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Lyme Disease and its Connection to Thyroid/Adrenal problems

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Posted 5/7/2016 2:03 AM (GMT 0)
cd3764, I've been taking desicated thyroid for a month now, and my eyebrows are growing back!
This is amazing! I'm a convert! I'm seeing my DO tomorrow and I'll be discussing this with her.
I'm sure she'll be convinced.


Yay!
Posted 5/7/2016 3:35 AM (GMT 0)
for you thyroid savvy members - What do you do when the TSH is too low...but the FT4 is in the middle of the range.

I mean low as in .03 (if I'm remembering correctly)

If he feels good....no issues?


edited to change the TSH and also where the FT4 is in the range.

I should really start a new thread...maybe tomorrow. and share more information
Posted 5/7/2016 4:49 AM (GMT 0)
yea, cut out that thyroid and here's your synthyroid, get well soon...............

Oh you still dont feel better? Must be in your head then.
-------------------------------------------------------
Going thru med school does not require one to be intelligent, just one who remembers text under pressure.

Your average farmer (the ultimate do-it-yourselfers with common sense) would make better Drs.
Posted 5/7/2016 12:44 PM (GMT 0)

Kathie said...
cd3764, I've been taking desicated thyroid for a month now, and my eyebrows are growing back!
This is amazing! I'm a convert! I'm seeing my DO tomorrow and I'll be discussing this with her.
I'm sure she'll be convinced.


Yay!

This is great news, Kathie!!!

Please be sure to continue increasing your dose until both your Free T4/T3 levels are well above mid-range.

Once they get close to the levels healthy people have, that's when it's appropriate to "wear" the levels for awhile to see how you feel.

Tiny dose adjustments from that point forward will help you "hone in" on your own set of optimal Free T4/T3 levels - these are called your setpoints.

Keep on keeping on with this great path!!
Posted 5/7/2016 12:54 PM (GMT 0)

Girlie said...
for you thyroid savvy members - What do you do when the TSH is too low...but the FT4 is in the middle of the range.

I mean low as in .03 (if I'm remembering correctly)

If he feels good....no issues?


edited to change the TSH and also where the FT4 is in the range.

I should really start a new thread...maybe tomorrow. and share more information

Girlie

There is really no such thing as a "too low" TSH despite what thyroid-clueless doctors might say.

TSH has no physiological implications whatsoever. Remember: TSH is a pituitary hormone - just like FSH (hormone measured to gauge possibility of menopause).

It's the amount of *thyroid* hormone that has physiological effects and those are measured by the FT4/FT3 levels.

A low TSH level is just that: a low TSH. It can be normal for the person, a result of pituitary dysfunction or perhaps infection and, yes, it *might* indicate hyperthyroidism.

As long as the FT4/FT3 levels are at healthy places, there is no concern. Healthy FT4/FT3 levels are usually around 75% of range or higher

This is where doctors often drop the ball - they get "stuck on TSH" (a very common cry on thyroid forums)

Please know that TSH fluctuates as much as 200% throughout the day in the body's attempts at maintaining stable FT4/FT3 levels. Yet another reason why TSH should not be used to judge thyroid status.

Just to show you how TSH tells us very little, here is the range of FT4/FT3 levels that keep me symptom-free along with my average TSH levels:

FT4 1.8 - 1.84 (range .82-1.77) Yes, I feel best with my FT4 slightly over-range (this is a common need)
FT3 3.8 - 4.2 (range 2.0-4.4)
TSH <.005 (yes, virtually undetectable) up to .007

I didn't bother listing the range for TSH because my lab has not updated their testing kits to reflect the AACE's 2002 suggestion that the range be lowered to .3 - 3.0 which is still too high.

Studies have shown that healthy people have TSH 1.0 or lower.

Just because a test like TSH is sensitive (has measured units into the thousandths) doesn't mean it's giving us the information we seek. This is yet another fact that doctors miss.
Posted 5/7/2016 4:19 PM (GMT 0)
To add to what cd said, or maybe put the info in a different form:

Your body measures the amount of FT3/FT4 and if they are too low, TSH hormone is produced and it tells the thyroid to produce more T3/T4. The body measures again and if they are still too low it produces more TSH. This cycle repeats.

That's why many docs just test TSH, because if you have an underachieve thyroid the TSH will go up and up trying to force the thyroid to produce T3/T4. If your thyroid doesn't work, the levels won't go up so TSH can get high.

But you really need T3/T4, free T3 and free T4. Many people feel better on the higher end of the scale for T3/T4. My primary told me that and we continued to up my dose until my symptoms went a way. Sure enough I finally stop having symptoms just over the expected range.

They get these ranges by check a group of "healthy" people and electing the information. We're not normal people. Most of what we have to do is try something and keep on with it until we have symptom releif.

