Thyroid info/treatment

[faith63]

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

[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]

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 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]

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]

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

Thanks again

[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]