Please comment on labs - new here!

[eliza]

Hey ladies! This is my first post, but I have lurked so long that many of you feel like old friends! Thank you all so much for all of the incredible information that you share on this site – you are truly changing lives.

This post is long – can skip to labs at bottom if prefer. Since teens, I have been low energy and have had horrible female issues. I had endometriosis, infertility, and now am likely entering menopause (47). I take a low dose continuous BCP (Allesse) to help with hormonal swings – I have horrible migraines that are worse with estrogen issues. I also take Zoloft, 50 mgs (was given this post partum 13 years ago, and it also helps with migraines).

Tired of docs trying to shove more antidepressants my way. Thanks to you ladies, I ordered my own labs! Here are symptoms -

Fatigue – could sleep at a red light!
Need lots of sleep – at least nine hours
Listless, no motivation
If attempt any exercise, fell horrible for next two days
Tinnitus since summer
Hearing in one ear is diminishing
Migraines
Low energy all life
Throat fullness off and on lately
Gained some weight last year (normally petite person)
Endometriosis – weird female hormone problems all life
Brain fog
Zero libido
Constipation
Light sensitivity
Blood pressure and heart rate crept up last couple of years

Twice when really stressed and was having horrible migraine, something happened – like flood gates opened for some chemical – immediate relief of headache and next 12-24 hours were better than had felt in years!


Labs:

TSH - 1.770 (range - .45 - 4.5)
FT3 - 2.5 (2.0 – 4.4)
FT4 - 1.26 (.82 – 1.77)
RT3 - 294 ( 90 – 350)
Ferritin - 50 (10 – 291) (not LC, but don’t eat enough meat likely)
Vit D - 41 (32 – 100)

Anyone have any thoughts? I would greatly appreciate any feedback and comments! Thanks so much -

[mimers]

Hi Eliza...since so many have read your post and not responded, I wanted to respond so you would have something to read! :-) A doctor would say you are "within range", but if you've been reading for long, you know that there is "in range" and what it means to be at a particular area of range.

I am certainly not the authority figure here and am hesitant to write anything...but I know you want to know that someone is reading and caring enough to attempt a response!!! :-) I'm sure there is someone here who knows how to do the calculations for a rT3 issue, and that "might be" an issue. Your Vit D is low and that's easy to supplement (take D3). Ferritin is low, but not as bad as many. From what knowledge I have, it seems that you are not converting well to FT3, but maybe more to rT3 instead? I am really hoping someone will jump in and help you with much more knowledge than I have. With your age and issues with hormones, are you taking supplemental progesterone by any chance??? That will help you sleep and also balance the high estrogen (and help raise cortisol). Also, with your symptoms (both adrenal and thyroid), you might want to have a 24 hour cortisol test done to see where you are and how to "fix it". I"m 61 and have had many of your symptoms.....but the sensitivity to light is an adrenal issue that I've been dealing with, and from my understanding, you can't fix anything easily/well in the endocrine system without first fixing your adrenals.

How is your pulse, BP and body temps during the day??? I have been charting mine several times a day and supplementing the adrenals and it's been a very enlightening journey. Sorry this is so long, but I did want to respond. Good luck!

[eliza]

Mimers - Thank you so much for replying! I truly appreciate any help that I can get. As for rt3, I agree - I think that could be an issue. I believe the FT3:RT3 ratio is a 9 - should be 20 or more. Someone please correct me if I'm wrong. Progesterone -I have compounded progesterone that I have tried, and it makes me depressed and anxious - don't need that - but thanks for the suggestion. My BP and pulse have been high for me - I will begin charting them and temp to see if any pattern or fluctuations. I had a 24 hour saliva cortisol in the summer, but I'm definitely worse now. I am ordering another cortisol saliva test. Results from last summer cortisol test are:

morning - 8.6 - (range 5.1 - 40.2)
noon - 4.0 - (2.1 - 15.7)
evening - 2.3 - (1.8 - 12.1)
night - 0.8 (.9-9.2)

All are low in range, and night is just below range. Will take another test haev current numbers.

