I Need Help With My Thyroid and DHEA Results (Hypo)...

[RubenO]

Hi Friends,

I really enjoy reading these forums and all the real knowledgeable people here. Hopefully someone can help me out.

Here is my story...

First about me. I am morbidly obese. I weigh 510 lbs and I am 6'-1" tall, big boned, 37 years old and I am a male. As a late teen I was pretty thin, out of no-where I started slowly gaining weight around 19 - 20 YO. Well 17 years later I am now 3 times the weight I was 17 years ago. Besides carrying around the weight, I pretty much felt good medically throughout my last 17 years.

The last time I seen a doctor was when I was 20 and I have not been to the doctors until recently due to me researching the thyroid.

About 7 weeks ago, I got thyroid bloodwork done at a generic weight loss center. My Thyroid levels came back as low:

TSH3 4.102 (Ref. Lab Range 0.350 - 5.500)
Free T4 0.84 (Ref. Lab Range 0.89 - 1.76)
Free T3 3.01 (Ref. Lab Range 2.30 - 4.20)

So the doctor that ran these tests started me on 1/2 grain of Armour Thyroid each day. After reading these forums and other forums, I realized what he put me on was really low. Besides my low thyroid, everything else they checked for was good (cholesterol, sugar, blood pressure, EKG, etc.).

So now that I knew my thyroid was not right, I did some research to find a good metabolism doctor in my area. I found Doctor Ken Woliner which has a bunch a good reviews and has written a few papers on the thyroid Understanding Thyroid Lab Tests, by Ken Woliner, MD

So I went in for a 80 minute consultation and check up with Dr Woliner on 7/24/08. He looked at my previous lab results and started me on 6 grains of Armour Thyroid and said I could increase the dose by a grain every 2 weeks if needed. He also drew more blood and ran about 12 other tests on me.

As he did my physical, he used a flashlight in the dark on my eyes and he informed me that my pupils did not reduce in size like they should. He said this was a sign of adrenaline problems so he ordered blood work for my adrenaline.

After 2 weeks he got my lab reports back and learned that my DHEA was low and I am slightly insulin resistant. There are also other things low like Vitamin D. Here are some #'s below:

DHEA Sulfate 123 (Ref. Range 250 - 350)
Ferritin 214 (Ref. Range 70 - 300)

Insulin 13 (Ref. Range <17 uIU/ml)

Vitamin D 25-OH, Total 20 (Ref. Range 50 - 100)

So he added 50 mg of Micronized DHEA daily and Metagenics Wellness Essentials for Men vitamins.

Well I've been on the Vitamins and higher dose of Armour Thyroid since 7/24/08 and I started the micronized DHEA 4 days ago. I am now beginning to feel like crap which makes no sense. I feel tired and sluggish and my muscles feel sore for no reason. I want to stay in bed all day and it now takes allot of energy for me to get out of my chair. I thought you were suppose to feel better with these medications and it doesn't seem to be panning out that way for me. Is it just not working properly yet?

Thank you for reading this long post, I appreciate any feedback anyone could provide me with here.

Ruben

[nonstickpam107]

Ah, Dr. Ken. (He will 'know' who I am by you saying "Pyroteknicpam", lol...he 'advised' me about perchlorate which is what screwed up a lot of my endocrine system..I worked with it).

It could be a number of things. My doctor was really good about that, I saw him for the first time, and then three days later I felt HORRIBLE and called. His nurse had it all righted around in no time.

If your adrenals are low, than taking Armour, even a small amount could be making you feel like you feel. At any rate, it's time to call and find out why you feel so fatigued. Dr. Ken is one of the very best doctors in the state of Florida (a friend, looking for thyroid care, calls it 'the State of confusion' ). I hope you get to where you are feeling really great, I know what it's like to be very sick and to finally feel well again.

Pam

[RubenO]

Hi Pam,

Thank you for taking the time to reply. I have been taking my temperature everyday and my temperature ranges between 96.6 and 97.5 degrees. Is this low reading due to my low metabolism? I think the normal body temperature is suppose to be 98.6 degrees, correct?

Thanks
Ruben

[nonstickpam107]

Temp means nuttin' to me. LOL. I'm WELL medicated and mine is almost ALWAYS under 97.3. All the time. Except when I'm really sick and have a fever, then it's closer to 98.5.

