lb weight gain from the steroid use) but that's been a slow go. I thought with as little as I eat, I should've lost a WHOLE lot more than just a measly 10 lbs.
Your thoughts
1 Comments
Hi bizzylizzy... Sorry to hear you're still not doing so well.
Are you still tapering down on the Cortef?
Did you take your Armour prior to the blood draw on the 27th? Your Free T3 is over range, but if you took your med prior, that would be a false high. Your FT4 is too low at only 25% of its range.. You need to try to cut back on the Armour to decrease your FT3 and add a bit of T4 med to increase your FT4. Your FT4 and FT3 need to be in balance.
FT4 should be about mid range and FT3 should be in the upper half to upper third of their ranges...
Are you still splitting your Armour dose to get take 1/2 in the morning and 1/2 around noon/early afternoon?
The lack of weight loss could be due to the cortef, yet your morning cortisol is on the low side. What time of the day do you take that? That could have something to do with the low cortisol, but you should try to get a saliva test that checks 4 times/day.
Your B-12 is still on the low side; are you continuing with the shots?
You could also stand to supplement magnesium, as yours is on the floor of the range. Magnesium citrate is the most easily absorbed.
Are you still tapering down on the Cortef?
Did you take your Armour prior to the blood draw on the 27th? Your Free T3 is over range, but if you took your med prior, that would be a false high. Your FT4 is too low at only 25% of its range.. You need to try to cut back on the Armour to decrease your FT3 and add a bit of T4 med to increase your FT4. Your FT4 and FT3 need to be in balance.
FT4 should be about mid range and FT3 should be in the upper half to upper third of their ranges...
Are you still splitting your Armour dose to get take 1/2 in the morning and 1/2 around noon/early afternoon?
The lack of weight loss could be due to the cortef, yet your morning cortisol is on the low side. What time of the day do you take that? That could have something to do with the low cortisol, but you should try to get a saliva test that checks 4 times/day.
Your B-12 is still on the low side; are you continuing with the shots?
You could also stand to supplement magnesium, as yours is on the floor of the range. Magnesium citrate is the most easily absorbed.
Your endo is either junior or not very experienced one and simply jumped into experimenting cortisol drug with you and I think that is the reason for most of the reason symptoms you are experiencing especially leg abdomen edema.
My suggestion is taper the unwanted cortisone in small steps and took it out fully. Adrenal fatigue is still vague and experimenting with it without the possible side effects is very harmful. To name a few it can raise your blood sugar levels and can lead you to diabetic very soon and all other related complications like nerve problems, heart problems etc. I am not saying hydrocortisone is bad for all but it need to be taken with caution and only if the case is very genuine and needed. Mild adrenal problems as you are experiencing in first place need to be dealt with better sleep habits, diet, reduction in stress, ignoring needless anxiety, fear etc and not by drugs in the first place.
Concerning thyroid condition too 5.5 TSH value does not even need any thyroid replacement pill as your Free T4 and Free T3 values were normal without pill. Pills are usually started when TSH go beyond 10 or if Free T4 go below reference range. So my suggestion you can either cut it off fully or partially under the supervision of another good experienced doctor. An experienced doctor is one who not quickly jump on prescribing unwanted medicines and diagnosis quickly.
Also the real thing which you need to deal with is Vitamin D deficiency as your level is way too low and your doctor need to deal with it by giving you suitable supplements to make it in optimal range.
My suggestion is taper the unwanted cortisone in small steps and took it out fully. Adrenal fatigue is still vague and experimenting with it without the possible side effects is very harmful. To name a few it can raise your blood sugar levels and can lead you to diabetic very soon and all other related complications like nerve problems, heart problems etc. I am not saying hydrocortisone is bad for all but it need to be taken with caution and only if the case is very genuine and needed. Mild adrenal problems as you are experiencing in first place need to be dealt with better sleep habits, diet, reduction in stress, ignoring needless anxiety, fear etc and not by drugs in the first place.
Concerning thyroid condition too 5.5 TSH value does not even need any thyroid replacement pill as your Free T4 and Free T3 values were normal without pill. Pills are usually started when TSH go beyond 10 or if Free T4 go below reference range. So my suggestion you can either cut it off fully or partially under the supervision of another good experienced doctor. An experienced doctor is one who not quickly jump on prescribing unwanted medicines and diagnosis quickly.
Also the real thing which you need to deal with is Vitamin D deficiency as your level is way too low and your doctor need to deal with it by giving you suitable supplements to make it in optimal range.
2 Comments
My endocrinologist is about 75-85 years old and is about the only endocrinologist in my immediate area. Over the past several months since I've been going to him (end of Feb/Mar 2016), he's been progressively making more & more questionable decisions; leaving one to wonder if it's past time for him to hang his stethoscope up & retire.
