Thyroid tests are normal?? Are you sure?

[Carolina Rose]

Pam ~ I got some partial results late this afternoon over the phone. I can pick up the full report on Monday. This is just a general family doctor, so he didn't (wouldn't) do the Free T3, but he did do the Free T4 and the TSH, of course.

The nurse told me I was definitely hypothyroid, and gave me these numbers (but I don't know what they mean!)

TSH - 6.262 (range .350 - 5.50)

Free T4 - 0.96 (range 0.61 - 1.76)

The doctor wants to start me on a daily dose of 100 mcg of Synthroid. I asked the nurse about Armour, but she said he doesn't prescribe it and she had only vaguely heard of it.

Thanks for any insight you can give me on these numbers!

[Carolina Rose]

Pam ~ One more thing (sorry! ) .... I was searching some old threads and read something you posted about not being able to take Snythroid if you're allergic to corn. Although I have never been *diagnosed* with a corn allergy, I'm almost positive that I'm allergic to it (along with wheat).

I had decided to go ahead and start on the Synthroid just to see if it helps and then talk at length with this GP about Armour at my next appointment on 10-30. His nurse said he'd be willing to hear me out.

But now, reading about your corn allergy, I'm wondering if I should start the Synthroid at all??

[Carolina Rose]

Well, heck, might as well make it three in a row!

Pam ~ I took the Snythroid this morning (Saturday the 29th). I read more last night here among your old posts and elsewhere online and I'm positive I want to go for the Armour. My question now: since I have started the Snythroid, can I still order the Thyroid Panel II at HealthCheckUSA to get my Free T3 tested? Or should I just hold off on the Snythroid, get the HealthCheck test and then show those results to my GP?

There is an endo, Dr. James Plonk, in Charlotte, NC that shows up on the Armour site's doctor locator. He's the closest one to me, but that's still an hour and a half away. I'd love to keep it local if I could, but can any doctor prescribe Armour?

Also, how expensive is Armour compared to Snythroid? Do insurance companies cover it just like any other thyroid med? I paid $10 for this one month supply of Snythroid.

Sorry to ask so many questions! No one around here, even the people I know who are on thyroid medication, seem to have any answers for me!

[nonstickpam107]

Generic Armour costs ME 6 dollars a month. But, you do NOT want to just start on that HUGE dosage of Synthroid (BAD idea!), most start on 25 to 50mcg. stay there for four months, re test and then go up by 25mcg. 100mcg. is unheard of, sorry.

You do NOT want a doc giving you Armour unless he/she has experience with it (sorry, but the doc you have doesn't even know how to dose T4!!! EEEK...you can tell I'm losing it here over that huge dosage!). I just know SOMEONE will come in and lose it over that...cuz many have become very ill starting at that huge dosage.

Armour is a RX'd hormone just like Synthroid (and let's not forget that a doc CAN add Cytomel to Synthroid, it is synthetic T3..but I wouldn't want just ANY doc doing that!). Yes, call the doc who's on the Armour list but ASK if a good number of his patients are on it (we've had posters telling us that docs will put their names on the list then refuse to RX. Armour saying they've 'given it once or twice' just to drum up business.

No WAY would I take, or let someone else take a starting dosage of 100mcg. of synthetic T4. Huh uh.

Pam

[Kona sunset]

Hi, Pam!

My head is swimming this morning from trying to understand all this. Besides, it's Monday and I'm always extra tired on Mondays! I haven't had time to read through this whole thread, but I really need some help.

Here's a little history:

I was told my thyroid was "low normal" when I was in college, early 70's. The doc (have no idea who he was or how I ended up there) put me on Synthroid. I don't remember the dose or how long I was on it, but it didn't do any good at all. One of my profs suggested I ask for natural thyroid, so I did. He put me on it (I assume it was Armour, but again, don't know), 1/2 grain as I recall. I started feeling great, then started feeling like my heart was going to beat right out of my chest. I gave up on the thyroid for a long time.