Any ides - anyone? What is driving the problem - thyroid, ferritin, cortisol? Thanks again Mimers!

[mimers]

HI..my ranges for cortisol are worse than yours, so I've been focusing on adrenals. That's where you need to start and there are lots of good books on it, but Adrenal Fatigue by James Wilson is what I think to be the best. Low cortisol is low adrenal function. By nighttime, you have no energy per the results. Morning is low, but at least "functional". Evening is also very low for "energy". The difference between us is that my temp, BP and pulse are really low...and I"m having to raise them, so what I'm doing is no doubt the reverse of what you'd need to be doing...and maybe that's why progesterone didn't work for you as it also helps raise cortisol, and maybe in turn raises BP and pulse as well? When you say the BP and pulse are high for *you* what does that mean. When I got a 106/70 BP I would say that was high for me....because I was 90/60 on average and sometimes 86/46!!!! Anyway, I'm curious as to what dose of progesterone you had compounded and how were you taking it....in cream? Mine is sublingual. Without it, I definitely don't sleep well at all. I used a cast iron skillet for my eggs to help raise iron levels easily...also took a food based iron supplement and started eating organic red meat (hubby is a hunter). I would guess the low end ferritin could also be part of the rT3 problem. Pam and others have posted recently about an OTC iron supplement that is high and you don't need an Rx for it. Hopefully they will repost the name of it. You are right that the "end result" for the rT3 needs to be over 20, but I don't know what divides by what to get that result...sorry. Over 20 means you are okay, so if you are a 9, then you do have an rT3 problem and should be medicated accordingly to get rid of the rT3. I think that means cortisol supplementation and Cytomel/T3....not 100% sure, but that's what my feeble memory tells me is correct in order to clear the rT3. Sounds like you have a good start and good knowledge of what is happening and why. Now you just need to put on your detective hat and start analyzing it all and getting someone to help you who will prescribe for you what you need. It's not a quick fix, so be prepared to be at this for some time. I think James Wilson/Adrenal Fatigue said that it can easily take 2 years to heal the adrenals. One thing that surprised me was that I have a wonderful life, wonderful home, wonderful husband, etc....so I don't feel "stressed" at all. But it was brought to my attention that when the body is out of whack, the *body is stressed* even though you don't feel you are. I'm hoping that one of the knowledgeable ones will be back online tomorrow or Monday and will really help out. I"m still in the "learning" stages. I just wish it was a faster and easier "fix" to be good to go! :-) Hang in there as there is always wonderful support here! ~~Michele

[nonstickpam107]

I couldn't agree more with starting with the adrenals first. And synthetic birth control..um...that could REALLY be an upset to adrenals! As well as 'bind' the T4 to T3 conversion. Not a good thing.

A lot of your symptoms point to adrenal fatigue. Which, untreated, can also cause RT3 issues..so you can't have thyroid replacement before having adrenals treated. Oh, and Zoloft carries a contraindication for thyroid disease too...it can cause triggering of hypothyroidism..if you HAVE to have an anti depressant, I certainly wouldn't use THAT one if I had adrenal/thyroid problems (we do believe my husband's hypothyroidism was triggered by the use of Zoloft).

So...first things first...no one has to use synthetic hormones...bioidentical hormones are much safer and are 'identical' to ones own hormones, so if you need estradiol, then that's what you should be taking, not birth control.

Where do you live? (Not trying to be nosy...but perhaps someone on the board has used a doctor who is good with BHRT and adrenals/thyroid who is 'near' you and could help you). I am in favor of what mimers has said...adrenals come first, and that synthetic hormone in birth control can easily upset your RT3 balance also.

I think one should 'start at the beginning' to fix things, and your 'beginning' is adrenal. Most cannot raise ferritin by diet alone, and should have a doctor who will 'moinitor' the use of a good iron (one that comes to mind that doesn't cost an arm and a leg is PolyIron150, it has roughly 120mg. MORE iron than any other OTC iron supplement, but again, you should be monitored by a doctor.

