Need help with my thryoid

[mike036]

I kind of stopped posting here because I want to address my cortisol and thyroid problems, which could take a long time.

I hope he tested your free T3 (ideally also reverse T3 but I doubt he did). If he didn't, he's pretty incompetent to think it's not important enough to test. Free T3 is the gas that gets our engines going. I am deficient in FT3 so that's partly why I feel like crap and my cortisol deficiency is preventing my T4 to convert into T3.

Sorry about the high RBC. Hopefully you have no other risk factors for clots.

I meet with my doctor next week to go over the bloodwork. I am going to suggest testing my t3, it only makes sense to. Keep us posted on how you make out !

 

[deadliftsquates]

Taking twice daily is a good idea given the short half-life of T3. However, the low T4 cannot be down to timing due to its much longer half-life. I would guess that your body converts T4 at a very high rate. What your doctor could try is to lower the dose of the armour thyroid to, say, 3 tabs, and to add in 50-75mcg of T4 on top.

Although no change may be needed as long a you feel good and have no symptoms of either hypo or hyperthyroidism.

I have no symptoms except I am not tired all the time like before and I look good. She lowered me to 4 tabs a day 2 in the morning and 2 at night 60 mcg. each.

 

[MyNameIsJeff]

I have no symptoms except I am not tired all the time like before and I look good. She lowered me to 4 tabs a day 2 in the morning and 2 at night 60 mcg. each.

What do you mean, lowered? Wasn't your daily dose already 4x 60mcg?

 

[supermofo]

My wife has numbers that indicate hyperthyroidism but exhibits symptoms of hypothyroidism. She converts on the high end of reverse t3 and minimal to free t3.the combo of t4/t3 made her feel much worse than 25mcg daily of t3 only. All doctor prescribed and monitored. Still can't figure out how to make her feel normal. She trains hard and maintains a pretty clean diet and rest about 8 hours each night but still has the hypo symptoms of extreme fatigue, feeling cold, etc. Going on 3 years now of treatment and still frustrated with the results or lack of....

 

[MR. BMJ]

Sorry I haven't posted here in a long time. I'm still an utter mess going from one bad doctor after another. The latest one prescribed me T3 only, which I kind of agreed with given my lab numbers, but only prescribed 10mcg. This has lowered my body temperature, which was already low (good indicator of hypothyroidism). I think I probably need 50-100mcg realistically to give myself a fighting chance.

Oh, and my cortisol is also very low, which is the main cause of my symptoms I believe. A 4 point saliva test confirmed this. I'm taking a ton of adrenal glandular now. I am calling my doctor today to see if he will bump my T3 dose dramatically but I just had to order liquid T3 in the meantime in case he doesn't. I also ordered tabs but those will take 2-4 weeks since it's from overseas (if anyone knows a faster shipping source of T3 tabs, please let me know). I spend every day wondering if I will ever get my life back.

You should contact Dr. Karl Nadolsky and get his thoughts. Hope you get better man!

 

[deadliftsquates]

What do you mean, lowered? Wasn't your daily dose already 4x 60mcg?

My fault I misspoke. I was on 6 - 60 mcg tabs a day and she lowered it to 4

 

[MyNameIsJeff]

My fault I misspoke. I was on 6 - 60 mcg tabs a day and she lowered it to 4

OK, so then your doctor's response to low serum free T4 is to lower the T4 dose? That's... interesting.

 

[muscle96ss]

My wife has numbers that indicate hyperthyroidism but exhibits symptoms of hypothyroidism. She converts on the high end of reverse t3 and minimal to free t3.the combo of t4/t3 made her feel much worse than 25mcg daily of t3 only. All doctor prescribed and monitored. Still can't figure out how to make her feel normal. She trains hard and maintains a pretty clean diet and rest about 8 hours each night but still has the hypo symptoms of extreme fatigue, feeling cold, etc. Going on 3 years now of treatment and still frustrated with the results or lack of....

