Thyroid info/treatment

Advise anyone, I have Hashimot'o's. Does anyone know how to tell if hyper labs[the free's and tsh] and hyper symptoms ,are a die off of cells from an attack or was I over medicated? I went hyper while at 105 mgs Armour. Dr. made me way cut back to 45 mgs. I went totally hypo. again. Finally back up to 90mgs. Some improvements, but I think I want to go up again, based on symptoms. But ,doc say's my labs are perfect! He said he treated "people not Labs" He's afraid that i'll "go toxic again". My current symptoms are cholesterol over 400, headaches, hair loss, I have to spend 13 hours in bed or I'm sick. Blurred vision,bleeding receding gums,distention and slow digestion,constipation ,body pain and 25lbs. of odd,lumpy swelling that came on in a few months in 2010! many more symptoms and this is an improvement! My latest labs from December are TSH 1.60,[ range up to 5.5,] free T3 3.2 [range 2.1-4.4,] freeT4 0.6 [range 0.6-2.7.]  I believe they are low. How can I get proper afford able treatment in Cincinnati area? T
Thank you, Emily

[goolarra]

There's no way to tell if your hyper symptoms were caused by your thyroid behaving chaotically as a natural part of the disease or if you were overmedicated.  

Were you having hyper symptoms when you went hyper on 105 mgs Armour, or was your TSH just low?  What were your FT3, FT4 and TSH at that point?  It would be really interesting to compare them to where you are now.  

Why did your doctor lower your meds so drastically?  105 to 45...that's quite a jump.  

Your current FT4 is extremely low.  FT4 often has to be midrange before symptoms are relieved.  FT3 is also on the low side...rule of thumb for FT3 is upper half to upper third of range.    

[faith63]

I'm so glad to hear from you. I'm very upset I've been ill for years and feel like I'm losing hope with this doc too. Yes, I was having hyper symptoms. The Doc says it IS because I was over medicated PERIOD! Won't let me go up now. The labs when hyper@ 105mg where: TSH 0.01[range 0.40-4.20] Ft3 6.0 [range 2.1-4.4] Ft4 2.6 [range 0.6-2.7]. He lowered the meds so drastically because he said I was SEVERELY over medicated! Now I 'am almost 5 weeks at 90 mgs., with symptoms .I also think my labs are low now. He says they are Perfect" What now ? So upset. It took a lot to find a doc that did Armour and  treated by symptoms and now this!

[goolarra]

I don't know quite where your doctor is coming from.  Your labs aren't "perfect" by any stretch of the imagination.  FT4 is on the floor of the range, and FT3 is below midrange.

I'm sure his concern is that your meds are approaching what they were when you went hyper, but your labs are NOTHING like they were then.  When you were hyper, your FT3 was over range (had you taken your meds prior to that blood draw?), and your FT4 was almost at the top of the range.  

I think he's spooked at this point.  He knows that you went hyper at 105 mg, and he's afraid to go there again.  BUT, your labs are no where near the same.  

Apparently, he's no longer interested in treating by symptoms since you have a lot of hypo symptoms, and he thinks everything is "perfect".  

At the time, you were overmedicated.  Why?  Perhaps it was a Hashi's swing.  You no longer are even close to being overmedicated.  Your doctor has to be able to adjust your meds dynamically as this disease progresses with all its excentricities.  What was the correct dosage back then isn't necessarily the correct dosage now as your labs clearly show.  Changing your dose from 105 to 45 was a huge adjustment.  He'd been better off changing it a much smaller amount, then perhaps raising it again when your Hashi's flair had subsided.

You can try educating him...or you can try to find a better thyroid doctor.  i think you need an increase.  I'd probably give him one more try.  Point out to him the difference in your labs at 105 and now.  List your hypo symptoms.  Talk about swings from hypo to hyper with Hashi's.  If you can't get through to him, move on.

One of our members, gimel, keeps a list of good thyroid doctors recommended by members.  He might be able to suggest someone in your area.

