A Perplexing Lab Result

[tex]

Hi All,

I had a CBC this week, and everything looked good, except for my thyroid results. My free T4 has always checked at the bottom of the normal range, or below range, so it wasn't surprising that it was below range on this test.

0.72 compared with a normal range of 0.76 to 1.46 ng/dL

However, my TSH has always checked in the normal range, until now. On this test, it was below range.

0.31 compared with a normal range of 0.36 to 3.74 mcIU/mL

Free T3 was normal.

3.6 compared with a normal range of 2.3 to 4.2 pg/mL

I posted a couple of months ago about unresolved thyroid issues and suspicious symptoms, especially since Forest Laboratories changed the manufacturing process, (but supposedly not the active ingredient), of their Armour thyroid hormone supplement. The only things that I have done differently that could have possibly affected my thyroid situation, (at least the only things that come to mind), are that I started taking 400 mg of magnesium daily, a few months ago, (early on, I took none, and earlier in the year, I took 320 mg every other day), and I started chewing my Armour tablets, a couple of months ago. While those changes might have had some effect, I don't see why they would have pushed my TSH level to below range. Up until now, my TSH level has always been in the normal range, even before I started taking a thyroid hormone supplement. (I started taking a supplement because I had hypothyroid symptoms, and my Free T4 was below range.) Thyroid antibody test results were negative.

My doc, of course, never gets excited about thyroid test results, and his opinion was to "see what happens next time", (which will be 6 months from now). As far as the thyroid function is concerned, I don't believe it's a big deal, but it's beginning to dawn on me that I must have a pituitary issue. I don't see any other way that both TSH and Free T4 could be below range. I take 1 grain, (60 mg), of Armour, daily.



Any thoughts?

Tex

[MBombardier]

Okay, Tex, we may not be long-lost brother and sister, but I get the feeling we are joined at the hip... It looks like we will both be investigating pituitary gland issues, n'est-ce pas?

[tex]

I reckon. LOL.

Tex

[tex]

Hi All,

To follow up on this thread:

Late in the summer, I was complaining about unusual symptoms that appeared to be connected with undertreated hypothyroidism, (such as low heart rate, stiffness, aches and pains, etc.), and BP was fairly steady, averaging around 115/65. After that, my heart rate returned to a more normal level, (for my age), roughly around 70 bpm. Beginning about 3 weeks ago, I started noticing a change in the trend, with a slow but steady climb in average BP. My heart rate was fairly consistent, but beginning about 3 days ago, it suddenly increased, and has been averaging around 80 bpm. In addition to my BP being up, it has also become somewhat erratic. 3 days ago, (in the morning), it measured 130/76, but the very next morning, it measured 94/64. When I checked it before bedtime, it was 149/75, and I hadn't done anything that should have caused an increase. That afternoon and evening, I noticed heart palpitations. Hmmmmmmm. Since then, it has settled down a little, and I haven't noticed any more palpitations, but I'm beginning to suspect that I'm starting to show similar clinical symptoms to Marliss. IOW, I'm beginning to show the symptoms of both hypothyroidism, and hyperthyroidism, and my lab numbers are conflicting, (no one should have low Free T4 and low TSH, together).

As I mentioned in my first post, my doc wasn't at all concerned about those numbers, and simply agreed that we should check them again, (in 6 months ). Without thinking, I downed a thyroid supplement pill this morning, and then it dawned on me that I should just stop using them for a while, and see what happens to my indicators. Maybe it's just me, but I find it difficult to concentrate on my work, when I have the feeling of agitation, nervousness, anxiety, etc., that comes with hyperthyroid symptoms, and, of course, having occasional heart palpitations doesn't seem to help anything, either. As another indicator of erratic thyroid performance, my weight seems to be rather erratic, also, in the absence of any diet or changes to my routine. I'm gonna hide the thyroid supplement, so that I don't take it without even thinking, tomorrow morning.

Tex

[sarkin]

Tex, thanks for this update, though I wish it did not involve palpitations - I can imagine how hard it is to concentrate. It must be difficult to know whether difficulty concentrating is an additional symptom, or a natural response to the concerning constellation of sensations you're experiencing.

I hope you get good information (and good results) from your experiment of taking a vacation from the thyroid supplement.

Love,
Sara

[desertrat]

Tex, I understand about the nervousness, anxiety and agitation! During the last three months I was extremely anxious, whether I caused it myself due to my feeling unwell or from the symptoms itself, well who knows? However, I went to a very well known doctor who prescribed two things to me: an herbal supplement called Serenagen by Metagenics (a classic herbal stress management formula used in traditional Chinese medicine to nourish and quiet the heart) and I-Theanine by Pure encapsulations. I can't vouch for the Serenagen because I don't think I gave it enough time, but as for the I-Theanine, it's wonderful! You have to get I-Theanine that has Suntheanine in it. If you google I-Theanine, you will find it has NO side effects whatsoever. It's an amino acid from green tea. The Pure brand contains no dairy, wheat, yeast, gluten, corn sugar, starch, soy, or oils. It's not too expensive either! I definitely notice a difference with I-Theanine within about a half hour. Hope this helps!
Mandy

[sarkin]

Mandy, that's interesting - my husband is a huge green-tea fan. I notice that Pure l-theanine has 'hypoallergenic plant fiber' - keep that in mind should you ever need to look for a potential 'suspect' in your diet. Thankfully, at least some benefit should come from enjoying a cup of green tea (white tea is similar, even lower in caffeine).

