# thyroid/adrenal? Looking for input on treatment and test results.



## Elvis12345 (Jul 25, 2010)

Q: I am wondering if anyone has similar symptoms and can shed some light onto the meaning of all these symptoms and tests results. While I have found a new/better doctor, I just want to see how my treatments compare to what people in a similar boat are doing. Thank you in advance for comments and opinions - it is greatly appreciated.

I was tested about a year ago. All of my testing came out "normal" but was borderline. The doc started me on cytomel. He pumped me full of that stuff and started me on a diet pill - I was so speedy and out of it that I finally had enough. I found a new doc who ran a few more tests a few weeks ago. The results are below:

Vitamin D: 27L (30-100)
Magnesium: 3.8 (4-6.4)
TSH 2 (.4 -4.50)
T4 .8 (.8 -1.8)
Free T3 286 (230-420)
T3 Reverse 27 (11-32)
Zinc 84 (60-130)
Cholesterol and Triglycerides high

Adrenal Stress Test:
Show signs of significant stress - cortisol fluctuations
DHEA - Normal

New Treatment (for thyroid only): Adreset, Cytomel (50mg), Vitamin D, and Magnesum

Below are a list of symptoms I have had for a very long time. I also have Crohn's Disease and Ankylosing Spondylitis Arthritis (which I have had for about 15 years). The following symptoms are all things I have experienced when I have not been suffering from a flare.

Extreme fatigue/ anxiety 
Wake up often at night sometimes sweating
Eyebrows fall out
Diagnosed with IBS in addition to Crohn's because of constipation / stomach issues
constantly gain weight no matter what (even with exercise)
irregular menstrual 
my bones/joints hurt 
Extremely sensitive to cold and hot temps
My voice is often hoarse - more often now
Diagnosed with ADHD - memory/attention
Recurrent tonsillitis/ sinus infections - I had tonsillectomy and my symptoms have gotten much better but still have problems.
Occasional Nausea
Headaches
Cold feet/hands


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## Lovlkn (Dec 20, 2009)

Welcome Elvis,

Most obvious item that I see is your low Vit D - has your doc addressed that? I am learning more about Vit D but know for one thing it shows symptoms in me of fatigue and sweats. I was complaining to my GYN about hot flashes and she told me they are not hot flashes and ran another Vit D test. In the same week I saw my DO and he agreed and prescribed me 50K IU of D to be taken weekly indefinitely in attempts to get my levels into the 80's range.

Total T-4 is low (you need to ask for a Free T-4 next time)

FT-3 is also below mid range.

All of these items could be contributing to your symptoms.

50mcg of Cytomel is a large dose - I like to call it TN3 because of it's power. When you began taking it did you "ease" into it or just begin taking the entire pill at once? I find I have to ease my body into getting used to it and have started on doses as low as 2.5mcg daily to begin the process and eventually worked up to 12.5mcg daily. I also find I have to split doses as I feel the meds about 2 hours after I take them


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## Andros (Aug 26, 2009)

Elvis12345 said:


> Q: I am wondering if anyone has similar symptoms and can shed some light onto the meaning of all these symptoms and tests results. While I have found a new/better doctor, I just want to see how my treatments compare to what people in a similar boat are doing. Thank you in advance for comments and opinions - it is greatly appreciated.
> 
> I was tested about a year ago. All of my testing came out "normal" but was borderline. The doc started me on cytomel. He pumped me full of that stuff and started me on a diet pill - I was so speedy and out of it that I finally had enough. I found a new doc who ran a few more tests a few weeks ago. The results are below:
> 
> ...


Welcome to the Board. You sure sound very unwell and I am so sorry for this.

This sounds like the late stages of Hashimoto's to me but it is only a guess.

Late Hashimoto's Thyroiditis or Hypothyroid and Adrenal fatigue Optimal to high Low Low and mildly to the Right of T4 Low and unstable The most common presentation of disease. Similar to adrenal fatigue but symptoms are predominately in the mixed column.

http://www.drrind.com/therapies/thyroid-scale-matrix

I personally recommend some antibodies' tests and a radioactive uptake scan. It is very important to know what to treat and how to treat it. You cannot do that by guessing.

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/understanding/conditions/thyroid.html

50 mcgs of Cytomel is a "lot" and I kid you not. How long have you been on 50 mcg.? Why such a high dose? Are you also on T4 (Synthroid, Levoxyl?)


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## Elvis12345 (Jul 25, 2010)

Thank you both for responding!

