Ok.. on NDT Acella.. feeling Hypo but have HIGH labs

[copi2k]

Hi everyone..

well since mid december 2013 im on Acella NDT... After 2 Weeks on it, i began to feel more more more hypo... and went to the doc for some results:

2,5Gr Acella:
02.01.2014
fT4 12,66 (10,8-25,8) = 12%
fT3  5,72 (3,4-7,2)= 61%

I felt awful with these results... my fT4 was at ~18-20 before Acella... fT3 didnt move.

Ok so i moved forward to 3 Grains and made some labs:

3 Grain Acella
17.01.2014 (2 weeks after last Bloodlabs)
fT4 14,26 (10,8-25,8) = 23%
fT3  5,94 (3,4-7,2)= 69%

ok... so the 0,5 more grain did a little bit. I've read that due the accumulation of the T4 that after 2 weeks there is 90% of the T4 accumalated in the blood... thats why I'm making labs acutally this close... because i felt not good.

ok.. so i increased again 0,5 Grain.. like STTM said on their page.. (0,5 every 2 weeks).

So... new labs.. :
30.01.2014
3,5 grain
fT4 21,49 (10,8-25,8) = 71%!!!!!!!!!
fT3  9,5 (3,4-7,2)= 162%!!!!!!!!!!!

Well.. what the hack?? i really really dont believe, that the +0,5 grain can make my labs jump that high, really!

The whole January i felt really awful... like in my deepest hypo-times... thats why i was increasing the dosage every 2 weeks and listen more to my body then to some labs.

since i got to the 3,5 grain, i start feeling better. Im not that sick like before...

ACTUALLY Symptoms on the "high" labs:

- Cold hands and feet.. but not icecold like before and sometimes they are warm :)
- Bodytemperature axilar 35,80-36,2°C.. on better days 36,4°C.
- more appetite (when im hypo, i barely eat something and losing weight.. :(, i have no appetite at all )
- brainfog is lifting somewhat (thanks god)
- still tired/fatigue
- often pale and dark eye circles
- cant get out of bed in the morning
- when i went to work for 2-3 days... im so exhausted.. i need 2 days to regenerate
- Bloodpressure and pulse: 135/85 (just like always.. when im hypo, my bloodpressure is getting high)... pulse 65/min.

My cortisol (salvia) was fine the last time.. my iron is fine too..

well.. i'm really confused due the labs... they say im SOSOSO hyper.. but i dont feel like that.. maybe failed measuring? Im not hot... i have no insomnia.. i have not a crazy-all-day appetite.. i am not hot.. i am not shaking (tremor).. i feel just somewhat better then 1 month ago :)

should i listen more to my body then to labs? maybe i shoul do a second measurement in 2 weeks??

[goolarra]

Seventeen hours is fine.  Most people split their desiccated into two half doses and take one in the early afternoon.  If they have their blood drawn first thing in the morning, they're at right about 17-18 hours.  Speaking of which...do you split yours?

You're preaching to the choir when it comes to TSH.  I have a pituitary issue, so mine hovers around 20.0 all the time.  For too many of us, it's so counterproductive to even look at.

It is hard to be patient, but listen to LazyMoose, because I know he's been there.  It can catch up to you really fast, and you end up raging hyper.  All that does is make it take longer in the long run to get to an ideal dose.  I've been overmedicated, and I'll tell you, I will take hypo any day.

Glad you're feeling better...

[copi2k]

hi everyone,

thanks for your advice :)

like i said i will stay at 3,5 actually to check in 3 weeks again... so far im looking better than last week.

I had my last dose 17h before the labs because i forgot to take it earlier.. :( i know there has to be a 24h abscinence.. next time i will hold that 24h.

Im just wondering.. when i got sick, i had a TSH of 2,8 with massive! symptoms... fT3 55% and fT4 42%... so in the beginning.. the Endo said that everything is fine.. i believed him... as time went by.. i got worse and worse... but have done some thyroid-labs every 3-4 months. 2 years later with still massive symptoms my fT4 was 0% and my fT3 was 24%... TSH was 1,47!!! but i still didnt realize that i had a thyroid issue... last year in summer i got the diagnosis hashimoto.. 5 years!!!!!! after having these strong hypo symptoms... so i dont give a damn about the TSH.. it seems to be inadequate. I think the body needs time to heal after 5 years beeing on "low".. but like you know... you want to get it faster done :/ its hard to wait until it gets better and go the slow way..
actually i FEEL better.. so i can slow down now.. :)

[LazyMoose]

Oh what fun starting a new dessicated med can be. Get a good pill cutter, you can cut some brands of natural thyroid into quarters. Its best to increase slow, as it can catch up to you in the long run like a runaway train (no fun). While hypo, some good naps and a red bull here and there were always welcome for some relief. Hyper takes so long to slow down, best to avoid it.

[ahmee]

Sage advice from goolarra. Your symptoms still seem hypo, not hyper, but you haven't given the hormones enough time to settle in your system. It's a good idea to slow down with dosing up once you reach the 2-2.5 grain range. Re-test every 4-6 weeks and make 1/4 grain adjustments as needed until you are feeling pretty good. Then minor tweaks or addition of synthetic T4 may be necessary after that, but you will always keep the adjustments and bloodwork apart by at least a month or two. This is just my advice based on my own experience of starting on desiccated thyroid, but it worked very well for me.

[goolarra]

Good question, ahmee.  Assuming still that you hadn't...

You don't feel hyper, but you also have two 0.5 grain increases that haven't completely settled yet.  

Labs are often first to change, with symptom relief lagging a little.  If you've amassed a plethora of symptoms, your body has a lot of healing to do before you're going to feel better.  That takes time...

If you continue to have hypo symptoms and your FT3 continues to stay at that level, you might do some research into thyroid hormone resistance (THR), which is a condition in which FT3 has to be sometimes many times the upper limit of range before hypo symptoms are relieved.

Very high levels of FT3 can also cause RT3 to rise, which can cause its own problems.  

I just don't think you can go by either labs or symptoms to the exclusion of the other, especially when you've increased so recently and FT3 is so high.

[ahmee]

Did you happen to take your desiccated before your blood work was drawn?

Since you are referencing STTM I assume you didn't do this, but never hurts to ask.

[copi2k]

hi goolarra..

thanks for your post.. ok i think i will take the 3,5 for another 2-3 weeks and do some labs on it ... strange that labs often dont collerate with the symptoms when u begin to raise your meds... like i said.. i really dont feel hyper anywhere :)..

[goolarra]

I think you have to pay attention to both labs and symptoms.

The FT4 portion of desiccated takes more than two weeks to reach 90%.  It's more like four weeks, and it takes 4-6 weeks to reach its full potential.

I think you're increasing too fast and retesting too soon.

"Well.. what the hack?? i really really dont believe, that the +0,5 grain can make my labs jump that high, really!"

0.5 grain didn't do that.  When those labs were done on 1/30, you'd increased 1.0 grains in 28 days.  The first 0.5 grain hadn't even totally settled in your blood, the second half grain was only two weeks in.

Symptoms relief often lags a change in labs.

I think you ought to give it a good four weeks on 3.5 (since your last increase), retest and reevaluate then.  Your most current labs are definitely saying "slow down!"  If you feel an increase is still in order by then, you might consider increasing somewhat less aggressively.  More is not necessarily better.