NonstickPam -please help me with my thyroid

[nonstickpam107]

Oh, hey, just remembered a doctor here in the USA who might be helpful!! You have a PM.

Pam

[WendyOH]

Originally Posted by nonstickpam107

It's a great question. Lately, instead of being 'sure' you're talking to a lowcarber (many of us who go lowcarb 'cure' our insulin resistence...mine never gets 'cure'..I'm on daily oral steroid) about thyroid, we have more and more folks coming to the site to get advocation and doc recommendations...many aren't lowcarbing...they just want Armour to cure them. They think if they take enough of it, they'll 'lose weight'. I'm trying to dispel that theory all the time

I've seen a lot of pre diabetics and diabetics raise T3 on Armour..when they get to the right dosage...and my T3 obviously went right up there...and my fasting insulin is about horrible...so I don't think just insulin resistance slows conversion as the 'norm'. T4 to T3 conversion also occurs in the brain.

If you've read studies on this, we'd like to see them Wendy....would be quite interesting. I would think that insulin resistance, not kept in check by diet/exercise/lowcarb would certainly impact the thyroid.

We see conversion go down in people who don't get enough carbs/cals (studies on anorexics abound with info), we see conversion go down in women who are peri meno and meno (progesterone is the thyroid's BFF..and the first hormone to go down the drain is progesterone, not estrogen), conversion is bound when using birth control, eating high amounts of phytoestrogens (soy, etc.) in the bloodstream, and now we have more women than ever presenting with Hashimoto's...in my area the run off from 'sprayed' soy fields and corn fields into our wells...in the city, too much fluoridation in the water, and other 'triggers' to the antibodies reactions.

Pam

I don't know of any studies. I have just seen it mentioned before.

So, what confuses me then is this....

Low T3 levels can either be due to lack of conversion or RT3? This is what I don't understand. Doesn't T4 have to be turned into something? And if it's not being turned into FT3, doesn't that mean it's being turned into RT3. Or is there another option? Can T4 just sit around and accumulate and nothing happen to it?

[nonstickpam107]

Actually, no T4 doesn't have to be 'turned into' anything...the most common 'option' (and most post menopausal hypothyroid women have seen this one!) is that we hold T4, and some gets expelled from the body, and 'skips' any conversion at ALL (I've seen over 1,000 labs of post meno women whose FT4 is way above the halfway of lab range, their FT3 is one point inside the bottom range and RT3 is 'nonexistant'..I was absolutely shocked at first...and then I had MY labs done, lol...that's what they looked like...my TSH was .25, my FT4 was almost 3/4 of it's range, and my FT3 was one point inside bottom range, with RT3 under the range). (At which time my doc placed me on progesterone and did block and replace...beta blockers for heart rate, small amount of thyroid hormone).

When the body cannot use T4 that's being made (or replaced..how many women have HIGH FT4 cuz they are taking T4 only and have almost NO FT3 at all?? Many! and their RT3 isn't high either, they just aren't making/converting to T3 at ALL) it expells it, much the same way we expell anything else (voiding).

AND..when T4 is high (usually from replacement synthetic T4 ONLY), and it isn't converting, the TSH will go WAY down...and the patient is generally nervous, and shaky (much like symptoms of hyPERthyroidism) to the point where THAT'S when doctors will MISdiagnose the patient as now being 'hyperthyroid'. Poor patient, too much T4, TSH low "finally" yet they aren't being able to convert and 'use' any of it. And the doc is misdx'ing them 'hyper' to boot, and generally just rips them off any replacement and I've seen a couple patients actually have the misfortune to be placed on ANTI thyroid!

Pam

[LynnScarlet]

Originally Posted by nonstickpam107

Perhaps there is a reason for your adrenals to be so horridly low too...do you take any sort of steroids on a daily basis? Like an inhaled steroid for asthma, or ...jeez, I'm really wracking my old brains here (and I MEAN old, lol). Were you taking anything during the testing? Hormones, birth control, doing cardio exercise that was new, etc? I recollect a young lady who showed very low adrenal on the salivary and come to find out, she had been given Advair a couple months before the test..it skewed the test badly.

In the meantime, if it were me I'd not be doing exercise..any cardio, and perhaps give myself a MONTH of no cardio, trying to NOT get upset over ANYTHING, and then re take the test. Maybe something disturbed the testing?? And..have they done an ACTH test on you to 'clinch' the diagnosis?

