Where I'm At - September 2008

Still on just Cytomel.. up to 75 mcg daily now (split into 2 doses). Tried adding in 1 grain of Armour, but within a few days felt depressed and just not quite right.. so I stopped taking it.

On the good side, I do feel slightly more energetic, my skin seems clearer and I am having less hypo symptoms. The depressed feelings come and go as does the 'brain fog'. On the bad side, the weight is still a problem and my skin disease, Granuloma Annulare is getting worse. I have some new spots and old areas are becoming 'bumpy' again. The spots had seemed to be fading while on Synthroid, so this is quite distressing to me. If anyone knows whyT4 seems to help, but T3 would make worse - please leave a comment.

I also started taking about 400 mcg of Melatonin (at Walmart in the vitamin section) at night to help me sleep. Takes about an hour to kick in. The dreaming is amazing on this stuff.

Update: I bought some synthetic melatonin in a higher dose (since the Rexall brand of natural was not in stock at my Walmart) and I do not recommend it. The natural melatonin is the best. I'm pitching the synthetic stuff, even though it is a much stronger dose it takes me longer to fall asleep and I find myself waking several times during the night. Check the label before you buy!!

Where I'm At - August 2008 - My Answer??

Within a few days of my last post I had a revelation of sorts. I felt bad on Armour, felt bad on combinations of Synthroid and Cytomel and on Synthroid alone. What was left? Plain Cytomel (T3)? Nah, that wouldn't work for me I thought... remembering the blood test (high T3 levels) that I had while on high doses of Armour... the same time I felt at my absolute worst. But then I read about Reverse T3... the standard T3 blood test doesn't distinguish between Ordinary T3 and the inactive RT3. IF most of the T3 in my blood at that time was RT3 - that might account for how terrible I felt!

T4 makes both T3 and RT3. During times of stress, the body makes more RT3. The inactive RT3 fits into the T3 receptors (kind of like a mirror image of the real T3) and blocks T3... no T3 into the receptors and your Hypothyroid symptoms will come back. For a better explanation Click here.
Problems with too much RT3 are treated with plain T3 - not Armour and not Synthroid, nor any combinations. Plain T3 (Cytomel or sometimes time-released T3) only.

I could also have thyroid hormone resistance which is also treated with T3 only. Usually people with this problem will need large amounts of plain T3.

Right now I am up to 30mcg of Cytomel split into 2 doses (morning and afternoon). I am feeling better today than I have for a couple years - I am thinking clearly, am motivated, no more midday slump, more energetic. Still having some muscle aches and light fatigue.. new problems are excess sweating (in has been in the 90's here though) and slight headache when upping doses. I've been doing some projects around the house and some long overdue cleaning.

My bedroom overhaul - I painted several furniture pieces and did a couple little decorating projects. I did the entire room for under $130. (the new bedding was the bulk of that). Yeah, I know this has nothing to do with Hypothyroidism, but I am so proud of myself! I got off the couch and accomplished something!!





I'm excited again about waking up in the morning and have lots of new project ideas popping into my head. I'm pretty sure I'll have to continue raising the Cytomel, I'd like to start weaning off the Hydrocort as well. The weight is still a issue, but I am hoping the T3 will start to increase my metabolism and I can see the pounds start to fall off.

If Armour or Synthroid isn't working for you, look into getting your RT3 checked. Have it checked with your Free T3 so that you can figure out your ratio. This is how to determine if your RT3 is too high:
Divide Free T3 by RT3 and it should be greater than 0.020 for pg/ml or greater than 19 if FT3 is measured in pg/ml and RT3 is in ng/ml.
IF your doctor okays you to take just Cytomel - DON'T start too high (even if it is prescribed to you in a high dose, this stuff is pretty powerful).. start slow.. like 5mcg twice a day.. then in a week add another 5.. and continue like that until all your Hypo symptoms are gone!

Lots of Links..........

