Skin problems and thyroid meds

[smartygirl]

Sorry this is so long, but I am desperate and looking for help.  I went to the doctor in December only because I had a feeling in my throat/chest that I kept trying to clear but could not. My hands and feet were always cold and I had night sweats, headaches and cravings but I attributed all this to cold winters and maybe premenopause or eating too much sugar. My TSH has been around 5 for around 15 years, so I thought I should just check it since I hadn’t had blood work done in a while.  I tried 65 m of levothyroxine many years ago and stopped taking it because of anxiety attacks and heart palpitations.  I am now on Tirosint for hashimoto’s disease. The doctor that diagnosed me put me on Armour initially and a bunch of some supplements to increase immune function because he thought I had lyme disease (turns out I don’t but was loaded up with megadoses of supplements for it).  (I am putting the list below).

I broke out all over my body over one month into the regimen. The rash was pretty scary. It started on my arms then torso, then into my legs. Since that time I have been living a nightmare.  For a long time my legs (the right one mostly) felt like they were on fire from the inside, but not to the touch, my skin is prickly/itching, stabbing/biting all over, it feels like I am wearing fiber glass on my entire body or that my skin is made of fiberglass.  The rash is not very visible any more but my skin stings/burns/bites/flares from deep within off and on throughout the day with some days being better/worse than others. My face is broken out and has stayed that way.  I am now experiencing grief and depression from it.

My allergist tried a bunch of antihistamines (which I hate taking but was too scared not to).  My doctor (integrated medicine) switched me to WP to try. I researched the supplements I was taking, saw that 5-MTHF, methyl B12, and selenium could all cause rashes and that Vitamin D is made from wool. Two pharmacists warned about staying on the natural saying allergies are rare but they have been known to happen.  Other pharmacists said try taking it. My doctor said try staying on it, but he would prescribe levo if I wanted, otherwise I would never know and maybe my body is just adjusting to it.  Adjusting???!  Really?  There’s no way adjusting can feel like this.  Can it?  Are other people having this burning, stinging, biting body reaction?

On the WP (50 mcg) I had symptoms I never had. Dryer skin, hair softer and thinner and seems like more than usual coming out in the shower.  A bit used to come out before diagnosis but I wasn’t concerned about it.  When I started armour and supplements, I could wash my hair with hardly any hair coming out, so I thought things were improving.  

I asked my dr. if I should increase the WP and they did not get back to me. I had the prescription for levo from the NP so I fill that and increased the dose to 75. It seemed like that helped for a bit. The next time I saw my dr. he increased that to 100. Again, it seemed like that helped for a bit (unless it didn’t and I was just more hopeful). I also started to notice that the feeling in my throat got more intense.

I finally got in to an endocrinologist and a new PCP in June.  The PCP didn’t want to put anything else in my body which I was grateful for since there was no way to know what caused the reaction.  Both doctors suspect the supplements.  However, I’ve been 3 months off supplements and 9 weeks off the fillers in generic levo and while symptoms aren’t as bad as they were, my skin still stings and bites  deep inside my skin and  looks all dried out on the surface; alligator looking on my legs and crepey looking on my arms.  When I get a chill and get goosebumps, it feels like the goosebumps are hard or nettle-like.  The endo didn’t think it would be related to the meds at all, but I see lots of people on here and in other forums who have skin problems with levo.   But I guess I can’t totally blame the levo because the severe breakout happened while taking Armour. I’m very very upset by the whole thing and fear I will lose my ability to cope.  I left the doctor who I feel  caused this mess and tried to tell me it was Coxsackie virus.  I was very hopeful that once all the mega doses of supplements that dr. put me on were out of my system, I would be feeling better.  When I search on here and other forums and see others having skin problems after medication, I get very scared.  Mary and anyone, can you offer any help?

Here are the medication changes and supplements by date started and ended:  Labs follow.