I'm optimally treated, but have lots of autoimmune diseases, so my temp just sits there. So, I do believe temp raises in those without autoimmune disease when they get up to around 3/4 of their FT3 lab range (using Armour, or Cytomel).

Pam

[AllieCat0817]

Wait... the dr STARTED YOU ON 6 GRAINS OF ARMOUR???????????

Pam isnt that SUPER HIGH to be starting, despite Ruben's current weight?????

[RubenO]

Originally Posted by AllieCat0817

Wait... the dr STARTED YOU ON 6 GRAINS OF ARMOUR???????????

Pam isnt that SUPER HIGH to be starting, despite Ruben's current weight?????

Hi Allie,

Yes, when I went to see him I was previously taking 1/2 grain everyday. He said due to my size, a 1/2 grain was way too low. So he started me on 4 grains and said I could raise it a grain every week if needed, so I did. He informed me if I started having palpitations to cut the dose down.

I am currently at 6 grains a day and don't see any difference except feeling much lazier and having sore muscles which makes no sense. My weight is still the same (goes up and down everyday).

I am waiting before making another appointment with him but the problem his services do not come cheap and he doesn't take insurance. So I am trying to give myself 6 weeks or so before I see him again.

Ruben

[AllieCat0817]

I have read that the symptoms you are now having can be a sign of too much Armour...

[Doggygirl]

I am very new to all this Ruben...so consider the source LOL!!

I too am a bit about raising Armour by a full grain per week. When I first saw my new doc, she stressed the importance of titrating up slowly with Armour. She started me at 1/2 grain as you started - but will ONLY increase my a max of 1/4 grain every two weeks. I'm on 1.25 grains now but we worked up to that from 1/2 grain over about an 8 week period.

For whatever it's worth - I'm sure that size must have an impact on required dose to optimize, but I'm not sure that your larger size would make it OK to titrate up that fast. I don't know the answer - just providing my own experience as you try to figure this out.

DG

[AllieCat0817]

I know Pam has said that your thyroid dose is NOT dependent on size, but your lab tests and how you feel. The lethargic weak muscles is a sign of hyPER (too much Armour)... any heart palps, insomnia, restlessness, anxiety?

[nonstickpam107]

I would go to four grains, wait six weeks, test FT4, FT3, TSH and go from there. Just a heads up.

ETA of course you are SPLITTING that dose, right? You should be taking 1/3 am, 1/3 early afternoon, 1/3 early evening. You should be testing four hours after you take the first dosage. T3 only has a half life of four hours but T4 can take six weeks to build..you need to stop somewhere and test. Online Lab Tests: blood work, blood testing and laboratory tests will do a TSH, FT4, FT3 (ask for Thyroid panel II) for under 90 dollars (give coupon code 12345 upon checkout), they send you to a lab near YOU and report back to you.

Pam

[RubenO]

Originally Posted by AllieCat0817

I know Pam has said that your thyroid dose is NOT dependent on size, but your lab tests and how you feel. The lethargic weak muscles is a sign of hyPER (too much Armour)... any heart palps, insomnia, restlessness, anxiety?

I'm not having any heart palpitations, insomnia, restlessness or anxiety.

I take 3 grains before bed and I fall asleep fast. I sleep very good and wake up well rested after 6 - 8 hours of sleep. I take another 3 grains in the morning as well along with 50mg of micronized DHEA.

I really wish I had some heart palpitations then at least I would know it was working .

I am also taking Metagenics Wellness Vitamin packs every morning and night and I don't feel as they are doing anything for me as of yet.

Ruben

[RubenO]

Originally Posted by nonstickpam107

I would go to four grains, wait six weeks, test FT4, FT3, TSH and go from there. Just a heads up.

ETA of course you are SPLITTING that dose, right? You should be taking 1/3 am, 1/3 early afternoon, 1/3 early evening. You should be testing four hours after you take the first dosage. T3 only has a half life of four hours but T4 can take six weeks to build..you need to stop somewhere and test. Online Lab Tests: blood work, blood testing and laboratory tests will do a TSH, FT4, FT3 (ask for Thyroid panel II) for under 90 dollars (give coupon code 12345 upon checkout), they send you to a lab near YOU and report back to you.

Pam

Hi Pam,

I am taking 3 grains in the morning and 3 grains at night. I'm also taking 50 mg of micronized DHEA every morning as well as Metagenics Wellness Vitamin packs every morning and evening.

