Need Help - Advice - Hopeless

[DD2992]

OK. I don't know where to turn next. I have been feeling absolutely awful ever since March 18, 2011 (2 wks ago)
I am currently on levoxyl (100 mg) Below are my most recent labs.
TSH, 3RD GENERATION: 0.94
T4 FREE,  1.3
T3 TOTAL, 98

*NOTE: 3 months ago my TSH level was 1.94, my TSH level has dropped from 1.94 to 0.94 in 3 mths

****I recently went to the doctor because I was feeling so bad. I feel dizzy/light headed and cannot concentrate. These come in spurts and last a couple hours then go away for a little while. It hurts to breath in, in my throat area. I was smoking cigarettes but I quit on March 19 because I felt so awful. *I smoked about 9 cigarettes a day, not a heavy smoker. I havent smoked since.  Im scared and dont know why im feeling so dizzy. My family practicioner doesnt know why either. He ordered chest x-rays and they all came back fine. I was on Synthroid (100 mg) about 8 moths ago. I felt really bad on Synthroid and they switched me to levoxyl. I really like levoxyl but I have gained 15 lbs ever since beginning this medicine.

I recently resigned from my job and accepted a job offer as an admin assistant at a hospital. This is a great opportunity for me but I am extremely concerned I wont be able to perform my job due to my dizzy spells. I've also noticed Im having dry mouth more. My endo told me to skip the levoxyl on Sundays and take a 5MG cytomel once daily.

My sugars are fine and ive been taking daily multi vitamins and eat very healthy. I run  3-4 miles everyday and stay very active. I really dont know where to go. I am seeing myself sink into depression from feeling so awful. Im scared this will affect my new job and cause me to lose this job.

Im wondering if I should as my Family Physician if I can try some natural thryroid supplements since my Endochronologist refuses to prescribe me natural meds.

I thought my breathing pain was due to respitory since it hurt when I breathed in and got really dizzy/lightheaded at times but my doctor doesnt think so?

Please let me know if you all have any ideas what could be wrong w/ me

[grantj]

Just FYI, in case you are not familiar, bio identical hormone docs are very much into endorsing and prescribing Armour.  Our traditional medical community as a whole are less likely to do so (some are, but as a whole, they are not as apt to do so).  Bio identical docs deal with hormone replacement on a "natural" level vs. synthetic.  Bio identicals are said to be identically matched to our own dna, much lower risk of cancer, etc.   In addition to Armour, I also take bio identical progesterone, which has also totally changed my life for the better.  I had a baby at 40 and all heck broke loose from there!  All is well now though, thank God.

[grantj]

Gimel, excellent info.  DD, try googling bio identical hormone doctors.  I believe you will find some resources in your area when doing this.  I once googled it for a friend located outside of my state and came up with several names/numbers.  They are out there, that is for sure, and once you find a good one that "speaks your language", you will be on your way.  I am sorry you have so much fear about the ability to do your job; I so would feel the same way, but try to think positive as there is help for this.  Please keep us posted.  Debbie  

[gimel]

Armour is a combo of T4 and T3.  FT3 is the most active thyroid hormone.  It largely regulates metabolism and many other body functions.  Scientific studies have shown that FT3 correlated best with hypo symptoms, while FT4 and TSH did not correlate.  Many of our members have reported that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range.  

Frequently TSH levels are suppressed and FT4 levels raised to near the upper limit, when taking significant doses of T4 meds, which frequently does not increase FT3 adequately.  This condition is due to T4 not adequately being converted to T3.  That is when a med like Armour is most valuable, since  it will increase FT3 levels and when high enough for you, symptoms are relieved.

By natural thyroid supplements, are you talking about the desiccated type sold as non-prescription.  If so, I would instead stick with Armour, or its equivalent, Nature-throid, or Wes-throid.  A one grain tablet of Armour is 60 mg, and it is roughly the equivalent of 75 mcg of a T4 med.  The one grain tablet contains about 38 mcg of T4 and 9 mcg of T3.  Since T3 is about 4 times as effective as T4, that is how you get to approx. 75 mcg of T4 meds.  You typically would not need to take Cytomel with a combo T4/T3 med.

If you run into difficulty with your family doctor, you can give him copies of links like this one.

http://thyroid.about.com/b/2010/05/17/t3-superior-t4-levothyroxine-hypothyroidism-thyroid.htm

[DD2992]

Thanks all for your input. Gimel, I will definately ask for Free T3 and  Free T4 as well as vitamin levels. Something is totally wrong and am affraid I will not be able to perform my new job. I really need to get a handle on this asap. I guess I will call my family practioner since my endochronologist refuses (as well as several others in the St. Louis region) to prescribe me natural thryroid supplements.

Now does Armour only have T4 in it or does it also have other Ts or do you still need to take cytomel w/ this drug?

Im wondering how much Armour I should take in replacement of my levoxyl?

Did any of you under go thyroid surgery also?

Thanks

I wish endo's around here would prescribe natural thyroid supplements.

[grantj]

Hello DD, I feel for you and hate to hear someone say they feel hopeless.  I have felt that way at times, but please know that there is always hope and it sounds like you might be best seeking another doc who is open minded to natural meds.  As the above poster notes, he/she changed to Armour and has never felt better.  I, too, have had tremendous success with Armour as many have on this forum.  Synthroid/Cytomel for me was a totaly train wreck.  There is nothing worse than feeling terrible and having fear you cannot even do your job; nothing worse, and totally not necessary.  Please continue to seek other options until you are satisfied.  You deserve the best quality of life possible.  p.s--congrats on quitting smoking!!  Keep up the great work.

[gimel]

There are several prior posts that give more info and insight into DD's problems.  Here is the link.

http://www.medhelp.org/posts/Thyroid-Disorders/TSH-Results--Need-Advice-Help-Understanding/show/1488995?personal_page_id=1681982#post_6767219

In my previous replies, I tried to explain that you should not be focusing on TSH.  Trying to use TSH as a diagnostic by which to medicate a thyroid patient just doesn't work, as many other members can tell you.  I have been taking a full daily replacement amount for about 30 years.  During that time my TSH has been about .05, with no hyper symptoms.  In fact I had lingering hypo symptoms, somewhat like you, until I learned bout the importance of Free T3 on the Forum and got my meds changed to Armour.  Now my FT3 is in the upper third of the range and my FT4 is around midpoint and I feel best ever.  

After having 90 % of your thyroid function removed, 100 mcg of T4 daily doesn't sound like anywhere near a daily replacement amount.  In addition, your symptoms sound like you are still hypo.  It would be far better if you had a FT3 test rather than total T3, but even your TT3 is low in the range, which is further indication of being hypo.

I really believe that you need to start with testing for Free T3 and  Free T4.  Since hypo patients often have deficiencies in other areas, sometime soon you should be tested for Vitamin A, D, B12, iron/ferritin, and selenium.  The most important thing I think you need is a good thyroid doctor.  By that I mean one that will treat you clinically by testing and adjusting Free T3 and Free T4 levels as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important to you, not test results.  Test results are valuable mainly as indicators during diagnosis, and then to monitor FT3 and FT4 levels as meds are increased toward symptom relief.

If you want to be more assured about this approach, this is a good link about clinical treatment.  It is a letter  written by a good thyroid doctor for patients that he is consulting with from a distance.  The letter is sent to the PCP of the patient, to help guide treatment.

http://hormonerestoration.com/files/ThyroidPMD.pdf