You're absolutely right about him jumping the gun & putting me on steroids. I wished more than ANYTHING I would've did my homework & said no thanks. I told him when stress should feel relatively low, like maybe a 2 on a 1-10 scale, it would feel like a 7 or 8 to me. I also told him how AWFUL the fatigue & exhaustion is & how WONDERFUL & FULL of energy & life I feel any time I've ever been placed on prednisone. He said ok. Well, let's just start you out on just a lil bit of steroids and see how you feel on it. So he started me out on 20mg of Cortef in the morning & 10mg of it in the late afternoon.
About 2.5 months after I started taking it, I had to triple the dose to 60mg after my 17 year old son attempted suicide due to a horrific side effect from being placed on an antidepressant (I had to stress dose because the 30mg just wasn't enough for my adrenal glands to withstand the incredible amount of stress I was under). To my surprise, being on this high dose had me physically feeling the BEST I'd felt since I was a teenager! (And it's been 20 years this year since I graduated high school).
I continued this dose in spite of knowing the potential consequences; osteoporosis, diabetes, etc...That's just how TERRIBLE I felt. I was willing to do anything just to feel better. Or so I thought. It was all going great...until it wasn't. It was like, all of a sudden, ALL of the VERRRRRY unwanted side effects (all of them I knew & then some) decided to show up...and they ALL showed up at ONCE! It's like when you're living on your own for the first time & everything's going great & as planned when suddenly, out of nowhere, extended family & some who you've never met before, show up, completely unexpected & unannounced with no plans of ever leaving or going back home. That's how I felt.
I knew about osteoporosis, increased appetite & a LITTLE weight gain...but I was COMPLETELY BLINDSIDED when I discovered I'd have to go on blood pressure medicine because it was causing my diastolic blood pressure (the bottom number) to stay in the 100's, my body just blew up seemingly overnight from from an accumulation of excess extracellular fluids pooling up in my legs, face & abdomen, fatpads had set up shop to unwanted areas of my body (especially on my face, back & abdomen).
There are so many more awful & unwanted changes that happened to me, but the WORST one of all was the EXCRUCIATING pain, DEBILITATING fatigue & muscle aches/weakness I've had to endure from the very moment I started the weaning process...No one, and I do mean NO ONE could've prepared me for the hell on earth my body would experience once I decided to titrate off this devil drug...
This was an extremely hard lesson learned. In the future, I don't care how crappy & lousy I'm feeling, I WILL NEVER EVER start a medication without doing my extensive homework on it EVER AGAIN!!
You're absolutely right about him jumping the gun & putting me on steroids. I wished more than ANYTHING I would've did my homework & said no thanks. I told him when stress should feel relatively low, like maybe a 2 on a 1-10 scale, it would feel like a 7 or 8 to me. I also told him how AWFUL the fatigue & exhaustion is & how WONDERFUL & FULL of energy & life I feel any time I've ever been placed on prednisone. He said ok. Well, let's just start you out on just a lil bit of steroids and see how you feel on it. So he started me out on 20mg of Cortef in the morning & 10mg of it in the late afternoon.
About 2.5 months after I started taking it, I had to triple the dose to 60mg after my 17 year old son attempted suicide due to a horrific side effect from being placed on an antidepressant (I had to stress dose because the 30mg just wasn't enough for my adrenal glands to withstand the incredible amount of stress I was under). To my surprise, being on this high dose had me physically feeling the BEST I'd felt since I was a teenager! (And it's been 20 years this year since I graduated high school).
I continued this dose in spite of knowing the potential consequences; osteoporosis, diabetes, etc...That's just how TERRIBLE I felt. I was willing to do anything just to feel better. Or so I thought. It was all going great...until it wasn't. It was like, all of a sudden, ALL of the VERRRRRY unwanted side effects (all of them I knew & then some) decided to show up...and they ALL showed up at ONCE! It's like when you're living on your own for the first time & everything's going great & as planned when suddenly, out of nowhere, extended family & some who you've never met before, show up, completely unexpected & unannounced with no plans of ever leaving or going back home. That's how I felt.
I knew about osteoporosis, increased appetite & a LITTLE weight gain...but I was COMPLETELY BLINDSIDED when I discovered I'd have to go on blood pressure medicine because it was causing my diastolic blood pressure (the bottom number) to stay in the 100's, my body just blew up seemingly overnight from from an accumulation of excess extracellular fluids pooling up in my legs, face & abdomen, fatpads had set up shop to unwanted areas of my body (especially on my face, back & abdomen).
There are so many more awful & unwanted changes that happened to me, but the WORST one of all was the EXCRUCIATING pain, DEBILITATING fatigue & muscle aches/weakness I've had to endure from the very moment I started the weaning process...No one, and I do mean NO ONE could've prepared me for the hell on earth my body would experience once I decided to titrate off this devil drug...
This was an extremely hard lesson learned. In the future, I don't care how crappy & lousy I'm feeling, I WILL NEVER EVER start a medication without doing my extensive homework on it EVER AGAIN!!