[faith63]

Thanks!  I  realized that I must have raised my dosage by 15mg. after the latest labs. that I wrote about. Those labs were done 6 weeks after I started 75mg. Sorry. I'm confused!  I'm at 90mg now. Have been for over 5 weeks .I was at 75 when last labs where done. I am still very symptomatic, as I have written above.  Yes, I believe he's afraid to over medicate and go to 105 with meds. No, I did not take meds prior to the "hyper" draw. He says it doesn't matter!  I don't believe he understands the Hashi's. He has made comments like'your thyroid seems to have a mind of it's own" and "your thyroid is really screwed up" On one hand, he is doing the right tests and put me on a med many want but can't get.. On the other, he doesn't want to see me until APRIL, 12 WEEKS AT 90mg. WITH HYPO SYMPTOMS. He has stopped responding to my emails. I believe with every flair he will YOYO" my meds.  Thanks

[goolarra]

..."your thyroid is really screwed up"...  "Screwed up" is a technical term, didn't you know that?  Google "screwed up thyroid" for further details!!!  LOL

You're right, April is way too long to wait.  If you've been on 90 mg for five weeks, you could really have labs now.  

Here's an analogy for your doctor:

Last summer it was 100-degrees outside (your FT3 and FT4 were very high and you had hyper symptoms).  Your doctor had you wearing a parka because he was afraid you were going to be cold.  You got too hot and had to take the parka off.

Now, it's winter, and it's zero outside (FT4 on the floor, FT3 still low, hypo symptoms).  Now you need your parka back because you're cold.  Your doctor says, no, no, I'll never give you that parka back again because it makes you hot.  

You have to look at the whole picture.  Tell your docotor that I don't think the "wires are quite touching" in his brain...also a technical term!  Just kidding, of course.

After a Hashi's flair, it's not unusual to required MORE thyroid meds once it's over.  The flair caused further destruction of thyroid function, so it stands to reason that you become more hypo.  If your dotor had lowered your meds more conservatively, you might not have had to go so hypo and spend so much time getting back to where you need to be.

See if gimel knows anyone in your area.  If not, you might try posting a new thread on the forum.  Get your city and state in the headline so members in your area can respond.  MH frowns on doctor recommendations on the open forum, so members would have to respond to you by PM.

[faith63]

I'm so glad you understood my post. Thank you.  I like the analogies!  It makes sense that I would feel worse after an attack . Is it possible that the 15mg. may bring up my levels over time? Yes,he lowered it so drastically, now I'm back to where I started.  I feel sick with every dose adjustment, so sensitive to meds since I was pulled off presc. benzo'z cold turkey. That's when this autoimmune condition showed up.... I accidentally logged out and can't retrieve gimmls entire message. [He doesn't know anyone in my area though] It now says my user name/password is invalid. I'm not to good with online stuff. Just learning. HELP

[goolarra]

The 15 mcg will bring up your levels.  You've been at 90 for 5 weeks, so the 90 mcg dose should just about have finished raising you levels as much as it's going to.  

If you go to your Inbox at the top right of the page, and click on it, you should be able to see gimel's message and open it.

You are logged in, or you wouldn't be able to comment.  Maybe it's telling you your name/password is invalid because you're already logged in???

[faith63]

Log in fixed itself late yesterday.  I can't believe he is going to leave me @ 90mg. til April, while so symptomatic. He has not responded to my Email, pleading for another 15mg increase.  My cholesterol is around 400 and it has gone down with med increases.  He wants me to take prescription fish oil as I can't take the statins.  My metabolism is so slow, I'm so puffy and can't lose even 1 pound, gained 11 lbs in 8 days, when this started and a total of 30 in three months, very uncomfortable!   I'm afraid I'm going to have a stroke or heart attack.  He's on the top doctor list too!

[goolarra]

Well, I don't believe he's going to leave you like this until April, either.  

Can you make an appointment to see him sooner and ask for a lab order?  It's harder to ignore you when you're sitting in his office than in an email.  

Yes, your cholesterol should come down when you're less hypo.  

So much for the list...

[faith63]

Yes , I think if I haven't gotten an email from him by Monday, I'll make an appointment, ask for labs, memorize the "Parka" scenario and explain that I believe he has a "short cicuit "in his brain and see if I can get a med increase based on symptoms.  Ya gotta laugh to get by in this world!  I'll let you know what happens.  Thanks for everything!