I had been tired all my life, it seems. My mom tells me she had to wake me as an infant to get me to eat! Not a problem now! In high school, I remember coming home everyday and crashing for about 30-45 minutes before I could do anything else. Some years ago, probably 20 or more, I went to a doctor who is rather controversial. I had been trying to get pregnant without success and had been keeping a basal body temp chart. Of course, my temp was always super low, 95, 96, etc. The doc I went to immediately diagnosed hypothyroid based on my BBT and put me on Westhroid. He had me increase it gradually until I started having the palpitations again. I ended up on 2 gr. Not feeling super wonderful, but able to function.

For a long time, I was able to get my med through the mail from him. Never had to go in. Then, he told me I needed to come in. Somehow, in the mean time, they had lost my chart! So, I began seeing a doctor once a year to get my Rx refilled. We moved away for a few years and the docs I went to always just gave me what I needed. I made sure the pharmacist would get the right med. Sometimes, they had to order it special, but I always managed to find a pharmacy where I could get it.

We moved back here 6 years ago. The doc I had seen originally was getting more and more controversial and wasn't on my insurance. (I don't think he takes any insurance at this point.) My PCP told me I was getting too much thyroid and cut my dose in half. I had done fairly well all those years on 2 gr. and didn't like it when he changed me. I changed doctors and started trying to learn more about hypothyroidism. I didn't get anywhere with the new doc. He only gave me a 3-month prescription for the 1 gr. When that ran out, I didn't really want to go back to him, but didn't know where to turn. I was off my med for a while. I became more and more tired, of course, along with the brain fog, etc. It got to the point that I couldn't even do any research, let alone anything else. I was barely functioning. I did the only thing I knew to do. I went back to the original doc even though insurance didn't cover it and got back on the 2 gr.

I have a pretty good PCP now who knows that I research things. However, she admits she knows nothing about Westhroid and would prefer that I be on Synthroid so she could more accurately adjust my dose. I'm scared to death to try that route for fear of becoming non-functional again. I've got to do something soon as my Rx will need to be refilled in a couple of months. My last lab was done on 6/23/06 (not sure how I got by with such a long Rx!). She tested not only TSH, but also FT4. Didn't test FT3. I have been tested at least twice for rheumatoid arthritis, including on this lab as I was having some serious problems walking at that time, something that happens periodically. It was negative. She also tested me for autoimmune disorders back in March or April of this year as I developed something call Erythema Nodosum. Painful! Again, negative, but I don't know exactly what was tested at that time.

FT4 - 0.86 Range 0.89-1.76
TSH - 0.110 Range 0.35-5.50

I live in Oklahoma City. I looked on the thyroid.org site that someone else mentioned and found two endos listed here in OKC. Both are on my insurance. Do you have a recommendation? And what should I be looking for? From what I've been able to ascertain since knowing the above numbers, I have some kind of pituitary issue, but can't seem to find out much on the internet. My PCP has not said anything more about it. I love her to pieces as a person and I think she is a very knowledgeable doctor, but she's not real good about doing follow-up appointments and that bothers me.

Sorry for such a long post, but I thought the info might be helpful since I seem to be sort of an oddball!

[nonstickpam107]

Kona..you will want to go to Armour Thyroid Official Site and use the 'docfinder' (goes by Zipcode, so put in zips up to two hours driving time away). Not testing T3 and giving Armour/Westhroid would be like not testing blood glucose and giving injectable insulin (and low thyroid is the same as being 'only a little pregnant'...no such thing).

Also, go to Yahoo Groups and look for the 'thyroid support group' for your State (and other states whose state lines are less than two, three hours away). That can really help. I can give you a page of 'patient recommended' docs, but far too often they have been recommended by patients that aren't, um...proactive. In other words, we have several recommended cuz 'they listened to me! they actually LISTENED!!!' (they then didn't do the correct tests and are still listening and not doing much of anything). Having said that, also CALL any docs on the ARmour list to make SURE they are well versed in thyroid..cuz many of THEM are on the list just to get 'new patients'. Here's the list for EVERYWHERE:

Thyroid Top Doctors -- Best Thyroid Doctors in the World as Nominated by Patients, from Patient Advocate Mary Shomon

Good luck to you, and if you still can't find anyone to do the correct tests/natural thyroid (and Westhroid is just Armour after being 'washed'...it no longer NEEDS washed, it is just as much an RX'd, FDA controlled drug as any OTHER Rx'd drug) pm me or post in this thread and I'll round up folks from your area to help.