The best web pages I've found so far.....
Gail's Thyroid Tips WOW! Lots of great info here!
Insulin Resistance Page - LOTS of links here
Metabolic Syndrome and PCOS
Hypo Risk Symptoms Checklist
Thyroid Top Doctors by State
Magnesium Information
Magnesium and Depression
Food Allergies - Lots of helpful links here!
Food addiction, allergies and weight gain
NAET (for allergies) Doctors - Not sure what I think of this yet.
Another SUPER allergy page - LINKS Galore! Some for Thyroid too!
Adrenal Symptom Questionaire
Autoimmune Symptom Checklist
Symptoms of Hashimotos
Hypothyroidism - Good General Info
One Woman's Cushing's Disease Story
Autoimmune Hypothyroidism - General Info
Chris Jackson's Page (Hypopit)
Smoking and Hashimotos - Interesting!!!
Thyroid Supplement Page
Thyroid/Heart Failure Connection
The Hashimoto's Brain
Diagnose me - Chronic Thyroiditis
Quotes of Interest - Thyroid
Do You Have Adrenal Fatigue?
More on Adrenal Fatigue
Anxiety and Depression with Thyroid Disease
The Adrenal Glands (from "Fatigued to Fantastic")
A Sheehan's Syndrome Story
Low Dose Naltrexone (for Hashi's, Cancer and More)
Dr. Lee and Progesterone
Why T3 Alone Can Be Okay
T3 and Reverse T3

Where I'm At - July 2008 ...... Half-Dead

Maybe I'm not half-dead... but I sure feel like it.

The exhaustion is overwhelming, a trip to the grocery store and a load or two of laundry will wipe me out. The bigger projects get put off over and over again. My husband and I took a short 4 day vacation to Branson a couple weeks ago... a little shopping, saw some shows, toured a museum. More than I usually do, but not at all what should have been too much for a 40+ woman... but I felt incredible exhaustion the entire next week to the point that I could barely function. I think this may be more an adrenal problem than a thyroid-related one... but I am already on 40 mg of Hydrocortisone.. so I don't know. 40 mg is about the highest dose that someone with adrenal fatigue should take. For some reason I was feeling really good around the 11th of June... I had just raised the Synthroid.. was hoping finally to get some relief from the hypo symptoms. For me it seems the stresses of planning a vacation and then over-doing it gave me a setback.

The Growth Hormone stim test hasn't happened. After calling several labs and hospitals in my area, I cannot find one that can do this test. I have more hospitals to call, but am not feeling optimistic.

The diet was a bust too. I'm just full of doom and gloom today, eh? I did lose some weight initially, but the weight started back up when I lowered the Synthroid and even though I am back up to the dose I was while losing weight.. the weight isn't budging this time. I've pretty much given up on slimming down at this point.

Lydia (poster child for the Couch Potato)

Where I'm At - June 2008 ..... B12 and Vitamin D

Just a quick update. My B12 and Vitamin D were low, so I've been started on Vit D at 50,000 iu once a week and injections of B12 once a week for now and then once a month after tomorrow. I'm giving myself the injections... pretty easy.. Just scrunch up some fat.. push in the needle (it really doesn't hurt at all) then inject! I look like I've been beat with all the bruises, but if it helps I can live with that. I don't feel like WOW or anything, but I do think my brain seems to be working a bit better. So, we'll see.

I got the okay for the GH stimulation test to be done at a nearby hospital and will see about having that done in a week or so. If I fail this, I may be able to get on growth hormone injections (oh boy, more bruises!) IF my insurance will even cover it. Growth Hormone is a very expensive treatment - around $1000. a month. Lots of women with Sheehan's feel much better on GH. If I do fail the GH Stim test, it is highly likely I do have Sheehan's since I also have other hormonal issues.

I'm taking a lower dose of Synthroid now (125 mcg) and thought maybe I was doing better.. but looking at an old symptom list I realize I still have pretty much all the symptoms I had a year ago. I think the 40 mg of Hydrocort I am on has helped with the anxiety and made me more calm, less angry... but I am still feeling severe fatigue, muscle aches, menstrual cramping (which is alleviated with Progesterone cream), sleepiness, hyperpigmentation, blurry vision, weakness, unable to tolerate exercise, cold hands (alternating with inability to withstand hot temperatures), low pulse, low temperature, hypoglycemia among other symptoms.