Pam

No steroids, don't take BC, hormones or anything. HOWEVER they said the first sample should be taken at eight so I followed the directions. However normally I work later and don't get up ill 10 or 11 so I was VERY sleep deprived the day of the test. Oh dear....did I mess it up then? I thought I had to do it at 8am exactly or it wouldn't be accurate. Maybe I ruined it on account of my different schedule of working from 12-8 rather than the typical 9-5

I don't normally do cardio so I'll just cut that out. What about my lifting? What is an ACTH test? My doc has sent me for another test now to get my electrolytes tested? Is this an ATCH?

Oh and today I got a copy of ALL the tests he ran and my TSH IS 1.64. Last time it was tested was a year ago and it was 1.14 so it's steadily rising. However today I read somewhere that metformin (the insulin sensitiser I take for PCOS ) can interfere with a TSH test as it suppresses TSH. Is this true?

So many questions, so much information

If you want a laugh at a stupid doc read this and my response as 'lynnsback'. Not a peep from the doctor since. After I posted this I got the PM's from people.

Armour Thyroid - available in Ireland? - boards.ie

[WendyOH]

Originally Posted by nonstickpam107

Actually, no T4 doesn't have to be 'turned into' anything...the most common 'option' (and most post menopausal hypothyroid women have seen this one!) is that we hold T4, and some gets expelled from the body, and 'skips' any conversion at ALL (I've seen over 1,000 labs of post meno women whose FT4 is way above the halfway of lab range, their FT3 is one point inside the bottom range and RT3 is 'nonexistant'..I was absolutely shocked at first...and then I had MY labs done, lol...that's what they looked like...my TSH was .25, my FT4 was almost 3/4 of it's range, and my FT3 was one point inside bottom range, with RT3 under the range). (At which time my doc placed me on progesterone and did block and replace...beta blockers for heart rate, small amount of thyroid hormone).

When the body cannot use T4 that's being made (or replaced..how many women have HIGH FT4 cuz they are taking T4 only and have almost NO FT3 at all?? Many! and their RT3 isn't high either, they just aren't making/converting to T3 at ALL) it expells it, much the same way we expell anything else (voiding).

AND..when T4 is high (usually from replacement synthetic T4 ONLY), and it isn't converting, the TSH will go WAY down...and the patient is generally nervous, and shaky (much like symptoms of hyPERthyroidism) to the point where THAT'S when doctors will MISdiagnose the patient as now being 'hyperthyroid'. Poor patient, too much T4, TSH low "finally" yet they aren't being able to convert and 'use' any of it. And the doc is misdx'ing them 'hyper' to boot, and generally just rips them off any replacement and I've seen a couple patients actually have the misfortune to be placed on ANTI thyroid!

Pam

Wow, this is fascinating! This is what I've been looking for b/c I didn't think that was possible either. I haven't ever seen anyone who had high T4, low T3 and RT3. Crazy! That certainly does suggest that T4 can just do nothing. Thanks for clarifying this for me. It's something I've wondered for months

[nonstickpam107]

And now I'M left wondering (since that 'pattern' has usually only shown up in post meno WOMEN only, not all with Hashi's either) if it denotes a lack of balance in OTHER hormones...we know progesterone plays a large part in thyroid balance amongst peri and post meno women...so maybe it's THAT..the lack of progesterone. But I have no proof of that...except for all the labs I've 'collected' and catagorized.

My doc has been at this for SO long (and perhaps soon to retire....I've heard rumors) that he's seen it over and over...and not just in pituitary driven, or in adrenally lacking...but he also does mostly female..Hashi's and BHRT, etc....and places emphasis on making sure he replaces progesterone in females peri or post...and REGARDLESS of them having a uterus or not...that's the part I found fascinating when I first met him. I'd been taught (medically) that progesterone is 'no longer required' after a hysterectomy. Now I KNOW it IS required for good thyroid health.

I'd love to have time to actually research this!

Pam

[nonstickpam107]

Originally Posted by LynnScarlet

No steroids, don't take BC, hormones or anything. HOWEVER they said the first sample should be taken at eight so I followed the directions. However normally I work later and don't get up ill 10 or 11 so I was VERY sleep deprived the day of the test. Oh dear....did I mess it up then? I thought I had to do it at 8am exactly or it wouldn't be accurate. Maybe I ruined it on account of my different schedule of working from 12-8 rather than the typical 9-5

I don't normally do cardio so I'll just cut that out. What about my lifting? What is an ACTH test? My doc has sent me for another test now to get my electrolytes tested? Is this an ATCH?