Pam

[Kona sunset]

Thanks, Pam! I had looked at the Armour site earlier and saw a couple of names, but didn't check them out. One of them is a psychiatrist. I just ran the search again with a broader range and came up with 8 names in the OKC-Tulsa area. Some of them are on my insurance, so I guess I'll start with those.

Also, there is a doctor on the thyroid-info website that I had noticed before, back when I was trying to figure out who to go to when my PCP had cut my dose in half. One of the testimonials mentioned being on a combo of Synthroid and Compounded Armour. What is Compounded Armour? And, would that mean that he is probably well-versed in using Armour? He is not listed on the Armour site. There are 3 testimonials, each with different circumstances and they all seem to think he is great. He is also one of the endos that I found on the thyroid.org site that is on my insurance.

Guess I'll do some calling tomorrow.

[nonstickpam107]

I've not yet found anyone who has done well on compounded Armour (I was on it for awhile because my adrenals were so knackered I couldn't tolerate it otherwise) and Synthetic T4. Now, I know plenty who've done well on both synthetic T4 and synthetic T3, as long as the doc would let them be 'optimized' on dosage (meaning leaving FT4 at about halfway of range and FT3 all the way to highest range, if need be to stabilize the patient).

So far, out of all the endo's...only about one out of every 101 is good with thyroid, the rest at good at diabetes and end up trying to tell the patient 'how the patient feels'...so watch out! One of the most famous thyroid docs in the world is in South Bend, IN and he's a psychiatrist. Psychiatrists are wonderful usually because thyroid disease manifests as emotional/psychiatric diseases/problems.

Here's a little info on psychiatric manifestations: The Thyroid and the Mind and Emotions

DO's are usually really good (Doctors of Osteopathy) if you can find one, and last, but certainly not least, just a family practitioner can be very good at managing and treating thyroid disease.

You must have tertiary hypothyroidism, for your TSH is very very suppressed on just two grains Armour, yet your FT4 won't 'budge'. (Tertiery is pituitary induced hypothyroidism..have you had an MRI of the head to check for a pit tumor...many docs think they are 'rare'...but they are NOT rare...and a neurologist would be the doc to do the workup to check for it...you'd call neuro's and asks 'how many pit tumors have you dealt with?' first...I've now met over 75 patients with pit tumors...they remove the tumor through the nose with outpatient surgery and the patient goes on to lead a normal life usually withOUT any thyroid problems).

Sheehans' can also render a pituitary induced hypothyroidism, my DSister has that type...she 'bled out' during birthing a large baby and it virtually shut down her pituitary.

ETA: Also join the forum at Thyroid Disease - Hypothyroidism - Hyperthyroidism - Cancer - Autoimmune Disease and ask who has an Armour doc in your area...they generally are great at helping also (plus a WEALTH of info at that same site).

Pam

[Carolina Rose]

Thanks for the advice and info, Pam! Well, at least this new GP of mine is willing to refer me to a specialist, if I can find one. I still very much like the idea of using Armour rather than Synthroid.

Thanks too for the info about the yahoo support group. I'm waiting on approval now.

[nonstickpam107]

Carolina Rose, the Yahoo_Thyroid_Groups has a USA site also, and interconnects with all the State thyroid support groups. I hope you find some help and support through these groups, I know quite a few have. And the Thyroid Disease - Hypothyroidism - Hyperthyroidism - Cancer - Autoimmune Disease site is a wealth of information, as well as the Stop The Thyroid Madness » Index Page site.

I am also a great fan of the Gail W.'s site: Gail’s Thyroid Tips She explains the way Armour works very well, many identify with her same symptoms and problems.

Pam

[ew1]

Hi Pam. I have an appt with my regular old GP tomorrow whom I love and works with me on a lot of things. I want him to Rx my Armour since I now know how my labs should look. The internist that I got off the Armour Thyroid site ran bloodwork and never even called me to discuss the low red blood oxygenated cell count, the low iron/ferritin, the low cortisol.I also had to look at my own labs and give you the results to figure out how I was doing. I knew about these things from you and other thyroid sites. My old doc always would send a note when he saw something out of whack.
I also want him to address this God awful facial and scalp sweating I am having lately (that's why I think adrenals are involved). This is more than menoapusal hot flashes. (My inner child appears to be playing with matches.)