A piece of this puzzle is obviously still missing. *insert long sigh here*

Where I'm At - May 2008

Received my Prolactin and Growth Hormone results and both are on the very low end of normal. After some searching I found a study done on women with Sheehan's Syndrome and my numbers match the average of those women. I also joined a private forum for Sheehan's and am getting additional information there. I still need a ITT (Insulin Tolerance Test) or a Growth Hormone Stim test and most likely a MRI to diagnose me ... maybe next month on those.
See Neuroendocrinology Letters No. 3 June Vol 26, 2005 @ www.nel.edu for the Sheehan Syndrome: Clinical and laboratory evaluation of 20 cases

I had DHEA, B12, Vit. D and Ferritin testing last week and will get those results tomorrow I hope. I did quit taking Iron supplements about a month ago, so that the results wouldn't be skewed.

April saw another 3 pound loss of weight, but it seems to be slowing down. I've also lowered my Synthroid to a measly 50 mcg to see if that would help with the hypo symptoms. Some people say it has helped them, especially if they were started on a high dose like I was. It's only been a week and if I didn't have a viral infection right now I think I might be feeling better. Next week I'll raise it a bit and see what happens.

I'm so envious of people who feel great within the first month of treatment. May will mark the 1 year anniversary of my diagnosis with Hashimotos.

Where I'm At - April 2008 ...Sheehans and Progesterone

I'm off the Armour once again. I was feeling so much fatigue, loss of motivation and general unwellness while taking it. I decided to go back on the Synthroid with just a bit of Cytomel. It's been a week now and I still feel like the walking dead. Hopefully by next month I'll be feeling a bit better.

The good news is that I am 8 1/2 pounds lighter than I was last month. Cutting back on the calories and having a free day to eat whatever I want is working. I am not feeling hungry at all. I still have afternoon and evening snacks - just making better choices than before. I still have a long way to go, but am feeling optimistic. Not exercising since I don't have the energy at this time.

I still have the feeling that my problems are more than just my thyroid and adrenal glands. While doing a Google search a few weeks ago I read about a rare syndrome called Sheehans. Sheehans Syndrome is a complication of postpartum hemorrhage. The pituitary gland is enlarged during pregnancy and is very sensitive to decreased blood flow caused by a large loss of blood. Failure to lactate and lack of periods after delivery are the most common initial symptoms. A woman with Sheehans will have varying degrees of thyroid, adrenal, ovarian dysfunction as well as possible hypoglycemia. I did hemorrhage after a miscarriage and a D&C back in 1981. Because it happened in my home I am not sure of how much blood I lost (it seemed like buckets of blood)...by the time I got to the ER I had quit bleeding and was sent home with nothing more than pain pills. Last week my doctor did give me both Prolactin and Growth Hormone blood tests which I am awaiting the results of. GH is rarely prescribed, but research shows that it can help with the fatigue a Sheehans patient experiences.
Sheehan's Syndrome

I started back on Progesterone Cream after my mid-cycle cramps returned once I had started the Hydro cortisone. I use a big glob of it twice a day right on my lower abdomen and WOW! Cramps seriously go away in about 15 minutes. Before I was using Progesterone cream I would take a Darvocet for the pain and have to take another 3 hours later...sometimes taking about 4 pills a night. This is just amazing to me.
Progesterone Cream Info
I use the Rexall brand of Progesterone from Walmart (I haven't checked the ingredients per the link above, but this cream seems to work very very well).

Where I'm At - February 2008

I actually feel like I might make it. The Hydrocortisone has been a real help...I'm up to 30 mg. now. Just last week I went back on the Armour (2 grains)...not quite right on the dosage yet..but I am tolerating it this time around and not becoming more Hypo. Yay! My doctor has okayed the Armour up to 4 grains which makes me confident that I can find my "sweet spot". I'm finding that 5mcg. Cytomel seems to help with the afternoon fatigue, so I've been taking that as well. Physically I feel more motivated and energetic, there is still a bit of itching since starting the Armour and some muscle aches...but I am feeling so much better that I won't complain.

