Feel free to discuss any topic of general interest, so long as nothing you post here is likely to be interpreted as insulting, and/or inflammatory, nor clearly designed to provoke any individual or group. Please be considerate of others feelings, and they will be considerate of yours.
My endo increased my meds based on my TSH. I continue to complain of fatigue and othe thyroid related symptoms that have not resolved. There has been great improvement since last year but I was a complete mess and it couldn't have gotten much worse than where I was at. Although, I am always hesitant to say I'm doing better since the reaction I seem to get is nothing further needs to be done.
My dose was upped a month ago to see if that would help. I am now taking 150mcg of levothyroxine on M,W,F and 100mcg the rest of the days. I am 136 pouns. I also take 5mcg of liothyronine every morning. I've been very clear I would like to try another 5mcg dose in the afternoon to see if that helps. No luck with that for many medical reasons.
I assume since my TSH dropped he will be very pleased. Sigh. I'm glad it's lower too but I'd like to know why my other numbers are the same and why "we" don't care too much about that since they are "within the normal range." I can feel myself revving up for a rant but I will forego it. He understands my request that I'd like to get my FT3 in the upper range of normal, just to see how I feel. I've told him that i've read patient comments stating being at the higher end of the range has made a world of difference. Why not me too?
Also, does stress/emotions have any impact on numbers? Mi e has skyrocketed the past month or so and I'm working on that too. I have noticed it has impacted my MC. Double sigh. I'm thinking It's time to trade in this body for a newer model.
Deb
"Do not follow where the path may lead. Go instead, where there is no path, and leave a trail.
-Ralph Waldo Emerson
2007 CC
2013 thyroid cancer- total thyroidectomy
2013 Hashimoto's - numbers always "normal"
2017 Lyme's Disease
All the B vitamins are required for production of the thyroid hormones T3 and T4. Vitamin B2 (Riboflavin) in its co-enzyme form is particularly important. A deficiency of this vitamin will supress thyroid function at the cellular level even when serum levels are in the normal range. Riboflavin deficiency will also result in low adrenal function leading to fatigue etc. Why not try taking a co-enzyme B-complex formula daily and adding some extra riboflavin-5 phosphate (the co-enzyme form).
I'm sorry that the problems just seem to go on forever. Looking at your numbers, I agree that your conversion of FT4 to FT3 seems compromised (which might indicate a need for more T3 supplementation), but your TSH says that all in all, everything is going pretty well. So your doctor has the evidence to back him up. Of course doctors tend to put way too much faith in TSH results, but that's a very common failing.
I believe that your concerns about stress are right on target. Chris Kressor has a good article on this, and I have a hunch that the section in the article under the subheading 2) Adrenal stress reduces conversion of T4 to T3 is especially relevant.
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Thanks for the article Tex. It's full of good information but I'm left with what do I do next? Give it time?
My endo sent me a letter after my labs that said his goal is to keep my TSH somewhere between 0.35 and 2.5. He is not changing my meds and wrote me off until my next appointment at the end of March. I will have another set of labs in November but don't anticipate a change since he is satisfied.
My job change plans have been postponed so the toxic environment I'm in now will remain for a while longer. I continue to try to change my own attitude as not to make it worse but the next few months will be intense. The article you referenced seemed to be written about me- exactly.
On a side note, after ten days of sickening hell worrying about my run away kitty, I found her. My neighbor called after I distributed flyers and said my cat was in his car (up by the gas tank) for two days and he couldn't get her out. He drove her across town, on the highway, to Walmart to get help to remove her. I almost sh** my pants for once not related to MC. She was taken to the Humane Society and I have her back. She is very sick and I'm taking her to the vet in a few minutes to decide her fate.
I am making every attempt to keep stress out of my life but I seem to fall face-first into it- all the time. I'm trying to keep some humor about myself but it's getting to be a challenge.
Maybe I should write a book because some of this stuff just can't be made up!
Deb
"Do not follow where the path may lead. Go instead, where there is no path, and leave a trail.
