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Liver and T3 conversion / high Bilirubin anyone?
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Liver and T3 conversion / high Bilirubin anyone?

I bet Stella knows this (?), but it's also a poll / question for any that have it - so please respond, its a rare question!  

My question comes up after I was reminded that T3 is converted via the liver on another post. Thyroid is linked with so much other stuff its hard to keep track!

I, like many here, might have a T4 to T3 conversion problem that does not show on the lab tests. I dont know how a conversion issue is proven, is there a way? My docs dont seem to know or care about conversion. All I know is I feel somewhat better with T3 in dessicated and I am driven to find out the very reason. Below may or may not be the reason why.

I just had a AMA comp panel (physical), and for years my Bilirubin is over the range (double!). Doc always brushes off the high Bilirubin since the other liver tests are OK. This has something to do with the liver and Juandice. My other liver tests (Alkaline Phosphate, AST and ALT) have always been and still are in the middle range, they are OK!. There is a name for this unbalanced condition.

My question(s): 1) Does anyone else have high Bilirubin with Hoshi's and have the other liver tests in range?

2) Anyone no what high Bilirubin has to do with the Liver converting T4 to active T3 in a Hoshimoto Hypo person?

Thanks, getting educated on this for my next appt if need be. I will admit I don't know much about the liver, but I know enough to take it easy on Tylonel (and booze)!

Moose


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Avatar_f_tn
I don't have the liver imbalance, but one thing struck me in your post..."I, like many here, might have a T4 to T3 conversion problem that does not show on the lab tests."  A conversion problem should be apparent on lab tests IF the physician reading them has any real expertise in thyroid issues.  What is your FT4 and FT3?
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Avatar_f_tn
hi, ive just read your post, ive had graves disease for 11years, and i have a high bilirubin level in my blood, it also shows up in my urine as well, but dont know what it means?
The doctors dont seem to be interested in it. So i would be interested to know more if you find out please let me know.
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219241_tn?1413541365
There are some many reasons why a person has high levels of biluribin  in their blood. I have not seen any of them related to thyroid disorder though. Hepatitis is a common reason. Often it is just one of those things that some people have higher break down of red blood cells than others.
There IS a test to find if you have a conversion problem. It is called Reverse T3. Unfortunately you may have to fight to be heard on this one, as many doctors do not even believe in it to start with. Also it is expensive. BUT having said that, if you find you have a high level ( it is worked on a mathematical formula and very confusing too!) then you know you have a conversion problem.
I myself am going through the whole works of the conversion of doctors into believing the results of my own conversion problems!
Cheers!
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Avatar_f_tn
High bilirubin level is usually with either high cholesterol or Gall bladder problems.
Get those checked.
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393685_tn?1325870933
OK - In my eyes - here's the jest...

On the conversion tests... RT3 can be associated with a conversion issue - but it is only one sided. A reverse T3 is the test to determine if the T4 conversion is storing the active hormone and really turning it backwards into RT3 - that is why the idea of removing the patient off T4 meds and putting them on a T3 ONLY med is given. To eliminate the reverse T3 hormone and release it to active T3 - with only a T3 med used.

On the conversion issues - that is pretty simple. An educated look at the Free testing can determine if you have a conversion issue. a high FT4 reading and a low T3 reading on any thyroid meds - could determine a conversion issue. That is simple math. BUT a range of testing on frees is look at and if you fall within the normal limits then usually a doctor will only look at one test or the other to determine the increase or decrease of meds to balance it out - of course with the TSH being their guide more so than the others.

You have a high enzyme count when it comes to the bulirubin results. It is enzymes of the liver that is creating that. Can Hashimoto be associated with that? Most definately.

AMA tests and Alkaline Phosphate, AST and ALT determine different issues of the liver and what is faulty. Can it peg out thyroid levels - no I don't think so.

But you have to always keep in mind that the liver is our filteration of us as living beings. What we take in - must be purified for our bodies to live well. Meds in any form - if swollowed - must be filtered through our livers and this will caused disruption.  Keeping the body cleansed is the best and BTW - a good lemon and water drink is wonderful to keep that organ clean.

Now - with Hashimoto hypothyroid - we swing into rages of hyper and hypo. Where are those hormones going? You guess it - the liver. the liver will fall responsibile to filter out the bad hormones- access - so where to those excess hormones store. Liver.