[sarkin]

I just had another thought - I will be interested to know whether you notice a reduction in the frequency and severity of your anxiety, as you remain GF for longer. That's what I would hope, anyway! I have a friend who's considering a GF experiment - her primary symptoms are depression and anxiety, and I know how hard it is for her to be sure this is a good idea (but there's one good way to find out!).

[Gabes-Apg]

I have had some 'new' symptoms appear in the last 2 weeks, one thing we are checking is thyroid.

today i will get the results of the blood tests, last night i had a dream about my Vit D level, that it went from 54 nmol/L to 957!!

[tex]

Mandy,

Thanks. I recall reading about theanine before, but I had forgotten about it. It's just a coincidence, but I just ordered a bunch of green tea, a couple of days ago, and I plan to see if it will work as my primary beverage, (after water). If it does, I should be able to see if the theanine helps, and if those symptoms return, I may need to try that supplement. Of course, I need to get the thyroid issue stabilized, anyway, because I don't have those symptoms unless I'm having erratic thyroid issues. Normally, I'm usually a pretty laid-back guy, so this caught me by surprise.

Thanks,
Tex

[tex]

Gabes,

It's always something, isn't it, (as Roseanne Rosannadanna always used to say).

I hope that whatever it turns out to be, is easily "fixed".

Tex

[bhm2wfd]

Hi Tex, I just noticed you are on Armour Thyroid for your thyroid problems. I took Armour thyroid for years. Then I moved to another city and my new doctor changed me to synthroid. I swear the D started them and with in 3 months and 15 lbs less I was diagnosed with LC. Do you think I should push to go back on the Armour Thyroid? What do the doctors have against it?

[tex]

Well, I must confess that I've never heard of a link between synthroid and MC, but there are a lot of connections related with MC yet to be discovered. I have no way of knowing if it was a factor in the etiology of your MC symptoms, but I'm pretty sure that it's possible. Here's why I feel that way:

MC seems to be very sensitive to hormonal balances in the body, as evidenced by the fact that pregnancy, HRT, contraceptives, etc., are well known, (at least on this board), as triggers for MC flares. When we take a thyroid supplement, it generates feedback to the hypothalamus, as well as the pituitary, which then decreases, (or stops), the production of thyrotropin-releasing hormone, (TRH), by the hypothalamus, and the production of TSH, by the pituitary, which in turn signals the thyroid to lower it's production rate of thyroid hormone, to compensate for the thyroid hormone already in circulation. Because the hypothalamus and pituitary also produce hormones that control not only the adrenals, which are responsible for producing natural corticosteroids such as cortisol, (from cholesterol, by the way), but also the gonads, that means that if anything goes wrong with the hormonal balances somewhere in that complex arrangement, the production of estrogen, testosterone, progesterone, etc., can be affected. Cortisol, of course, is a major stress hormone and has effects on many organs and tissues in the body, including on the brain, so if anything in that long chain of connections rocks the boat, it can have major repercussions for the body, in general.

I suspect that one way this can happen, is due to the fact that synthroid contains only T4, which means that the body has to produce T3 from it. In some cases that's not possible, or at least doesn't progress normally, resulting in a shortage of T3, even though there's plenty of T4 available. Armour, of course, also contains T3, in a natural balance with T4, so that the body is not required to alter it's normal processes, in order to correct the imbalance. IOW, this altered processing may somehow throw a monkey wrench into the production of some other vital hormones, thereby upsetting other hormonal balances.

The bottom line is that there are a lot of potential ways that the use of a synthetic thyroid hormone supplement can cause hormonal imbalances, and otherwise gum up the works, including, but not limited to, the thyroid hormones themselves, all sorts of sex hormones, cortisol, and no telling what else. There is a heck of a lot that we don't understand about the way the human body works, and when we try to change one thing by adding a synthetic ingredient, it can have major implications somewhere else down the line. For "normal" people, of course, synthetic hormone supplements work just fine, but if we were normal, we wouldn't be needing these supplements in the first place, and we wouldn't need to be meeting here every day, trying to second guess the mistakes that our doctors so regularly make.

If I were in your situation, with your history, I would certainly search for a doctor willing to prescribe Armour, (or one of the other natural thyroid hormone supplements), because it just might be your ticket to remission. Some people are lucky enough that all they have to do is to stop using the medication that triggered their MC, and that is sufficient to bring stable remission for them, without any other intervention.