Oh and today I got a copy of ALL the tests he ran and my TSH IS 1.64. Last time it was tested was a year ago and it was 1.14 so it's steadily rising. However today I read somewhere that metformin (the insulin sensitiser I take for PCOS ) can interfere with a TSH test as it suppresses TSH. Is this true?

So many questions, so much information

If you want a laugh at a stupid doc read this and my response as 'lynnsback'. Not a peep from the doctor since. After I posted this I got the PM's from people.

Armour Thyroid - available in Ireland? - boards.ie

Here's an explanation of ACTH:

ACTH: The Test

Are those salivary cortisol tests results you gave, or blood? (Cuz I've read that Metformin can 'challenge' those tests, and my MIL had to STOP her glucophage five days before taking the salivary. ??? Dont know her doctor or why...he's an endo (so he does diabetes, not thyroid, heh heh).

Um, you don't EVER go by TSH with thyroid. And if I were you I'd want both the ACTH test and another 4x in one day salivary after I'd been off ALL meds (including metformin) for awhile, and they specifically wanted MY DH to do the first salivary at 6am...then at noon, then at 4pm or so and then bedtime. He'd gotten some pretty kneejerk reactions from doing blood cortisol draws...that didn't work and he looked as if he was suffering from true adrenal fatigue.

You do the salivary test at home, and you need to pick a day where you're not driving anywhere, rushing around, nervous, etc....on YOUR schedule, I don't see why you couldn't start the first salivary at a time when you naturally wake up and so on. Perhaps you aren't suffering as badly as those tests show....and the supplement will work, and you can start Armour soon.

My Dsister lives near London and comes back here to be treated...she just can't get good treatment in UK...and she had the misfortune to be thrown into Sheehan's Syndrome after the birth of her 2nd child..they let her just bleed out, she almost died, then they couldn't 'grasp' the concept of Sheehan's Syndrome and that although it's a pituitary syndrome, OF COURSE it affects the thyroid and the thyroid must be treated.

My DD is a translator in Italy and says it's really strange there...she couldn't get a TSH test in a large city there, yet when she saw several small town doctors, all of them had NO problem testing ONLY her T4/T3 antibodies (one doctor said to her 'Why in the world would I be looking at your TSH...that's a pit test anyway, doesn't show your thyroid hormones!') and giving her Armour.

Pam

[LynnScarlet]

Originally Posted by nonstickpam107

Are those salivary cortisol tests results you gave, or blood? (Cuz I've read that Metformin can 'challenge' those tests, and my MIL had to STOP her glucophage five days before taking the salivary. ??? Dont know her doctor or why...he's an endo (so he does diabetes, not thyroid, heh heh).

And if I were you I'd want both the ACTH test and another 4x in one day salivary after I'd been off ALL meds (including metformin) for awhile

It was a salivatory cortisol test x 4 times daily.

Looks like this is gonna be a LONG LONG road ahead. Feel free to pm me any U.K. doctors. Although if your sister can't find a good one in London, then your list must be very short indeed.

[nonstickpam107]

The list for UK is short (not as short as the Ireland one though, lol). You have two pm's (I wanted to include a lot of the original recommendations from patients and didn't have enough room on one PM).

Gosh, should we be suspicious?? (snicker, snort). My dog (in avatar) is straight from Scotland...and she has hypothyroidism! They were gonna put her down after she won a large show and had a litter because they couldn't figure out why she was having seizures (one of the most common cause of canine seizures in this breed is hypothyroidism, autoimmune..my HUMAN doctor humored me and did T4 and T3 after the vet drew her blood...for a TSH only).

Pam

[LynnScarlet]

Well when I get my health sorted I am gonna start a charity here for thyroid patients. So that we will have educated doctors and more than ONE doctor in the friggin country who knows what the hell they are talking about!!!

BTW I presume your sister is aware of thyroid UK advocacy Thyroid Patient Advocacy-UK: Building Thyroid Awareness

[nonstickpam107]

No, my sister won't so much as even google the WORD 'thyroid'! She's mad, angry at the entire medical system there (Sheehan's can be prevented, and they did a hysterectomy on her...had let it get so 'out of hand' that she almost bled to death) and tells me I'm 'crazy' for being an advocate. (Meh...she's eight years younger than I am...from a different generation, and kind of got treated for thyroid 'easily' over here....BECAUSE of my advocacy...she doesn't 'get it' how difficult it is for many).

Thanks for the link for ME though! I've got email from all over the world...had a very difficult time finding help for someone in Switzerland, and Africa wasn't easy either.

Pam