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starting new treatment

6K views 28 replies 7 participants last post by  Andros 
#1 ·
hi all, we are moving over from newbie to here to report on our treatment plan and ask a few questions. my daughter had her first appointment with our naturopath and we have a treatment plan. he re- ran her tests and started her on 30 mg or armour and adrenal supplements although her saliva adrenal test came out normal.

we found a few changes in her numbers. her THS has gone down from last summer from 4.36 to 1.69 and her reverses t3 is also lower. it went from 375 to 302. her ft4 is 1.21 and ft3 is 3.3.

however, her cholesterol is high @ 210 and HDL 64 and LDL 132. her B12 is good. everything else is is looking pretty middle of the road. we didn't retest those antibodies. we are going on those previous numbers since it was only a couple of months ago but she does have them...some. (MBH is 5.2, neutrophilis 62., lymphocytes 28.5, lymphocytes abs, 1.5. i don't know much about these last few...i don't know what they pertain to but i will look into it)

so we giving her adrenal support supplements 3 times a day and 30 mg of armour to start. she has been on them for about 7 days and is more exhausted then ever. we are assuming that the 30 mg is the lowest dose and may not do much. In a week he is putting her on a detox fast with lots of nutrients for 11 days which he hopes will get her metabolism kicking into gear. I am reading three books about thyroid treatment and i think that starting out with 30mg is reasonable but i'm wondering where we might go from here. i've heard so many different opinions about armour these days although he says that he has not had any problems with this one. We plan to meet with him after her fast to reassess which will have her on this dose for about four weeks. my guess is she will need more armour to feel better although with her numbers are improved for some reason and she no longer looks that much out of the normal range. I'm wondering if the adrenal support is making her feel worse or if a low does of armour could actually be making her more tired.
any thoughts or opinions would be welcomed. thank you!
 
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Discussion starter · #3 ·
Thanks andros, here are the ref ranges
FT3-2.3-4.2
FT4- 0.75-2.00
RT3-90-350
THS-0.30-4.70

her antibody tests were -

thyroglobulin antibody-<20 range 0-40
thyroid peroxidase ab-<10 range 0-35

As for adrenal support: he gave it to her because even though her tests came out normal she still had many of the symptoms of adrenal fatigue so he thought he would treat the symptoms and see if that helped her.
I'm wondering if there is any danger in keeping her on 30 mg. for a month?
thank you!
 
Discussion starter · #5 ·
thanks all. we have cut back on adrenal support, however the doctor has scheduled her for a 9 day fast. A mid day meal and two shakes a day for 4 days interspersed with by 2 days of shakes only which apparently are chock full of amino acids and nutrients. i keep reading how fasting can inhibit thyroid even more and i'm wondering if anyone else has been put on a similar regime?
I realize in some cases when the writer is referring to fasting they are referring to starvation.
thanks!
 
Discussion starter · #7 ·
Hi andros and everyone else,

I shall stick with this thread since I failed to see three weeks ago that andros last commented.
For convenience, I will repost my daughter latest lab work as well as include the ref. range for the thyroid antibody test that andros asked for. (see end of post)

My daughter has been on 30 mg, 1/2 grain of armour for one month we just returned to our Doctor after her proscribed 11 day fast. (she lost 6 pounds which the doctor said was a good sign.) Mainly she did not feel anymore energetic or rested on the 30 armour. the doctor was willing to double her dose to 60mg simply for symptoms sake however he told us this:

Looking at her current labs he feels as though he can not see enough evidence for hypothyroidism and that if she does not respond to the doubled dose of armour in the next several weeks he thinks that we should give up on this particular treatment all together. He thinks that she does not have a thyroid problem. I mentioned her High RT3- 302, it was 375, 6 months before as well as her THS had been at the top end of the range @ 4.35 and is now 1.69. I might add that these numbers came down before she received any armour.