I have spent the past 20 years going from one diet to the next. Lost weight (as much as 40 lbs) several times, only to end up gaining it all back. I have lots of willpower and can pretty much stay on any crazy plan that's out there...unfortunately none of them have worked at all the past few years. The best plans I've tried in the past were the Rotation Diet (way too low of calories though..so I added in more), the CAD (Carbohydrate Addict's Diet) - very slow weight loss, but pretty easy to follow and The Fat Flush Plan...strict, odd requirements but the weight came off fast with that one. Right after losing almost 40 lbs. on the Fat Flush Plan was when my problems really started - when I started gaining back the weight it wouldn't come off no matter what I tried. The Fat Flush Plan calls for lots of Flax and other goitrogenic foods like broccoli and cauliflower - which I ate almost on a daily basis. I'm not saying this diet caused my hypothyroidism...I'm pretty sure I was already hypothyroid by then. Some of the weight loss may have even been from the Hashi's swings, which is where you go from hypo to hyper while your thyroid tries to sputter back into action.

So.... I've sworn off diets for now. What I'm doing now is what I think I can do the rest of my life. I'm choosing lower calorie foods, skipping the sweets 6 days a week and giving myself a free day to eat anything that I want once a week. I'm guessing I am cutting out about 500 to 800 calories a day just by switching to yogurt instead of cereal/milk for breakfast, skipping the dessert and or chips that would often be my afternoon snack, substituting mustard for mayo, having 1 lite beer instead of 2 or 3, having fresh fruit for snacks. The idea of having a free day to eat whatever I want (within reason) I'm hoping will keep my body losing weight (the rotation idea - lower calories days mixed with higher calorie ones) . A good book for choosing lower calorie foods is "Picture Perfect Weight Loss" by Dr. Howard Shapiro. It calls for less meat, (I'm pretty sure he is a vegetarian), more veggies, fruit and breads. Breads people!!...you gotta love this diet! I'm down a couple lbs. already but have a long way to go.

In the coming months, I hope to do more posting and to do so in a smaller size of jeans!

Where I'm At - January 2008

The Isocort didn't last. I decided it wasn't doing anything and quit taking it. I had a doctor's appointment about a week ago and my doctor agreed to let me try Hydrocort (oral hydrocortisone) after I told her about my results with the Pupil Test*. She wanted me to take 5 mg. 3 times a day and increase my Cytomel by 12.5 mcg daily. I started the Hydrocort at 2.5 mg once per day to make sure I wouldn't have a "thyroid dump"...but according to a moderator at the Real Thyroid Help forum...I did have a dump. I was expecting a super hyper awful feeling ..but instead it was absolutely wonderful. I had more energy that 1 day then I have had for several years. It was the fastest I've ever cleaned my house. Unfortunately, even though I still feel better on the Hydrocort (up the the full 15 mg a day now), I am not having any more days quite like that. I am sleeping better, feel more energetic during the day, less constipation, the heel pain and itching is gone again. No complaints.

Hydrocort and Cortef are both very weak steroids. They can be taken in doses as high as 30 or 40 mg per day without any of the side effects one would get from Prednisone. The amount taken is only to replenish your body with the amount that your adrenals are no longer making. Most people can take quit taking the hydrocortisone after a few months, which is long enough for the adrenals to rest.

The saliva test for adrenals is the recommended test for adrenal fatigue. The test will show your cortisol levels at different times during the day. My doctor did not do the test as she says she does not know how to interpret the results.

* The Pupil Test (copied from STTM website)
This is called the Pupil test. You need to be in a darkened room with a mirror. From the side (not the front), shine a bright light like a flashlight or penlight towards your pupils and hold it for about a minute. Carefully observe the pupil. With healthy adrenals, your pupils will constrict, and will stay small the entire time you shine the light from the side. In adrenal fatigue, the pupil will get small, but within 30 seconds, it will soon enlarge again or obviously flutter in it’s attempt to stay constricted. Why does this occur? Because adrenal insufficiency can also result in low aldosterone, which causes a lack of proper amounts of sodium and an abundance of potassium. This imbalance causes the sphincter muscles of your eye to be weak and to dilate in response to light.

