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798555 tn?1292787551

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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798555 tn?1292787551
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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Avatar universal
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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798555 tn?1292787551
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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Avatar universal
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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798555 tn?1292787551
So, you actually got a cortisol test at night? Blood or saliva?
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Avatar universal
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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Avatar universal
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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649848 tn?1534633700
COMMUNITY LEADER
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 universal
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?1534633700
COMMUNITY LEADER
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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Avatar universal
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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Avatar universal
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 universal
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 universal
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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1070570 tn?1283436213
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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649848 tn?1534633700
COMMUNITY LEADER
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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Avatar universal
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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393685 tn?1425812522
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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798555 tn?1292787551
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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1070570 tn?1283436213
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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734073 tn?1278896325
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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798555 tn?1292787551
"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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Avatar universal
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?1292787551
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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