I am going for a cortisone shot for hip bursitis, seems to be a semiannual event with me, and I told the nurse when I scheduled the appt that I wanted to discuss bloodwork. Since there is no reason for me to go higher with Armour at this point, (I may even need to go a little lower if he thinks the adrenals are out of whack which I think) I am hoping he will Rx for me for the near future. I am in PA and as you have said, there are no great endos. Even two of the ones on Mary Shoman's Top Dr List, Bonnie Shanis and Adj Djerassi (who I actually saw), have been removed from the list. Shanis is one of the Drs mentioned on the Armour site.

[nonstickpam107]

Well, as you know, the dispensing instructions on any thyroid hormone clearly tells the physician to check/test the adrenals before giving. And if the patient is uncomfortable, and tells the doctor, something should be changed/done...that's how it should go. So, here's to you along with your doctor, finding out just what is causing the problems. j

Pam

[ew1]

Pam, had a great Dr visit. He said he has no problem Rxing my Armour.He listens to the info I give him from you and what he doesn't know he finds out. I wish he wasn't an hour away since I moved.

I showed him the bloodwork labs and we are repeating the cortisol test and more iron tests and a few others on adrenals. (I may sneak a thyroid lab in there since I am going anyway) He basically said "Your metabolism crashed". He looked at the labs and IMMEDIATELY knew something was way off.

I also got a flu shot while I was there, didn't realize he was giving them out this soon. Bonus time!!
Anyway, it was a love fest and I am not going back to the internist.

[ew1]

PS, the diagnosis on the new bloodwork for tomorrow is anemia and/or Cushings.
I'm going out at lunch to get the pill I am supposed to take tonight for the cortisol supression test.

[nonstickpam107]

Well, it may be just that you are 'Cushingoid' not full blown autoimmune Cushings. And that can happen when the adrenals are over run by too much thyroid hormone and not enough progesterone too. (and other reasons). Glad the doc is looking into it!

Pam

[ew1]

As usual, lucky you, I will get a copy of the tests. Not as fast since he's not the local doc, but I'll get them!
Thanks for all your help

[ew1]

Oh, forgot to add I also checked off progesterone and testosterone on the tests just to see where my levels are. My estradiol is only from my patch at this point, no ovaries, etc....
Doc's gonna wonder when he sees this.....

[nonstickpam107]

Doesn't matter where your estradiol is 'from'..your body needs progesterone also..it's not just to 'slough uterine lining'. It benefits the other hormones in the body. Make sure you got 'free testosterone' there.

Pam

[carrielyn]

Finally got my most recent tests in after being on 75mg of Armour for 5-6 weeks.

Thyroid Panel with TSH, 3rd Generation
T-3 uptake 31 22-35%
T-4 (Thyroxine, Total 5.4 4.5-12.5 mcg/dL
Free T4 1.7 1.4-3.8

TSH, 3rd Generation 1.03 0.40-4.50 mIU/L

T3, Free 403 230-420 pg/dL

What's your opinion of the above. The endo who ran the tests wants to put me on Synthroid/Cytomel. I have no problem with this if there is any chance I will do better on this.

Any opinion on this?

Thanks,

[nonstickpam107]

Carrielyn, most need to be on Armour for way longer than you have been, say...a six MONTH trial. The doc is 'freakin' cuz of the very low T4 (yes, it will be that low with Armour, with the FT3 high in range, as yours is)....doc's who like synthetics see a HIGH FT4 with midway FT3 (that's opposite of what most women like).

If the doc is a 'mastermind' with Synthroid and Cytomel, than fine, he probably has more experience with it, and that's ok too...BUT...ask him 'where' he wants your FT's to be on Syn. and Cytomel...ask how MUCH Cytomel and Synthroid he will put you on, etc. Right now you are getting about 44mcg. T4 and about 10mg. T3 with the 75mg. dosage (very very low, denoting you have NOT been on that long enough to tell, you could wait another three months, test again and get totally different results).