Sensitivities & Thyroid

I've been drinking coffee since I was 18. I love coffee. Something happened though about the time I quit smoking. Caffeine made me nervous, trembly and unable to sleep and I had to switch to decaf which I still drink daily.

Last year in an attempt to discover the cause of my daily headaches I decided to try a Claritin-D. I thought maybe the headaches which only occurred during the fall and winter might be from a allergy to woodsmoke. A half hour after taking one Claritin-D I considered having my husband drive me to the emergency room. I couldn't walk without falling over, I was very dizzy and felt inebriated. I did a quick search on the www and found that the "D" in the Claritin was a decongestant called pseudoephedrine and could cause the symptoms I was having.

In Mary Shomon's book "Living Well With Hypothyroidism" she states "some people with hypothyroidism seem to develop sensitivities to caffeine, to pseudoephedrine. and even natural ephedra, a herb used in many diet and energy supplements".

I also recall having horrible reactions to a diet pill containing ephedra back when I was in my 20's.

Glad that chocolate isn't on the list. :-)

Heel Pain and Thyroid

I started having heel pain while on Armour and it has continued even when switching to Synthroid and Cytomel. Mine is a pain in the back of the heel (Achilles tendinitis), but others have pain on the ball of the heel (plantars fascitis). Now that I am on Hydrocort (oral hydrocortisone), I have not had any heel pain. I theorize that the Hydrocort is letting the thyroid hormones into my cells while before they were just pooling up in my blood. Other people have noticed their heel pain went away once starting thyroid meds.

It's likely that the edema many complain about is compressing the nerves in the ankles and feet. The Achilles Foot Clinic says that most cases of PF are caused by the genetic structure of a person's foot...BUT other causes include HIGH/LOW THYROID, diabetes, arthritis, collagen disorders, tumors or nerve injuries.

If you do have a thyroid disorder and are suffering from heel pain, try to optimize your thyroid medications and see if the pain doesn't go away.

Smoking & Thyroid

I quit smoking in February of 1998...almost 10 long years ago and still have those nicotine cravings. Anybody remember the Satin cigarettes? Boy, I miss those.

I smoked a pack a day for 20 years. I'm embarrassed to say I even smoked through my pregnancy, that's how addicted I was. (BTW - My daugher is healthy, beautiful and in college now.) I think I had a harder time quitting than the average Joe. I went to a Hypnotist, plunked down my $60, left and never smoked a cigarette again...but how I wanted one.. I chewed straws, leaned in close to anyone smoking to take a huge breath of the trailing smoke, I cried. I ended up depressed. If you've ever had the depersonalization, you know it is an awful feeling...one I never want to have again. I was on Paxil for about 6 to 9 months. I gained about 20 pounds during this time. The Paxil did help the depression, but not completely. I imagine I was already Hypothyroid at that time and that my body was crying out for Thyroid hormones and not an anti-depressant. I quit the Paxil cold-turkey , but do NOT recommend anyone else to do this. I seriously thought I was going crazy with the withdrawals.

Even 10 years after quitting, I still have those cravings. Last spring when I went thorough the ordeal with the Armour (taking it without dealing with the adrenal problems first) - I had severe cravings for a cigarette. I sure didn't want to start back up smoking...so instead I bought some herbal cigarettes. Still not good for you, but no nicotine. I buy the Smokin Joes from eBay dealer clovesmokes. The Smokin Joes are made in the USA and not in China like some of the herbals. I liked the Cherry flavor, but that has been discontinued. These are a strong herbal cigarette, but help to ease those cravings. You won't get addicted to these, I was smoking one or two a day or so till I got through my rough patch...now I smoke maybe 2 a month. My husband likes these too. I'm not suggesting you go out and buy a pack, but if you are considering starting up smoking regular nicotine cigarettes again - this is a better option.