My question is this: From the labs I've posted is this how it appears to you all and/or could there be a RT3 resistance issue possibly and how would we know this? it seems to me that Her THS and Rt3 must have been high for a reason, coupled with the fact that she wakes up exhausted every day, eats reasonably, diets some and still puts on the weight despite efforts and also a host or other symptoms. She does not have irregular periods or constipation or seem to have terribly low temperature.

If she is not hypo... great but i just don't want to give up on this if we just haven't hit it right. Looking at her labs would anyone else draw the same conclusion.
thank you!

reference ranges
FT3-2.3-4.2
FT4- 0.75-2.00
RT3-90-350
THS-0.30-4.70
ferritin-10-291
iron-40-150

ft4 - 1.21
ft3 - 3.3.
Rt3-302
cholesterol is high @ 210 ref range-<199
triglicerides 71 (ref range <149
HDL 64 (ref r. -40-59
LDL 132- high (ref range-<=99)
B12 is good
Adrenals tested normal
thyroglobulin antibody-<20 range 0-40
thyroid peroxidase ab-<10 range 0-35

her ferritin and iron have not been tested since last september but were low
ferritin-29 (10-291)
iron 59 (40-150)

thyroglobulin antibody-<20 range 0-40
thyroid peroxidase ab-<10 range 0-35
 
Discussion starter · #9 ·
These labs are from before she was put on Armour. she has not been retested since she started armour a month ago and she has only been on the 60mg for about 5 days. so far she doesn't feel anything. I am just wondering though if it seems appropriate looking at her labs as they stand presently for the doctor to conclude that there is no evidence for even subclinical hypothyroidism. I guess to be subclinical you have to be slightly over the top end of the range...I don't remember exactly the numbers for that...
 
Discussion starter · #11 ·
she took it for a while and then with this new doctor he didn't put any emphasis on it so she dropped it. I have read here that its important to get your iron in place before treatment but it seems as though that i've also read that iron can inhibit thyroid. sounds like you might think it a good idea for her to go back on it...? any idea how much and it should be taken away from thyroid, right?
 
Discussion starter · #14 ·
yes, I do, thanks. We are trying to figure out a way she can take it in the morning before school and still have time to have breakfast. I've read that you should wait an hour to eat and stay away from iron and calcium. the other option is to wait two hours and take it after breakfast...tricky with school age kids, however.

Andros, In your experience, have you seen labs like this where the person is hypo in spite of most of the labs being in range...also with regards to a high but still within range RT3?
thanks you.
 
Discussion starter · #16 ·
Yes, thanks. the labs i have posted are current but they were taken just prior to taking armour and as I said she just doubled her dose and has not yet been re tested. the doctor said in a months time he will.
As for rt3? i thought that the more savvy doctors did look at that. Although as you said, i didn't realize that without the presence of high antibodies it was not an issue.

we have not done a sonogram or uptake scan...i'll have to look that up since i'm not quite sure about what they are.
thanks.
 
Discussion starter · #19 ·
Lainey, yes the second TSH was 1.69.
as for T3 resistance :
you say :"you should know that "Wilson's Syndrome" and it's treatment is considered spurious at best in most parts of the world."

thank you for that. i have reading about it and I also see that most think wilsons syndrome is bogus but i didn't realize that it was one and the same, so that is helpful to know.

Then you say, "He has a valid point. I don't agree with increasing the dosage without running the lab work first. You have no idea what her levels are now, if the 30mg of Armour has made her hyper (as it very well could have because her numbers were pretty normal) she wouldn't be feeling any better, and the increased dosage wouldn't help. The only way to know is with a blood test. If these are the labs BEFORE armour, she should have labs before increasing it to 60mg."

I understand, however we had just done the lab work before we put her on 30mg. starting dose, after 4 weeks he raised it to 60 mg. he plans to test her in three weeks or so. she has not had any ill symptoms yet on 60mg. no hyper symptoms either.

