Adrenals - Pam

[DebM]

Pam,

Saw the dr on Friday, 9/24

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These were my labs:

Free T4 1.1 0.8-1.8
Free T3 352 230-420
TSH .01 .40 - 4.50

MCH - 33.1 27.0 - 33.0

Vitamin D 50 20-100

Estradiol 1.1 0-5-1.7 post menopausal 0.8-12 estrogen replacement (optimal 1.3-3.3)

Prog 384 12-100 Postmeno 200-3000 topical
(optimal 10-30 mg)
Testosterone 19 16-55 (age dependent)
DHEAS 6.1 2-23 (Age dependent)
Cortisol morning 2.0 Low 3.7-9.5
noon 2.0 1.2-3.0
evening 1.3 0.6-1.9
night .4 .4-1.0

I didn't want to post again on Leilax's post since she is also asking for help from the same doctor..... You said that if your prog was as high as mine that you'd want to eat and sleep all the time and that most docs would address the adrenals first. I started with Body Logic in Feb. 2009 and I thought that we were headed in that direction and in April he added armour 1/4 grain for 2 weeks then 1/2 grain (I was on the hyper end previously and former endo started me on atenolol and methizole). Body logic said get off the meth immediately so after 6 weeks or so he added the 1/4 grain armour.

After the Sept. appt he dropped my armour back to 1/4 grain because I think my low a.m. cortisol. I called 2 weeks later and asked to go back to 1/2 grain because of my low afternoon energy and he okayed it.

I have nooo clue what to do at this point. The past few mornings I've waken with a headache. He upped my testosterone to 1 mL 6 days a week, progesterone is .75 ML 6 days a week and bioest (just added in Sept.) is .1 for 6 days a week.

Drop the armour? Unfortunately I don't have even a smidgeon of your thyroid knowledge to know what the doctor is thinking even to ask the right questions. He most likely was going to go back and address the adrenal issue since he said to drop the armour back? But not to 0 armour.... I may just stop the armour and see what the next labs are in December. I know he said we might be "tweaking" for a year or so to get me feeling better. I just hate to think that they can't help me and the only other doctor there is his brother.....

[nonstickpam107]

First...are you taking ORAL progseterone (prometrium) or transdermal (cream you rub on a different area each night)? Are you taking oral Biest or is it also in the cream? Same with the testosterone..is it oral or transdermal? And why six days a week?

And I can only answer with my opinion on the Armour...your labs look ok on the Armour...even with the BHRT binding...I'd just stay where I was at with those.

Pam

[DebM]

Sorry, yes Pam they are all creams. He does 6 days a week versus one week off a month. Seemed to think that was easier to do and you would feel better. I can't imagine being without those creams for one solid week.

The bloodwork and saliva were without the biest cream, higher testosterone and the progesterone that I've had is .50 ml. Newest prog that just came is .75 ml. I think he's hoping it helps me sleep better.

Thanks again!

[nonstickpam107]

No doctor that I know does a program where you are off a week every month, so that further puzzles me. So what he's doing is 'different' than what I have been treated and what most of the patients I've heard from.

I do, however, know that if you aren't feeling 'better' while being treated with BHRT, than telling the doctor should change the treatment...and the doctor needs to explain 'why' his particular treatment is being done (skipping a day with progesterone and biest?????).

If you are feeling MUCH better than you did, than keep that. And my feelings on the Armour would be this: if it takes only 1/4 GRAIN to get you to where your FT3 is midway of range or more...perhaps you don't need it...and again, I'm just going by what I've seen/heard....most patients need two grains or HIGHER to attain the levels you have. I, also, started out being BOTH hypo/hyper until I settled and needed only one grain per day split to start (or my FT3 would SHOOT over the top). So, I know what that's like. As soon as I was settled on BHRT...that's when I needed more Armour.

Um...your own body makes hormones EVERY DAY...how does he keep women from doing THAT? (Think about it. why skip a day ...does the body skip making hormones on Sunday? huh uh).

Pam

[leilax]

he had me skipping 1 day a week as well, for what its worth.

how long does it take for hormones to "get in your system"? I experienced adverse reactions very shortly after taking bhrt, but when I called and explained my situation, they said that it would take like 4 weeks to have the effects I claim I am having and that it would not show up in blood or saliva. is that true?

[DebM]

I thought that when you use the transdermal cream it is "in" your bloodstream so I would think you'd feel better quickly but I'm not sure on that one....

This might be a weird question, So Pam if I go ahead and keep taking the 1/2 grain split and use the higher progesterone, new bioest and testosterone, as long as I take my first 1/4 grain and wait 4-5 hours to have blood drawn, the bloodwork would pretty much be as if I had no thyroid supplement in my system?

I'm just thinking that if my adrenals are still kind of messed up re the low a.m. cortisol, and I'm taking a higher amount of progesterone, now taking bioest and higher testosterone since the Sept. bloodwork, shouldn't the doctor see what my results would be without the armour ....to know what I need? if there is some binding going on at my Dec. bloodwork?

[nonstickpam107]

You are waiting the four/five hours after half your dose to see where your FT3 is at at the 'ebb' of the tide (ebb and flow) of the incoming T3. At the four to five hour mark after, will show 'how' your body is using it. If you took blood right AFTER you took the 1/4grain, it would reflect ALL the T3 in the med, not in your blood.

