new labs..here we go again!

[deetee958]

After a few months of feeling good and my hair finally getting back to normal BAM here's what happened.  I started a health kick and was drinking green shakes (mostly kale) Now I realize a No-No in the thyroid world.  Had my labs drawn a couple weeks after starting and still feeling great at the time.  By late June the symptoms started again.  Itchy skin, scalp, hair dry brittle falling out, trouble sleeping,  just feel like crap!  I had not changed my dose of NT.  Still at 1-1/8 grains.  What can I do???  Its a never ending rollercoaster!!  

I see a new endo who does prescibe natural thyroid but my appt isnt until the end of September.  I could e bald by then :(  any suggestions???  Im so unhappy and I have a big party to attend at the end of the month.  Looks like I will be wearing a ball cap!

TSH COPC: Your TSH COPC results are within normal limits
TSH 0.64 Range: 0.50-6.00 MIU/mL (Collection Date: 06/14/2013)
TSH Your last value was 0.32 Range: 0.50-6.00 MIU/mL (Collection Date: 10/02/2012)

Free T4 COPC: Your Free T4 COPC results are within normal limits
Free T4 0.8 Range: 0.7-1.8 ng/dL (Collection Date: 06/14/2013)
Free T4 Your last value was 0.7 ng/dL Range: N/A (Collection Date: 11/23/2010)

FT3 COPC: Your FT3 COPC results are within normal limits
FT3 485 Range: 200-490 pg/dL (Collection Date: 06/14/2013)
FT3 Your last value was 274 pg/dL Range: N/A (Collection Date: 11/23/2010)

Any ideas??
dt

[Jackie440]

I had similar problem when dosage changes were changed.  My pharmacist called me to ask me why so many changes so quickly every few months they were either upped or lessened.  He told me problem could be the lab that the med comes from and the fillers they have put in that are causes me the problem of itchy skin , insomnia

[deetee958]

I actually have enough as my original rx was for 1 1/4 cuz it was easier to figure out.

[goolarra]

If you increase to 1 and 1/4 grain, won't you run short before you can refill?

There is more than one way to skin a cat.  I think your best outcome would be to increase your NT.  However, that requires your doctor's cooperation.  You'll run out of NT if you try to increase on your own.  However, the addition of 25 mcg of T4 certainly won't hurt, and if you convert at all, it might make you feel quite a bit better.

I get so frustrated with how stubborn these doctors are.  What about not feeling well don't they understand.

If I were you, I'd keep taking the 1 and 1/8 NT (if you have enough) you usually take and add in the 25 mcg T4, as your doctor suggested.  Re-test in 4-6 weeks, and if she's as uninterested in your symptoms as she was this time, move on to someone else.  

[deetee958]

Ive been to so many docs about this.  Im not sure anyone but people like you really understand my symptoms!

At her suggestion I got an rx for t4 and took 25mcg this morning with my 1 grain of naturethroid, skipping the additional 1/8th I usually take.  

I think I agree with what you are saying more though!  Should I just increase my NT to 1 1/4.  My dose for forever has been 1 and 1/8th grain.  Since Im only one day into the t4 addition what do you think might give me the best outcome?
dt

[goolarra]

I don't agree with your endo!

Your FT4 is at 10% of range...50% is the rule of thumb.  FT3 is at 26% of range...the rule here (especially when on desiccated) is 66+% of range.  So, both are low.  Furthermore, and most importantly, you still have hypo symptoms.  With both FT3 AND FT4 low, I'd ask for an increase in NT.  Adding a little T4 might help, but if I were you I'd stick with NT for now and just try to get an increase.  Is she at all interested in your symptoms???

[deetee958]

Goolarra--
Finally saw new endo.  Took long time to get appt!
Would just like opinion on my labs.  Any suggestions appreciated.  I will tell you that the endo says I'm not under medicated ...in her opinion. Im not so sure i agree. She said I could add some t4 if I want. These labs were drawn first thing in am total fasting without meds. My symptoms:still dry brittle hair,  hair loss (a lot), depression..constipation.   Naturethroid 1 and 1/8 grain. Should I add 25 mcg of t4?