Andros and lainey:
as for antibody testing initially she had thyroglobulin Ab and thyroid peroxidase antibody done. When i suggested that she be tested for the other antibody tests, ie.,TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin) ANA (antinuclear antibodies), both doctors we were seeing said those are very expensive and i don't see that we need to do those. I recently ask again about her low levels of antibodies and he said that they were not high enough to be an issue...

her C-peptides were high when we first tested them last august. 4.8 (1.0-4.0). as i mention earlier also high cholesterol and LDL.
And lastly fasting glucose was 92 (60-99)

"Has she had any GYN testing--full scale female hormone, sonogram for ovarian cysts (polycystic ovarian syndrome) and insulin resistance?"

not really, They did a c-peptide earlier.

" but insulin resistance testing includes that with a glucose challenge."
no, I don't think so. that's when they give you something to drink and then check your sugar levels, right?

She has not been tested for polycystic ovarian syndrome because she doesn't seem to have any of the symptoms that go with it. but maybe its time to go to a gyno and have that checked out.

As for the insulin resistance? I keep asking about it i i get a no, although I don't really get why. my understanding is that is because they said that her triglyicerides would be higher and her HLD would be down. I'm still trying to understand why her cholesterol and LDL are high and where that fits in.

thank you for trying to point us in the right direction and help. it is a mystery though..something is not right, we just don't know what it is exactly.
Our doctor wants her to do another cleaning fast for 30 days to see if that will shake something loose but that might not be in the cards for a 17 year old not to mention the expense.
thanks again
 
Discussion starter · #22 ·
Thank you all for your heart felt concern. As i said she was tested and and given 1/2 grain. four weeks later she was given 1/2 more. Calling it a fast was misleading on my part.. she wasn't fasting, it was a very healthy diet with lots of specially formulated shakes, salads and lots of protein and fruit. she was never hungry.

As to your concern about changing her dose before she was retested...I hear you both loud and clear. The doctor made this decision and assured us that it was just a very small increase and if she felt any hypo effects we would immediately back her off of it. I hear that you are saying that he shouldn't have made the increase without retesting. I thought he did so because he felt that he has just tested her but now you have raised my concern. I have to say that he has been practicing for many yeas and that he is well regarded as to thyroid treatment. Also I wanted to add that she hasn't felt a thing and she has been on it for 6 days now and before that 1/2 grain for a month.
Still no new symptoms.

Here is the big question: Is it possible to have it build up after weeks and then all of a sudden go hyper?

I have been extremely hesitant about this process of medication and now i'm very nervous. I shall call him and ask if we should continue without further testing
 
Discussion starter · #25 ·
Okay, so please tell me if this is what you recommend now.
make an appointment to have a new panel done and on the day she is to have the test have her skip her meds to see more accurately what her body is doing?
Or what?

And then what? if the numbers are the same or better keep going with the 60mg for another month or so and then retest?
If the THS is too low obviously we go back to 1/2 or do we slowly come off of it all together?

what other things should i look for in the numbers?
she is not feeling anything negative effects what so ever...

advice please?
 
Discussion starter · #28 ·
Thank you. i understand that changing too many things can confuse results...we are on board with that.

Lainey, the reason i asked about whether she should skip her doses before she does the blood work is because I read in one of the many books that I have been reading...Here it is, from mary shomans book, Living Well with hypothyroidisn, page 117.

the heading:
Timing Of When to Take Your Pill on Test Day

she says this:

[While when you take levothyroxine pill doesn't typically have an effect on your over all THS levels, the timing of a T3 drug can. So ideally, on the day you have your blood test, you should try to avoid taking your thyroid hormone until after you've had your blood taken. this is particularly important if you are having T# and Free T3 levels measured.}

So, thats where i got that idea.
Having said that Lainey, I see what you saying. you are saying that if you want to know how her system is handling what she is on then test while she has the daily thyroid in her blood stream. Is that right?
thank you.
 
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