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New Labs, major problems- adrenals- rT3

Me again. Back in April I had felt the best I had in a very long time, it was a long road back. My levels were a tad over range, but I felt great. Here's the link to that thread if you want to see those levels:

http://www.medhelp.org/posts/Thyroid-Disorders/MY-latest-labs-7-weeks-on-Acella-NP/show/1713908?personal_page_id=2042079

Just after that posting, I had some very stressful events one of which was moving. The week I started tovpack, I DID start to feel a bit hyper so I backed off from 3 1/12 grains nP Thyroid to 3gr and still felt fine. The week after I moved I felt like I got hit by a truck and realized the move had me cranked up before and now had me wiped out. Then some more stress. Spent a month waiting for my system to go back to normal and also had to wait a month to see a doctor who doesnt even know how to treat thyroid issues. Had gone back up to 3 1/4 grains at that point.
Then I remembered a friend who had seen a chiropracter that had diagnosed her Hashi's and got in to see him this week, had tests done just before. This also makes me worry about how we are all tested as I wasnt quite buying the hospitals FT4, so I had it redone at Labcorp 2 days later. I got a lot of tests, here are the pertinent ones:

TSH         .04     (.34- 5.60)
T4Free    1.16   (.61- 1.12)   LABCORP FT4: 1.59  (.82- 1.77) wtf?
T3 Free    4.1     (2.0- 4.4)
REVERSE T3   44.3   ng/dl  (13.5- 34.2)***
Antithyroglobulin ab  <20   ui/ml    (0-40)

I am seriously low in Vit D, Protein, Iron and some others, can post those if needed. Somehow my liver is great.
Doing the saliva test today where he is testing my adrenals and hormones and I am thinking this guy was dropped out of the sky into my lap!! Too weird to find someone who looks at adrenals----have to go to a chiro to get proper testing???

Does that antibody test say I have Hashis though?? I was feeling so good, then had to go and move. Although I do know that those low vitamins, iron and protein were gonna catch me eventually. I think he is going to wait for saliva tests to come back before doing anything but is there anything I can do myself to get that reverse t3 back down? I also have to go on a diet of sorts....no wheat....sugar, etc.....a lot ahead.....can't catch a break. Any input would be apprecaited as always :)
Best Answer
Avatar universal
In your other post, you said you thought this doctor was "Hashi-happy", and although elevated TGab has to be disproven to rule Hashi's out, I think you're probably right about his Hashi-happiness.  That's because most chiros treating thyroid are following a protocol developed by a chiro named Datis Kharrazian.  His whole premise is that Hashi's shouldn't be treated as hypothyroidism alone, but the underlying autoimmune disease should be treated.  Mainstream medicine says there is no way to treat the autoimmune component. If you google his name, you will find plenty of marketing for the protocol.

So, if you don't have Hashi's, then you don't fit their protocol...or do you?  K says that not everyone with Hashi's tests positive for antibodies.  Does that mean they can "make" you fit into their protocol?  IDK, but I'd do some serious reading with a very critical eye.

Bear in mind that the more diagnostics performed, the higher the probaility of generating treatment.  If you're the one distributing these treatments, then there's a money trail to follow.

As far as your RT3 is concerned, stress is one of the major factors in raising it.  It's a natural reaction that protects the body in times of crisis.  There are only two ways for the body to purge excess T4, either convert it to T3, which in times of stress can create too high levels, or convert it to RT3, which is inert.  It's the body protecting itself, and it should be a self-righting condition once the stressor is removed.  It's only when it becomes chronic that it's a problem.

As to the recommendations from the STTM site, I'd be very cautious about #2, especially doubling the recommended amount of anything except under a doctor's supervision.  Both T3 and RT3 are converted predominantly by the liver.  The two enzymes responsible for catalyzing that conversion are both selenium based, so you mess with one, you mess with the other and you can let a whole lot of toxins loose in your system in the process.

Just do your homework...  