I'm going to try what you said.

Thank you
Ruben

[Doggygirl]

I don't want to confuse any issues as Pam is experienced and I am new.

But.... 3 grains RIGHT before bed and you fall right to sleep? That seems odd. My doc originally had me taking my full (albeit small!) dose of Armour in the AM. I was "crashing" a bit in terms of energy level in the afternoons, which was when she had me start splitting my dose taking the second dose at 1PM. My low energy problem in the afternoons went resolved ASAP. It certainly didn't make me fall asleep.

I'll be curious about Pam's feedback...sorry to hijack your thread with questions that might be irrelevant to you. I shall try to stop doing that!! (sometimes I have a hard time and can't help myself LOL)

DG

[nonstickpam107]

Hey, some people NEED their Armour to get to sleep. I'm just worried about that T4 building up and 'whopping' him all at once a couple weeks from now. I can't sleep if I take my Armour after 4pm, BUT DH can take him second split AT bedtime and sleeps like a baby...ya just gotta experiment.

Pam

[RubenO]

Originally Posted by Doggygirl

I too am a bit about raising Armour by a full grain per week. When I first saw my new doc, she stressed the importance of titrating up slowly with Armour. She started me at 1/2 grain as you started - but will ONLY increase my a max of 1/4 grain every two weeks. I'm on 1.25 grains now but we worked up to that from 1/2 grain over about an 8 week period.

For whatever it's worth - I'm sure that size must have an impact on required dose to optimize, but I'm not sure that your larger size would make it OK to titrate up that fast. I don't know the answer - just providing my own experience as you try to figure this out.

DG

Hi,

My Dr. felt my body would act as a buffer due to my size. He didn't feel that the dose he started me on was too much. He did tell me not to overdo it and start off high, he said to build up from the 4 grains a day over time if needed.

Ruben

[AllieCat0817]

I guess the only way you will know is when you get your next test...? Not sure.

[nonstickpam107]

Well, if you're anything like ME, along with upping the Armour, you'll be losing weight. About the time I got to 4 grains, I had lost over 65 lbs....so 4 grains was too much for me at that point, lol. I'm with great hopes that the incoming Armour will help 'normalize' your metabolism to the point that lowcarb really works well for you.

Pam

[inatic]

Originally Posted by nonstickpam107

Hey, some people NEED their Armour to get to sleep. I'm just worried about that T4 building up and 'whopping' him all at once a couple weeks from now. I can't sleep if I take my Armour after 4pm, BUT DH can take him second split AT bedtime and sleeps like a baby...ya just gotta experiment.

Pam

i take a dose at bedtime and also go to sleep.

[RubenO]

Originally Posted by nonstickpam107

Hey, some people NEED their Armour to get to sleep. I'm just worried about that T4 building up and 'whopping' him all at once a couple weeks from now. I can't sleep if I take my Armour after 4pm, BUT DH can take him second split AT bedtime and sleeps like a baby...ya just gotta experiment.

Pam

It's going to be 4 weeks tomorrow since I've been on the higher dose of Armour and the Vitamin packs. I still do not feel any different (for the better) and my weight is up 5 lbs one day and down 5 lbs the next. This is really confusing.

A big portion of my life I always thought meds were placebos because nothing never seemed to work for me. I took vitamins for a year before along with other meds and I never saw a change for the better.

I feel like taking 10 grains at once and seeing if my heart speeds up to see if this stuff is really working.

Ruben

[AllieCat0817]

Ruben sorry for your troubles. When are you due for your next round of testing? Don't give up, wait for your next tests. I am going next week for mine to see how my labs look after 2.5 grains of Westhroid (same as Armour).

[nonstickpam107]

Wow..four weeks. Go figure. (Sorry, I'm joking!!) It took me about a year throughout dosing schedules, etc. to feel better. Hormones aren't antibiotics, they don't work fast. It's a gradual process. And if you're feeling like you need to 'speed that up' you better call your doctor. He'll explain it to ya.

BTW Ruben...that up and down five pounds doesn't sound right if you are following Atkins or Protein Power or some other lowcarb plan. You should be dropping weight like crazy if you are under 30 grams of carb a day. (Perhaps I'm assuming...you ARE doing a lowcarb plan, right? Maybe we can help you with the only five pounds up and down).