So sorry to hear that, such an experienced and old doctor prescribed you cortisol all needlessly. Also even the armour thyroid is also not the drug of first choice for hypothyroidism instead levothyroxine. Armour or NDT is usually prescribed to those whose T3 levels are lower and T4 on higher side. But yours is just opposite and levothyroxine might bring that balance you are experiencing still now. But due to your long supplementing with cortef and relatively high armour dose its tough to remain on levothyroxine only and need a combo dose with the supervision on another doctor.
Based on your latest lab results I'll suggest you to take magnesium citrate supplement in low dose daily just to make sure you getting daily requirement. But not any excess as excess is harmful. Also for thyroid to bring T4 to mid range ask doctor for levothyroxine as levothyroxine only needed as your T3 already way up. A suitable dose for your existing armour is 125 mcg but need to adjusted after 4 weeks. For adrenal issues no need to raise cortef instead choose another natural adrenal support herb ashwagandha it have both cortisol support and DHEA and is an anxiety reducer.
Concerning your kid's antidepressant usage too, that doctor also put him into needless prescription drug which is common among all doctors but they care less about his future as it soon lead to dependence and need more dose and also many side effects. If possible taper that too and find alternative approach.
Based on your latest lab results I'll suggest you to take magnesium citrate supplement in low dose daily just to make sure you getting daily requirement. But not any excess as excess is harmful. Also for thyroid to bring T4 to mid range ask doctor for levothyroxine as levothyroxine only needed as your T3 already way up. A suitable dose for your existing armour is 125 mcg but need to adjusted after 4 weeks. For adrenal issues no need to raise cortef instead choose another natural adrenal support herb ashwagandha it have both cortisol support and DHEA and is an anxiety reducer.
Concerning your kid's antidepressant usage too, that doctor also put him into needless prescription drug which is common among all doctors but they care less about his future as it soon lead to dependence and need more dose and also many side effects. If possible taper that too and find alternative approach.
Btw: i followed your advice & got my b12 & folate checked. On Oct 31- my b12 level was 532 (211-946) & my folate was 13.7 (>3.0) My vit D levels continue to be low so he put me on vit D 50,000u 2x week. I don't know if this is of any significance to you or not but my chloride level has been either under the low range or hovering just a hair above the lowest reference range
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Typically, a saliva cortisol test is done by providing 4 samples in the same day... one in the morning, one at noon, one in the evening and one at night. Since cortisol is supposed to be highest in the morning, when you're getting up and getting ready for the day and lowest at night when you're getting ready to sleep, the idea is to see if your levels are where they should be at the various times of the day. The way you did your test, basically, told you nothing except what your levels were between 11 PM and midnight...
It isn't necessary to avoid dairy for 4 hours after you take your thyroid medication.. You only have to avoid taking calcium supplements for that long, because of the amount of concentrated calcium; you don't have to avoid all foods that contain calcium, because there isn't so much calcium in most foods that it's going to affect your medication... I take my thyroid medication between 5:30 and 6:00 am and if I want cereal or a glass of milk for breakfast, I go ahead and have it. I just take calcium supplements at night and I have nothing to worry about.
I also take a T3 medication and because my T3 dose is very small, I take it around lunch time, to keep from crashing in the afternoon... I still sometimes do.
I'm sure if you tried splitting your Armour, you'd see a difference in the way you feel, because it would keep the T3 more stable in your system. It's also possible that you need an increase in your thyroid meds since your levels in September were quite low, even though they were "in range"... Many of the symptoms you listed are those of hypothyroidism.
You're right that your vitamin D should be higher than it is, since you've been on the weekly 50,000 IU since March... It's not customary to prescribe more than that, though your doctor may decide to have you take it twice/week instead.
How long have you been on the B-12 shots? Your vitamin B-12 is also relatively low in the range, in spite of the shots. I have pernicious anemia (inability to absorb B-12 via the gut) and I find that I have to keep my level at the very top of the range in order to keep symptoms at bay. I take my shots on a weekly basis. In addition to the shots, you could try taking a sublingual or liquid B-12 supplement to see if that would increase your level. Be sure to get methyl B-12.
You might also ask to have your folate levels tested. Folate deficiency often accompanies B-12 deficiency and also causes extreme fatigue. For folate deficiency, you need to take a body ready folate, such as 5-MTHF... Do not take folic acid; it isn't the same thing.
I can see why you'd be having trouble sleeping. If you get some of these other issues resolved the sleep issue might start resolving, as well.
When are you scheduled to retest thyroid hormones? Be sure to get a copy of the report...