  
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Avatar universal
Pretty much "my way or the highway"...  It's called CYA.  She's much more interested in covering her butt in court than in providing any real medical "treatment" plan.  Ex out another one...
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Avatar universal
Just a note to add to this thread right now, I had asked the doctors office above to refund some, if not all of my money due to the nurse misinforming me about what the doctor tests and wasting a month of my time and my money. I told them not to worry, I wouldn't be coming back. Today I received a letter from that doc, certified, that starts:

"Due to your noncompliance with the medical treatment plan I developed for you, I find it necessary to inform you that, as of the date of this letter, I will no longer be able to continue to provide you with medical care."

So ok, medical treatment plan??? Pay attention all, this is what you may have to deal with until you find the right doctor. She gave me NO medical treatment plan and didn't even address some of the main things I went there for. That and she'd have me taking about HALF of the thyroid med I need. All her plan was, was a script of Vit D!! Always something to fight. SO glad I waited a month and spent 140 on that appt!!
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Avatar universal
If looks could kill....thanks for the offer I may take you up on it! :)
I went to the trouble to ask what they test there BEFORE I made the appointment. They said they were sure she tested the FT3, otherwise, I would not have watied A MONTH for the appt.- would have never gone there. When she said that about that particular test, a test I KNOW shows HYPO and said she never tests FT3 my mouth dropped open, literally. I had meant to ask her that at beginning but a lot going on. I then calmy and firmly told her that now I understand why there are so many sick and miserable people out there...I get it now. That's probably when my bill went up to 140, they had told me the visit would be 70. I am writing a letter to her tomorrow or possibly small claims as she seems to be a cocky, know-it-all type and doesnt mind sticking it to me for doing basically nothing. The endo she wanted me to go to has no idea what he's doing either as I have a friend who has seen him.
Now on 50,000 iu of D a week- 1000 B12- 800 Folic Acid. I guess the RT3 is going to have to work itself out cuz ain't no one gonna help me it seems!!!!

If i had walked in there with a prescription bottle that said 3 1/4 grains NP, and no tests at all, I would have a refill for 3 1/4 grains from that woman. Sheep.
They all need to go back to school....or get on the damn internet!!! Having said that...the idiot doc who would only give me 2 grain scripts down south and also thought the old test meant I was HYPER, also wrote a 2 grain script with like 9 refills......so should be good thru early Sept. He underprescribed something my thyroid needs and over prescribed and addictive drug. go figure. Sorry about the rants, tough day. Especially tough because I KNOW the pitfalls and did everything i could to avoid this very thing. Thanks for the support :)
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Avatar universal
I'm so sorry that went so badly.  An FT4 of .98 just fine...okay...goes to show what she knows.  Let's get her some ATMs, tie her down and make her take them until her FT4 is .98 and see what she thinks then!  I'll help you!

You know, when you're not taking meds with T3 in them, there might be SOME (not really) excuse for not testing FT3, but once on T3 meds, there's not only no excuse, it's downright irresponsible.

Do you have enough meds to last until August?