[faith63]

You seem so knowledgeable ,I need your opinion,if you don't mind.  Realized i've been feeling so jittery, lately. Seems, in general,that since I started treatment [10 mos ago] it has increased my heart rate, especially bothersome when trying to sleep. It pounds hard and can feel and it's in my ears. It can be in the 70's-90's. Never gets below 70. Worse lately, my temp was 96.3!  Blood pressure always low. Stomach distention is always there and presses near my chest which makes it hard to breath too. I Can this be actually due to hypo? Is this part of having Hashi's or does this improve with proper treatment? When I tell the doc, he says I have a Panic Disorder! Same symptom when I was hyper, though. Is this common? I have 10mg. propranolol from heart doc[I had extensive testing ] I take this at times.Isn't effecting the FT3 reading at this dose. What do you think? No sleep again tonight.  Thank you, Emily

[gjk9999]

Hi Faith63,

Don't loose hope.  I had Hashimoto's and had to have my thyroid and part of my parathyroid removed (over 3 years ago) and have been in rather good health ever since.  The improvement was dramatic and immediate.  Only just recently (last 3 months) have my levels (TSH and free T3 & T4) acted up a bit but I think that this will resolve itself shortly.  You might want to consider seeing an endocrinologist.  They will conduct a few additional tests (sestamibi scan, ultrasound, etc.) to determine the extent of disease of your thyroid and the possibility of your parathyroid being affected.  Given this information, then you can decide is the possibility of surgery is in order.  Don't fret if surgery is suggested but only you can decide if this option is viable for you.  Keep tuned to this forum and people like myself and goolarra will be there for you.  (Thanks go to goolarra for their comments to my ?'s also).

[goolarra]

One of the problems with treating by symptoms is that many symptoms "cross over", and you can have the same ones whether a little hypo or a little hyper.  The symptoms you list all can be due to hypo.  It's not part of Hashi's.  If your meds are properly adjusted and you're no longer hypo, there should be no more symptoms.  

Do you take your propranolol regularly or just as needed?  I've been on another betal blocker (atenolol) ever since starting meds, but I take it every day.  I think beta blockers are more effective if they build up in your system.  I'd never have been able to do the increases without the beta blocker.  Once you get on a proper dose of thyroid meds, you might be able to d/c the propranolol (you have to wean off).    

[faith63]

I 'm so very glad I came to this forum and cried when I read that you will be there for me. You wouldn't believe how alone I have felt and have been home bound for years.. My doctor IS an endocrinologist!  He say's my thyroid is almost gone by touch alone, I believe based on symptoms I've had this for many years. My Gp thought it was mental and put me on large doses of benzo's and anti depressants. Only my TSH was checked  2x in 20 years.  Endo. has never mentioned tests other than blood, but I'm aware of them. I have a high Serum Serotonin Level {carcinoid syndrome?], which he says is the cause for many symptoms, although my thyroid levels are low.  I have had c/t scans and x rays looking for tumors and nothing has been found. Other tumor markers are negative. I'm in protracted benzo withdrawal as wee and it is very confusing. I'm not sure what symptom is what. Blood work has let me know I'm hypo, but he thinks tests ok. He says the beta blocker will raise the T3 and make me fatter! He doesn't think they're necessary and I don't think he'll refill them. I take them as needed , 1x day, my BP is low. I better see if he will refill or i'll end up with a cold turkey. I do feel hopeless often and I do wish I could have my thyroid removed.   I wish one of you lived nearby, you are so sweet and kind. What to do next?  Thank you!

[goolarra]

Well, you have a number of things going on, and it is hard to sort through all of them.  However, you do know your current thyroid levels, and you are hypo, so you have to work on that and see what symptoms it resolves...you might be amazed at how many actually are thyroid...I was.

My PCP once told me that taking atenolol was going to require me to take more thyroid meds, which was going to require me to take more atenolol, ad nauseum...talk about depressing!  However, when I started seeing my endo, he said this was NOT true.  As you raise your dose of thyroid meds, you may have to raise your dose of beta blocker (I did), but that does NOT require you to take more thyroid meds.  

I don't think the BB will raise your T3, and raising your T3 should make it easier for you to control your weight, not more difficult.  

