Please can somebody help me work out what to do now...

[Boronia]

Hi All, I would really appreciate any comments or suggestions on my sad and sorry, if oh so common, tale. (Please Note-Reference Ranges are shown below and all dates are for 2013)

First a bit of background....I was diagnosed Hyperthyroid in Jan this year (TSH-0.02, FT4-40.2, ESR-125) I didn’t go on the Cabrimazole as prescribed by an extremely expensive, arrogant and dismissive Private Endo who told me that I would have a heart attack if I didn’t take it. I sought a second opinion and it was suggested that I wait a bit and see. Luckily I didn’t take the Cabrimazole as I then went Hypothyroid. I had an Ultrasound and a Radioactive Isotope which showed 3 nodules-1x 1.5cm and “hot” and two other smaller ones. The consultant Endo was not concerned about them but felt that the “hot” one may be overfunctioning at times. The other theories were that it is Hashimoto’s Thyroiditis or De Quervain’s disease (self-resolving Thyroiditis) and the outcome was “wait and see”. (The original Endo only mentioned the second two possibilities after I asked her about them based on my own research.) Thank goodness for patient advocacy websites.

I am now in the public system and these Endo’s are also on a “wait and see” basis. The only good thing about them is they will generally let me get some of the blood tests that I want-except for FT3 and RT3!!! This is how I finally got the full iron panel.

I see a Herbalist who is also a GP who prescribed the Armour Thyroid on my request, but she does not seem to know an awful lot about the subtleties/interactions of Thyroid difficulties and much prefers to treat with herbs. I started taking the Armour on the 19/7 and it has taken a while to get up to 2 grains-I dropped the dose back down a couple of times as I felt strange and heady and built up very gradually.

I also see my local GP for Medical Certs for work. She works on the Endo’s recommendation but knows that I take Armour and feels that I am overmedicated and wants me to cut right back on the Armour as she feels that my TSH is way too low and that I would feel better if my TSH is between 1-2. She thinks my FT4 is fine?? She now thinks that it may be Chronic Fatigue Syndrome. I am starting to wonder if she is right about the overmedicating bit?? .

I have had only 1 saliva test on 2/6 which showed low morning cortisol sample 1-10.4 range 12-22 (sample 2-6.8 range 5.0-9.0, sample3-3.0 range 3.0-7.0 and sample 4-1.5 range 1.0-3.0). Money has been very tight so I haven’t had another saliva test since. I have also had a short Synacthen test which the Dr said should double. The results were 497-796 whic is an increase of 166% Dr said it was fine??

I take Armour 2 grains 1x per day 3 &1/2 hours before I get up. I have built up to this amount and back to this time gradually. I started the T3CM method using NDT because I live in Ireland and it is prohibited to import Adrenal Cortex I am working on the iron by taking Floradix Liquid iron 30ml 3x per day but am thinking of adding in some Solgar Gentle Iron 20 mg as well. I take the iron at least an hour after other supplements and away from the Armour Thyroid. I am also taking 1000mg Solgar Vit Ester-C PLUS 3 x day with the iron, Solgar Megasorb B Vit Complex 2x, Selenium 200ug 1x, Udo’s Choice Probiotics 1x, Solgar Magnesium Citrate 1x.

My main current symptoms are extreme fatigue, (overdoing it one day-which can be not doing much-can knock me out for the next day) mind fog, muscle aches and pains, shortness of breath on exertion (sometimes worse than others), hungry most of the time & gaining weight but very slowly and my periods make all my symptoms worse.

Please can someone have a look at my latest bloods from 25th November and comment on them for me. (Reference Ranges in Brackets)

Total protein 66 g/L (64-83)

Albumin 44 g/L (39-51)

Total Bilirubin 7 umol/L (1-19)

ALP 62 U/L (35-104)

ALT 34 U/L (0-40)

GGT 13 U/L (6-42)

Magnesium 0.81 mmol/L (0.65-1.05) (Previous results 19/3-0.95, 1/7-0.83, 25/9-0.85,)

Free T4 11.3 pmol/L (10.5-22)

TSH 0.09 mIU/L (0.27-4.20)