I also would like to know if you'd just taken that dose before the tests. And a T3 Uptake is a useless, senseless test....just thrown away money once you are medicated. It's actually a test of T4 binding.

Time will tell whether you need T3 or not too...cuz yours has come right up, yet your TSH is not low as most on Armour and your FT4 is very low...perhaps you convert well and should be on a T4 only hormone for six months or so then test again to see conversion.

Pam

Pam

[Kona sunset]

Had the appointment with the doctor yesterday. Not totally sure what I think of her yet. I was a little too out of it to ask all the questions I should have and to tell her about all my symptoms. However, she is already starting to do some things. She added 50 mcg Synthroid to my Westhroid because I am obviously low on FT4. FT3 was not tested the last time I had labs, so don't know about that yet. I am to have a fasting lab done. These are the tests she has ordered:

CBC w/ auto diff
CHEM 14
FERRITIN
HEMOGLOBIN A1C
INSULIN
INSULIN FREE
IRON
LIPID GRP
ESTRADIOL
PROGESTERONE
TESTOS TO
THYRO PERX
TSH

I am to add the Synthroid after the lab is done. She also prescribed bio-identicals which I will start a week after starting the Synthroid, then double the dose a week after that. She also gave me some information handouts. I go back in a month. We shall see what happens then.

[nonstickpam107]

Kona, FT3 would have been the most important thyroid test the doc could have done. Westhroid and Armour both 'act' about the same...they leave FT4 low and FT3 higher in range (just how a woman's body responds) yet most doctors freak when they don't see LOTS of T4 (sigh...can you tell this just makes me tired now?? LOL sorry).

My labs on Armour (Westhroid is just 'washed' and very expensive Armour) are not even to midway of range on FT4 scale and almost to top of FT3 scale...and I do just fine on it. You don't try to 'balance' FT4/FT3 while on Armour...Armour/Westhroid 'mimics' the human thyroid quite well.

If it were ME, I'd be calling that doctor and asking for a FT3...and then want it EVERY time I'm tested too (most important tests are FT4, FT3...certainly NOT TSH).

Pam

[Locarb4me]

Pam, I found this. Opinion?

Progesterone helps the thyroid hormone work
Taken From a transcript of a Seminar by Dr John R. Lee, M.D.

Progesterone helps the thyroid hormone work. Estrogen interferes with the thyroid hormone. This wasn't my discovery, this was described in the 50's in a study in Lancet. It doesn't interfere with the gland, it interferes with how the thyroid hormone is working. So the person acts as if they're low on thyroid but the blood tests of T3 and T4 are okay. But the doctor often ends up giving more thyroid and can overcome this sluggishness of the thyroid by giving more of it. So he thinks he's doing a good job. And he can do that, forcing more thyroid hormone than the cells really need. But then you set up the stage for Hashimoto's thyroiditis. And that was described 30, 40 years ago.

And yet, the endocrinologist I saw this week wanted me on an estrogen patch. I'm confused.

[nonstickpam107]

If you have NO hormones (post meno either surgically or naturally) you need progesterone (yes even if there is no uterus because one of the 'triggers' for thyroid disease/Hashimoto's is when a woman is going through perimenopause...you are losing progesterone, not estrogens...and hence the reason I feel 'bad' about the term 'estrogen dominance'...it's not really a 'dominance' it's an imbalance...progesterone drops quickly during perimeno and the thyroid 'tries to take over' the job of progesterone....and the thyroid ends up going downhill fast also), estradiol, free testosterone and estriol testing (salivary didn't 'work' for me....but does for some...I got better labs through blood testing and my endo is one of the 'pioneers' of bio identical replacement hormones for both men and women) and then decide how much of which hormone you need.

Big mistakes made when doctors think progesterone is only for sloughing uterine lining and don't bother giving it to women who don't have a uterus.

Pam

[Tazcat]

Hi Pam - the Cytomel/Synthroid combo turned out to be a disaster for me.

Going back to Armour - day 3. I look like a chemo patient seriously - my hair

I don't have my numbers with me, but I'm having a sonogram of my thyroid soon. Can you tell me what he'd be looking for?