I've heard that atenolol is the BB that interferes least with thyroid meds.  Maybe your cardio would consider switching you to atenolol?

"He say's my thyroid is almost gone by touch alone, I believe based on symptoms I've had this for many years. "  Once your thyroid is completely "dead", and it sounds like yours probably is (my endo and I think mine is, too), then there's usually even less reason to remove it than there was when it was in the process of dying.  Once your thyroid is no longer producing hormones, and you're on 100% replacement, Hashi's becomes much more stable and easier to manage.

Of course, there are tests that will tell you exactly how much thyroid function you do have left.  

[bac7bac]

I am also in the greater Cincinnati area...  I sent you a PM... hope you are able to get into your inbox.

[faith63]

Thank you.  Sounds hopeful. Yes the symptom list is huge, effecting every part of the body.  stopthethyroidmadness and Broda Barnes book, Dr. Lowe is where I got most all info.  Doc has said very little.I wish I wasn't treated like "a nervous female" This is not in my head!  Why do you think there is this need for beta blockers to remain comfortable?  What is this lumpy fat stuff , Mucin? I had been slim for 47 years and BAM!  I know my doc doesn't realize that this is very unusual for me and that I am actually overweight. I'm only 5'1 with little bones , was 105, now 128 or so. I miss life so. What are the tests that show how much thyroid is left?  Thanks again, Emily

[faith63]

Previous message is for you!

[goolarra]

Yes, what an image, huh?  Nervous female...sounds like something that ought to afflict a race horse!  

I have a congenital heart defect that has caused me to have episodes of tachycardia all my life.  MY PCP swore thyroid meds weren't going to affect it...wrong.  T3 receptors in the heart react to T3.  When I was increasing meds to try to get to a stable dose, I would have sworn that the more thyroid meds I took, the worse the heart symptoms were going to get.  However, once I got on a stable dose (I've been on the same dose for over 2 years now), my tachycardia has been the best it's been since I was about 8 years old.  I haven't had an episode (knocking on wood) now for 20 months.  So, i do think that it's a process of adjustment.

I don't know about the lumpy fat...cellulite???

Once you get your thyroid hormones on track, you'll have an easier time taking off the excess pounds.  I fought my weight all my life, mostly successfully...you're lucky to got 47 years!  I'm jealous.

Have you had a thyroid ultrasound?  That gives a pretty good image of the physical characteristics of your thyroid.  It's relatively inexpensive (as imaging goes).  RAIU is more involved and requires being off thyroid meds for close to 6 weeks before you can do it.  It actually shows your thyroid "working" (or not).  I don't know how much information of any value either of those would add if you thyroid is so far gone that your doctor can tell with his bare hands.    

[faith63]

Wish I was a race horse, I'd just tie myself to a tree and...Don't be jealous of 47 years of slim  it just makes it that much harder to take, I think. Again sounds, encouraging and I'm glad your doing so well.  What a shame so much life spent feeling so bad when it all could have been corrected much quicker. I had this lumpy fat come on in 11days. I think its some kinda fluid. No thyroid ultra sound, maybe I should ask. I don't know. Maybe the heart thing will improve soon as meds are ok for me too. Did you ever get blurry vision?  It scares me! Im going to go in and see the doc if the emails don't work.He did respond he said "be patient,relax" I explained that not agreeing on treatment makes me upset that my life is at stake here!  I really hope , if I can get stable, then I won't have to keep contacting him. Just stay on Armour and be done with it. This is all so awful.    Thanks

[goolarra]

Check out myxedema...not myxedema COMA, just myxedema.  Perhaps that's what your lumpy fat is???

I have never gotten blurry vision, but I know it can be a symptom.

It couldn't hurt to request a U/S just to see where your thyroid's really at.

[faith63]

Yes , sounds like myxedema. At this point i'll go in and try and educate this doc and see what happens. I just can't imagine going on the search again at this moment.  Emails with him seem to cause miscommunication, has happened before.Were do these doctors get their education, anyway?  Seems like so many are having a terrible time and staying sick longer than they have too.  Your lucky if you can even get the proper tests.  It's all very cruel! I'm so glad I found this forum, I don't feel so alone anymore.  Thanks , I'll let ya know what happens.