-Ralph Waldo Emerson
2007 CC
2013 thyroid cancer- total thyroidectomy
2013 Hashimoto's - numbers always "normal"
2017 Lyme's Disease
Deb wrote:Maybe I should write a book because some of this stuff just can't be made up!
Definitely keep notes on everything of interest in a file. It will make writing much easier when the time comes to write that first book.
Stress is definitely dominating your life and your symptoms these days. I wish I knew of an easy way to resolve it.
Maybe if you start writing now, you will find that putting it all on paper (or on a hard drive) is relaxing and therapeutic.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Vitamin B2 (Riboflavin) in its co-enzyme form is particularly important. A deficiency of this vitamin will supress thyroid function at the cellular level even when serum levels are in the normal range. Riboflavin deficiency will also result in low adrenal function leading to fatigue etc.
Dr. Ann,
My 7 yr old daughter had a complete stool analysis (CDSA) showing Dientamoeba fragilis and an Organic Acids urine test (OAT) showing excess byproducts of candida (arabinose) and most curiously...Riboflavin deficiency! I read that being deficient is nearly impossible! She's now taking a liquid B-complex supplement and an occasional B2 pill, but why would someone on a normal diet (albeit not much milk) be riboflavin deficient?
That is what allopathic medicine would have you believe. Deficiencies, particularly when consuming the Standard American Diet (SAD), are far more common than you might think. Also, candida, parasites, and/or SIBO can disrupt nutrient absorption and cause deficiencies by doing so. Did you know that Candida Albicans has been implicated as possibly contributing to Celiac Disease and gluten sensitivites?
I am aware that the EnterLab site states that Candida does not appear to be involved in MC. However, I am not so sure. Take a genetic predisposition to gluten intolerance (such as HLA-DQ1, HLA-DQ2, or HLA-DQ3) and couple that with antibiotic-induced candida overgrowth, and you could have the perfect setup for MC/IBD. I am not saying that is the only cause of MC/IBD, but it may certainly be one set of circumstances that could lead to these disorders.
I have seen Candidiasis often enough in my work with IBD patients that I have to wonder if it is not just coincidence.
Ann wrote:Did you know that Candida Albicans has been implicated as possibly contributing to Celiac Disease and gluten sensitivites?
Whoa! That pubmed article doesn't prove anything, in fact it isn't even connected with any specific research data. The authors simply speculate that Candida might be involved in the onset of celiac disease. Well hell, the phase of the moon might be involved (but I doubt it ) I agree that if one is predisposed to the development of celiac disease, then the development of a yeast overgrowth or any other major digestive system disruption would almost surely be likely to speed up the development process. But so what? Where's the proof that the Candidia overgrowth comes first?
And we already know that MC can be triggered by about a jillion different issues, so 1 more won't raise many eyebrows.
The point is, Candida is an opportunistic parasite. When digestion is disrupted, and the immune system is distracted on other issues (such as food sensitivities), then Candida seizes the opportunity to become established. But that makes it a symptom or side effect of celiac disease and MC, not a cause.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
This may be way out in left field, and I certainly don't pretend to know the literature/research on ibd's, but I am suspicious of the search for the cause, as if there is some smoking gun out there. Decades ago, when I was a grad student in developmental psychology, i learned that this is a multi-determinant world and many factors can contribute to the processes that effect the development of a child. This seems to also be true for diseases, many factors can contribute to the development of any disease, without any one factor being, in any simple way, the cause. Even the word "cause" has several different meaning. To take this even one step further, diseases are merely concepts not things, and as knowledge increase, diseases get redefined, one disease broken up into more than one, several once separate diseases being combined into one. Nutrition, gut flora, toxins, genes, stress, all of these probably play a role in all disease processes. This kind of complexity is impossible to study in a standard research protocol. I have decided that for me what is most important to know is what I have to do in a very practical way to make myself as healthy as I can possible be. I have no illusions about being able to understand the why's and wherefore's. That gut flora play a role in health and disease seems undeniable, but our understanding of it seems to be really in its infancy so I don't pay much attention to it other than knowing that in the past when I took an antibiotic I could avoid a yeast infection if I also took acidophilus (luckily it has been years since I took an antibiotic). I also make my own sauerkraut and beet kvass because I like the stuff and it may be adding beneficial bacteria to my system, but maybe not. At least it does no harm. When i read the media reports on medical research it often seems that conclusions are drawn without any basis. I'm an intellectual conceptual sort of person, but when it comes to my health I tend to stick with what works, regardless of theory.