Slow production (hypo) causes the liver to become starved too. It knows it must filter the bad - but it won't work properly when nothing is feeding its way. What will it do? It (as weight is for hypo's) stores the bad stuff inside and becomes ill itself - because the body is not moving in the right gears to keep everything well.

Hense - high tests

Flush your livers - it's our life filtering machine.



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393685_tn?1325870933
Oh and ditto on Smiler Deb - it's so associated with high cholestrol tests.
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798555_tn?1292791151
Goolarra and/or anyone good with labs:
I'm due for a new test in two weeks, here is some past labs. For some reason my muscles recover quicker on dessicated, its a fact after 5 months of trial. Less brain fog too. But still a little tired.

Keep in mind I dont know if I ever had the old Armour, As I switched in mid may from Synthroid.

June: alternate between 90mg and 105mg Armour per day

free T4     .71     range is   .71 - 1.85 ng/dl
TSH       3.87     range is   .30 - 5.00 uIU/ml
free T3    3.08     range is 2.30 - 4.20 pg/ml

August alternate between 105mg and 120mg Armour per day
free T4     .87     same range
TSH       2.56     same range
did not do free T3 this time

I was still ramping up on the Armour a little between June and August, I am now on a generic dessicated with the same ratios per grain of T3:T4 as Armour. Was ramped up again to 2 grains (on this generic 2 grains is 130mg like Nature -Thriod mg's).

I will ask specifically for free T3 on my next test in two weeks

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Smilerdeb :
-My doc got back to me - High Bilirubin, but with good labs on other Liver functions is called Gilbert's Disease and is genetic. He says its not really a disease - still makes me wonder. My cholesterol is really good for a 42 year old. I will ask about the gallbladder, good point! (hope my doc wont put up a fuss, when dont they?).

Stella:
- I will look into a good liver cleanse, Enzyamatic Therapy brand should be safe and is from the cheese head state! He// we got Brett Favre now, might as well try your brand of liver cleanse too! Purple and Gold really aren't his colors though.

Thanks all - everyone
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798555_tn?1292791151
I will ask my doc about reverse T3 test if needed after you guys look at my labs.

Thanks
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393685_tn?1325870933
After all his moodiness, Mr. Farve doesn't look good in any colors in my opinion. . You don't necessarily need to go straight for the gusto on a harsh liver cleanse. Purifying the liver should be a simple daily thing to keep levels good. Depending on the toxin level your liver is at - this is where you learn what's best for you too.

Straight lemon water throught the day is wonderful and there is a supplement that could help too. Bioavailable Diindolymethane ( or DIIM) for short can help rid those toxins too. It doesn't give you the nasty side effects of a cleanse either.
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Avatar_f_tn
Iced lemon tea does it for me....I had bad levels from anti-thyroid meds and the iced lemon tea fixed my liver up.
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Avatar_f_tn
WHY don't they do FT3 every time, especially when you're on a T3/T4 combo med?  That's a rhetorical question....

So, in June, you were still pretty hypo with a TSH of 3.87 (currently accepted range is 0.3-3.0 - your lab and doctor, like most, are using the obsolete range).  FT4 was on the floor, but FT3 was into the mid third of the range.  You were definitely not lacking T3 relative to your T4 levels.

How long after the switch from Synthroid to Armour were those June labs run?  Did you take your Armour before the labwork?

By August, your TSH had fallen into range, and your FT4 had improved, though still pretty dismal.  Unfortunately, we have no clue what FT3 was doing.  

Do you know what your FT3 and FT4 looked like prior to starting Armour?

It will be interesting to see your labs in a couple of weeks.  WIth the last complete labs done in June (3-4 months ago), and incomplete labs with no T3 done in August, and meds changes in between, we don't have a lot to go on.  

Your muscles recover quicker on Armour because of the T3 content.  The biologically most active hormone is available to them.  However, in June, your FT4 was so low that there was very little T4 available for conversion to T3.  When that's the case, your body will "protect" itself.  The brain, the heart, other essential organs get their share before the muscles (which are expendable - you and your body may disagree on this point!) do.

Since you're on meds with a high T3 ratio, it IS difficult at this point to figure out if you have a conversion problem.  When you were on Synthroid, were labs ever run that had TSH and FT4 in range (and off the floor)?  However, until your FT4 gets up higher in the range, I wouldn't be too quick to jump to the conclusion of a conversion issue.  Before you think about a conversion issue, you have to have enough T4 there TO convert.  Your FT4 still has a long way that it can go.  

