Aa
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
Thank you, Emily
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!
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!
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.
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.
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.
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.
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.
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?
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.
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?
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?
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!
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.
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?
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?
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
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!
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!
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!
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!
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.
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.
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!
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...
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...
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
Emily
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.
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.
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. *****.
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. *****.
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?
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?
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]
Thank you, for your help [your so good at wording things]
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