Excellent observations. That even extends to mathematics, engineering, and physics. Back when I was in grade school, I learned that there is only one correct solution to any given problem. But eventually I learned that there are actually many solutions to most (possibly all) problems. The trick is to sort out the redundant and/or irrelevant input parameters and boundary conditions, so that we can apply the tools we have to get a valid solution. Once we are able to properly define the problem, then a solution can be derived. But if we are unable to correctly define/describe the problem (mathematically), then we are doomed to fail, because any possible solutions will be worthless.
This appears to be at the root of a lot of misguided medical research these days. The research conclusions are worthless, because despite good intentions, the researchers didn't (or couldn't) properly define the problem initially.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
tex wrote:[The point is, Candida is an opportunistic parasite. When digestion is disrupted, and the immune system is distracted on other issues (such as food sensitivities), then Candida seizes the opportunity to become established. But that makes it a symptom or side effect of celiac disease and MC, not a cause.Tex
Tex:
We may just have to agree to disagree.
All dysbiosis, by definition, is opportunistic! Celiac disease has been shown, in the literature, to often present itself after one or more courses of antibiotics. Remember, genetics is the gun but environment often pulls the trigger. Candida overgrowth is a common consequence of antibiotic therapy, as are other forms of dysbiosis, like SIBO. Once the overgrowth occurs, the body in its effort to defend against this yeast, can begin to attack the antigens on its surface, including those similar to gluten.
I did not say that candida was THE cause of MC/IBD or celiac disease. The circumstances that result in each individual developing MC/IBD or even celiac disease are unique. However, we should not discount candida as being one of them. Candida overgrowth should be investigated as one possible contributing factor to any autoimmune disease. To fail to do so would be a disservice to the patient.
I agree with you that it certainly can push other digestive issues to a new level, and I'm sure that there are instances where this egg may come before the chicken (and cause celiac disease to present), but we don't have the data to be able to safely say that is is a common cause of celiac disease or any other IBD. Probably, as you say, it is one of many possible environmental influences that can complete the equation by which celiac disease is activated.
My main concern was that some readers here might misinterpret the term "implicated" to mean "proven", or associated with compelling evidence, when in fact, the researchers who wrote that article were merely proposing a theory, without offering any proof to back it up.
And I totally agree that sometimes we just have to agree to disagree. IMO, disagreement is not an evil thing. Without disagreement, mistakes and oversights can fall through the cracks. Disagreement usually leads to a much better understanding of a concept than agreement could ever provide.
Thank you for your response.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
tex wrote:.
My main concern was that some readers here might misinterpret the term "implicated" to mean "proven", or associated with compelling evidence, when in fact, the researchers who wrote that article were merely proposing a theory, without offering any proof to back it up.
Tex
I find the members of this forum very informed and capable and I am certain they understood the publication for what it was. I look forward to future discussions!
Sooo…while we're on the topic of candida. I recently completed an almost 3-month course of Nystatin pills for yeast overgrowth which was diagnosed though an organic acids urine test. My arabinose levels were high (candida byproduct in the urine). It was not surprising, given I've been on prednisone for almost 2 years (starting at 40 mgs and tapering slowly), and I have a history of antibiotic use for UTIs and mitral valve prolapse in my youth. However, I've only had 2 female yeast infections in my life, decades ago, and no other signs of candida (other than failing the morning spit in water test). Of course I know the anti-candida community would blame my MC, DM, and food sensitivities on the candida too. Anyhow… the die off symptoms of headache, D and brain fog were bad the first week, then manageable.