Based on what you are saying of high rT3 and low free T3, it makes sense that she has symptoms of hypo and also makes sense that adding T4 did not help; as the lack of T4 is not the issue here. You need to see a doctor that actually understands the thyroid and can figure out why she has such high RT3. I would look at cortisol levels(stress can be a HUGE factor) as well as a full nutritional panel including things like selenium, iron, zinc, etc....Unfortunately, some of the tests may not be covered by insurance because our healthcare system sucks and is more about treating symptoms than causes; but that is a whole different topic in itself.

One other thought, you might just try switching to Armour Thyroid or Nature-throid. They are bioidentical formulas that most doctors are oblivious to because of the power of pharma(another long tangent, lol). People that are on T3 and have high RT3 and have switched to the bioidenticals have had some success in eliminating that problem.

 

[fitzchivalry]

The ratio of T4 to T3 secretion by the human thyroid gland under physiological conditions, is close to 13:1. So if you take a medication with a thyroid mix of 4:1, you are unlikely to end up with a high T4 and normal T3 levels. Quite the contrary. Naively one would expect T3 might be high-normal and T4 low when taking a 4:1 mix. Though in practice this would be alleviated by reduced T4 to T3 conversion so that most likely you will end up with high-normal T3 and normal T4 levels.

Take the above with a grain of salt though, I'm not too familiar with the literature.

This is my experience so far. I have also heard that taking t3 in any form will knock down t4 a bit even if using a combo.

I was on 2 grains morn and 2 grains afternoon and free t3 was well over range (4.9 on 4.2 top of scale) 17 hours after afternoon dose. T4 was on the lower end. I was experiencing extreme depression/anxiety on that dose and actually went to 1 grain three times a day and latest test had me at just at top of range for free t3 but free t4 at .9 on .8 scale (lowest end).

 

[fitzchivalry]

I have no symptoms except I am not tired all the time like before and I look good. She lowered me to 4 tabs a day 2 in the morning and 2 at night 60 mcg. each.

What were you taking before this dose? I went up to 3 and 3 at one point as I was unsure if I was experiencing hyper or hypo symptoms as some symptoms are indicative of both and had pretty bad heart palps.

You are splitting morning and night and not morning and afternoon? Maybe the morning and afternoon dosing caused the t3 to really build up for me and had too much at once in my body.

 

[supermofo]

Based on what you are saying of high rT3 and low free T3, it makes sense that she has symptoms of hypo and also makes sense that adding T4 did not help; as the lack of T4 is not the issue here. You need to see a doctor that actually understands the thyroid and can figure out why she has such high RT3. I would look at cortisol levels(stress can be a HUGE factor) as well as a full nutritional panel including things like selenium, iron, zinc, etc....Unfortunately, some of the tests may not be covered by insurance because our healthcare system sucks and is more about treating symptoms than causes; but that is a whole different topic in itself.

One other thought, you might just try switching to Armour Thyroid or Nature-throid. They are bioidentical formulas that most doctors are oblivious to because of the power of pharma(another long tangent, lol). People that are on T3 and have high RT3 and have switched to the bioidenticals have had some success in eliminating that problem.

Tried armour and which still contains some t4 and same result "bone tired" as she calls it. Straight t3 however at 25mcg which is as high as her doc will prescribe her makes her feel better but 37.5mcg - 50mcg of t3 and she feels great though probably not the healthiest option. I will get the doc to test cortisol and the others that you mentioned on next visit. Her/our doc actually listens to my suggestions she also does my trt. Thanks for the suggestions.

 

[nothuman]

Based on what you are saying of high rT3 and low free T3, it makes sense that she has symptoms of hypo and also makes sense that adding T4 did not help; as the lack of T4 is not the issue here. You need to see a doctor that actually understands the thyroid and can figure out why she has such high RT3. I would look at cortisol levels(stress can be a HUGE factor) as well as a full nutritional panel including things like selenium, iron, zinc, etc....Unfortunately, some of the tests may not be covered by insurance because our healthcare system sucks and is more about treating symptoms than causes; but that is a whole different topic in itself.

One other thought, you might just try switching to Armour Thyroid or Nature-throid. They are bioidentical formulas that most doctors are oblivious to because of the power of pharma(another long tangent, lol). People that are on T3 and have high RT3 and have switched to the bioidenticals have had some success in eliminating that problem.