It isn't necessary to avoid dairy for 4 hours after you take your thyroid medication.. You only have to avoid taking calcium supplements for that long, because of the amount of concentrated calcium; you don't have to avoid all foods that contain calcium, because there isn't so much calcium in most foods that it's going to affect your medication... I take my thyroid medication between 5:30 and 6:00 am and if I want cereal or a glass of milk for breakfast, I go ahead and have it. I just take calcium supplements at night and I have nothing to worry about.
I also take a T3 medication and because my T3 dose is very small, I take it around lunch time, to keep from crashing in the afternoon... I still sometimes do.
I'm sure if you tried splitting your Armour, you'd see a difference in the way you feel, because it would keep the T3 more stable in your system. It's also possible that you need an increase in your thyroid meds since your levels in September were quite low, even though they were "in range"... Many of the symptoms you listed are those of hypothyroidism.
You're right that your vitamin D should be higher than it is, since you've been on the weekly 50,000 IU since March... It's not customary to prescribe more than that, though your doctor may decide to have you take it twice/week instead.
How long have you been on the B-12 shots? Your vitamin B-12 is also relatively low in the range, in spite of the shots. I have pernicious anemia (inability to absorb B-12 via the gut) and I find that I have to keep my level at the very top of the range in order to keep symptoms at bay. I take my shots on a weekly basis. In addition to the shots, you could try taking a sublingual or liquid B-12 supplement to see if that would increase your level. Be sure to get methyl B-12.
You might also ask to have your folate levels tested. Folate deficiency often accompanies B-12 deficiency and also causes extreme fatigue. For folate deficiency, you need to take a body ready folate, such as 5-MTHF... Do not take folic acid; it isn't the same thing.
I can see why you'd be having trouble sleeping. If you get some of these other issues resolved the sleep issue might start resolving, as well.
When are you scheduled to retest thyroid hormones? Be sure to get a copy of the report...
1 Comments
Hi Barb. It's me again Margret
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What type of saliva test did you take that was botched? Was it a 24 hr test? I find it hard to believe that your endo started you on the cortef not knowing whether you needed it or not...
I'm confused, but that's not unusual... ☺ Were the thyroid tests done in March, the first ones you'd had? The Free T4 and Free T3 do not indicate that you even need replacement medications. The only thing that's out of range is the TSH being too high. That could indicate a different problem.
In May, how long prior to the blood draw had you taken the Armour? It's odd that your FT levels would be lower after taking med than they were prior to taking it.
It seems that the higher the dose of Cortef, the lower your thyroid hormones seem to be...
The biggest thing I see is that you're taking all of your Armour at one time in the morning... most of us taking a medication with a T3 component, find that we have to take it in more than one dose, such as 1/2 first thing in the morning and the other half around noon/early afternoon. The reason for this is that T3 is fast acting and very short lived... it's into your blood, peaks and is gone within a few hours, so what's happening to you is that you're getting the whole slug all at once, then by the end of the day, you have nothing, but the cortef may be kicking in during the last part of the day...
It's normal for the adrenals to kick in when the thyroid fails, but once we start providing thyroid hormones again, things, typically, tend to go back to normal. That's why I'm surprised that the endo started you on the cortef, even though the test was botched...
The other thing I see is your vitamin D, which is obviously, way too low. How long have you been on the 50,000 IU weekly? Vitamin D deficiency can cause a lot of hypo-like symptoms.
Due to the horrible fatigue, I'd have to wonder if you've had vitamin B-12 tested... B-12 deficiency can cause the most horrible fatigue imaginable.
It should be noted that cortef can cause weight gain, swelling/edema, dry skin, increased sweating, and some of the other symptoms you're having.
You might want to talk to your doctor about discontinuing (tapering off) the cortef, then retesting to get a proper result to see if you really need that. Perhaps the thyroid hormones and vitamins are really all you need...besides, maybe a different doctor.
I'm confused, but that's not unusual... ☺ Were the thyroid tests done in March, the first ones you'd had? The Free T4 and Free T3 do not indicate that you even need replacement medications. The only thing that's out of range is the TSH being too high. That could indicate a different problem.
In May, how long prior to the blood draw had you taken the Armour? It's odd that your FT levels would be lower after taking med than they were prior to taking it.
It seems that the higher the dose of Cortef, the lower your thyroid hormones seem to be...
The biggest thing I see is that you're taking all of your Armour at one time in the morning... most of us taking a medication with a T3 component, find that we have to take it in more than one dose, such as 1/2 first thing in the morning and the other half around noon/early afternoon. The reason for this is that T3 is fast acting and very short lived... it's into your blood, peaks and is gone within a few hours, so what's happening to you is that you're getting the whole slug all at once, then by the end of the day, you have nothing, but the cortef may be kicking in during the last part of the day...
It's normal for the adrenals to kick in when the thyroid fails, but once we start providing thyroid hormones again, things, typically, tend to go back to normal. That's why I'm surprised that the endo started you on the cortef, even though the test was botched...
