Need advise on thyroid/adrenal issues

[db0704]

Typically, how hard is it to regulate hypothyroidism?  I was diagnosed 1 1/2 years ago and was placed on Armour Thyroid.  My TSH was within normal range but my t4 was low.  Since then, it seems like it has not been regulated yet.  Also, approx. 3 months after the thyroid diagnosis, I was diagnosed with adrenal insufficiency via 24hr saliva testing, in which it showed HPA axis deviation and my adrenal glands were basically flat.  At the time, I was extremely ill!  I was put on hydrocortisone at that time and am still on 10mg daily.  My current dose of Armour is 90mg am and 45mg pm.  This was just increased from 60mg am and 30mg pm.  This last increase barely changed my labs at all.  These are the results.  

April 2015 - free t4 0.74 L  free t3 1.8 L
Increased dose for 6 weeks and retested.  These are those results
May 2015 - free t4 0.67 L   free t3 1.9 L  tsh 1.29 normal

My doctors says it seems like I'm not absorbing the medication properly.  I still haven't decided whether I am even doing the right thing or seeing the right doctor.  I still feel ill, especially in the morning.  Just sick and have an extreme hard time waking up and getting up.  My hair has been steadily falling out since January 2015.  I have been on medical leave for 1 1/2 years and even though I am better than I was, I am still not well.  I can't seem to handle any stress, whatsoever.  I get almost a dizzy like, foggy feeling in my head, causing me to be unable to focus or concentrate.  It's a horrific feeling.  My skin on my face looks so bad.  It's dry and splotchy, I have new wrinkles and gray hair that seemed to pop up overnight.  I am starving all the time and eat like a pig and of course have gained so much weight, it's not funny!  My heart seems to pound loudly in my ears off and on and I haven't found a correlation to what causes it yet. I am so far, what my doctor says as just a mystery but I can't imagine that no one really knows what is wrong with me.  Does any of this sound familiar to any of you?  Ask me any questions and give any input you have!  I would greatly appreciate it!  I really, really want to go back to work and feel better!

[db0704]

Thank you both so much.  I am going to suggest these to my doctor.  

[Barb135]

You might try splitting your Armour to get a more even dosage between morning and afternoon... it also sounds like you simply need a larger dose.

In addition to that, many people on desiccated hormones find that FT4 tends to stay very low and they have to add a source of synthetic T4 to increase FT4 levels.  Considering that you would convert, at least, "some" of that to FT3, that should also help increase your FT3 levels, too.

Your symptoms are, basically, those of hypothyroidism and when we don't feel well, we do tend to get a bit cranky!!

[Red_Star]

I personally did not do well on Armour as I wasn't absorbing most of it. At the time I had severely depleted stomach acid.  I have no problems absorbing synthetic T4 regardless of stomach acid and pancreatic enzyme levels.  Stomach acid signals the pancreas to produce digestive enzymes to further break down food; proteolytic enzymes are secreted by the pancreas.

Excerpts from the book: Thyroid Diseases: Clinical Fundamentals and Therapy by Fabrizio Monaco, Maria A. Satta, Brahm Shapiro, Luigi Troncone...

"There is some differences in the rate of absorption between animal and synthetic preparations. After a single oral dose of synthetic L-T4, the absorption is approximately 70 - 80%, 20 - 30% being recovered in the stool.  It is absorbed rapidly, mainly in the distal small bowel, reaching maximum plasma levels in 2 to 4 hours."

"Variability of absorption also occurs with desiccated thyroid, dependent on proteolytic enzymes of the gastrointestinal tract. Since desiccated thyroid and thyroglobulin preparations contains T4 and T3 incorporated into thyroglobulin, to release thyroid hormone the crude preparations must be hydrolyzed by gastrointestinal proteolytic enzymes, which indirectly influence the absorption of T4 and T3."

[db0704]

I also thought maybe I should add a couple of symptoms I had when I first became ill.  Prior to becoming ill, I was one of those women that seemed to have a small bladder.  It seemed I was constantly having to urinate, day and night but prior to my getting sick, I noticed I almost stopped urinating except for a few times a day.  I didn't notice any swelling anywhere and thought it sooo weird.  I even went for urine testing just to make sure I didn't have a UTI, though I didn't have any symptoms.  I still have that to this day but I realized that I do retain fluid, just not where I thought.  It's in my abdomen and face but not severe.  The other weird symptom is that I used to worry about so many things at work and have always been extremely dependable and reliable but all of the sudden, I found that I just didn't care as much.  I even called in a few times and missed meetings I never would have.  I also have always been very sweet and very nice, never causing problems but this also seemed to change overnight.  I got mad easily and irritated easily.  My son says my personality has completely changed and I believe it really has.  No one really wants to listen and I hate talking about this too much, as I'm scared I will not be taken seriously and written off as a psycho!  Which reminds me, my depression is horrific!  Moods come and go like a roller coaster!  This is all new too!  Could my low thyroid actually cause me to feel this bad?  Thanks again and I appreciate all your help!