Your vitamin D also, needs to be raised and that will have to also be monitored/given by a doctor. You might make some very good progress if you: get Vitamin D3 in an Rx'd amount and formula, get good iron supplementation monitored by a doctor, and perhaps get the adrenals addressed.

Pam

[eliza]

Pam and Mimers – thanks so much for your reply!

Pam – I’m in Augusta GA area – borders with South Carolina, so I am open to docs in GA and SC. Please tell me that you have a miracle worker in this area!

Synthetic hormones – yes – I know – must get off. Have a gyno appt in a couple of weeks and intend to switch to something else – hopefully a patch. Have tried compounded bhrt over last two years, but problem is that the delivery via cream doesn’t provide a steady state in system (even multiple dosing during day) so migraines were aggravated. Will do anything to avoid migraines! Hopefully a continuos delivery via patch will work. Will also discuss iron and vit d with gyno (no idea how open he will be to discussions – will see).

Zoloft – I’m hopeful that when hormones/adrenals are at a better stage that I will be able to drop it. But at the moment, it is helping with tension headaches and migraines. Scared to change too many things at once, you know?

For last two years I have been asking everyone I know about docs – trying to find a good one. Wouldn’t believe where all I have had hormone conversations with strangers! I have talked to local compounders (have used one) and one may be a possibility – to early for verdict. The search for good doc continues and I will not give up. Tired of them trying to shove more bandaids and no desire to determine/fix problem.

Michele – I read through amny of your previous posts to try to understand your situation better. Wow – so glad that prog is helping you! Fantastic that you are finding one piece to your puzzle. I saw that you are taking a thyroid now while also working on adrenals. Do you mind me asking what you are doing for adrenals – HC or cortef or anything like that? I have read much about adrenal fatigue and will get the book you recommended (thanks for suggestion!) but it seems that most people end up needing HC or cortef. Would love to heal naturally if possible, but will do what it takes. As for BP, wow – how do you function with such a low BP? Mine used to be very low, but year or so has been hovering around 120/80 – sometimes up 10 pts on eihter side. My heart rate is ususally in mid to high 70’s, and temps always a bit low – 98 ish, sometimes higher 97’s. If there are any changes you have made that you feel have helped, your adrenals, please let me know.

Thanks again to both Pam and Michele for your time! This board is awesome!

[mimers]

HI...glad Pam was able to answer lots of your questions. With regard to my adrenals, I am supplementing them naturally since the only person I've found to help me (after dozens that aren't helpful!) is a nurse practitioner (and her husband/chiropractor who has food based supplements). Since I have....*had*....low BP, pulse and temps, and that relates to poor adrenal function, they have had me on doses of licorice, B5 and rehmannia rhizome for about 6 weeks so far. They are to RAISE my BP, pulse and temps to help the adrenals. The NP also gave me high doses of progesterone for a month to also help raise the adrenals and help me sleep and "calm me ". It's all working, but it's been a slow process. One trip to Red Robin the other day with their loud music had me physically shaking due to the loud noise and I felt I was back to square one. The NP won't give me HC or cortef (so far)...but I've only been to her once and she wants to try it "her way" for the first couple months. So, I have to just go along with it since it's a prescription and not OTC for me to get myself. Also, I had taken HC years ago with a wonderful doctor (deceased) who said it didn't work for me. So?? I'm just trying to go slowly and move in a good direction. My adrenal function has been low forever. My compounded thyroid is now just plain porcine powder with dextrose as a filler. That made a huge difference to be away from all cellulose as a filler. And, I'm slowly titrating up from one grain to 2 grains, as my BP, pulse and temps also rise with the licorice, B5 and rehmannia rhizome. I"m at 1.75 grains now with success and finally feeling a change for the better. So far...it's been slow, but I am coming to life again. Just this last week (getting into the 1.75 grains) I actually wanted to get up, get dressed, and even do a bit of quilting! Feels good to have some of my normal activities back in my life. I feel like the turtle..slow but sure...I'll reach my goal! :-) And I do love to learn the mysteries of the endocrine system and am most grateful for a friend in Florida with amazing knowledge who has been mentoring me, and Pam and the group here! Great support! Now I"m just wondering how long to stay on 1.75 grains before moving up to 2 grains!?!?! Some say one week, others say 2 weeks to remain before raising it another 1/4 grain. Any ideas?? :-)

[nonstickpam107]

OH, I have a friend here who lives in your state! Let me PM her with directions to this thread, see if she can 'drop' a couple doc names for ya...