Kim
Posted 5/7/2016 4:36 PM (GMT 0)
How do you best titrate up? Some of these thyroid meds are pretty strong so do you take 1/4 of a pill for several weeks or how best to titrate up? I just started increasing my meds. I'm just hoping that as I beat back some of this inflammation my body will better use the meds. I've definitely noticed that since the inflammation has increased I've needed more meds but my numbers aren't really reflecting improvement. again something else to add to my dr discussion list.
Posted 5/7/2016 4:41 PM (GMT 0)
And then there's people like me - in my blood there appears to be enough T3 & T4, but my thyroid doesn't use it efficiently, so I need supplementation - and not just a low dose. This was proven when I took over my own treatment and raised my dose of thyroid meds - I not only lost the extra weight (YAY!!!), but I can now eat my spinach, kale and other foods again without my thyroid swelling so much I couldn't even swallow any pills.

Another little tidbit from the oddball here (me!), my thyroid swelling is contained to the back side of the thyroid - it can't be seen on an ultrasound scan - but I can sure feel it!!

There is soooo much more than what tests can show!
Posted 5/7/2016 5:48 PM (GMT 0)
My DO approved of my thyroid supplement (believe it or not, cd!) but doesn't believe TSH should be below 1. She believes in treating clinically. Big respect for her...she's an amazing, open-minded osteopath...she really listens. I lucked out when I found her.

We're repeating my thyroid labs...I look forward to seeing what they are now!
Posted 5/7/2016 6:27 PM (GMT 0)
Congratulations, Kathie!! I hope it all goes smoothly for you! And yes, your doc is a real gem!!
Posted 5/7/2016 6:41 PM (GMT 0)
Traveler - when you test...are you over the top end of the FT3 and FT3 range?

cd - okay, thanks...I knew that the TSH being less than 1 was fine (mine is naturally - I think 0.4) but was concerned that my husband's was .03.

We got a call from the Dr. office - because that lab result was out of range....He had just recently upped his dosage to 156 from 125 (about three weeks prior to the test) whatever 125 plus 1/4 tablet is. So, I've made him an appt. with her...and coached him about what to say.

But, the strange thing is he's not feeling as well as the 125...but I'm thinking he should ride it out a bit...the weather has just turned quite warm in the past week or so...and wondering if he's attributing how hot he's been to too much thyroid....
Posted 5/7/2016 6:44 PM (GMT 0)
No, not at all. I'm in the mid range for T3 & T4 - while on thyroid meds. I was on 2 grains (120 mgs) of Armour, then Naturthroid as well. I wanted to raise my dose, but doc said no - repeatedly - even though I still showed signs of thyroid issues.
Posted 5/7/2016 7:01 PM (GMT 0)

Kathie said...
My DO approved of my thyroid supplement (believe it or not, cd!) but doesn't believe TSH should be below 1. She believes in treating clinically. Big respect for her...she's an amazing, open-minded osteopath...she really listens. I lucked out when I found her.

We're repeating my thyroid labs...I look forward to seeing what they are now!

Actually, "the word" on thyroid forums is that DO's can sometimes be relied upon for proper thyroid treatment (that wasn't the case with my DO of 25 years). Still, I'm happy yours is helping!!!

And, I'm sorry to tell you, Kathie, but taking optimal doses of desiccated thyroid means suppressed TSH. If she believes in treating clinically then she should be ignoring TSH.

You may recall that Thyroid Science article I linked for you awhile back - reading it "converted" a family practice doctor and made him realize he needs to ignore TSH and focus only on the FT4/3 levels when prescribing thyroid meds. Maybe you might want to share it with your DO:

www.thyroidscience.com/hypotheses/dommisse.feb.2008/dommisse.feb.2008.pdf

I'm glad she's open-minded. She just might appreciate an educated patient teaching her something that will make her a better doctor.
Posted 5/7/2016 7:11 PM (GMT 0)

gkamom said...
To add to what cd said, or maybe put the info in a different form:

Your body measures the amount of FT3/FT4 and if they are too low, TSH hormone is produced and it tells the thyroid to produce more T3/T4. The body measures again and if they are still too low it produces more TSH. This cycle repeats.

That's why many docs just test TSH, because if you have an underachieve thyroid the TSH will go up and up trying to force the thyroid to produce T3/T4. If your thyroid doesn't work, the levels won't go up so TSH can get high.

This is how things happen with "regular" hypothyroidism.

There are many situations when TSH does not increase when thyroid levels go to low.

One example is mine: a post-remission Graves' patient who has TSH-receptor antibodies that skew TSH low.
To be more specific, even with too-low-for me FT4/FT3 levels, my TSH ranges from <.007 to a "high" of .005

Clueless endos wanted to put me back on anti-thyroid drugs when they saw that TSH level. My current thyroid doctor, an internist, told me she knows to ignore TSH in Graves' patients...and that's why I'm still with her 7 years later (but I often have to remind her to ignore my TSH ;)

Another cause of low TSH with hypothyroid FT4/FT3 levels is infection. Lyme is a perfect example of this. There are many people on this forum who are dealing with hypothyroidism and have a normal/low normal TSH level.