I have a PCP that I keep going to (actually a married couple of doctors who share a practice).  They're not great diagnosticians.  In fact, both my husband and I have diagnosed ourselves or each other faster than they have.  Why do I keep going to them?  Because they are NOT condescending...  Oh, the choices we have to make...
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Avatar universal
Should have said, I spent $140 to not even have a band-aid doc, get talked down to, aggravated AND a Vit D script!
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Avatar universal
Ok, RAGE and frustration don't even cover what I am feeling right now. I went to D.O. today and hoped to get somewhere with above issues. I had planned on her being my "band-aid" and prescription doctor in any event....but not doing that now either.
I had even called before making appt. 2 months ago to be sure what they tested for thyroid there supposedly they tested the right things. Well, she looked at an old old test of mine and said my FT4 was just fine at .98 (range .82- 1.77) and my TSH was way too low. It was a test that she failed miserably. It was the test done right after my armour crash in '10 and I was seriously HYPO. She looked at my current numbers (above in thread) and told me I am taking too much med and wants me to see her Endo who is not scheduling until AUGUST. She also goes by FT4 and TSH, doesn't even test for FT3....and if I want Xanax, I would have to go see her once a month. I am an insomniac who does not abuse my med, btw.
SO....I am really on my own. I spent $140 to get a script for Vit D and she didn't/wouldn't address my period-hormone issues either and didn't even try to pass me off to someone else for those. On top of all of that, she was a condescending bi$#%---and i didnt even mention the internet. And REverse T3?? What is that???? SO PISSED, SO TIRED don't know where to go from here.
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Avatar universal
Yes, that was all me...I have been on my own in all of this for so long, forgive my foolishness. I do know all things expressed here are just opinions, but it helps to know all of the things that are shared with me here. Message received loud and clear! I had never taken thyroid med under my tongue before until just now....NP Thyroid (Acella) dissolves well and tastes very sweet....which makes 2.5 grains for today, and only on 2 grains for 4 days.
if N.P. won't get on board, I will simply do 3 grains or just under, and work on my iron and vitamins etc. Thank you for the input, again I was desperate for change and just wasn't sure, won't be happening again! :)
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Avatar universal
Going to 2.5 would mean you'd dropped your T4 by about 31 mcg...25 mcg changes at one time are really all that's advisable.  If you're going to add the T3 you lost in the decrease back in with a compounded T3, then 2.5 might work.  However, if your NP won't go along with prescribing the T3, I'd probably think about trying to go back to 2.75 or overall between the loss of the T3 and the T4, you are going to be way lower.  All just my opinion, you understand, what I'd try if it were me.  I hope your NP has some input to add...
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Avatar universal
Ok!! Wasn't sure how much to knock off at all. Going to bring it back up...been taking 2 grains down from 3 1/4, maybe go up to 2 1/2? more? Yes, that was i bit impetuous...just wasn't sure how much to drop and was really only going to do it to see if it helped. Think I got desperate. Storm today killed land lines, so trying to get into N.P. in the next day or two....
Sorry to make you nervous! Was just so damned miserable...
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Avatar universal
You've cut your desiccated a lot.  That can be good for a few days, if the dose had been too high, but for a sustained period of time, it may not work so well.  You've cut your T4 intake from 133 to 76 mcg and your T3 from 31 to 18.  Big changes.  Since you only did that a few days ago, most of what you're feeling is from the drop in T3.  It will take much longer for your T4 levels to drop.  

I'd proceed very cautiously here.  If you add in T3 to compensate for the 13 mcg of T3 that you've lost in the decrease, you're still going to be getting a LOT less T4 (your dose is almost cut in half).  I'm just afraid that if you don't keep a reasonable T3/T4 balance, you're going to pay for it later.  Makes me nervous!
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Avatar universal
PS, I realize I am being "impatient" and should see what the saliva tests say, but after 2 months of feeling this bad and really 2 years of this rollercoaster, I feel the need to get moving on this. May not see the saliva results for some time and feel if anything, I might have low cortisol levels.
Not really noticing that 1 to 2 months had gone by has really freaked me out. This is why I am hell-bent on feeling better and trying to be proactive rather than waiting for someone (Dr's) to tell me something that may or may not be true or send me on wild goose chases. Kind of a process of elimination...if i add T3 to a lowered dose of NP Thyroid and feel bad again, thinking that may indicate adrenal problem or other things. I will tell you, I feel SO much better since dropping my Thyroid dose last week and taking the load off of the reverse T3---can't even tell you. Ok, end of ramble.
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Avatar universal
Spent quite awhile on the phone today. My old compounding pharmacy is amazingly helpful. On 3 1/4 grains I was getting 31mcg. of T3 and 133mcg of T4. I am now since lowering, taking 18 mcg T3 and 76mcg of T4. I may try to go on just T3 for awhile if I can get the Doctor/N.P. to agree. This would be from the compounder with an olive oil filler and NOT Cytomel and not time release either.
Got through to the Chiro today finally, and asked if they would add the estrogen etc to the test and all she said was "Did you tell the lab you did the saliva test over 2 days?" of course I did. I know that's bad, but I had no choice really. Had the migraine that was brought on by chiros manipulation of my neck---was told that would happen as he was righting things.....ooooookay.
I am starting to think that the stress back in April in tandem with all the low vitamin D and iron levels did cause the high RT3 and really doubting I have adrenal fatigue, although I could be wrong, but I think I will work on the above low levels, do T3 for a little while. If my adrenals ARE an issue, I will cross that bridge when I get to it- won't even see those tests for well over a week, if even then as I have to get a copy from Chiro. Trying to get in to see the other Doc's nurse practitioner THIS week. Thank you, goolarra for holding my hand and very helpful info :) and thanks to flyingfool and Red_Star for the very helpful info....these can be scary times but here I am with a plan now. You're all pretty wonderful :)
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Avatar universal
Tough question.  