Forest Laboratories used to have a feature on their website that allowed anyone to search for doctors in their area who prescribed Armour, but when they "improved" their website last year, (by creating a new one from scratch), that feature was missing, and it was still missing a few months back, when I checked. I haven't checked lately, though.

The reason why most doctors won't prescribe Armour, is due to the same old problem that has proven to be the bane of patients since Big Pharma came into existence, and they discovered that doctors are so short on time, (and so gullible), that they are willing to take the word of drug reps, on almost anything pertaining to drugs and their use. When the pharmaceutical companies noticed that hypothyroid patients are on thyroid supplements for life, they began to salivate like Pavlov's dogs, and they soon developed a synthetic supplement, together with a plan to discredit natural thyroid hormone supplements, which had been safely and effectively used for many, many decades. They simply convinced the doctors that synthetic supplements are "more modern", and the production of natural supplements couldn't be nearly as precise as the production of synthetic supplements, and doctors around the world fell for it.

The truth of the matter is, in all of the spot check results that I have seen, the dosage tolerances of natural hormone supplements are virtually always tighter than the synthetics. Many synthetic thyroid supplements have been recalled because they were out of compliance with dosage tolerances, but I've never heard of that happening with Armour. And yet, most doctors are faithful to the synthetics, because they're "more modern", and their drug reps have assured them that the synthetics are "better". Doctors, (and their patients), could benefit immensely from an additional year or two of honest-to-goodness medical training related to drugs and their use, rather than allowing doctors to get their drug education from drug company reps. I never cease to be amazed that drug training for doctors, that includes such a blatant conflict of interest, is allowed to continue, after all these years, and it just gets worse and worse. It seems pretty clear that those who have regulatory oversight are being paid off, in one way or another, all the way up the line.

Of course, I could be all wet, 'cause I'm not a doctor.

Tex

[Robbie]

When my doctor put me on Synthroid in 1985 he mentioned he wanted to put me on Armour but was finding that the dosage per pill was too inconsistent, giving his patients bad results. I had never heard of it at the time. My MD that practices integrative medicine agreed to let me try it when I suggested it about 18 years ago. It would not work for me at all (it was like I was taking a sugar pill) and I went back to Synthroid. I have also tried the generic version of Synthroid and it won't work either.

Are you sure it's okay to stop your medicine cold turkey, Tex? Would it not be better to reduce the dosage a bit at a time over time? I ran out of Synthroid once and it knocked me for a loop to stop it out of the blue (thought I had another bottle on hand and could not get more for awhile). But maybe that would not happen with the natural product? Also, do you think maybe you got a bad batch?

I switched to the generic Ambien for sleep when it came on the market a few years ago and every so often it simply does not work. Well, I used to use the name brand and it worked without fail. I think there is a quality control issue going on. I have heard this from others I know who use it and have switched to the generic.

[tex]

Hi Robbie,

Well, I'm only taking 60 mg, which is not a very big dose, so I doubt that the effect will be major. You raise an interesting point, though. I doubt this would be possible with natural thyroid products, but back in the early days of this board, one of our members received a batch of synthroid, (I believe), that was 10,000 times as potent as the label indicated that it should be. It turned out that the product was mislabeled at the factory. Needless to say, after one pill, she and 5 or 6 other customers of that pharmacy were in a life-threatening situation. After a couple of weeks or so, her heart and BP finally began to settle down, and I believe she eventually fully recovered, but several of the others ended up with major, permanent issues.

I started a new bottle of pills, 4 days ago, so the reactions that I'm having now would still be mostly a result of the previous batch. If the previous batch was faulty, and the current batch is OK, then my symptoms should begin to settle down within a few more days, surely. Of course, I have no way of knowing whether this batch came from the same lot as the last one, because I don't know how often the pharmacy has to reorder, and what size batches they receive. There's a good chance that it might be from the same lot.

Looking at the logistics, the blood sample for the test was drawn exactly 21 days ago. That means that I had 17 pills left from the previous batch, at that point. So I had taken 13 of them, which is roughly the right amount of time needed to reach a state of homeostasis, (roughly 2 weeks), after a dosage adjustment. At that point, the blood test showed that I was taking way too much thyroid supplement, (my TSH was below range), but my BP and heart rate were still normal. Immediately after that, though, they began to increase, over the next 2 or 3 weeks.

Since 2 weeks is considered to be enough time for the body to reach equilibrium with a new dose, my BP and heart rate should have been in a state of homeostasis at the time of the blood draw, and shouldn't have continued to adjust over the next 2 weeks, yet they continued to increase. That makes me suspect a thyroid event, rather than a medication problem. Also, if an overdose were the actual problem, my free F4 and Free 3 should have been high, not low on the T4, and normal on the T3. Low T4, together with a low TSH, should not be possible for an overdose.

Maybe I'll call my doctor, and see what he thinks about it, but I doubt he'll raise an eyebrow.

I'm pretty sure you're right about generally poor quality control with most meds. Some of the stuff I've read suggests that the industry as a whole has a rather cavalier attitude about manufacturing tolerances.

Thanks for your thoughts, everyone,
Tex