Tsh 0.43.         0.40-4.50
Ft3 2.8             2.3-4.2
Ft4 0.9             0.8-1.8
Ferritin 81        10-232
Vit D 63            30-100
B12 1241                     200-1100 mildly elevated
Total cortisol 14.7.       No range listed
Cortisol 17.2                no range listed
ThyG anti <20              <20 IU/ml
Thy perox <10              <35 IU/ml
Total testosterone 46   2-45 mildly elevated
Free testosterone 2.4     0.1-6.4

Let me know what you think-dt

[hempem]

Don't be sad deetee - my hair got really thin and gross but there are a LOT more hats out there than baseball caps, I've found, and I get so many more compliments for some reason when I wear a hat.  :)  Even a wide hairband in different fabrics ( I have crocheted ones and chiffon and even velvet) - you can cover a lot of stuff and still look pretty.  Heck, I'm so lazy now I prefer to wear hats and thicker hair bands because it's faster and quicker to get ready!  

[deetee958]

Thanks so much for your help.  I cant tell you how much I appreciate your input.  I think Im gonna stay where I am for a couple weeks and see what happens.  I may also order my own labs then too.  B-ball caps and party dresses--I could start a new trend I guess ;))
dt

[goolarra]

Your symptoms really sound more hypo than hyper to me.  Heat intolerance is usually a symptom of hyper, but it IS summer and hot in many parts of the country at the moment.  Hypo would also make more sense, since the goitrogens would have lowered what's left of your thyroid production.

I don't know how long the goitrogens would keep affecting you after you stopped eating them.  However, when I have to guess about things like this, I usually assume that if it took 2 weeks (for example) for whatever you were eating/taking to cause symptoms, it's likely to take that same amount of time after you stop for you to get back to "normal".

It is a crap shoot without labs.  If I were you, I think I'd stay where you're at with meds unless you want to order your own labs online and get some guidance.

No, it's not vain...hair is important to all of us, and any symptom that just went away and decides to come back is very discouraging.

[deetee958]

Well I started to have symptoms around the last week in June.  Stopped Kale shakes immediately.  So its been a couple weeks since Ive had any goitrogens.  I never know if im feeling hypo or hyper.  Biggest symptoms are hair, dry and coming out, itchy burning feeling on scalp and neck, constipation, irritability anxiety and restless sleep.  I have no trouble falling asleep I just toss andm turn alot.  Ive also noticed the heat bothers me more.  Usually thats not one of my issues at all.  No heart palps or issues of that nature.  Its a crap shoot...hypo/hyper?? Decrease meds a from 1-1/8 to 1-1/16 maybe???? or just stay at my regular dose?  

Thyroid disorder is a bad rollercoaster ride.  I know it sounds vain but I had just gotten my hair back to a decent texture and added a little bit of volume back.  Im sad : ((

[goolarra]

So, you think your symptoms were hypER (overmedication) symptoms?  "Itchy skin, scalp, hair dry brittle falling out, trouble sleeping..."  The first three are usually hypO symptoms, and trouble sleeping can be either.  Do you have insomnia, trouble staying asleep or trouble getting restful sleep?

I'm glad you'll be seeing a new doctor.  TSH just isn't adequate.

With out current labs (meaning labs since your symptoms returned), I wouldn't have any idea which direction to suggest you tweak meds in.  If the kale did affect you, it would have lowered your FT4 levels, making you more hypO.  Of course, that could have translated into making you MORE hypER when you stopped...hope that's not too confusing.

When did you discontinue the kale relative to the 6/14 labs and the recurrence of symptoms?

[deetee958]

Yes 2 weeks later after labs and still feeling great all of a sudden it happened.  I can think of nothing else that may have affected it.  I stopped the shakes immediately and am being very careful of what I eat.  

Im feeling a bit hyper still.  I did sleep good last night though.  First time in a couple weeks.   And yes...it was so long ago that i convinced my doc to do t3t4.  She fights it every time but like I said am seeing new endo in Sept.  I will start getting my labs on my own if I have to.  

My hair had been doing SOOO good!  Its now depressing to think I have to go through it all again :( Dont know whether to tweak my dose a bit or ride it out???  

[goolarra]

Your labs looked really pretty good at that point.  FT4 was on the low side, to be sure, but that's not unusual when on desiccated.  FT3 was almost top of the range.

Kale contains goitrogens, which interfere with the synthesis of thyroid hormones, so if you still have some thyroid function left, you might have knocked it for a loop.  It does not however, interfere with thyroid meds.

So, less than two weeks after these labs, your symptoms returned?  And they continue?  Any improvement at all?

Is this the first time since 11/23/10 that you've had FT3 and FT4 tested?

[deetee958]

I was feeling great at blood draw!

[goolarra]

The 6/14/13 labs are when you were still feeling well, or were you already having symptoms by then?