Is your fatigue sporadic?  Certain times of day?  Do you split your Armour dose?

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798555_tn?1292791151
How long after the switch from Synthroid to Armour were those June labs run?  Did you take your Armour before the labwork?  I was on Armour for about 12 weeks prior to that June test. The test prior to that looks better but the doc did not ramp me up so I felt hyper and shaky - dont think the test is worthy since I felt realy bad. I have my lab work at 8:30 am before I take my meds to be consistant.

By August, your TSH had fallen into range, and your FT4 had improved, though still pretty dismal.  Unfortunately, we have no clue what FT3 was doing.  I cant believe they did not do T3, very dissapointed!!

Do you know what your FT3 and FT4 looked like prior to starting Armour? My last test on Levothyroxin (levothyroxine) after 10 years was Jan this year:

Free T4    1.4       range .71 - 1.85
TSH           .67     range .30 - 5.00
Free T3    3.49     range 2.30 - 4.20

During this time (above) my fatigue was very sporatic (sitting and driving) and I had major muscle spasms. This was with a good multi vitamin. I do know something about vitamins / supps. I take more Mag and potasium for muscles, it helped a little, but not for fatigue.
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After months of Armour I am less tired but not yet normal energy. I have to keep active. I am now layed off work so its hard to judge my energy levels.  My doc would not test for D, said its not proven! I tried 3000 ui of D last month and it might have helped. I lowered back to 1000 ui of D because you cant try out two new things at once- I really need for the dessicated to level out before I try changing vitamins to know what helps and what does not. So, time is on my side for that, until my ins runs out. If that happens I will use a new cash doctor I spoke with and a cash lab I found.  Doctor $40 , lab $80.

thanks
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Avatar_f_tn
I know, getting FT3 is like pulling hens' teeth.  I have to check on this before every blood draw.  

I find your January test interesting because even though you were on a T4-ony med, your FT3 looks really very good...it's at the very top of the middle third of the range.  So is your FT4 for that matter.  And January labs look way better than either June or August.  

When I was hypo, sitting was deadly for me.  As long as I kept moving, I was fine, but the minute I sat for more than about ten minutes, I was asleep.  I'd categorize it more as a kind narcolepsy than fatigue.  As long as I kept moving I had plenty of energy.

Good idea...only change one thing at a time, otherwise you have no clue.  

It looks a lot to me like you're one of those people who has to have FT3 and FT4 well up in the range before all your symptoms are relieved.  I don't really see any indication of a conversion problem.  (RT3 would confirm that.)  Your labs really did look good in January, and with just mild fatigue lingering, a small meds adjustment to nudge your numbers up just a little might have done it for you. I'll be interested to see what's going on now.  
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798555_tn?1292791151
I do feel better now on dessicated (with not so fantastic labs) than in January with good lab levels on T4 only. But I'm still not symptom free. Even though my Jan labs numbers look good, I felt like garbage, - like many years prior. I was the classic looks good on labs, but still symptomatic T4 patient. So if its not a conversion issue its good to know. I always look for a reason for things, somethings take longer to figure out.

Will post new labs in a few weeks.
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681545_tn?1318020980
hi bilirubin is called gilbert syndromedoc arnt to worried about it,well that's what my doc told me last week.i have grave's one year now but i did have a high bilirubin when i was expecting my daughter 2 year's ago it did settle down it was in the thousand figure's it's now at 48 in july it was at 38 but was told not to worry you can look up on computer to get more info ,xxx
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Avatar_f_tn
Well, there is no point in having "perfect" numbers and feeling like cr@p.  The object is to be symptom-free.  

You could have a conversion issue...I'm not a doctor, but I just don't see it in the labs you've had so far.  Usually, if there's a conversion issue, FT4 will be high (or higher) and FT3 will stay low.  Of course, once you're on a med with T3 in it, that can get a little muddled (less so if you consistently take your meds after your blood draw).  But, I don't see it in your January labs, either.

You may just need a little increase in your Armour.  It'll be interesting to see the labs.  
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Avatar_f_tn
Oh, and I keep meaning to ask...Who is Billy Rubin, anyway?
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219241_tn?1413541365
Billy Rubin is the cousin of Arthur Ritis!
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798555_tn?1292791151
Goolarra -"WHY don't they do FT3 every time, especially when you're on a T3/T4 combo med?  That's a rhetorical question...."