Mathematically (theoretically) I suppose that's what you'd do.  I don't know how much good the time release is going to do you because the T3 in your desiccated is not time released.  Perhaps regular T3 would work as well???  Do I remember correctly that you take your desiccated all at once?  Perhaps taking regular T3 away from your desiccated would balance out your day better?  I don't know...just something to think about.

I'm afraid the chiro doesn't really surprise me.  I've always felt that there's a money trail there that's plain as day.  The author of the book I mentioned actually says in the book that treatng thyroid is a good way for chiros to "jump start" their practice.  Well, i guess that makes it pretty clear!  
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Avatar universal
Ok, game plan (IF I can bend someone to my will :) :

This is my fourth day of a much lower dose of NP Thyroid and the change in my thinking alone makes me know the main culprit has been my RT3, also not as weak, sleeping less (which is good) and better spirits. The thing is, on only 3+ days of less NP, I have a boil coming up so far and can expect REAL hypo to hit at any moment. When I lowered this, I had NO real game plan, was just waiting for my saliva tests to get done and get back to the Chiro and into the  D.O. in a week ....I simply needed to feel better QUICK. Thanks for the input, and I have done a lot of reading. I was offered an appointment with the DO's nurse pratctitioner originally and turned it down. Now that the fog is clearing, I realize that if I go to the N.P. with info (and I am told this very N.P. basically looks things up on the internet that she isn't familiar with) and tell her I want about a month of time release T3 (compounded, from my old pharm)- I might be able to get what I want. It took me a year and a half to get what I feel are my perfect ft3 and ft4 and I don't want to blow it now.
Tell me if I am wrong, but I believe that I would get an equal amount of T3 time release to the amount I have shaved off my dose of NP Thyroid: I would have about the same amount of T3 as my optimal dose, just less T4.
I can then work on adrenals if there is a problem....and already working on my Vit D, protein, iron etc.
The past dew days have been a blessing. Best I have felt since before my move. A long way to go, I think but I would be alone in all this if not for this board. These are some tricky problems that most doctors don't seem to know about. Thanks to all here who share their experiences and knowledge with others-  it has made all the difference to me and to many others.

PS. The chiro was supposed to email me about our 1st appt (tues.), I asked him to since I was having memory issues. He didn't. I then called when I noticed he wasn't even testing my female hormones at all, not even in the saliva tests---I asked him to call that lab and ask that to be added. Nothing. I made it clear to him that while I could pay for some tests and office calls, that I had no insurance and limited resources at the moment and also made it clear I had my own vitamins etc......and now nothing. Yup.
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Avatar universal
"I did great in any event"

should have said, up until the reformulation.... :(
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Avatar universal
To anyone reading this thread, when I was on Armour at 2 grains, I took the whole dose at once and did alright with one dose. In hindsight, I may have benefitted from splitting the dose- but again, I did great in any event.