[goolarra]

Lots of doctors never pick up a medical journal.  It is very frustrating, and I'm quite sure it's not limited to thyroid treatment.  We understand thyroid treatment, so we know how bad that is.  My guess is that it's pervasive in medicine these days.

In med school, they've been taught for years that TSH is the "gold standard" in thyroid care.  Some have allowed FT4 to creep in, fewer still FT3.  They're on auto pilot treating patients.  Treating by the numbers is less messy than having to deal with symptoms (so subjective!), AND it keeps them out of court.  It's a mess...  

[faith63]

I agree.  You seem very knowledgeable and well spoken.  You've been such a great help!  Oh, the doc said to get labs done and come in for an appointment. Step in right direction!  How do you think I should explain the need to go up if labs aren't much improved? Like the Ft3 being in upper end and Ft4 in mid to upper? Also, not to be afraid to increase because I went hyper last time at 105. He believes I was toxic, with over dose. Does he even understand Hashi's swings? I really need to do this right, my life is at stake here!    

Thank you, for your help [your so good at wording things]

[faith63]

Also, how to make an argument for the use of the beta blockers.

Thanks again

[goolarra]

Midrange for FT4 and upper half to upper third of range for FT3 are really just guidelines for people who have yet to find where they individually feel most comfortable.

Just look at those two sets of labs:

               Most Recent         When Hyper
FT4               0.6                         2.6               (0.6-2.7)
FT3               3.2                         6.0               (2.1-4.4)
TSH              1.6                         0.01             (0.3-3.0)

There's a world of difference.  In the most recent, your FT4 is on the floor, FT3 is below midrange.  When hyper, FT4 was close to the top and FT3 was way over the top.  I'd ask him if he didn't think there was a happy medium in there somewhere.  C'mon Doc, have you looked at those two sets of numbers side by side?

Do you have any labs where you were actually feeling well?  Those are the numbers you have to shoot for.  The population ranges are only very broad guidelines.  We all have our personal range within that very broad population range.  

Any number of factors can change your hormone needs.  You can't just say 105 was wrong back then, so it's wrong now, too.

Have you ever considered maybe adding a little synthetic T4 to go along with your Armour?  I'm just thinking that your FT4 is so low that you might get a better balance of FT3 to FT4 by just adding some T4.  

I don't think it should be difficult to convince your doctor to give you beta blockers.  They help your symptoms, and there's really very little down side to them.  Of course, BBs are used all the time for people who are hyper, so it may not be where you want to go with a doctor who's already gunshy about your going hyper (overmedicated).  What about your cardio?  Would he refill the script?  

[faith63]

Thanks so much on spending so much time on this! Have you read the stopthethyroidmaddness site?  It says with Hashi's labs will go hypo/hyper. Making it impossible to dose by labs alone. What do you think?
I have never felt okay, my symptoms are so many and they change rapidly.  Could be due to the benzo withdrawal issue. Today, no sleep again and inner vibrating,diarrhea,headache. Sounds hyper, but could be gone tomorrow. I don't know what is what, he doesn't either. Also the high serotonin issue can cause symptoms too. In almost 10mos of treatment I have never stayed at one dose for any more than 6-8 weeks whenever I see a little improvement for example the acne.  It could clear up for 4 or 5 days and I wake up to 10 on my chest. The cardio gave me them for 6 months[until I got the thyroid straightened out] Recheck cholesterol and put me on cholesterol meds. Can't take statins and the thyroid is the reason it's so high anyway. Endo  has done the blood work instead. My heart symptoms are do to thyroid , heart is fine, cardio said. I just hope the endo refills them. Never got to the point of adding a med, since feel bad no matter what. Just all so confusing. I rarely feel well enough to leave the house and spend 12 hrs in bed per night. *****.

[goolarra]

I agree that you can swing hypo to hyper with Hashi's.  That's usually in the early stages of the disease, diminishing as it progresses.  The inconsistency I find with your situation is that you and your doctor think your thyroid is dead.  If that is the case, then you would no longer be having flairs (if the thyroid is dead, it can't dump hormone into your blood as cells die off).  Of course, it's possible that when you went hyper, it was your thyroid's last hoorah before it died.  