Smoking seems to increase the chance of someone having thyroid problems. Quitting seems to sometimes bring out the Hypothyroid symptoms, perhaps because the nicotine masks the fatigue and weight gain that Hypothyroid patients often experience.

A good Smoking/Thyroid link

Headaches and Thyroid

The last 4 years I have been plagued with chronic daily headaches that lasts through the fall and winter. During those months I had more days with a headache than without. Advil and Tylenol don't touch it, a Darvocet or Vicoden is helpful. The first headache started the day after a fall bonfire, I woke up feeling like I was suffering from the worst ever hangover. I went to several doctors, none had a solution and after several months the headaches would go away and I wouldn't see the doctor again. This year is the first in 5 that I haven't had the headaches (migraines according to the neurologist). Why?? Maybe because this year I started on thyroid medication.

A study found that 30% of patients with hypothyroidism presented with headache a few months after the initial symptoms of hypothyroidism. The headache was slight, nonpulsatile, continuous, bilateral and disappeared with hormone therapy.

Why did I have mine in the colder months? There is a theory that the north wind is to blame. Benzene from the factories can cause headaches, dizziness and pain (brain tumours and leukemia too). Is pollution partly to blame for seasonal headaches?

I think my headaches were caused by the combination of my weakened immune system and Hashimotos along with the change of weather. Hopefully now that I am on thyroid medications the headaches will continue to be a thing of the past.

Female Problems & Thyroid

I've had PMS problems since the birth of my daughter over 18 years ago. The irritability, fatigue, breast tenderness, bloating and especially the cramping had come to last almost 2 weeks of every month. The cramping always started at ovulation... and it's not the sharp pain called mittelschmerz. It is intense cramping that feels like someone is twisting and pulling my insides - these sensations come and go sometimes lasting over a week.

About 15 years ago, I started taking 1200 mg of calcium daily and that helped significantly for a couple years. It stopped working suddenly and I came to rely on over the counter pain medications. Fibroids were discovered later during a medical exam and they were blamed for the painful cramps. A ultrasound showed several fibroids, one as large as a 3 month pregnancy. I began taking Darvocet at that time. I have continued to take the Darvocet for the cramps for about 5 years. My gynecologist was frowning on my use of the Darvocet which is a narcotic and she threatened to cut my supply off unless I scheduled a hysterectomy. I was having cramps, but nothing else (no excess bleeding) that I felt warranted such a major surgery. Once I was diagnosed with the Hashimotos, she promised to give me some time to see how the thyroid hormones might affect my cramping. Thankfully, the Synthroid/Cytomel combo seems to have lessened the cramping. In the past 3 months I have taken only 2 Darvocet. There is still some cramping, but it is manageable. It's only been 3 months though, so I am trying to not be too optimistic.

What does the rest of the world have to say about female problems and thyroid?

Dr. John Lee has corrected PMS symptoms in his patients by using progesterone cream. Their hypothyroid symptoms decreased or disappeared! Dr. Lee believes too much Estrogen interferes with thyroid hormone - if you have too much estrogen, adding progesterone will solve the problem. Personally I've never had any luck with progesterone cream..but if you would like to read more do a search for Dr. John Lee and Thyroid.

Here is another website that sees a connection between gynecology and the thyroid.
An interesting read.

A google groups writer named Marianna wrote this interesting bit on 6/12/2000
"Hi Mazie,
Wow, I wish I'd talked to you about six years ago.
I have avoided having a hysterectomy by taking T3.
I had terrible bleeding (all the time) and I had numerous gynae operations to cure
it. (four)
Nothing worked. I couldn't have a hysterectomy because I was busy with work and
kept putting it off. It is a major operation and I just couldn't go through with
it. You still sound young.
Then I was told about T3 by this group, and in Three weeks, THREE WEEKS, I stopped
bleeding.
So, at least TRY the T3 before you jump in and have the operation, at least you
will know you tried everything, and really the T3 changed my life."

And finally:
Mary Shoman - trying to sell a book, but some interesting info here anyhow!
Covers infertility and other common female problems.