Problem is, the D seems to have gotten WORSE since I stopped taking the Nystatin. I wonder about a couple of things (well, many things…):
1. By killing off bad and beneficial yeasts, could I have encouraged SIBO or some other form of bacterial overgrowth? If so, is ingesting water kefir and fermented veggies going to help replenish the balance? Or might it contribute to more bacterial overgrowth?
2. I've read that beneficial yeasts act like scavengers in the GI tract and actually help with detox, etc. Am I missing out now on an important function of beneficial yeast? I bought S. Boulardi. Good idea to take it??
3. I believe you cannot eradicate candida, and the goal should be to simply get it to balanced levels. However, I read about people on candida boards starving themselves of all starches and sweets (including fruit) for months or years, trying to eradicate candida, as if it's the root of all health woes. They seem to *know* when their candida is coming back or "flaring." I've had no such sensations. Are they crazy, or am I?
4. Assuming candida is one of my root causes, should I plan to do periodic candida cleanses, either through high dose C, coconut oil, oregano oil, garlic and the like? Are they better in the long run than Nystatin?
5. I know prednisone is a strong contributor to candida overgrowth. Now that I'm only on 3 mgs a day (less then a replacement dose), is that still enough to encourage candida overgrowth?
6. My daughter was also just diagnosed with intestinal candidiasis (no surprise after lots of antibiotics for strep, e.coli and now amoebas.) Is Nystatin the way to go for her, or should I consider natural antifungals and probiotics/fermented veggies first?
Unfortunately, antibiotics and steroid therapy can foster candida overgrowth. It is a common side effect of such therapy as are other forms of dysbiosis. Fortunately nystatin has not been shown to adversely affect the good bacteria in the gut so let me dampen your fears of that possibility. It will, however, kill off other yeasts.
You are absolutely correct that you cannot eradicate candida and that the goal should simply be to get it back into balance. You are also correct that you cannot starve this yeast. Trying to do so will actually force it into it's mycelial form which is far more dangerous. Depriving the patient of all starches and fruits is counter-productive and will only serve to starve to patient of vital nutrients so necessary to regain health. I have personally seen clients who have done this and have damaged their health considerably in the process. A healthy restriction of refined sugars and some starches is all that I recommend. Fruit can be consumed in moderation, but fruit juices should be avoided.
Beneficial yeasts do act as scavengers in the GI tract, but S. Bulardii is not a normal gut inhabitant. When it is taken as a probiotic, it is a transient resident only. It will compete with candida, thus inhibiting its growth, but does not remain in the gut. It's use is meant to be temporary. Prescript Assist is a great probiotic and I often recommend it. It is a combination of soil based organisms that have been shown to take up residence in the gut. Studies have shown it effective in IBS, but its use in IBD is yet to be studied. It does contain S. Cerevisiae (baker's yeast) and other soil based yeasts, so if someone has a known sensitivity to yeast, or has developed antibodies to S. Cerevisiae, I recommend another probiotic.
Lactic acid producing probiotics are a another great choice for dealing with yeast overgrowth. In sufficient amounts they will take up residience and compete with the yeast to restore microbial balance. Probiotics I have used successfully are VSL#3 and Renew Life. Some Renew Life products contain FODMAPs so read the labels. Ultimate Flora Critical Care 50 Billion, Ultimate Flora Ultra Potent 100 Billion, and Ultimate Flora Mega Potent 150 Billion are three Renew Life formulas that do not.
While on low dose Entocort, you might consider taking 3 caprylic acid capsules/day to help keep candida at bay and practice a healthy restriction of refined carbohydrates. With children I prefer using natural antifungals or fermented foods first. Children seem to bounce back so much faster than adults. However, nystatin does not enter the blood stream so it is a pretty safe drug. Talk to her doctor about a possible short course.
I almost sh** my pants for once not related to MC. She was taken to the Humane Society and I have her back. She is very sick and I'm taking her to the vet in a few minutes to decide her fate.
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