high T3 and anxiety and balance between thyroid and adrenals

[kevieb]

i am on 30 mgs of hydrosortisone and 60 mcg of armour thyroid.   the first thyroid check after being put on the 60 mcg was in the normal range---the second check showed me to have low TSH normal T4 and high T3.   the endo told me she was ok with the T3 being a little high.  as time went on, i noticed i started getting shaky a few hours after taking my thyroid meds.  i am also having ALOT of trouble with feelings of anxiety.     in doing a little research, i have read that hyperthyroid can cause shakyness, sweating and feelings of anxiety.  i forgot to say that doing even simple jobs such as cleaning a toilet, vaccuming one room or even just drying my hair will cause me to break out into a sweat that leaves me feeling drenched--sometimes enough that i have resorted to changing my underclothes.       i guess what i am wondering is this---if my first thyroid check was normal, then as a little more time went by my thyroid check--on the same dosage----showed my levels as being slightly high-----now that more time has gone by, could my levels have increased even more?   i'm thinking that maybe my dosage is too high.

  the endo originally had me on only 30 mcg.  when armour was temporarily unavailable, she put me on levothyroxine.   the psychiatrists office checked my thyroid because it had not been checked in awhile.  one of the docs in the office kept trying to normalize my TSH  (not going to happen with a pituitary problem)  so he kept lowering my thyroid meds until the psych finally saw a blood test and told me my thyroid was too low  (but the other doc had finally succeeded in normalizing my TSH at the expense of my T4 levels!!)  the psych put me on the 60 mcgs of armour at that point.

i don't feel well quite often and keep hoping something can improve for me.  doesn't there need to be a proper balance between my thyroid and my adrenals?    my endo does not check my levels any more often than 6 months.  i thought that when medications were being ajusted that you needed to be checked a little more often--like every couple of months, until things get stabilized.

fortunately i have been accepted as a patient with a different endocrinologist.  i am told that he will not take just anyone as a patient---i guess my blood work looked screwy enough that he must think i've got something going on.  i am told that he is supposed to be one of the best in the northwest---but i have to drive 3 hours to get to him.  i've also been told that he is well known for dealing with adrenal problems. (i asked)

sorry for the long post, but i'm just trying to figure out if the shakes, sweating and anxiety could be the thyroid meds.

[rumpled]

There are - and they are important. It is good that you have a doc on your side. I had a couple helping me but they were not my main docs just like you.

Fibro like pain is often associated with adrenals to be honest... cortisol coming and going hurts like heck.

I live in NJ, tried NYC and ended up in California for treatment! My hubby calls me *have tumor will travel* as we go every and anywhere trying to get help...

[kevieb]

i didn't even know there were neuro-endos or pituitary centers.   we live in a small town in southern idaho, so we have to drive  a bit to see specialists.     it was my orthopedic surgeon that felt my thyroid was too low, which is what finally led to the AI diagnosis-----any of my other docs would have just looked at my test and said i was in the normal range.   i have since had a couple of docs tell me that they need to treat the symptoms, not just the blood test.       the first time my bun and creatine levels were flagged, my orthoped was the only one that was a little concerned about it and told me i needed to be tested again at a later time to make sure things were ok.

sometimes we feel like our orthoped takes better care of us than our family doctor.  he treats my fibro pain---i couldn't get any help from the rheumy or the neurologist.

[rumpled]

If the thyroid and adrenals quit together then that is schmidt's syndrome or something like that...that is an auto-immune disease from what I know...

I have both primary and secondary adrenal disease as my adrenals are gone and my pituitary is ferklumpt. I take florinef. Not everyone needs it but it should be based on your sodium and potassium levels or your renin and aldosterone levels. I needed it when I had high cortisol even so the need may not be cut and dry.

BUN and creatnine are kidney tests - I think they test the kidney as the adrenals are on top and they want to make sure the kidney function remains good. Are the levels so off you need care? I have not heard they are related directly though.

Just sounds like there is something else going on - otherwise you should be feeling better. Is your doc a neuro-endo? Since your issue is pituitary, you should go to a pituitary center.

[kevieb]

i think the contrast was done while i was in the machine---but i don't know if it was a new MRI machine or not.

i am not on florinef because because there hasn't been any indication for it---and i have read that it is usually not needed with secondary adrenal insufficiency.

i know of someone who had addison's and low thyroid.  his mother told me that his thyroid finally quit working completely-----and then it became alot easier to regulate his addison's.

i think i read somewhere that somehow BUN and creatine (SP?) levels might be related to the adrenal issue and i know that several times both of them have been flagged when i had blood tests------but not always.

[rumpled]

How was the MRI done? Was it dynamic in that contrast was given while you were in the machine? Was it one of the new MRI machines - a 3T? That can help pick up smaller tumors.