If your FT3 is 'that high' with all the binding BHRT incoming, than it shows you may not need that much Armour or T3 at all (down the road though...I didn't like testosterone in cream form and if you have dry skin or poor absorption than you can end up only absorbing/using about 1/19th of the cream). I absorbed the testosterone like CRAZY (and ended up with lip hair, back hair, etc. bad mood, rages, so on) and didn't absorb the Biest at ALL...my levels were horrible..I went to using oral estradiol and I absorbed progesterone in cream too well and ended up with swollen everything and looked five months preggers....so..each to their own )

Pam

[Harmony1]

Pam, can you explain the BHRT... and why you refer to the 4 -5 hours after the first FT3 dose. My daughter is supposed to split the FT3 (synthetic 2,5 mcg twice a day) dose and I see that she gets sluggish in mid-afternoon and have suggested she take the 2nd dose then... does that make sense to you? She has only been on it for a month.

[nonstickpam107]

What do you mean 'explain' BHRT? Is your DD also on estrogen, progesterone, testosterone?

T3 is 'active' for about four hours. Unlike T4 (which has a half life of about six WEEKS, but is 'working' and will show up in testing in four WEEKS). So, when I split my dose (I take 180mg. porcine thyroid, which is equiv. to about 111mcg. T4 and approx. 27mg. T3 per day) I'm taking half of it (which would be about 13.5mg. T3 or thereabouts) and then test about four hours later, which shows the 'ebb' of my four hour half life ebb and flow. In other words, my T3 is now in my body, (and Free's show what's AVAILABLE, not what's just floating around...like totals do) and I'm almost ready for another dose at about the five to six hour mark. That's where I want to test to see if I'm 'mimicking' the human thyroid's quantity and ebb/flow of T3.

How old is your daughter? And where is her FT3 at? (giving lab ranges that are given on HER LAB COPY, which you are keeping all copies of)?

Free T3 (or FT3) is the name of the test. And most of us do well with BOTH T4 and T3 (not JUST T3). Armour, Naturethroid, Westhroid all contain T1, T2, T3, T4 and calcitonin, not JUST T3. Is your daughter taking only Cytomel? You need to be looking at BOTH Free T4 and Free T3 testing. As well as RT3 in some (Reverse T3).

Pam

[Harmony1]

Pam, I've now looked up BHRT - had never heard of that, and of course my 19 y.o. daughter is not taking hormone treatment for menopause... but I do wonder if she should have been taking hormone treatment....

If the FT3 only lasts a few hours, why don't you take it more than twice a day? I personally couldn't function with only a 10 hour day. Seems like her doctor gave her a miniscule dose of FT3, (2,5 x 2 day x 7 days) - after a month on it... her FT3 taken when she had not taken any medication that morning was in the upper 1/3 level of the range. But I guess this test didn't test her free floating T3 since it was taken in the early morning before she took her medication for the day. So, would that mean that her FT3 will actually be MUCH higher when she takes the pill... and maybe tooo much higher in fact?? What do you say about that? (I have seen our other correspondence too) Harmony1

[nonstickpam107]

It sounds as though they only did a Total T3 on your daughter..and I'm not into 'guessing'...you need to be keeping copies of ALL her labs. With lab ranges as each lab range is different per lab. Totals just show what's in body, Free's show exactly how much and how she is utilizing them and how they are 'bound'. My Free's are always LOWER than my Totals. I don't eat a lot of soy, and NO gluten, and about 60grams carb total per day (and I eat those after lifting weights). I'm post meno, no incoming hormones now..so nothing is 'binding' up my FT's.

I say have her take that teeny, tiny split dose (2.5...jeez...the human body makes about 18 to 29 mcg. per day, btw) and then test Free T3 test about five hours later. See where she is at then. The human body usually makes about 7 to 10mcg. T3 in am, if the adrenals are good...and then a little less early afternoon, and then less than that near early evening. If the adrenals are low, than the patient will not be able to tolerate incoming thyroid hormone until they are brought up to par.

And make sure they do a FT4 while they are at it! (and about 67% of all female who are hypothyroid also are low in iron and ferritin...even if a hundred pounds OVERweight....eating has not a lot to do with it...a poorly functioning thyroid makes a poorly functioning body and hormone system).

Pam

[nonstickpam107]

Harmony, I also wanted to have you read this site (and although I don't agree with EVERYTHING they have to say...they are, for the most part, right on the money):

Stop The Thyroid Madness

also this site (and join the forum):

Thyroid Disease Information - Hypothyroidism - Hyperthyroidism - Thyroid Cancer - Autoimmune Disease - Hashimoto's - Graves' - Goiter - Nodules

Pam

[Harmony1]

I have spent soooo many hours on the internet in addition to reading text books...but I haven't come across anyone who seemed as knowledgeable as you - getting these exchanges going feels like a real breakthrough. I checked out the madness page yesterday and will check out the other website you gave me. Thanks. Harmony1

[nonstickpam107]

You are SO very welcome...we need to help each other, and my advocation is to help patients get doctors (and information!) that will steer them to treatment (and relief).

Pam