The other thing I see is your vitamin D, which is obviously, way too low. How long have you been on the 50,000 IU weekly? Vitamin D deficiency can cause a lot of hypo-like symptoms.
Due to the horrible fatigue, I'd have to wonder if you've had vitamin B-12 tested... B-12 deficiency can cause the most horrible fatigue imaginable.
It should be noted that cortef can cause weight gain, swelling/edema, dry skin, increased sweating, and some of the other symptoms you're having.
You might want to talk to your doctor about discontinuing (tapering off) the cortef, then retesting to get a proper result to see if you really need that. Perhaps the thyroid hormones and vitamins are really all you need...besides, maybe a different doctor.
2 Comments
I was given 5 little cotton swabs to swirl and shish around in my mouth for up to 2 minutes then "spit" back into a little tube. I was to do this 5 days in a row between 11pm and midnight. When my dr office gave me the hospital the orders, they closed early that day, then was off for the next week, so I had to go on the instructions of the hospital vs my endo (my endo is literally 85 years old and takes A LOT of time away from the office)
needless to say, after I had done them all and turned them in, waited forever for the results and my next appointment, I was quite frustrated when the dr said I was given the wrong instructions & I shouldn't have been told to do the test the way I did it....when I asked him if we should repeat the test the way it should be done, he said we didn't need to because I said prednisone always makes me feel SOOOOO good and my serum cortisol levels were already "off", we would just try 20mg in am and 10mg in pm and see how it goes. (He's one of those dr's who'll not only treat according to lab values, he also treats symptoms....) It's like he tried to fix my adrenal glands and my thyroid all in one visit instead of trying to fix the obvious one (thyroid) first then see how it went...
But I digress....
No. The thyroid tests in March wasn't the first ones. I've had other tsh tests done that showed elevated level. I think the highest one was almost a 7. Pretty much, any time my tsh was checked, it was high.
Because of the whole "4 hour before and after" calcium thing with Armour, I've ALWAYS taken my whole Armour dose around 2:30-3:30am since I started (I wake up at 5:30am to walk 2.5-3 mi/day with my dogs) and this particular blood draw says it was done at 15:30 (3:30pm)....So we'll say this lab was drawn approx 12 hours after I had taken my daily armour dose.
It's ironic you should mention taking it in divided doses...I set my alarm to take it at @3:30am and maybe not even 12 hours later, I feel like I've been crawling around in the gutter...I feel pretty good/decent in the morning time. Most mornings, no matter if I'm working on 3 hours of sleep or 5, I'm able to get up and go walk my dogs 2.5-3 mi. Then, after we get back, I feed them & fix me something to eat, I can feel myself getting more tired and more exhausted & about board the next train; headed straight for "going to bed & not doing anything ANY time soon-ville"...
I've never heard of nor been told to take my armour in divided doses before but it makes perfect sense! I'm VERY gluten sensitive and therefore eat a pretty strict gluten-free diet. It'd be very tough trying to find breakfast food that'd allow me to eat gluten free but also accommodate my armour thyroid med & the whole, "no dairy 4 hours before and/or after" rule and be able to take it in divided doses...ugh...then between the Hashimoto's & the Cortef, it has both my blood pressure and my lipid profile screaming for mercy :*O So bfast foods like eggs are limited...
I've been on weekly 50,000u of Vit D capsules since March when I first started seeing my endo. It was discovered MUCH earlier by my dysautonomia dr but it wasn't until I started seeing this endo I started taking Vit D weekly. I've made an appointment to see my endo on Monday and I'm gonna ask if we can either increase the dosage on the Vit D or see what other options we have b/c I know after taking 50,000u/week, my levels should be much higher than they are and more needs to be done in order to get it there...
I've also been diagnosed with low b12 and was rx monthly b12 injections. The last time they were checked was in March-which was 603...
My sleep hygiene is VERY poor and in need of some desperate help...I really do believe a lot of my issues could be made better by getting more adequate sleep and getting rechecked for sleep apnea. (Had sleep study done some YEARS back and opted to use oral appliance vs cpap mask...but haven't wore appliance in about 2 years because dental procedures I've had done has now caused the appliance to not fit over my now shifted teeth)...
needless to say, after I had done them all and turned them in, waited forever for the results and my next appointment, I was quite frustrated when the dr said I was given the wrong instructions & I shouldn't have been told to do the test the way I did it....when I asked him if we should repeat the test the way it should be done, he said we didn't need to because I said prednisone always makes me feel SOOOOO good and my serum cortisol levels were already "off", we would just try 20mg in am and 10mg in pm and see how it goes. (He's one of those dr's who'll not only treat according to lab values, he also treats symptoms....) It's like he tried to fix my adrenal glands and my thyroid all in one visit instead of trying to fix the obvious one (thyroid) first then see how it went...
But I digress....
No. The thyroid tests in March wasn't the first ones. I've had other tsh tests done that showed elevated level. I think the highest one was almost a 7. Pretty much, any time my tsh was checked, it was high.