If you have a pituitary issue, yeah, TSH as a level for you is out... the doc should know that but alas, most are pretty silly about it. I had a known tumor and docs kept chasing my TSH - I had every color med... and felt horrible. I finally had my thyroid removed for all the nodules and all - and got stabilized. But this took forever!

Has your doc put you on florinef at all? The whole androgen balancing act is pretty tough - I still don't have it right and it bounces around...

I don't know if the children's issue is related, but it is sad. I hope the period issue not hormonal as well.

[kevieb]

i am on hydrocortisone for secondary adrenal insufficiency.   i have had an ACTH stimulation test---fasting, of course, my 8am level of cortisol was only 2.4  (range was 5-20) my ACTH was 5, which was the lowest number  on the range.  at 30 min i was 9.something and at 60 minutes i was 11.something----my understanding is that a normal response should have put me 20 or over.  

i have had an MRI with contrast done which showed no apparent pituitary disease.     i am pretty sure that my doc tested for antibodies.  my original blood work showed low testosterone---(free and bioavailable, both), low DHEA, high sex hormone binding globuline, and estrogen over 1000.  the endo looked at my blood test and told me that she had never seen this before----my blood work and symptoms didn't fit any particular disease.  i was sent to the endo originally because i needed carpal tunnel surgery on both wrists and my orthoped checked my thyroid and B-12 first to make sure they were not causing the carpal tunnel symptoms.  my thyroid was at the low end of normal----and he felt like it was too low---my B-12 had been flagged as high.

i have had multiple thyroid nodules for 13 years and had been on thyroid meds to shut my thyroid down for 10 years. (to shrink the nodules)  when i first saw the endo, i had been off of thyroid meds for a year.  she did an ultrsound and biopsies---and has wanted to do an ultrsound every 6 months to make sure the nodules don't change.

she put me on 30 mcg of armour and  25 mgs of DHEA.  my estrogen level must have been a fluke--gyno said it was probably a surge before ovulation--he said he had seen levels that high before, but only a few times.  

i didn't show improvement in how i felt---tiredness, fibromyalgia, low blood sugar---then the endo tested my cortisol.  once she put me on the hydrocortisone she told me i should start feeling better pretty quick---i've never felt any better.  at some point in time another hormone level dropped down to almost nothing---maybe hydroxyprogesterone?--but it returned to normal.  she got everything back to normal ranges except my testosterone.  i used a cream for a month and actually got the testosterone a little too high.  skip ahead to last december and all hormone levels she tested were in normal ranges except for low TSH and high T3----but this was after i had been changed to 60 mcgs of armour.   my TSH levels have been low most of the time over the last 3 years---except when that doctor kept lowering my thyroid meds till he got the TSH normal----and made my thyroid too low.

i don't think he knew i had the secondary adrenal insufficiency, which would make my TSH unreliable for testing my thyroid.  when i was on meds to shut down my thyroid there were times my TSH was at 0----and back then i felt fine---although the fibro symptoms started setting in about 2 years after i started thyroid meds (headaches first)  and just slowly got worse over the years.

i had a scope to dilate my esophagus in december (3rd time in 4 years)  it showed i may possibly have eosinophilic esophagitis.  i recently read an article that connected secondary adrenal insufficiency with eosinophils.  i've had the low blood sugar problems for at least 23 years.

just realized some of this post was a repeat of teh last one--sorry, but i was hoping to give a better explaination of what has been going on with me.  

just an interesting side point, i have 3 children with celiac disease---a set of identical twin girls and my daughter that is just younger than them. both twins have had eating disorders.  the first one was 5 years ago and was hospitalized for 3 months---she is well now. her twin sister started with the eating disorder during her first year of college.  she has not been hospitalized, but she has had to be put on potassium supplements.  they will be 20 on the 31st of this month and neither one has started her period.   we've had genetic testing done and my husband and i, and 8 of my 9 kids, all carry one of the main genes for celiac disease.  i know there is a connection between addisons disease and celiac disease---but i don't know of any connection to secondary adrenal insufficiency.

[rumpled]

Back to the beginning - has the original doc tested you for antibodies like hashimotos, and as well, have you had an ultrasound? Have you posted in the thyroid section?

Why are you on hydrocortisone? Those diseases can suppress TSH and cortisol itself can suppress TSH so trying to uh, treat to the TSH (which is a pituitary, not thryoid) test is kinda weird.

Armour has a high ratio of T3 as you probably know so if you take it alone, and you don't need that much T3, it will effect your T3 a lot - so you either need to balance it with a little T4 to help or use a different mix. I take a T4 and cytomel just to control my t3 add...as yes, the shakes etc, sound like you have gone hyperthyroid...Just a simple search can show you that your symptoms fit...