# Saw the Endo - Confused. Advice?



## CorralesNM (Nov 6, 2011)

I saw my endo yesterday, and she saw me at my worst because I was crying. I was crying because the day before was very stressful, and how I am now reacting to stress - not happening in October - is by having a really bad next day. And that really bad generally includes crying. I told her that, and I told her that my mind isn't working. It's coming back a bit.

And I also told her my vision is blurry, and it is occasionally double (over/under double, not side-by-side double.)

So she looked at my labs:

Thyroxine (T4) Free: 1.37 ng/dL (Range .82 - 1.77)
TSH 4.280 uIU/mL (Range 0.450 - 4.500)
Hemoglobin A1c 5.9 (Range 4.8 - 5.6)
Triiodothyronine, Free, Serum 2.5 pg/mL (Range 2.0 - 4.4)
Thyroid Peroxidase (TPO) Ab 217 IU/ml (Range 0 - 34)
Antithyroglobulin Ab 49 IU/mL (Range 0-40)

She confirmed that I have Hashimoto's, and she prescribed a half a tab of Armour, and she was going to prescribe Metphormin to prevent diabetes (I'm 4'11, weigh 122)

Then she told me that the levels she's seeing would not be causing the emotional lability. She said I seemed anxious and depressed, and she referred me to a holistic, board certified psychiatrist, who doesn't take insurance. She said the thyroid levels could exacerbate the psychiatric issues. And she told me although she was prescribing a minute amount of Armour, she asked that I not take it until I see this psychiatrist.

She noted - and this is true - that I appear not to tolerate pharmaceuticals - codeine, compazine, the SSRIs, levothyroxine, and novocaine.

In 1990, I had a major depression. The onset of what I now is different. The sleep/wake patterns are different. I didn't have mood fluctuations: I was initially anxious, and then I became depressed, so depressed that I thought I'd pretty much "broken" and I'd never be the same.

But I didn't have blurry vision. My blood pressure didn't keep dropping.

My blood pressure on Nov. 9 was 116/75, then it went to 108/68 then 106/62. Yesterday it was 94/63.

And my heart rate continues to climb. It started at 67, and it is now 100.

I think I'm sick.

I emailed and then called my therapist, who is the exact therapist I need right now, yesterday. She advised I see an integrative physician (like Dr. Weill) she uses, who diagnosed her with Epstein-Barr, another disorder that can appear psychiatric.

This doctor, with whom I have an appointment on January 3rd, takes my insurance. He uses very few pharmaceuticals, although he does prescribe Armour, and he is a board certified in Otolaryngology. So I think I'm making the right decision. I think whatever is going on with my body is causing the emotional lability and mental dullness and not the other way around. In other words, I don't think my anxiety is blurring my vision and causing my blood pressure and temperature to drop and heart rate to rise.

My question: Given that my endo didn't want me to start on the Armour until I got the okay from the holistic psychiatrist, and given that I'm not going to see this psychiatrist and instead see an integrative physician, who does prescribe Armour, what would you do? Would you go on the Armrour or wait until January 3?

Thanks.


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## HeidiBR (Apr 4, 2010)

T3 is know to help with depression. Whether the T3 comes from synthetic T3 (Cytomel) or Armour. I think with depression, Cytomel is usually used.

You might want to read this book - it is all about the mind/thyroid connection:

http://www.amazon.com/Thyroid-Solut...6620/ref=sr_1_4?ie=UTF8&qid=1323271552&sr=8-4


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## Andros (Aug 26, 2009)

CorralesNM said:


> I saw my endo yesterday, and she saw me at my worst because I was crying. I was crying because the day before was very stressful, and how I am now reacting to stress - not happening in October - is by having a really bad next day. And that really bad generally includes crying. I told her that, and I told her that my mind isn't working. It's coming back a bit.
> 
> And I also told her my vision is blurry, and it is occasionally double (over/under double, not side-by-side double.)
> 
> ...


You have very little Triiodothyronine (T3) and this is a disaster in my book!

Low Free T3 affects the limbic system negatively in a huge way.

I would go on the Armour. Absolutely! You are in dire need here.


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## CorralesNM (Nov 6, 2011)

Thank you, Heidi. Thank you, Andros. This seems like good advice.
Maureen


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## Andros (Aug 26, 2009)

CorralesNM said:


> Thank you, Heidi. Thank you, Andros. This seems like good advice.
> Maureen


Let us know. I'll bet any money as soon as you take the Armour, you will feel the black cloud somewhat lifted in a few hours.

Keep a journal.


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## Prairie Rose (Nov 17, 2011)

How did they officially diagnose Hashimotos for you?
Did they do a radiaoctive uptake scan?

That is how I was officially diagnosed with Graves. My regular doc thought Hashimotos, but the scan showed Graves.

I have the same vision issues.......


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## bigfoot (May 13, 2011)

CorralesNM said:


> Then she told me that the levels she's seeing would not be causing the emotional lability. She said I seemed anxious and depressed, and she referred me to a holistic, board certified psychiatrist, who doesn't take insurance. She said the thyroid levels could exacerbate the psychiatric issues. And she told me although she was prescribing a minute amount of Armour, she asked that I not take it until I see this psychiatrist.


I'm just a newbie here, so take all of this with a grain of salt. It appears that your FT3 & FT4 are a little low; I know folks here mention striving for around the 75% range. And your TSH is awfully high at 4.28 for someone with Hashi's. So it appears you are on the hypo side of things. I'm not so sure about her comment about your thyroid levels not causing the emotional liability. While I'm no doctor, I was recently diagnosed with Hashi's and my TSH had only gone from 2.7x to 3.1x over the course of a few months. I felt absolutely awful, both physically and mentally -- and I was already on 50mcg of levothyroxine. My understanding is that even small movements of hormone levels up or down (including thyroid hormones) can cause a variety of signs & symptoms. Here is an excellent article by Dr. Hall that makes a lot of sense: http://www.drrichardhall.com/anxiety.htm

Thyroid issues have been tied into dang near everything: blood sugar, cholesterol, heart, brain, memory, mood, vision, sleep patterns, libido, metabolism, etc., etc. The list goes on and on. Something else you might want to investigate would be adrenal/cortisol issues and other hormone issues (testosterone, estrogen). And your Hashi's could be giving you transient signs & symptoms of being hypER.

So on one hand, she is right. Adding in external thyroid hormones will change the overall hormone levels. You will probably notice it, there will be some speed bumps; good days, not-so-good days. But on the other hand, if you aren't adequately treating your condition, things are not likely to just improve on their own. Just to confirm -- you are NOT taking any thyroid medication at the moment, right?

My $0.02: the blurry vision, high heart rate, and lowered blood pressure should be investigated. Could be tied into your untreated Hashi's, could be tied into something else.

hugs3


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