I am a prime example of what you speak of. My RT3 is high due to my T4 to T3 conversion problem, but it went way up (from 21 to 36) when using 1 grain of Armour (T3/T4) while the other numbers didn't improve. I already have plenty of FT4 so it's the FT3 I need to help me function.

 

[nothuman]

Tried armour and which still contains some t4 and same result "bone tired" as she calls it. Straight t3 however at 25mcg which is as high as her doc will prescribe her makes her feel better but 37.5mcg - 50mcg of t3 and she feels great though probably not the healthiest option. I will get the doc to test cortisol and the others that you mentioned on next visit. Her/our doc actually listens to my suggestions she also does my trt. Thanks for the suggestions.

This is what I need to try. I am completely under prescribed at 10mcg T3 right now, which has zero effect. Body temperature is still just as low. I want to give 50mcg a shot. The only question is whether it will work or not given my adrenal/cortisol problem.

 

[aphextwin]

I hope you find something. You have been suffering long enough.

 

[w8tlifterty]

No human, sorry to hear your situation.. I posted awhile back about high tsh (6+) and feeling like shit w typical signs of hypothyroidism. My dr is a pain in the ass and not at all easy to work with so I took matters into my own hands. My t4 was always in range just ever increasing tsh for the last 3 years. I added in 12.5 mcg t3 for the last 2-3 months. Not only have I felt much, much better but bloodwork just came back. Tsh is now 4.10 and back in range. T4 remained unchanged and well within range. Unfortunately, he would not test anything else in regards to the thyroid. I noticed you recently started low dose t3. Now, I know our situation is different but keep on trying to figure out out and keep your spirits up man.

Side note... fuck my younger, dumber self. At 37, I could have avoided a lot of the bullshit 'this game' has eluded too.

 

[nothuman]

I hope you find something. You have been suffering long enough.

Thanks. It took me a year and a half to discover why I had these symptoms, so finally getting an answer was a step forward. Low cortisol is no joke.

I know "adrenal fatigue" isn't a medical condition but the symptoms associated with the cause of weak adrenals are really crappy. Zombie mode and brain fog all day. It's hard to fix the thyroid without proper adrenal function, which isn't easy to correct. If I work out with any form of intensity, or even drink a cup of coffee, the symptoms get very bad. I'm in a few facebook groups where a lot of people have the same issues. We either have to use hydrocortisone or adrenal cortex (milder but safer, which is what I am using. But it seems to be hit or miss depending on the person)

 

[MyNameIsJeff]

Thanks. It took me a year and a half to discover why I had these symptoms, so finally getting an answer was a step forward. Low cortisol is no joke.

I know "adrenal fatigue" isn't a medical condition but the symptoms associated with the cause of weak adrenals are really crappy. Zombie mode and brain fog all day. It's hard to fix the thyroid without proper adrenal function, which isn't easy to correct. If I work out with any form of intensity, or even drink a cup of coffee, the symptoms get very bad. I'm in a few facebook groups where a lot of people have the same issues. We either have to use hydrocortisone or adrenal cortex (milder but safer, which is what I am using. But it seems to be hit or miss depending on the person)

Good to hear you finally found the issue. What's the doctor's diagnosis? Have you been tested for adrenoleukodystrophy? Did you get tested for low ACTH and low CRH?

 

[nothuman]

Hey Jeff. I had that brain MRI finally and it was normal. I think that would have shown ALD if I had it.

ACTH was high and aldosterone was low. Here they are:
ACTH (plasma): 75.4 (7.2-63.3) I was taking Thorne adrenal cortex at the time so it might have been even higher before.
Aldosterone: 3 (0-30)

I did a four point saliva cortisol test. Here are those results:
Cortisol AM30 9.6 nmol/L 14.0 – 25.0 7.0 – 30.0
Cortisol Noon 5.3 nmol/L 5.0 – 10.0 2.1 – 14.0
Cortisol Evening 1.9 nmol/L 2.0 – 5.0 1.5 – 8.0
Cortisol Night 1.4 nmol/L 1.0 – 4.0 0.33 – 7.0
DHEA* 279 pg/mL 137 – 336
Secretory IgA* 190 µg/mL 75 – 330

I've gotten my iron panel back up from an aggressive ferrous bisglycinate regimen so the iron shouldn't be holding me back anymore. I also got my iodine back up.