Because of the whole "4 hour before and after" calcium thing with Armour, I've ALWAYS taken my whole Armour dose around 2:30-3:30am since I started (I wake up at 5:30am to walk 2.5-3 mi/day with my dogs) and this particular blood draw says it was done at 15:30 (3:30pm)....So we'll say this lab was drawn approx 12 hours after I had taken my daily armour dose.
It's ironic you should mention taking it in divided doses...I set my alarm to take it at @3:30am and maybe not even 12 hours later, I feel like I've been crawling around in the gutter...I feel pretty good/decent in the morning time. Most mornings, no matter if I'm working on 3 hours of sleep or 5, I'm able to get up and go walk my dogs 2.5-3 mi. Then, after we get back, I feed them & fix me something to eat, I can feel myself getting more tired and more exhausted & about board the next train; headed straight for "going to bed & not doing anything ANY time soon-ville"...
I've never heard of nor been told to take my armour in divided doses before but it makes perfect sense! I'm VERY gluten sensitive and therefore eat a pretty strict gluten-free diet. It'd be very tough trying to find breakfast food that'd allow me to eat gluten free but also accommodate my armour thyroid med & the whole, "no dairy 4 hours before and/or after" rule and be able to take it in divided doses...ugh...then between the Hashimoto's & the Cortef, it has both my blood pressure and my lipid profile screaming for mercy :*O So bfast foods like eggs are limited...
I've been on weekly 50,000u of Vit D capsules since March when I first started seeing my endo. It was discovered MUCH earlier by my dysautonomia dr but it wasn't until I started seeing this endo I started taking Vit D weekly. I've made an appointment to see my endo on Monday and I'm gonna ask if we can either increase the dosage on the Vit D or see what other options we have b/c I know after taking 50,000u/week, my levels should be much higher than they are and more needs to be done in order to get it there...
I've also been diagnosed with low b12 and was rx monthly b12 injections. The last time they were checked was in March-which was 603...
My sleep hygiene is VERY poor and in need of some desperate help...I really do believe a lot of my issues could be made better by getting more adequate sleep and getting rechecked for sleep apnea. (Had sleep study done some YEARS back and opted to use oral appliance vs cpap mask...but haven't wore appliance in about 2 years because dental procedures I've had done has now caused the appliance to not fit over my now shifted teeth)...
And I am currently tapering down on the Cortef...not quite as fast as I'd like or hope for. The dose I'm currently on is 30mg in am, 10mg at noon and another 10mg around 3(ish)...I try to cut the dose by 2.5-5mg/week; depending on how it's making me feel. The withdrawal side effects/symptoms can be HORRIFIC, lasting for 3-5 days after I've cut the dose. It causes the muscles in my arms, thighs and calves to hurt, ache and throb SOOOOO freaking bad (worse than flu like pains), unregulated temperature with temp fluctuations with chills, goosebumps, feeling HOT and sweaty but skin (especially fingers and toes) SUPER cold to the touch, GROUCHINESS, IRRITABILITY & MOOD SWINGS...I'd say the 3 absolute WORSE side effects I have to deal with is the God awful fatigue, the God awful muscle fatigue/pain/achiness...but the probably the worst thing is the God awful depression and the inability to get up and get things done & the ability to feel happiness in things. I have the want and desire to do things such as walk my dogs, clean the house, heck, even to shower and wash my hair (my hair is literally past my butt cheeks) but aside from knowing most time I just don't have the energy to do anything, there's still something else going on that makes it next to impossible to get anything done. I don't wanna leave the house most of the time and I've discovered some of my aches and pains are actually coming from being SOOOO depressed...I LOATHE the way I'm physically, mentally, emotionally, and psychologically feeling right now...
I tell you what, this medicine may be helpful to some but for me, it was sent straight from the devil himself!
I tell you what, this medicine may be helpful to some but for me, it was sent straight from the devil himself!
COMMUNITY LEADER
Hi bizzylizzy06... Thank you for the vote of confidence... :-)
First off, can you tell me what your exact symptoms are?
Secondly, do you have current labs you could post? Your doctor should be ordering Free T3 and Free T4, along with TSH, on a regular basis. Please post reference ranges along with any results, since ranges vary from lab to lab.
Once I know symptoms and see what your actual thyroid hormone levels are, I'll be able to give you a lot more information...
First off, can you tell me what your exact symptoms are?
Secondly, do you have current labs you could post? Your doctor should be ordering Free T3 and Free T4, along with TSH, on a regular basis. Please post reference ranges along with any results, since ranges vary from lab to lab.
Once I know symptoms and see what your actual thyroid hormone levels are, I'll be able to give you a lot more information...
4 Comments
Here's the symptom list I wrote down for my endocrinologist when I first saw him in March this year...