I just asked the clinic to include my free on my lab test this week T3 since I was taking T3. There answer "we usually don't test T3 on patients taking it because the T3 in Armour will falsely elevate it, it will not be accurate" That was the nurse I always have to talk to. She needs to stop playing doctor, I am losing patients with this woman.

Well, they might as well not test T4, since I am taking that also!

This is supposed to be the best Endo place in this state, they clearly don't know much about managing thyroid. I didn't even think of asking about Reverse T3, I'm sure they think that is non-sense. I will have to demand free T3. Even though the doc did prescribe Armour at my request after years of symptoms on T4, this is clearly what I call a TSH, Synthroid clinic! That's the age we live in. They didn't want to do vitamin D either, that's a subject on another post!

Inadequate medical testing  is what let a sometimes curable disease take my fathers life in 1993 so I have developed zero patients for clinics that only treat symptoms half heatedly after the fact. We are their customers and they don't get this.

Geez, I had to vent twice today- about our medical system!

Anyone with a great doctor - remember to be thankful you found him/her !

Moose

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Avatar_f_tn
I wish I could tell you you're overreacting, but your tirade about the medical/industrial complex pales in comparison to some of mine.  I haven't had a PCP do anything right lately.  On the other hand, I have found a great endo (sheer luck) and recently saw another specialist who impressed me.  I'm really beginning to believe that you now have to diagnose yourself and refer yourself to someone who knows something.  If you need a tetanus shot, see your PCP, otherwise, forget it.  Of course, as with your experience, a specialist isn't any guarntee, either.

The T3 in Armour will effect the test, but if you consistently don't take it until after the bloodwork, there isn't much hanging around from the day before.  Furthermore, as you said, why test T4 based on the same logic?  

You're right...we are the customers and we're paying dearly for the round 'em up, move 'em through medical mentality.  

Just remind them you're paying for this, and you want FT3.    
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798555_tn?1292791151
Well said.

And Billy Rubin? ......I think he was in a Monte Python movie.

: )




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393685_tn?1325870933
what a rediculous comment made by your doctors office.

"There answer "we usually don't test T3 on patients taking it because the T3 in Armour will falsely elevate it, it will not be accurate"

Oh my Lord.... If you are taking anti cholestrol meds - aren't they going to test your HDL and LDL to see if it's working?"

Where are these doctors getting these answers?

I am finding the the "best" so called thyroid doctors/specialists are the most closed minded.

It seems - at least as I take it - the little guys in a hole somewhere are really the ones who look at these tests and people walk out much better from them then going to the biggest hospitols around.
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798555_tn?1292791151
My thought on specialists also! They hate that fact that I'm on dessicated. When I told them about the shortage, I think they silently smiled. Then I found the generic and they fround (on the phone). There speech of "we have 700 thyroid patients and only 15 on Armour, so you probably dont need it either!" Well maybe I am # 16.

The thing is, the Mayo Clinic in this state does not reflect at all with the rest of the medical community here.

Yes, some hole-in-the -wall , old school docs are the best.
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798555_tn?1292791151
I think the thing is with these doctors  comments, is they think patients are stupid and can not possibly understand the human body. When we know more on a specific subject they feel threatened. And they should, that is exposing there lack of interest in a specific subject. It blows me away when a doctor starts off with "well back in medical school , bla bla ,bla"  Which tells me some never self learn after school. Once out of med school thats it, and close the mind.

I think the real difference is in a doctor who is just in it for the money and status (80%-90%?), and those that have a real interest in healing people. If not interested in healing people one should not be in medical, duh.
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Avatar_f_tn
I think you're giving them too much credit in a lot of respects.  Yes, sometimes they think we're too stupid to understand.  But I think they're sometimes just plain stupid!  Their knowledge is severely limited.  

I read a book quite a long time ago called "The Lost Art of Healing" by Theodore Lown.  He was a cardiologist who came of age just after WWII, and he describes the changes in medicine during his career.  It's a fascinating book.  The art of healing is an endangered species.  It's been replaced by the science of medicine, and we're all suffering from it.  I have no idea if the book is still in print or not, but it's a good read.  He talks about a mentor of his who could diagnose a heart attack by asking the patient a few simple questions...his success rate was higher than what's achieved now with all our expensive testing.

Really, a lot of these guys must be just boring themselves to death.    
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798555_tn?1292791151
"I think you're giving them too much credit in a lot of respects.  Yes, sometimes they think we're too stupid to understand.  But I think they're sometimes just plain stupid!  Their knowledge is severely limited."