I wish I knew whether my current plan will work or not. I've been told to use adrenal cortex at higher doses and the doctor put me on 10mcg T3 only (FT3: 3.0 FT4: 1.9 RT3: 21 TSH: 1.8 with no antibodies. This was while off meds)

If you have any additional thoughts, shoot. Thanks

 

[MyNameIsJeff]

Wow, those numbers look like textbook primary adrenal insufficiency (aka Addisons disease). The worsening of symptoms after exercise fit, too.
I take it that the adrenal issue is self-diagnosed? I can understand your reluctance to entrust another doctor with this, but you will bring him a very strong case so he will have no choice but to do formal testing for Addison's. I.e. specific blood work, an ACTH stimulation test, abdominal imaging, and subsequently maybe a test for the presence of VLCFA, maybe genetic testing.

It's important to get a precise diagnosis since that will determine the best treatment plan. For example, if there's an autoimmune problem and you have adrenal cortex autoantibodies, then taking that Thorne supplement may make things worse by flooding the body with antigens. In general, I don't think the bovine adrenal cortex extract is sufficient in all but the lightest cases. In those who are not deficient in any micronutrients like yourself, I don't really see how it would help. In any case, the blood tests will tell you the extent of the deficiency and will inform you and the doc whether you'll need hydrocortisone and possibly fludrocortisone medication, and if so, at what dose, and with what dosing pattern. Even if you don't need them regularly, having some on hand in case of a particularly severe adrenal crisis is a good precaution to take.

 

[nothuman]

Wow, those numbers look like textbook primary adrenal insufficiency (aka Addisons disease). The worsening of symptoms after exercise fit, too.
I take it that the adrenal issue is self-diagnosed? I can understand your reluctance to entrust another doctor with this, but you will bring him a very strong case so he will have no choice but to do formal testing for Addison's. I.e. specific blood work, an ACTH stimulation test, abdominal imaging, and subsequently maybe a test for the presence of VLCFA, maybe genetic testing.

It's important to get a precise diagnosis since that will determine the best treatment plan. For example, if there's an autoimmune problem and you have adrenal cortex autoantibodies, then taking that Thorne supplement may make things worse by flooding the body with antigens. In general, I don't think the bovine adrenal cortex extract is sufficient in all but the lightest cases. In those who are not deficient in any micronutrients like yourself, I don't really see how it would help. In any case, the blood tests will tell you the extent of the deficiency and will inform you and the doc whether you'll need hydrocortisone and possibly fludrocortisone medication, and if so, at what dose, and with what dosing pattern. Even if you don't need them regularly, having some on hand in case of a particularly severe adrenal crisis is a good precaution to take.

I ordered the saliva test on my own since none of the 100 doctors I saw thought to suggest that. I do have a new doctor now who specializes in adrenal issues that I brought the tests to (the one who prescribed a little T3). He didn't recommend hydrocortisone for me after I asked. Wanted me on a full adrenal glandular product (which I was using but then went back to Thorne Ace after doing some research bc I didn't want the adrenaline). He does not think that I have Addisons. I am following up with him in two weeks after getting a major set of bloodwork yesterday (they drew at least 10 vials of blood). You're right that I am not deficient in any micronutrients since I had them checked 2 months ago.

Is Addisons something you can develop in your 30s? Remember these symptoms only began just under two years ago. My free T3 was higher in my mid 20s, for what its worth.

I have HC (hydrocortisone) on hand, but gathering info before I make a move and use it on my own accord. I have been browsing a few facebook groups with HC dosing info based on people's results. So I have an idea how I'd be supposed to take it if I fail to get proper doctor's supervision.

Getting a precise diagnosis is easier said than done as it's rare that I find a doctor who is truly experienced with adrenals. I'm hoping my current one knows what he is doing since I did some research before using him (out of pocket), but he isn't going to change anything until he sees my new set of labs in two weeks. I will suggest an ACTH stimulation test and abdominal imaging when I see him. If I don't think he is steering me in the proper direction and I don't feel any better, I will have to find someone else (again).