Meds/Supplements
1/30/14    
Armour 30 mg
Vit D3 10,000 IU every other day
Turkey Tail 2 g
5 MTHF – 5 mg
Methyl B12 5,000 mcg (also has 1 mg 5MTHF)

1/27
Selenium citrate 200 mg
OrthoBiotic Probiotic 40 billion cpu
Tri-Fortify orange liposomal glutathione 900 mg w/ vitamin C 100 mg

3/4   Added: (for rash)
Zantac 150 mg 2x/day
Zyrtec 10 mg night
Stopped Armour

3/5   - Added: Claritin 10 mg day
3/7 - Started WP natural thyroid hormone 32.5 mg
3/8 - Switch from Claritin to Quercitin for day use
3/10 - Started probiotics again, ran out for a week or two
3/11 - Stopped all supplements except probiotics
3/12 - Stopped Zyrtec
3/13 - Aleve for headache
3/14 - Didn’t take WP
3/15 - 50 mg Levothyroxine
3/16 – Levo
3/17 – Went back to WP
3/19 – 75 levo
3/21 – stopped probiotics
4/8 – 100 levo
4/25 – Stopped Vitamin D
6/9 – Switched to 70 mcg Tirosint








Labs

7/2014
TSH .8
Free T4 1.0 (from memory at the moment, it may be a little different and I will update)
Free T3 3.0 “                “

4/2/14
T3 99
Free T3 2.6
Free T4 1.26
TSH 2.430
Reverse T3 18.9
TPO Ab 111

2/20/14
T3 82.36
Free T4 .67
TSH 3.14
TPO Ab 105
Anti-TG Ab <1.0

1/16/14
T3 80.47
TSH 8.35
TPO Ab 93
Anti-TG <1.0

12/4/13
TSH 6.19

12/24/08
TSH 3.95

11/27/07
TSH 4.91

7/16/07
TSH 5.38
Free T4 .73

1/31/05
TSH 5.53
Free T4 .67

12/04
75 mcg levoxyl

5/13/04
TSH 2.62
Stopped levoxyl

4/8/04
TSH 5.42
Free T4 .82

2/18/04
TSH 6.37
Free T4 .67

6/12/02
TSH 5.04

11/30/01
TSH 6.87
Free T4 .93

[Barb135]

Not much info about her, but you never know.  

You should be able to get by with just your pcp until Dec, shouldn't you? Seems like a long time, but hopefully, it will go fast.

[smartygirl]

I am waiting for an appointment with a new endo but have to wait until December, ug. I'm on the waiting list though. According to health grades she looks good and a friend's doctor recently recommended her.

http://www.healthgrades.com/physician/dr-jessie-block-galarza-xc6x2

[smartygirl]

Thank you Barb for that ray of hope in my day. A big hug to you.

[Barb135]

Yes, TSH is a very sensitive test, but it's not a thyroid test at all; it's a pituitary hormone that's trying to prod the thyroid into producing thyroid hormones.  Once a person in on thyroid hormones, TSH is pretty much irrelevant, as it neither causes not alleviates symptoms, nor can it any longer prod the thyroid into producing hormones.  

I also disagree with him about the dry skin not being thyroid related... that's a prime symptom of hypothyroidism.  I also disagree with him about the high FT3 causing heart palpitations... it might, for a short time, but it's unlikely.  

If you wanted to go even slower than a jump from 75 mcg to 88 mcg, just to make sure, you could even alternate the 2 for a while 0 75 mcg one day, 88 mcg the next for an average of 81.5 mcg/day before going up to the full 88 mcg.  I've done this a number of times with various dosages and it works very well.  

Sounds like your pcp has a little sense, but you might need a different endo.  

[smartygirl]

I showed your suggestion to my PCP. She thinks it makes sense and added the 13 mcg for me. When I told my endo, he said not to raise. He said they TSH is the most sensitive test of thyroid function and he doesn't want it any lower. He also said T3 is already on the high side and he wouldn't want that to go any higher. He said increasing dosage won't do anything but give me heart palpitations. He says dried, scaly skin not thyroid related. I had some hope thinking about raising. Now I have a hopeless, dreadful feeling. I don't know where to turn.

[Barb135]

It would appear that something in the supplements, initially, caused the rash, as has already been suggested, but it's very possible that your anxiety over it is what's keeping it from going away, since anxiety keeps both cortisol and adrenaline levels higher than normal.

Your most recent labs show your FT4 at only 27% of its range, with FT3 at 60% of its range.  Rule of thumb is for FT4 to be about mid range, so, as you can see your level is falling quite a bit short.  Rule of thumb for FT3 is upper half to upper third of its range.  You're in the upper half, but you have a lot of wiggle room yet.   When you retest next time, you may need to increase your Tirosint from 75 mcg to 88 mcg to bring your FT4 up higher.

FYI - your antibody tests show that you have Hashimoto's - since you've been diagnosed, it's not necessary to test the antibodies anymore.  Once you have Hashimoto's, you always have it, so you can save some money by not testing those.