Thyroid Wife.

[love_en]

Originally Posted by pmgamer18

Thanks this is my thinking also she had a 24 hrs urine test that came back normal but we don't have this the last Endo did this. I also have asked her to have her hormones checked E's and all but like I said thinks I am playing Dr. In the above of my post this cut & paste said
"also hormone replacement therapy which is only expected to be
temporary, Vliet in "Screaming to be Heard" mentioned low estrogen can cause
high cortisol, another connection to the adrenals) she no longer has high
cortisol. "

When the big cancer scare came out about HRT she stopped her Estrogen and Predigestion (spelling) treatments. I have told her many times there are safe HRT meds pellets, compounded creams and such. But this gets back to my playing Dr. The first thing I saw when she stopped HRT was the loss of her libido. I feel she needs this checked also.

Sometimes it is hard to figure people out. A doctor would be the last person I would trust when the subject at hand is the thyroid, adrenals or gonads. They have stopped looking at the patient and pontificate about reference ranges when the are not sure. An endo saying a result is normal is a red flag. You can be one point above the minimun on that bullshit reference range and be sent on your way as normal. The central issue is how people are denied proper treatment because of a flawed testing method and its interpretation. For those doctors who sit on their ivory towers, I hope the tower pokes through their pants and exits the top of their heads.

To dose thyroid replacement by the TSH is like telling you or I "no more T for you, your LH and FSH are below O.5" My endo refused to treat me because my FSH and LH were low.

I have said it before, that using Premarin and Provera on women is one of the most horrible things medicine has done. Those are not pure estradiol and progesterone. The equivalent of that is to say that nandrolone and methyl testosterone are appropriate for TRT. No wonder I hear of the cancer and cardiovascular incidents common to women on those poisons for any length of time. One of my aunts is in need of hormonal replacement, adrenal, thyroid, and gonadal. She won't do it and it is hard to find a doctor who will do it right. She prefers to be on a toxic cocktail of psychotropics, cholesterol pills, high blood pressure pills, and antiinflamatories. I sometimes wonder which sex is more stupid and stubborn when health is involved.

If you can get Dr John to see her and treat her, that sounds like a plan. He is a DO. I have heard mostly good reports about DOs and hormonal problems.

[love_en]

It is also a sad statement that many of us here on the forum know more about hormonal deficiencies than the doctors who are supposed to be experts in that area. "Playing doctor" saved me from a lifetime of disability and debility or worse. I am only 33, too young to be old and frail.

[pmgamer18]

Well thanks for all the replies yep she tells me I am playing Dr. so I told her do what you want and when get no where and want to find out what is wrong let me know. I don't understand women if I do something she does not like I hear about it. She is being pushed so hard at work that she comes home crying. They sold her Co. and she works HR her co-works are being lay-off right and left. They sit there day after day waiting to get the axe. Mean wile she is the only one that knows the in's and out's of the dept. Her boss from the old Co. told her they are not keeping anyone. Yet she lets them drive her into that ground she is so stress out. I told her last night just go to work and take your time you don't have anything to gain by letting them work you to death. She can tell me where to go yet go's to work and takes this shit.

[pmgamer18]

After reading a reply by Love en and thanks for the link.
http://www.stopthethyroidmadness.com
I went to this link and after reading for hrs. I am sure my wife does not have adequate adrenal output. And her tests show this her T3 FREE = 2.67 range 1.5 - 3.5 pg/mL and her TSH = 0.304 L range 0.4 - 4.7 uIU/mL. My Dr. saying TSH is to low on 2 grains of Armour. In the link the ave. on Armour is 3 to 4 grains she feels hyper on 2 grains. They say the reason for this is low cortisol levels. When your cortisol levels are low you can never get up to the higher dose of Armour. They also say one needs to have FT3 up at the top of the rang or just over and doing this will make TSH go low but not to pay att. to it. They said if one is on T4 throid meds for a long time they will get low cortisol levels from this type of med stressing the adrenal output. This is my wife. I feel like just getting some Isocort and backing down her dose of Armour to 1 1/2 grains and giving her 8 tablets of Isocort for 2 weeks and then start upping her Armour 1/4 grain every 2 weeks until she hits 3 grains then wait 4 to 6 weeks and test and see how she is feeling. What do you guys think.