How are you feeling today?  Have the vibrating, diarrhea and headache gone away?  Have you ever had any adrenal testing?  Sometimes adrenal problems can cause swings in thyroid levels.

[faith63]

Thanks. How are you?   I don't know if my thyroid is dead, actually I think maybe it has a little life left and maybe this is causing some problems. May bring up an ultra sound, just to see what's left. Feeling some better today ,headache though. Been having to take the propranolol most nights.  My pulse, when trying to sleep, was 84. Laying down makes it worse.  I again, was jittery and hrt. was pounding in my ear, took a prop. and within 30 min. It was down in the 60's. I felt relief. My stomach is distended under my ribcage and I think it presses near my heart, also if I can burp or throw up , my heart slows down too!  Loads of excess acid and gas sometimes.  Maybe stomach is huge part of it.? GI doc said it was due to hypo thyroid, Endo says its my stomach. Most nights, my whole body has sharp pains and when I move in my sleep , the pain wakes me up.  My feet cramp up too. I know it's not a defeciency because it will just stop on it's own, then return. Could be the hypo? It's to the point that I dread bedtime. Joints hurt so bad at times[can't walk the steps or lift anything] then it just mysteriously stops. Never had any of this until was pulled cold turkey of prescription benzodiazepines. Even gained those 11 lbs. in 8 days right after.  My thyroid[I believe] just shut down.  Yes, I did on my own a saliva cotisol; did a 12 hour because of cost.  It showed my cortisol was low upon awakening and rose during the day.  The opposite of what it should do.  A bell curve. Doc say's there is no test for adrenal fatigue, but believes it plays a part in this.  Have read though, that once thyroid is treated it improves like everything else.. have also read that you need to you treat adrenals first or can't raise thyroid meds properly.  I don't know. Adrenals aren't something he does unless it's full blown Addisons. Do you have Hashi's too?  Your opinion is so important.  Thank you.

Emily

[goolarra]

It would be nice to have an ultrasound and know where your thyroid's at.  

Have you ever tried the Valsalva maneuver?  You can google it for a description.  My cardio recommended it to me.  It slows down your HR.  It works great for me.  "...f I can burp or throw up, my heart slows down too!"  That's what made me think of it because when you make yourself burp, you're in effect doing the Valsalva.

Really, all your symptoms could be hypo symptoms.  

Yes, I have heard that it's almost impossible to regulate thyroid hormones until adrenals are in line.  Just my interpretation, you understand...but I'm thinking adrenals will come into line once thyroid hormones are regulated, but it's not pleasant that way.  When adrenals are out of line, people seem to be very, very sensitive to meds changes, for example, they're hypo on one dose and hyper if raised to the next.  Once thyroid hormones are right, it just takes everything else a while to fall back into line around the new levels.

I think maintaining a consistent dose is a huge help in that.  

Yes, I do have Hashi's.  I've had tachycardia all my life, so my first year on meds was a nightmare.  It got better once I balanced the thyroid meds and the BBs.  

Hope you're having a good day...

[faith63]

That is so interesting!   Valsalva?  I think I had some of  that in my salad last week!  It would be great if I could get off the beta blockers!  { he refilled them}  I'll look it up.  Thanks.  I'm concerned that the doc will lower my meds if he thinks the level is too high again, without improvements in symptoms, if so this may never end.  How do I know when my meds are right?   How long can it take once meds are right to see significant changes?  I see some improvements but haven't been able to eat much for 3 days due to distention.  So distressed that I still can't lose a single pound , have increased exercise too. There is no way to eat any less. So heavy and uncomfortable, concerned about another spring and summer where I can't hide under clothes. My skin is so taught that you can't pinch it!  Again, you give me hope because you feel better, it's a very slow process isn't it. Thank you so much!

[goolarra]

Well, you know you're not TOO bad off when your sense of humor is still intact!  Valsalva in your salad, huh?  LOL

There are a couple of rules of thumb on meds.  FT4 target is midrange.  FT3 often has to be upper half to upper third of range before symptoms are relieved.  When on a combo T3/T4 med, like Armour, FT3 often runs a bit lower and FT3 higher.  You'll know where it's right FOR YOU when you feel well.  It's often worth taking it slow, though.  If some of your symptoms are relieved or partially relieved, it can be worthwhile to take a break from meds changes and see just how everything settles out.  After being hypo for a while, your body has to have time to heal.