Yes, sometimes they are just plain stupid. I try to show a little bit of respect for them, only for how gruling medical school sounds. And of course this is a public forum, I have to remind myself of that!

Then again one of my finals in Engineering was 6 hour long, and I dont get no respect (like Dangerfield) LOL. Doctors absolutly hate logically minded folks that ask intelligent questions. They come back with "you engineers think of the body like its a machine...." My answer: it is like a finely tuned machine with flesh and a soul!

I really try to hold back on what I think of doctors, gets harder to filter every post.

The most knowledgeable 'doctor' I have met was (seriously) a homeopathic chiropractor. Gastroenterologists are way worse than Endos, don't get me started on them. Errrrrr......wait, mooses snort don't they!  I guess I need to find a snortalogist to spell out a snort sound.
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734073_tn?1278899925
If a patient goes into their doctor to discuss their symptoms as being possibly thyroid related, hands them a list of the proper thyroid test to run, and then the doctor runs everything but; then I consider that a slap in the face! This happened to a friend of mines father yesterday! We are so upset, and they have no insurance! I told her, he shouldn't pay that bill because that is not what the CUSTOMER asked for! However he did give him a nice fat script of Loratab extra strenght with refills and extra cholesterol medicine! My aunt went to her doc. yesterday and he refussed to run anything for her! Yet she hurts all over (Fibromyalgia my ***) and has had all the symptoms of hypothyroidism for sooooo long! Anyone know of a good doctor for her in the Layfayette, LA area?
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1070570_tn?1283439813
Hey!
I have a high bilirubin too. I was also having a little liver area tenderness, so my doctor had me get an ultrasound on it. I am still waiting on those results. I also just started a compounded T3 med and Hydrocortisone twice daily. Just thought it was interesting that many of us "hypos" have high bilirubin...there has to be some connection with that. I am eager to see what my other liver tests reveal...
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798555_tn?1292791151
Hopefully your other liver tests will be fine and like others, you just have high bilirubin. On the other hand, its a reminder to be kind to the liver.

Let us know how the extra T3 goes with you, or did you take dessicated before and just changed to compounded since the shortage?

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393685_tn?1325870933
I met a chiropractor yesterday to do a live webchat for us. I found him online and set up a brief meeting with him.

I was blown away with our brief conversation. He is brilliant in thyroid  healing discussions and understanding.

I ventured a question since I had my own thyroid removed in 2004 by ablation, if there is a way to rebuild the body back to it normal state after ablation. I was left with the thought it can happen for some. and I believe him.

It was mind blowing to me that a chiropractor had such an interest in thyroid health - but yet it makes total sense if you research it. Before he was certified - he began his career in lab testing. Sounds to me - like he mastered the knowledge of many tests and knows what's bogus and what really pin points certain things. He is a supporter of Free  testing too and not fond of the TSH.

Our brief discussion was around amino acids - some herbs - hormone balance - and the spirit side of healings. There was more involved but these touch a few real underlining issues that cause illness.

Even through I have been reading on thyroid and hormones for over 7 years - I was taken back on how everything I learned can come together - with my discussion I had with him. Seriously I couldn't sleep last night and have been up and down all night going back through all my information and putting things together based off that meeting.

He has a passion for health and for the human body. In 15 years and all the doctors I have seen when I was so ill, I had never witnessed such christian medical caring for a person as I saw in this man's practice. He also was very open to giving me some praise for being such a global advocant for this disease. I appreciated that from him.

The real issue is the most "medical" communities will debunk any treatment without their background of information. I find that appauling. Not one method is right for all.

It's amazing what available out there for us to find better health. It's not just the onesided treatment options that are oversized in treatment plans.

I am working on getting this chat up in 2010 for Thyroid Awareness Month.
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Avatar_m_tn
Hello ,
after increasing the dose of the Eltroxin (T4) , my AST and ALT jumps very high ~300 !!
and it took them few months to start to sink !