Pam

[inatic]

Eliza, join our ga yahoo group.

Georgia_Thyroid_Groups : Georgia Thyroid Groups

[nonstickpam107]

Thanks Ileen...I can always count on you! Love you girl!

Pam

[eliza]

Pam – Thanks for getting Ileen to post the GA board. I joined and will post requesting info about my area.

Referring back to my labs in the first post on this thread – I have a question. Do you think that once adrenals and ferritin are where they should be, that the thyroid and rt3 issue will correct itself? Or do you think I will still need thyroid help? And since my adrenals aren’t horrible but need work, could I begin thyroid meds soon after beginning adrenal work? Thanks for any opinions or comments.

Ileen – I joined the group – thanks for the link!

Michele – Thanks for info on what you are doing for adrenals. I bought some of the Wilson Adrenal supplement (rhodiola, panax, etc) and have begun taking it. Also, I’m trying to watch the adrenal stressing foods and sugars. Ordered the Wilson book also. I hope these steps will help! Did you wait for while after starting adrenal support until you started thyroid meds? I just want to feel like a normal person. Just this morning I was in the grocery store, standing in front of the salad dressings, and totally had a senior moment. I had to stop a lady and ask her what kind of dressing to use on spinach salad! Brain fog! I’m so glad that you are able to inch up on your meds. I obviously have no idea what to tell you about your increases. Why not start a new thread asking about increasing? We all learn so much from other people’s posts, and I’m sure you aren’t the only one wondering about timing of increases. So please consider a post for your benefit and for the rest of us that lurk! Hope you are having a great day and feel like quilting!

[mimers]

Eliza, love your posts! Re: the rT3 issue -- from everything I've read it doesn't reverse itself, you have to make it go away. I think I will be cautious and only give you my "interpretation" of what to do as I am no authority. I joined an rT3 group as I thought it might have been my issue when I started all this, but it wasn't. But I think you have to have T3/Cytomel to clear it, and not Synthroid (T4) which makes it worse. Or, depending on your tests, a little NDT with extra Cytomel.....it's really a balancing act from what I have read.

I tried Wilson's supplements and didn't feel improvement with them, but know friends that definitely did have great results. We are all so very different! What works for one, won't work for everyone. I am taking Thorne's Cortrex and that works better for me as far as adrenal glandulars. Standard Process by Mediherb has one, but it's in wheatgerm oil (I have celiac sprue as do most thyroid people so that was a strange thing for them to do!). I am going to call the NP today and get in to see her about lots of things. My adrenal things are going well (BP, pulse and temp are going up), but that's because I'm paying a small fortune to keep up the licorice, B5 and rehmmania, and I'm wondering if HC/cortef will give me better results. I"m not going to go above the 1.75 grains of NDT because I feel I might crash the adrenals and do NOT want to do that. I'm trying to keep the 2 balanced so I can do them together. Shames has a book (fat, frazzled/fuzzy) or something like that where he has individual tests (lots of questions) to see if your issues are hormonal, adrenal or thyroid. My scores were through the roof for both adrenal and thyroid (and hormones not far behind), but they were also identical! Something like 226 scores and over 22 was considered a deficiency! ha ha Anyway, since both were equally and identically bad with the scores, I am working on them slowly together. Everyone is going to be different, and it really takes patience and persistence and paying close attention to how you are feeling and what is and is not working for you. I'm still trying to find someone to help me with it all, and so am hoping this new NP will work out. I am ever so grateful for this forum and especially for Pam and many others that always jump in to help!