[love_en]

As you have probably read on that terrific website, it is common for adrenal problems to compound a low thyroid. The fact that your wife still feels bad on a high dose of Armour is telling. Adrenal deficiencies in and of themselves makes a person's life hell. At this point, Isocort sounds like a good idea. Follow the advice given by those great people on stopthethyroidmadness.com. The subject of thyroid and adrenal replacement was discussed in another thread a while back. Chrisgj was a contributor and is the moderator for the hypopituitary section of stopthethyrid madness. He was the one who got me to rethink whether my adrenal output was "normal". I hate that word. "normal" might be ok for someone who is at home under no stress. I highly doubt it is adequate for me, where it is seldom under 80F in the day time , 12 months a year and I work outdoors or your dear wife who has the job from the 10th level of hell.

Unless someone has blood or urinary cortisol levels at the top of or a multiple of the reference range, a trial of adrenal replacement seems reasonable. 8 Isocort is 20 mg hydrocortisone, is 5 mg prednisolone. I can think of worse drugs the medical establisment experiments with. Still cannot get the concept of why a replacement dose of corticosteroids is taboo.

[pmgamer18]

Originally Posted by love_en

As you have probably read on that terrific website, it is common for adrenal problems to compound a low thyroid. The fact that your wife still feels bad on a high dose of Armour is telling. Adrenal deficiencies in and of themselves makes a person's life hell. At this point, Isocort sounds like a good idea. Follow the advice given by those great people on stopthethyroidmadness.com. The subject of thyroid and adrenal replacement was discussed in another thread a while back. Chrisgj was a contributor and is the moderator for the hypopituitary section of stopthethyrid madness. He was the one who got me to rethink whether my adrenal output was "normal". I hate that word. "normal" might be ok for someone who is at home under no stress. I highly doubt it is adequate for me, where it is seldom under 80F in the day time , 12 months a year and I work outdoors or your dear wife who has the job from the 10th level of hell.

Unless someone has blood or urinary cortisol levels at the top of or a multiple of the reference range, a trial of adrenal replacement seems reasonable. 8 Isocort is 20 mg hydrocortisone, is 5 mg prednisolone. I can think of worse drugs the medical establisment experiments with. Still cannot get the concept of why a replacement dose of corticosteroids is taboo.

This is the part that caught eye.

"THINKING THEY ARE ON TOO MUCH BECAUSE OF HYPER-SYMPTOMS. It’s common to think that because a patient is having hyper-like symptoms (anxiety, shakiness, fast heart rate, etc), especially on doses lower than 3 grains, they are on too much. Often, though, the hyper-like symptoms could be the result of underlying low-functioning adrenals (i.e. not enough cortisol)"

When her Dr. got her Armour up to 120 mgs. or 2 grains she felt the above symptoms. Her chest hurt so bad we took her to the ER. After a blood test and all they did was TSH they lowered her back down to 60 mg. At 120mgs today she still does not feel right and her Dr. said 120 mgs is to high her TSH is to low yet her FT3 is not high enough. So if she can do a Adrenal test this will tell us what she needs. I don't feel sending her to see another Endo will help. I have to see my Dr. this morning about my low T and will talk to him about this.

[pmgamer18]

I saw the Dr. and he said to cancel the Endo appointment and felt this could be what is wrong low cortisol. So he gave her Prednisone 1 mg. said to stay on the Armour 120 mgs. and take the Prednisone 1 mg. for 10 days then on the 11th day come in and do a blood test. So if this works she should be able to start upping the dose of Armour 30 mgs every 2 weeks untill she hits 3 grains of Armour then stay on this for 4 to 6 weeks and do a blood test.