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649848_tn?1357751184
My latest bilirubin 9/30/09 - was very low - 0.3 with a range of 0.2-1.2. My ALT was "low normal"; AST, about mid range.  I have Hashi's AND high cholesterol levels, along with a conversion problem.  
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1070570_tn?1283439813
I took levoxyl before..I just started compounded T3 a week ago. I haven't had any major positive changes yet. But hopefuly I will and I will let everyone know!!! Take care!
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Avatar_m_tn
sept 30 you posted that when hypo you had plenty of energy so long as you kept moving. Marvellous to identify with that! I find that sick and dizzy I can force myself to get on my bike and do 5km in 23 mins and feel ALIVE. But does it mean something medically, about our condition? (i'm the old goat,81, with heart/thyroid problems)
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Avatar_f_tn
Well, I'm the slightly younger goat (59 soon) with the heart/thyroid problem!  I don't know what it says about our condition.  I just think it's important in that it's YOUR personal symptom of being hypo.  I was really never tired when I was hypo, but I got to the point where I could sleep anytime, anywhere.  So, now I know that if I'm actually feeling "tired", it's probably related to something else (like my 2 am ruminations on death and destruction!).  If I'm not falling asleep at inappropriate times, it's probably not a thyroid symptom (for ME).  Also, I have never, in my adult life, slept during the day or in the car (if I do that, WHO is copiloting?!), so this was extremely unusual for me.  It could be that the bike ride just stimulates your metabolism and makes you feel that much better...gets the blood flowing, clears out the cobwebs.  Do you have a theory on what it says about our condition?
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Avatar_m_tn
I haven't a  theory but the germ of an idea. It's about heart, not hypo. If my echocardiograph 'suggested' a 'probable' triple block (of unknown extent), and the clearest symptom of this condition is breathlessness and chest malaise, especially after exercise, how is it I can really push it on the bike for full 30mins and breath easily, slow and steady and feel fit for all or most of the day afterwards? If there are narrowed sections in my heart arteries, where are they when I'm pedalling ike a lunatic on the flat and pushing hard  uphill?
My 2am dooms are acute. Once they were rather anger over past errors and missed opportunities. Now they are real anguish over the same events and unaccountably painful sympathy with the small hurts of others, hurts not of my doing. I tell myself to wrench my head away from these ruminations and latch onto some small bright spot in the day - like cutting a minute off my time for 6.5kms biking. It's a struggle. It clouds life.
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Avatar_f_tn
I have to say that's a good question.  It seems your symptoms don't fit the test's diagnosis, but we're all very familiar with that scenario...  If you wanted to explore it further (and relieve yourself of some cash in the process), you might consider a nuclear stress test.  This actually sees what's going on in the heart during and after exercise.  

My heart problem is a congenital defect that predisposes me to tachycardia.  Obviously, I've had it since I was born, but never knew exactly what it was until just a few years ago.  Long story...but I had been made to feel like a whack case in childhood when I talked about my tachycardia/palpitations, so I always kind of kept it to myself.  I believe it was when my thyroid went hyper prior to going hypo, the tachy went from a few times a year to 20-30 times a day.  It was back to its few times a year until I got on levo.  Anyway, to try to start making a long story short, I finally went to a doctor to find out what was wrong when it went wild at 20-30 times a day.  Of counse, she did an EKG and said, you've had an MI.  Wrong, I said, I've had this all my life.  No, you haven't, she said, this is something different, you've had a heart attack.  Anyway this went back and forth for about eight hours during which time I got my tachy in her office.  She couldn't believe my HR was 208, but aside from that I was doing fine.  After faxing my EKG all over the state, she finally very reluctantly believed that I hadn't had a heart attack...but, man, I'll tell you, after that EKG popped out with MI written all over it, there was no convincing her until the specialist's specialist got in on the act.  Despite the best of modern tests, thing's still aren't always what they seem, and as much as they want to discount those messy, subjective symptoms, it simply can't be done.

I wish I knew the answer to the nightly ruminations as both my husband and I and several of my friends suffer from them.  Of course, I stubbornly stay in bed and "try to go back to sleep".  I often think I should get up and distract myself instead of torturing myself.  But I don't.  I think this started when I was overmedicated/hyper and has become a bad habit.  I wake up at almost exactly the same time every night...even automatically adjusted for the change to standard time the other night!!!!  If you come up with a solution, let me know.
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649848_tn?1357751184
Okay, you two, let me in on this with you.  I'm hypo and also have heart issues, although I don't know at this point how severe it is.  I have the same ruminations in the middle of the night -- but what usually wakes me up is the horrendous pounding in my chest.  This usually happens after I've been asleep for a few hours, so I'm just at the point where I'm tired yet, but can't go back to sleep.  Like goolarra, I feel like I "should" get up and do something constructive, but I lay there in the hope of going back to sleep because I know if I get up TOO early, I will never make it through the day, since I often have a hard enough time doing that.  