When I went on Compounded and got up to 3 grains, I realized that dose was just too much to take at once and have been splitting my dose ever since.
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Avatar universal
You know, I was swearing back then that I MUST have been getting OLD Armour from Ohio! Sometime in Jan '11, I was just racking my brains about what could have changed. I suddenly realized all my problems started when I stopped getting my Armour in OH the previous summer. i even called my pharmacist up there asking if he had any idea. he didn't know. No one thought it possible for me to still be getting OLD Armour into 2010, but now I think that was the case too. That has been nagging at me for a long time!! I think my adrenals were involved at the time as well.I am dying to know what my saliva tests say. Thanks a lot....that had continued to bug me :)
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Avatar universal
My bet is the Ohio meds were the old formula, and when it became available again locally, you were getting the new formula.  A lot of forum members had a TERRIBLE time with the reformulation, and how it affected them seemed to be all over the place.  Your doctor might be right.  The huge increase from 2 to 3.5 grains makes a lot more sense now...
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Avatar universal
lol...
I never ran out of Armour, my old pharmacy up here must have had a big supply, but it seemed that things changed when I COULD get it down there in the summer of '10. The second doc said that I lost weight because of the new fillers in Armour, which may or may not be true. I have no way of knowing if I was getting the old Armour or the new Armour from Ohio until June '10, but I never ran out. The switch to compounded (Feb '11) seemed to to the trick for me and i do feel like the new Armour is now poison to me.
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Avatar universal
So, was it about the time of the reformulation that you started having to increase so much?  Could you not get it due to the shortages caused by reformulation?

Cats only eat protein...maybe the alley cat analogy is trying to tell you something!  LOL
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Avatar universal
Thanks so much, so glad to feel a bit better...lost some time there.
I was on 2grains (give or take) Armour Thyroid from '06 to very beginning of '11. I was living down south and couldn't get it there until summer of 2010 (was having it shipped from Ohio) as soon as it was available in the south, I started getting it there and it seems thats where my problems started. I lost 20 lbs, had a crazy elbow pain like carpal tunnel, boils that wouldn't heal, etc. and within months went a bit nuts. Went thru losing my job and a breakup and BAM. Was too busy working to address weight issues and had a crappy doctor. When he finally tested, he tested TSH only, had to beg for the others----he had me cut down med based on TSH, but by other levels I was extremely HYPO. I freaked- went to another doc who put me on Compounded and I could tell the difference almost immediately. Went up to 3 grains of that. To this day, I do not know what occured then as no one would address my adrenals. I did go off the pill a year ago so my body would absorb my thyroid med better, but that came with it's own set of problems. I had no idea about the Armour situation until I got really bad in Dec '10. Seems everyone else went hypo and GAINED weight.

What you said about age makes sense. lol....I am 47....and I have been eating like an alley cat, well an alley cat who likes sweets and carbs! Thanks again!
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Avatar universal
Even if the cause of your hypo is not Hashi's, whatever the cause was might still be progressive.  You might lose more and more thyroid function as time goes on, even if it's not the little critters (antibodies) chomping on your thyroid doing it.  Also, many factors affect our requirements...aging (just try to stop that one!), stress, trauma, general health, surgery...the list goes on.

Were you on 2 grains of the same brand that whole time ('06-'11), or did you have to switch during the shortages and reformulations as so many people did?

Certainly, what I eat affects how i feel day to day.  There are times of the day that my energy just drops, and I know I have to go scarf down some protein...nothing else works, and carbs almost make me feel worse.

Glad to hear you are feeling better.  
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Avatar universal
I have done some reading on Hashi's, RT3 etc...and female hormones. Wondering if with simple Hypothyroid if people do have to go up in dose from time to time. That's one of the things that stood out to me about hashis....I was on 2 grains from diagnosis in '06 until beginning of 2011 had to go to 3+ grains.

Weird too, been on a lower dose of NP Thyroid for 3 days now with addition of vitamins and foods with iron and protein etc and actually have more energy and in a better mood. Seems like I have been in a haze for 2 months and starting to think almost normally. Is that weird? Am I just imagining that??? lol
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Avatar universal
I talked to the lab already. I had no choice as I had to take migraine med after first 2 vials (Midrin) and that drug would probably have messed with the test. I did the 2nd day vials under the same circumstances and times I would have on the 1st day. Again, had no choice and half the test already done so had to make the best of it.
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