It is a process, and the more you try to rush it, the slower it sometimes gets...three little steps forward is better than one huge step forward and two little steps back.

Have I asked you if you split your dose?  Your FT4 is so low at the moment that there's virtually nothing available for conversion.  Once the T3 in your meds wears off, your body's flat out of hormones.

[faith63]

Hi G
I just take the 90mg on empty stomach when I wake up. I find it difficult to split my dose because my stomach takes so long to empty, yesterday I threw up 5 hours after I ate and it was just sitting there.  How would you suggest I split the dose? Oh boy, really out of hormones in 3 hours?  No wonder I feel bad.  I can't get labs done for 2 more weeks and doc visit in early March!  OMG! They don't do labs anywhere else either. Will look up Valsalva now, maybe have it tomorrow with dinner.  Thanks!

[goolarra]

I think if you research Armour, you'll find that you don't have to take it on an empty stomach.

Splitting the dose is very individual.  As a start, I'd try splitting it 50/50...50% first thing in the morning, and 50% sometime early in the afternoon.  Most people avoid taking meds with T3 in them after about 3 pm (on a "normal" sleep schedule), but you can experiment and see what works best for you.  Some people take 2/3 in the morning and 1/3 later in the day.  The idea is to avoid the "crash" that can happen when the T3 component deserts you.

I'm doing labs in a couple of weeks, too, with doctor's visit early in March...love my endo, just wish he didn't charge me $200+ to talk to him for 15 minutes!

[faith63]

Nice to here from you again.   Yes ,it says on an empty stomach ,which may really be a problem!   I never feel that "crash" or even energized upon taking my meds.  Probably because they are still too low? Should I try multi again even if I notice no difference? What would you do?  Boy I really wish I didn't have to wait so long for labs and to see the doc.It will put me about 10 weeks n current dosage.  So glad you found a good doc!  Wish I could make $200 an hour.     Thanks

[goolarra]

If it doesn't make a difference in how you feel, then it's probably not worth doing, especially since it's a hassle for you in terms of food.  In 90 mg, you're still getting a pretty fair amount of T3...some people feel it much more than others.

Hopefully, your doctor will raise your dose again.  If so, ask him if you can have labs again and see him sooner than you  did this time.  That is a long wait between appointments.

That's $800 an hour...$200 for 15 minutes!  Ridiculous, isn't it?

[faith63]

It has been raised 15mg since those labs.  Then it took all this time to get him do abs, then they were booked up!  It may be in a better range, but I don't feel so good. I did have some muscle pain and the doc said to rub some Valsalva on it.  Good stuff!  Doc's do make tons of money and it's crazy considering most are pretty worthless. I'll keep in touch if that's ok.  Thank you so much for everything ,I'll let you know if those exercises relieve things, still need to research them.

[faith63]

Hi again, It has been suggested that maybe some symptoms may be the result of BHRT.  I can say the symptoms were there before I started them, but could they be stopping me from losing the weight and that awful acne? My dosage of Vivelle patch is 0.05, 2x a week and progesterone cream is 24mg. nightly. They are both low dosages.  What effect does the estrogen have on the thyroid tests?  Would like to get off them.  Should I wait to have current [90mg] labs done, in 2 weeks or wean off now, then have labs done?  So confusing.  They are expensive and don't do anything much. Blood says I'm still post menopausal. Don't have the $ to do saliva testing frequently. Your opinion is most helpful.  Thanks!

[goolarra]

If the symptoms were there before you started the BHRT, it's probably a pretty good indication that they didn't cause them.  However, I know one of the side effects of HRT is weight gain/inability to lose.

I have read that HRT has an effect on thyroid tests and that there's a specific FT4 test you should get if you're on HRT.  Apparently, estrogen binds thyroid hormones.  You might check the archives.