Here are my previous TSH:FT4 Results (31/1-0.02:40.2, 12/2-0.02:17.54, 27/2-2.65:7.8, 19/3-9.08:9.0, 30/4-4.42:11.5, 21/5-3.11:14.1, 3/6-2.66-range 0.4-4.0:11.0-range 10-22, 1/7-3.69:14.1, 2/9-1.45:10.8 25/9-less 0.02:15.8,)

I have only one result for FT3 and RT3 from a Genova test done when I was in England-FT3-3/6- 4.97 range 2.8-6.5, and RT3-3/6-0.33 range 0.14-0.54. I haven’t visited England since and my Doctors here will not do either of these tests.

D25 (OH) Vitamin D 125 nmol/L (Previous Vit D results 12/2-49, 19/3-206, 25/11-125,)

Serum Vit B12 1097 pg/ml (187-883) (Previous B12 results 13/3-918, 21/5-442, 1/7-542,

25/9-788,) I have stopped taking B12 but am not sure is this the right thing to do??

Serum Folate 18.3 ng/ml (3-17) (Previous results 31/3-14.3, 21/5-20+, 1/7-20+, 25/9-20+,)

I have never taken any folate/folic acid.

Serum Ferritin 48 ng/ml (10-200) (Previous results 13/1-183.1, 21/5-10.9, 1/7-24.4, 25/9-48.6,)

Iron 15 umol/L (9-32) (Previous results 25/9-16)

Transferrin 3.1 g/L (2.0-3.6) (Previous results 25/9-3.2)

Calculated TIBC 78 umol/L (53-95) (Previous results 25/9-80)

Transferrin Sat. 19 % (19-43) (Previous results 25/9-20%)

I also have results from bloods done on 1/7 for:

Potassium 4.1 range 3.5-4.5 (Previous results 20/3- 5.5, 25/3-4.6,)

Sodium 25/9-142 range 136-145 (Previous results 31/1-137, 30/4-140, 21/5-138, 1/7-140,

25/9-142,)

My antibodies have always come back fine (TPO: 12/2-less 1, 19/3-less 1, 3/6-less 10, 2/9-less 1 :range 0-35, and TG: 3/6-less 20 :range 0-40) Sometimes I feel that I am getting better on my Circadian dosing and other days I wake up extra tired, a bit spaced out/dizzy and a tiny bit shaky. I wonder are my Thyroid levels changing (although I don’t think that my bloods are reflecting this) and therefore maybe sometimes I am over medicated and sometimes not?? Is this possible or is it all back to the low iron??

I have got so much help and support from these pages from reading others stories and advice and am hoping that someone has a brainwave as to which way to turn.

Thanks

Di

[bantam12]

It might be an idea to rewrite your results as the above is very difficult to read.

[Boronia in reply to bantam12]

Apologies hypohen-started writing and could hardly stop-do you think it needs to be spread out more?

[Chippysue]

One thing to ask is when are you taking your iron? Just want to check that you know that you must take iron, calcium, antacids at least 4 hours apart from thyroid medication?

The T3 in the Armour will show a suppressed TSH. Ideally your Free T4 will be at the top of the lab range and your Free T3 towards the top of the lab range.

Did you have your B12 and vitamin D tested too?

Sue

thyroiduk.org

[Boronia in reply to Chippysue]

Hi Sue-thanks for the reply.

I have been taking my Armour Thyroid dose (2 grains) once per day at 5.00am to try and help my adrenals. I take my first iron dose at about 9.30 or 10.00am.

My last B12 result was 1097 pg/ml (range-187-883)

Previous B12 results-

13/3/13-918

21/5/13-442

1/7/13-542

25/9/13-788

I have stopped taking B12 but am not sure is this the right thing to do??

My last D25 (OH) Vitamin D result-125 nmol/L (range-"above 75 is considered optimal for bone health"-this is the only info on range on my blood printout)

Previous Vit D results-

12/2/13-49

19/3/13-206

25/11/13-125

[Boronia]

Thanks reallyfedup123-How much iron do you think I need to take in each dose? i have been trying to fit in 30ml of Floradix liquid iron 3x a day with 1000mg Vit C with each dose of iron.