-knuckle dragging fatigue
-cold intolerance
-profusely sweat under minimal exertion
-unable to lose any weight
-heart palps- revved up feeling
-hoarseness
-dry mouth
-dry brittle nails
-hair loss
-EXTREME irritability & depression
-insomnia
-crave sweets & salty foods
-muscle ache/pain/fatigue
-hard to get going in morning time
-catch my 2nd wind late afternoon/early evening
-Inability to handle/tolerate/process stress/stressful situations appropriately
-eyes extremely sensitivity to light
-severe brain fog/mental unclarity
3/24/16...(no meds)
tsh- 5.390 (0.450 - 4.500)
FT4-1.42 (0.82 - 1.77)
FT3- 4.3 (2.0 - 4.4)
Thyroglobulin Ab-7.3 (0.0 - 0.9)
TPO Ab-36 (0 - 34)
Endocrinologist put me on Armour Thyroid 30mg. After a botched saliva cortisol test, he just started me on Cortef for my adrenal glands. I was put on 20mg in am and 10 mg mid afternoon.
5/9/16... 60mg Armour, 30mg Cortef
symptoms same as earlier with no improvement. (took armour before this blood draw b/c I didn't know you weren't supposed to take it before blood test)
tsh- 1.460 (0.450 - 4.500)
FT4- 1.03 (0.82 - 1.77)
FT3- 3.5 (2.0 - 4.4)
Was instructed to increase Armour to 75mg then to 90mg
5/25/16: family crisis-ordered to double Cortef to 60mg/day...
(doubling the cortef initially made me feel better; for the 1st time in sooooo many years, I actually had my first "normal" feeling day where I had so much energy and the brain fog lifted. so he had me keep it at this dose...only lasted for 2 days then it went back to the same ol same ol knuckle dragging fatigue on a now higher dose of steroids)
7/7/16...Armour 90mg, Cortef 60mg (but titrating down because I want to lower the dose)
tsh-1.520 (0.450 - 4.500)
FT4-1.17 (0.82 - 1.77)
FT3-3.4 (2.0 - 4.4)
Thyroglobulin Ab- 24.5 (0.0 - 0.9)
TPO Ab-29 (0 - 34)
(I took my 90mg of Armour Thyroid med a few hours before my blood draw)
Continue feeling extremely fatigued with all the above symptoms continuing. The Dr. kept me on Armour 90mg but added 5mg of Cytomel in case the problem was trouble converting...
8/25/16- Armour 90mg, Cortef 30mg/day
(I discovered you aren't supposed to take thyroid meds before blood draw...)
tsh-4.480
FT4-1.39
FT3- 4.6
Feeling extremely sluggish...continued knuckle dragging exhaustion where it feels as if all the energy I had was only enough to keep myself alive. instructed to stop Cytomel & continue Armour at 90mg...
9/27/16- 90mg of Armour, Cortef 60mg/day (had weaned down significantly on Cortef but had to double again & went back to 60mg/day)
tsh- 1.170 (0.450 - 4.500)
FT4- 1.15 (0.82 - 1.77)
FT3- 3.0 (2.0 - 4.4)
Thyroglobulin Ab- 1.3 (0.0 - 0.9)
TPO Ab- 13 (0 - 34)
Instructed to increase Armour to 109mg (90mg + add 15mg tab)
10/2016-
I haven't went back to the endo yet. I've been taking Armour 109mg every morning and the Cortef is at 30mg in am, 10mg at noon and 10mg late afternoon. Aside from the MASSIVE weight gain (loads of extra fluid/water accumulation in legs & abdomen area) & the weight/fat redistribution happening to my face, neck, back and stomach, I'm actually FINALLY starting to feel like I'm crawling out the deep dark hole I've been in for so long. A lot of the symptoms have gotten better. What makes me think I could be in a hyper state is the worsening of heart palps & that anxious-like revved up feeling (usually starts midday and lasts well up until late night), nervous energy feeling (like I can't sit down...wanna be up pacing or piddling with something) and continued insomnia...no matter how tired I am or how little sleep Ive gotten, my usual bedtime is between 1-2am...
I haven't had any labs done since starting the 109mg dose to see where I stand. I'm LOVING the increase in energy & having wayyyy less fogginess in the brain dept and it even feels like I'm less agitated & having less mood swings...but the nervousness, jitteriness, etc...is what still bothers me. I'm afraid if I were to back off and go back down on Armour, I'm so afraid of having to trade back out the nervousness for the energy...ugh...