I'd say it would be best to stay on your HRT until after the test.  That way, only one thing will have been changed since your last labs...the 15 mg increase.  You should also talk to your doctor before discontinuing in case there are any special considerations.  Perhaps it would be worthwhile to d/c the BHRT after these labs without increasing Armour???  It's possible that d/cing HRT will in effect be an increase in thyroid meds if they are interacting...just a thought.

Which brings to mind another question...were you on HRT when you went hyper at 105 mg?

[faith63]

Thanks.  Yes, I was on HRT when I went hyper.  Started it about 2 months before I got any treatment for thyroid.  It's the bio identical type of HRT at such a low dose. Doc hasn't mentioned a special T4 test,this all just complicates things, but so does going off them now.  Oh, I was on propranolol when I lost a bunch of weight [I believe I went hyper for awhile] I do know it can mess with the T3.

[faith63]

I just looked up the Valsalva Maneuver and It has to do with a very deep exhale, which is very interesting because I have noticed that my diaphragm got very weak with this hypo t and the stomach distention.  I have trouble even blowing my nose and can't exhale well since this started. This is probably putting pressure near the heart?

[goolarra]

What you're actually trying to do is put pressure on your vagus nerve, which runs from your neck down through your torso.  Pressure on the vagus nerve slows HR.  

Let me say that I "discovered" this maneuver on my own and was doing it years before I knew it was a legitimate technique or had a name, so my method might be somewhat different.  I just hold my breath and push, but no matter how you accomplish it, it's like trying to exhale without letting any air out, or continuing to try to exhale after all the air is gone.  I just find it easier to do with lungs full of air rather than empty.

It takes a little practice.  If I've been having tachycardia a lot lately, I get pretty good at it and can usually stop it in a matter of seconds.  If it's been a while since I did the maneuver, I might have to practice a few times before it works.

[faith63]

Too bad!  you could have had this method named after you,instead of after a salad fixin'.  Sorry about your heart acting up.  I guess I'm just not "comfortable" accepting feeling so ill so often and maybe increasing the meds. will help. I'm not ready to believe this is benzo withdrawal, especially with the low labs and the symptoms like not being able to lose a pound. You'd think i'd see a little more improvement. The other day I tried to grocery shop and my feet and butt and legs cramped up and my vision was so blurry and my head hurt.  I was literally in tears. My food didn't digest and I had to throw it up to breath.  I ate again later and got reflux and nausea and threw up.  I was delirious and it' was like my body just ran out of fuel.  So ,actually I'm unable to do much more than sit around and the 20lbs doesn't help either. The vision thing is frightening and I'm just very down.  I wish my doc would really "listen" to what is happening and not make me wait 10 weeks plus for labs.  Thanks for listening.

[goolarra]

Ten weeks is way too long.  Next time around, ask him if you can see him in 4-6 weeks.  When m endo was adjusting my meds, I had blood work after 4 weeks and saw him after five.  it worked out well.

[faith63]

My doc has always done testing in 4-6 weeks until I was raising on symptoms alone and then became hyper.  He said I had a toxic dose of meds; which I believe was a "hyper, Hashi's episode"  Now he is very hesitant  to raise and this is why 10 weeks is happening. I have had to plead with him to even check my blood because I am nearing the 105 dose I was on when I had hyper labs.  I feel that I will know that I'm nearing a correct dosage when my labs look better and I don't have so much pain and swelling and my weight starts to drop some.  I'm very puffy and it shows up on the scale.  Under eye and drooping upper lids and swollen fingers etc... missing part of eye brows too, just not much improvement. Now I have to try to convince him to go up, cause 90mgs. aren't working, no matter what my labs might say.  I know some improvements can take time but this puffiness happened overnight and the weight gain came on in days and just kept going.  That tells me that it can improve rapidly too. Thanks for listening and your opinion is so appreciated.

[goolarra]

I think your best argument is that lab comparison I posted above.  Your numbers now are nowhere near where they were when you were hyper.  Make sure you get your lab results well before the appointment with your doctor so you can plan a strategy!

[faith63]

I'll do just that.  Thanks for everything!  I'll be in touch when I get labs, if thats okay.  Oh, my bp is 90 over 65 and I feel so bad .  Took Hydroclorathyozide and then later a propranolol and lowered my bp too much.  How can I bring it up?  Will never do that again, I forgot they lower bp too!