Thyroid meds don't MAKE one lose weight, btw...some people think they do. They just make it easier to lose weight while you are adhering strictly to the plan.

I started Atkins before I was medicated for thyroid and lost 50 lbs. just before I was medicated...it was a bit easier once I had thyroid med...not too much faster though...Atkins is a pretty fast way to lose if you go by the book.

Pam

[RubenO]

Hi Pam,

Sorry I have been away for a while. I stopped by Dr Woliners office for a recent visit (I told him you said hi). After he looked at my last lab results he put me on some new meds and also said I could up my Armour thyroid to 12 grains a day due to me being resistant and he also increased my DHEA. Here is what he added to the vitamins packs and DHEA I have been taking already...

Metagenics - CoQ-10 ST 100 Mg a day
Pure Encapsulations - Magnesium (Glycinate) 4 capsules a day
Pure Encapsulations - Vitamin D (10,000 i.u.) a day
Ortho Molecular Products - Diaxinol - 2 a day
Pure Encapsulations - Micronized DHEA - 400 mg a day
Armour Thyroid - 12 Grains a day (6 in the morning and 6 at night)
Phentermine - 1/2 Tablet every afternoon.

I previously was on the Atkins diet but I was developing migraine headaches and developed a cloudy thought process. I now do a Jenny Craig diet which seems to work when I can stick to it.

The Phentermine works really well, I can't believe how well it suppresses your appetite. I ate out tonight and barely ate anything.

When I went to fill the prescriptions he had wrote 720 mg of Armour Thyroid a day on the prescription. The pharmacy refused to fill it because they said that amount was way too much. I had a big argument with the pharmacy and the next day Dr Woliner called them to explain. They filled the prescription after he called.

Dr Woliner also gave me an article he pulled up from the NY Times from 1908 about a 23 year old girl from London who had arrested development. She was only 33" tall and had all the symptons of thyroid. They began treatment on her with 12 grains of thyroid extract. Two months after, she grew over 2.5 more inches and all her symptoms started going away. Her mental condition improved, her hair started growing, teeth and regained her appetite.

Dr Woliner was going to take this article to a Lecture he was doing on Friday and made me a copy to read and share. He also informed me of a new revolutionary procedure that just came about last week to suppress the appetite.

Researchers Successfully Suppress Ghrelin, The "Hunger Hormone"

Johns Hopkins scientists report success in significantly suppressing levels of the "hunger hormone" ghrelin in pigs using a minimally invasive means of chemically vaporizing the main vessel carrying blood to the top section, or fundus, of the stomach. An estimated 90 percent of the body's ghrelin originates in the fundus, which can't make the hormone without a good blood supply.

"With gastric artery chemical embolization, called GACE, there's no major surgery," says Aravind Arepally, M.D., clinical director of the Center for Bioengineering Innovation and Design and associate professor of radiology and surgery at the John Hopkins University School of Medicine. "In our study in pigs, this procedure produced an effect similar to bariatric surgery by suppressing ghrelin levels and subsequently lowering appetite." READ THE REST


Ruben

[nonstickpam107]

Thank you so much for the article Ruben! Very thoughtful of you. Yanno what? If you NEED 12 grains...then ya need 12 grains! (And Im delighted you wrote of your progress also...a couple people on the board have PM'd me and I've given them Doc Ken's particulars...and these folks are 'thyroid gun shy' iffen ya know what I mean!).

I can't have anything 'Jenny Craig' (if you mean the 'almost all soy' program?..I'm SO allergic to soy..anaphylactically so). I think patients should use a Way Of Eating that works for THEM...not necessarily try and stay lowcarb if it doesn't suit them...but try and eat as healthy as possible (no refined foods). I think more women are affected by soy than men (phytoestrogens usually bind all their incoming Armour and T4 to T3 conversion).

The article from 1908 is very astute for these times (I can't count the number of times I've been in a nursing home, talking to the residents and being told that once their Armour Thyroid was taken from then, and synthetic T4 only was put in it's place, that's when their lives 'went downhill'. Perhaps new interns/residents should be MADE to work in these homes and to listen to that...'first do no harm' might take on a whole NEW meaning!).

I'm so very happy you are getting the care you deserve, and I certainly look forward to your 'I'm at goal, I'm healthy now!' post!! Carry on!!

Pam