I'm sorry this is so long. I didn't know how detailed you needed it to be so I just gave you ALL of it :)
-knuckle dragging fatigue
-cold intolerance
-profusely sweat under minimal exertion
-unable to lose any weight
-heart palps- revved up feeling
-hoarseness
-dry mouth
-dry brittle nails
-hair loss
-EXTREME irritability & depression
-insomnia
-crave sweets & salty foods
-muscle ache/pain/fatigue
-hard to get going in morning time
-catch my 2nd wind late afternoon/early evening
-Inability to handle/tolerate/process stress/stressful situations appropriately
-eyes extremely sensitivity to light
-severe brain fog/mental unclarity
3/24/16...(no meds)
tsh- 5.390 (0.450 - 4.500)
FT4-1.42 (0.82 - 1.77)
FT3- 4.3 (2.0 - 4.4)
Thyroglobulin Ab-7.3 (0.0 - 0.9)
TPO Ab-36 (0 - 34)
Endocrinologist put me on Armour Thyroid 30mg. After a botched saliva cortisol test, he just started me on Cortef for my adrenal glands. I was put on 20mg in am and 10 mg mid afternoon.
5/9/16... 60mg Armour, 30mg Cortef
symptoms same as earlier with no improvement. (took armour before this blood draw b/c I didn't know you weren't supposed to take it before blood test)
tsh- 1.460 (0.450 - 4.500)
FT4- 1.03 (0.82 - 1.77)
FT3- 3.5 (2.0 - 4.4)
Was instructed to increase Armour to 75mg then to 90mg
5/25/16: family crisis-ordered to double Cortef to 60mg/day...
(doubling the cortef initially made me feel better; for the 1st time in sooooo many years, I actually had my first "normal" feeling day where I had so much energy and the brain fog lifted. so he had me keep it at this dose...only lasted for 2 days then it went back to the same ol same ol knuckle dragging fatigue on a now higher dose of steroids)
7/7/16...Armour 90mg, Cortef 60mg (but titrating down because I want to lower the dose)
tsh-1.520 (0.450 - 4.500)
FT4-1.17 (0.82 - 1.77)
FT3-3.4 (2.0 - 4.4)
Thyroglobulin Ab- 24.5 (0.0 - 0.9)
TPO Ab-29 (0 - 34)
(I took my 90mg of Armour Thyroid med a few hours before my blood draw)
Continue feeling extremely fatigued with all the above symptoms continuing. The Dr. kept me on Armour 90mg but added 5mg of Cytomel in case the problem was trouble converting...
8/25/16- Armour 90mg, Cortef 30mg/day
(I discovered you aren't supposed to take thyroid meds before blood draw...)
tsh-4.480
FT4-1.39
FT3- 4.6
Feeling extremely sluggish...continued knuckle dragging exhaustion where it feels as if all the energy I had was only enough to keep myself alive. instructed to stop Cytomel & continue Armour at 90mg...
9/27/16- 90mg of Armour, Cortef 60mg/day (had weaned down significantly on Cortef but had to double again & went back to 60mg/day)
tsh- 1.170 (0.450 - 4.500)
FT4- 1.15 (0.82 - 1.77)
FT3- 3.0 (2.0 - 4.4)
Thyroglobulin Ab- 1.3 (0.0 - 0.9)
TPO Ab- 13 (0 - 34)
Instructed to increase Armour to 109mg (90mg + add 15mg tab)
10/2016-
I haven't went back to the endo yet. I've been taking Armour 109mg every morning and the Cortef is at 30mg in am, 10mg at noon and 10mg late afternoon. Aside from the MASSIVE weight gain (loads of extra fluid/water accumulation in legs & abdomen area) & the weight/fat redistribution happening to my face, neck, back and stomach, I'm actually FINALLY starting to feel like I'm crawling out the deep dark hole I've been in for so long. A lot of the symptoms have gotten better. What makes me think I could be in a hyper state is the worsening of heart palps & that anxious-like revved up feeling (usually starts midday and lasts well up until late night), nervous energy feeling (like I can't sit down...wanna be up pacing or piddling with something) and continued insomnia...no matter how tired I am or how little sleep Ive gotten, my usual bedtime is between 1-2am...
I haven't had any labs done since starting the 109mg dose to see where I stand. I'm LOVING the increase in energy & having wayyyy less fogginess in the brain dept and it even feels like I'm less agitated & having less mood swings...but the nervousness, jitteriness, etc...is what still bothers me. I'm afraid if I were to back off and go back down on Armour, I'm so afraid of having to trade back out the nervousness for the energy...ugh...
I'm sorry this is so long. I didn't know how detailed you needed it to be so I just gave you ALL of it :)
btw: lab results on 9/27/16 - no thyroid meds beforehand
and thank you so much for taking a look at this for me! this is all so confusing to me...and apparently for my 95 year old dr as well :o
oh one last thing that might be important I left out...
3/24/16- Vit D was 13.6
was rx Vit D 50,000u/weekly
5/5/16- 27.9
7/7/16- 24.5
8/25/16- 28.8
9/27/16- 23.4
3/24/16- Vit D was 13.6
was rx Vit D 50,000u/weekly
5/5/16- 27.9
7/7/16- 24.5
8/25/16- 28.8
9/27/16- 23.4
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