Pituitary dysfunction can also mean low TSH but hypothyroid FT4/FT3 levels.

I'm really, really, happy for you, Kim, that your doctor recognizes that symptom relief is the main focus - that *is* what proper thyroid treatment is all about.
Posted 5/7/2016 7:15 PM (GMT 0)
Kathie - even though the range starts below 1 for TSH? How can they say that...?

0.32-5.04 - That was the range on my husband's last TSH test. And since his is .03, he got the phone call to see the Dr.
Posted 5/7/2016 7:20 PM (GMT 0)

Krimpet said...
How do you best titrate up? Some of these thyroid meds are pretty strong so do you take 1/4 of a pill for several weeks or how best to titrate up? I just started increasing my meds. I'm just hoping that as I beat back some of this inflammation my body will better use the meds. I've definitely noticed that since the inflammation has increased I've needed more meds but my numbers aren't really reflecting improvement. again something else to add to my dr discussion list.

Low and slow is the way to titrate thyroid meds.

When FT3/FT4 levels are below mid-range, dose increases tend to be a bit larger. For someone taking desiccated thyroid, it's not uncommon for doctors to prescribe 1/2 grain (30-35mg) dose increases.

Once those levels get above mid-range, smaller dose increases (1/4 grain) are appropriate so you don't overshoot your goal (go hyper on meds).

Accurate labs can be done 3-4 wks. after a dose adjustment.

Wash/rinse/repeat until levels are optimized and the patient achieves relief of thyroid symptoms.

Please know that 2-3 grains of desiccated thyroid represent very common dose needs....significantly overweight people might find themselves needing 5 grains or more.
Posted 5/7/2016 7:25 PM (GMT 0)

Girlie said...
Traveler - when you test...are you over the top end of the FT3 and FT3 range?

cd - okay, thanks...I knew that the TSH being less than 1 was fine (mine is naturally - I think 0.4) but was concerned that my husband's was .03.

We got a call from the Dr. office - because that lab result was out of range....He had just recently upped his dosage to 156 from 125 (about three weeks prior to the test) whatever 125 plus 1/4 tablet is. So, I've made him an appt. with her...and coached him about what to say.

But, the strange thing is he's not feeling as well as the 125...but I'm thinking he should ride it out a bit...the weather has just turned quite warm in the past week or so...and wondering if he's attributing how hot he's been to too much thyroid....

Girlie

If hubby's dose was increased by 1/4 of a 125mcg tab, I'm not surprised he's not feeling well. That's an ~30mcg dose increase he's trying to adjust to.

He would have been better off if the doctor prescribed 25mcg tabs with instructions to take 1/2 tab along with the 125mcg dose and do that for a couple weeks and then transition to the full 25mcg tab + the 125mcg.

Just because someone's levels need a lot of help doesn't mean their body can be bombarded with large amounts of hormone trying to compensate.

Slow and steady wins the thyroid disease race, too.
Posted 5/7/2016 7:29 PM (GMT 0)
To anyone who might want to understand why we need to do things slowly when titrating thyroid meds, you might be interested in the sponge analogy shared here:

thyrophoenix.com/adjusting_doses.htm
Posted 5/7/2016 7:34 PM (GMT 0)
....ok, thanks cd. The problem is it's difficult for him to get a med change - so his thoughts are if he does it with what he has already...and feels better...and labs aren't out of range...he can argue a case.

But, I didn't realize that 1/4 of 125 was too much of an increment...so I will pass that on.

I will tell him to ask for the two doses...and tell her that he wants to try 137.5 ....that makes sense.
and cross my fingers that she is okay with it....like pulling teeth...
Posted 5/7/2016 7:47 PM (GMT 0)

Girlie said...
....ok, thanks cd. The problem is it's difficult for him to get a med change - so his thoughts are if he does it with what he has already...and feels better...and labs aren't out of range...he can argue a case.

But, I didn't realize that 1/4 of 125 was too much of an increment...so I will pass that on.

I will tell him to ask for the two doses...and tell her that he wants to try 137.5 ....that makes sense.
and cross my fingers that she is okay with it....like pulling teeth...

Thing is, Girlie - his TSH will be out of range if he'd medicated properly.....

Maybe you might share with his doctor that Thyroid Science article I linked for Kathie.

If I remember his labs correctly, he most likely needs to be taking 150mcg and possibly more. It's just that he needs to get there incrementally.

Believe you me, I know from personal experience that it's like pulling teeth when trying to negotiate needed doses. I've spent as much as 5 minutes arguing my case with my doctor....but I don't let up until I get what I know I need.

I remind her that I've already scheduled my next appointment/labs in 4 wks. and that seems to make her feel better in the thought that we'd "catch things". It's always worked out.
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