I'm finding it more and more difficult to exercise much without being short of breath and it seems like it takes longer each time to recover.  

I'll be happy to hear the solutions you guys come up with.
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You don't know how serious your heart issue is? me neither, becasue I had a echocardiograph with dubotaminbe (dye). The conclusion was that the test 'suggested' heart problem and that the examning doctor thought it was 'probably' trifasicular (triple block). The next step, they say, is  catheter and dye exam and probably put in a stent or two while they're at it; or, if it really is triple, go for a bypass. I said I'd go the medication/execise/diet route while i think it over. Did you not even have an EKG? Mine shows a left and right bundle block. I am now looking for a noninterventionist cardio because I don't think my meds are the best combination. My heart doesn't pound so much as before. I can feel it at times nd listen to it. It is steady on what evryone calls a clearly inadequate dose of propafenone - only 150mg/day.
Ruminations. I thought I saw this in a list of hypo symptoms. I confess to taking .50 alprazolam at night for the past week.  I sleep eight hours and have not  had the dooms. the hot/cold sweats stopped too. Doom, of course, can hit in daylight but don't last more then a minute. Why? because you're doing something. That means when you get a 2am doom, get up. That's what grandma used to say.
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649848_tn?1357751184
My heart problem is that my aortic valve is leaking (regurgitating).  I've known it for about a year, but when first discovered, it wasn't bad enough to be concerned - they couldn't even hear a murmur or anything, nor did I have any symptoms.  Over the past few months, I have developed symptoms, including shortness of breath, pounding heart beat and horrible fatigue AND they can now hear the murmur very distinctly.  I was put on atenolol a month ago and it calms the pounding, but has slowed my heart down, almost too much.  

I had an EKG, which came back "normal".  I also had an echocardiogram and will get the results of that Monday of next week.  

I don't necessarily have the feelings or thoughts of "doom" -- I just mull things over - and over- and over -------- seems like once something invades my mind, there's no getting it out; or it THAT one things goes away, something else "moves in".  

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Avatar_m_tn
i know that obsessive thinking. It won't go unless you sit up and shake your head. Then you can't even remember what it was about. But then you're awake...
First amiodaraone then propafenone held my pulse to 60. after a year with up to 20,000 skips in one day.I was not too comfortable with 60. Now on the lowest dose of propa in the history of cardiograhpy, 150/day, it's 64 to 70. Good.
When I felt weakish at 60 I found that some slight exercis would put it up 5 points or so and I felt better. Proof for me that 60 was too low for my system.
during my echocardioram or graph the doctor got a panic call on his cellphone and talked for 20 minutes with what was clearly a young cardio with a desperate situation with a nine-year-old with heart attack. I couldn't grudge this but started to yell that's enough! he was watching th screen hold the sensor to my ribs and talking. I got very peeved anfd upset. No wonder I got a bad diagnosis of triple CAD (of unknown extent until they catheerize, whtich I won't  do). I pray you had a quieter time in your test.
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I seem to have all the symptoms of conversion from t4 to t3 issues, including low body temperature. But my tsh was normal (of cource ;) ). What I did find was lipid levels were odd. This was eventually found to be a sleeping disorder. I have apnea. I would stop breathing and my hypothesis is I would get a sudden rush of epinephrine and cortisol only at night and be jarred awake and breath again. This caused my liver to release glucose and cause higher triglycerides and lipids. Of course when you go get a blood test, everything looks normal by then, except the lipids. If they took my blood when I was sleeping, that might have been a different story. One other effect of the nightly cortisol is a conversion of t4 to rt3 instead of t3.  I have been using a CPAP breathing mask at night and in 2 days, my lipids were normal and I felt fine. It is more than 6 months later and I still have a lot of energy just from sleeping deeply. The problem was not lack of sleep, it was high adrenal function only at night messing with the rest of my endocrine system. I wonder if the higher bilirubin could be a result of something sililar?
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So, you actually got a cortisol test at night? Blood or saliva?
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OMG, I am so glad I found your post!  I am a third-generation "heavy baby" (8lb 7 oz in1960) hypothyroid female, who never knew it: apparently women of my maternal line present hypothyroid after the age of 30-35 typically, and I was a competitive athlete into my 30s, but from childhood I was prone to occasional bouts of hypoglycemia (from just "having the shakes" to "graying out"), usually following eating eggs for breakfast, and worse if not ballasted by whole wheat toast or cereal or something like that. In my early 20s I was diagnosed with elevated bilirubins ("Gilbert's Syndrome - jhill-behr's - maybe what you were talking about?) and my doc told me to always tell them to do a fractionated bilirubin test b/c only one type of bili is typically elevated in Gilbert's. But the point is, my thyroid was headed south and started to fail around 34y. Elevated TSH, and by age 49 or so the fasting blood sugar was elevated as well.