[1cc]

Originally Posted by pmgamer18

I saw the Dr. and he said to cancel the Endo appointment and felt this could be what is wrong low cortisol. So he gave her Prednisone 1 mg. said to stay on the Armour 120 mgs. and take the Prednisone 1 mg. for 10 days then on the 11th day come in and do a blood test. So if this works she should be able to start upping the dose of Armour 30 mgs every 2 weeks untill she hits 3 grains of Armour then stay on this for 4 to 6 weeks and do a blood test.

It would have been nice if he would have tested her first to be sure, like 24 hour urine for free Cortisol (saliva would have been better) and serum DHEA-S.

Hydrocortisone is better than prednisone because it is similar to the body's own cortisol. Prednisone lasts much longer, though, and some people do okay on it. Prednisone 1mg is a very small dose, equivalent to about 4mg hydrocortisone.

[love_en]

Originally Posted by 1cc

It would have been nice if he would have tested her first to be sure, like 24 hour urine for free Cortisol (saliva would have been better) and serum DHEA-S.

Hydrocortisone is better than prednisone because it is similar to the body's own cortisol. Prednisone lasts much longer, though, and some people do okay on it. Prednisone 1mg is a very small dose, equivalent to about 4mg hydrocortisone.

A test is only as good as the person interpreting it. Test away in a case like this and all that will be found are values that are low, but within that reference range. I am impressed that this doctor is concerned enough to forget the tests and rule out adrenal fatigue via a therapeutic trial. The usual prednisone dose is more like 5 mg. I can see the logic in starting slow. If you give someone who is poorly responding to thyroid a full dose of corticosteroids, thyrotoxicosis can occur. All of a sudden, the thyroid hormones previously unavailable, become available. The stopthethyroidmadness site talks about this in detail. Be advised that the adrenals will cut back on natural production and rest, so a dose increases may be needed weekly.

[pmgamer18]

Originally Posted by 1cc

It would have been nice if he would have tested her first to be sure, like 24 hour urine for free Cortisol (saliva would have been better) and serum DHEA-S.

Hydrocortisone is better than prednisone because it is similar to the body's own cortisol. Prednisone lasts much longer, though, and some people do okay on it. Prednisone 1mg is a very small dose, equivalent to about 4mg hydrocortisone.

This was his point he did test her she had a 24 urine and a Cortisol morning blood test and they he said were good. But after I told him about others feeling hyper on 2 grains of Armour. This is what I showed him.
"HOW MUCH CORTISOL DO YOU NEED for SUPPLEMENTATION?? If you confirm that you have low cortisol production, whether from the self-tests above, or the saliva test, or simply the very strange reactions to Armour, patients have learned that they need approx. 20 mg of cortisol to bring sluggish adrenal function up to it’s proper and optimal normal daily amount.

Up to 20 mgs. is called a ‘physiologic’ dose, as compared to the high ‘pharmacologic’ doses. A physiologic dose is safe and doesn’t cause the side-effects of larger pharmacologic doses. This would also bring your cortisol up to the amount to tolerate thyroid hormones and distribute them from the blood to your cells. Occasionally, you will find a patient who had to get up to 30 mgs. to benefit from Armour.

Once adrenal insufficiency is confirmed, patients tend to use hydrocortisone (such as the brand name Cortef) or Isocort (which is over-the-counter). Hydrocortisone will give you simply cortisol, whereas Isocort will give the adrenal cortex. There is 2.5 mg. of cortisol per tablet of Isocort.

Some patients prefer simply cortisol or Hydrocortisone and find it to work better than Isocort. Hydrocortisone or Cortef has a half life of approx. 8 hours, but can be much less depending on the metabolism of the individual. Thus, patients have to multi-dose it."
So he felt adding Cortef for 10 days and then testing will tell us if she needs to help her adrenals with meds. I think if this helps he will order a saliva test or just keep her on Cortef the generic being Prednisone. I just hope this works. Do you think if it works her test levels will come down because the Armour will being going into the cells.