I'm not diabetic yet, not even deeply hypothyroid yet, but I'm on synthroid (to try to keep my thyroid from swelling more??). I would dearly love to know what I can do and what I have to watch out for; it's nearly impossible to lose weight these days and incredibly easy to put it on, and while I still enjoy exercise, it does not seem to be keeping metabolic syndrome at bay as well as it did earlier. My own baby was 10 lb 14 oz, which my endocrinoligist says is typical of moms with metabolic syndrome (I used to think that was code for "heavy," but there's a lot more to it).

Finally, does it seem to you that you are meeting more and more people with thyroid malfunctions? It's scary, almost, and I wonder whether there is some environmental contribution, for far too many of the young people I meet already have serious thyroid issues in their 20s. The endocrinologist prescribed metformin to try to hold off the hypoglycemic episodes -- anyone have recommendations on that? Many thanks, and bless you all for being here.
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SeaMammal -  You found a good place to learn about thyroid issues (its purpose), but not high Bilirubin!

This is one of those old long posts  (2009) that dragged out forever, and the topic morphed into everything else. I skimmed across again, not the whole thread though, its way to long to read again..

Never found any answers or earth shattering information to high Bilirubin count, Gilbert's Syndrome. If it does anything or has any links, no one on the planet knows yet. Oh well.

Eventually I went on natural thyroid from Canada made by Erfa, its made a huge positive difference with my Hashimoto. I too have always been athletic but have had elevated fasting glucose (pre-diabetes) at my worst thyroid times. I still take holy basil which has been known to lower blood glucose and 'level' cortisol levels. That, and controlled thyroid on Erfa seem, to be helping lower glucose to healthy levels. As far as weight gain with hypothyroid, I am one of the lucky ones, and being male might help me in this area. But its a common topic here.

As far as hypoglycemic episodes go- I'm not knowledgeable in that area. Besides the sugar load test (a drink), I've never been tested for any other specific body reaction to glucose. My glucose doesn't seem to go up and down dramatically.

About your thyroid- synthroid does not keep your thyroid from swelling more, it replaces the T4 hormone your thyroid can produce as well as it used to. That is the hypothyroid med most are started on. I would guess it works really good for maybe 75% of people on it- meaning it controls the symptoms, not just putting lab test numbers where Dr's like to see them. I am not in that 75% and learned a lot here since 2009.

You dont mention Hashimoto, but say your thyroid is swelled, a possible symptom of Hashimoto. If you have not had thyroid auto-bodies tested- ask the Dr to order these blood tests TPO, TgAb. Hoshimoto is an autoimmune disease, not all hypothyroid is. That and regular thyroid hormone tests called free T3 and free T4, which are more important than TSH.

You will get good responses if you make individual posting for your questions.

welcome to the club.
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I am new to this list (Nov 2013) and after reading your post, I thought "maybe this is what I am experiencing" in regard to high cortisol (am always stressed out). I am going to copy your posting and send it to my doc (who works with David Brownstein MD up in the Detroit area..famous for a lot of alternative thyroid ideas. I actually am a patient of his partner Dr. Richard Ng, as Brownstein no longer takes on patients. Perhaps using a CPAP would help, although I flunked 2 sleep apnea tests in the far recent past. Thanks for your ideas.
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Welcome to the forum. Posts are dated hear and you can click on their name for their profile to see the last time they were active.

Thyroid people that don't respond to stress as well as they used definently can benefit from a 24 hr adrenal saliva test (Genova is one), its more accurate than standard testing although insurance will not cover it. Reverse T3 is also good to get and ins should cover it.

Sleep tests are very iron in design: If you cant sleep, the test cant collect data. A swollen thyroid and night acid reflux (choking on acid) can also result in breathing blockage. In that case a CPAP is just a poor band-aid. There are so many people with CPAP machines that it really make you wonder what there real problem might be. I'm sure some really need it, but not all, very "iffy" and confusing area.
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