Lovlkn - My doctor has started me on Vitamin D 6,000 IU daily. My Vitamin B12 was also very low so I have started weekly B12 injections. I have noticed the effects of the shots , not sure if I have noticed the Vitamin D. I feel like I have a little more energy (it could be both).
Andros - Thank you for the two links, they are very informative. Cytomel doesn't seem to work at all. My first doctor had me on 75. I told him I wasnt feeling anything so he just kept raising it. My new doctor started me at 25 and the same thing happened - I told her it wasn't working and we went up to 50. I refuse to take anymore than that though. I am not on any T4. Do you think that is something I should ask her about or wait until I have further testing? The first time I was on cytomel (75) it was for about 5-6 months. Then I weaned off of it for about 3-4 months and now at 50 for about 1 month.


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## Elvis12345 (Jul 25, 2010)

P.s. Do you think it is possible that my cytomel isn't working because of my adrenals? Or, is it possible for cytomel just to not work for some people?

Thanks again!


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## Andros (Aug 26, 2009)

Elvis12345 said:


> Thank you both for responding!
> 
> Lovlkn - My doctor has started me on Vitamin D 6,000 IU daily. My Vitamin B12 was also very low so I have started weekly B12 injections. I have noticed the effects of the shots , not sure if I have noticed the Vitamin D. I feel like I have a little more energy (it could be both).
> Andros - Thank you for the two links, they are very informative. Cytomel doesn't seem to work at all. My first doctor had me on 75. I told him I wasnt feeling anything so he just kept raising it. My new doctor started me at 25 and the same thing happened - I told her it wasn't working and we went up to 50. I refuse to take anymore than that though. I am not on any T4. Do you think that is something I should ask her about or wait until I have further testing? The first time I was on cytomel (75) it was for about 5-6 months. Then I weaned off of it for about 3-4 months and now at 50 for about 1 month.


Please have your doctor run a rT3 (reverse T3) lab test and then we can talk more about this. There are antibodies that bind the receptor site which prevents cellular uptake of T3.


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## Elvis12345 (Jul 25, 2010)

Hi Andros-
My result was... T3 Reverse 27 (11-32). This is what you are referring to, correct?

Thanks again, I really appreciate everyones help in this - it can be a stressful process.


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## CA-Lynn (Apr 29, 2010)

Elvis - what meds are you taking for the Ankylosing Spondylitis? If you're taking any steroid, even sporadically, this can explain the cortisol/adrenal fluctuations.

As far as the Vitamin D.....if you treat that first [50,000 IU weekly Vitamin D2 by Rx] then you should see a good positive overall change. Once you're in the normal zone after a month or so, you may or may not have to maintain that dose. In my case the minute I cut back my Vitamin D tanked again, so I 'm back on a maintenance dose of 50,000IU weekly.

Many of your symptoms could be overlapping from the Vitamin D, but if the Vitamin D treatment doesn't effect a positive change, then look to the Ankylosing Spondylitis. I'm assuming you have a rheumatologist and are being treated accordingly with DMARDS or other drugs appropriate to your disease.

Also, you mentioned being on a diet pill. Have you been checked for type 2 diabetes? If you have been taking Metformin for this, that drug will deplete B-12. Also, if you're taking certain DMARDS THOSE drugs can deplete B-12.

In short, your endocrinologist and rheumatologist should be working closely together on this.

And yes, I have Ankylosing Spondylitis and other autoimmune arthritic diseases in addition to Type 2 diabetes and Hashimoto's [which flipped into Graves when my Vitamin D dropped, but has since reverted to stable Hashimoto's since the Vitamin D has been regulated].

Good luck.


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## Elvis12345 (Jul 25, 2010)

I was diagnosed with AS at age 12, with a very serious flare. Since the initial flare I have had one bad one. The rest have been pretty minor aches that I treat with Tylenol. To be honest, I have put it on the backburner with everything else going on - the Crohn's always felt more urgent. I am not taking any steroids for my AS or Chron's. My Gastroenterologist uses it as a very LAST resort. The longest I have been on prednisone was about 6-7 months at the age of 19. No steroids within the last two years.

I need to find a good rheumatologist to monitor progession (if any) and to keep tabs on my AS.

The diet pill I took a year ago for about one month - I had to stop becuase the side effects were more than I wanted to deal with. The Doc basically had me on a cocktail of speed.

Thank you CA-Lynn very much. I am definately going to watch and see what happens with the Vitamin d.


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## CA-Lynn (Apr 29, 2010)

That's wonderful news about so few AS flares. I totally agree about the Pred, but when you need it, you need it. I just use short burst MethylPred pack at low dose for 6 days and just hope there's no rebound effect.

I hear you - with multiple autoimmune stuff it's a royal pain trying to figure out what's causing the symptoms.

I will say this: for whatever reason my Vitamin D tanked this year and when it did it sent my 20 years' stable with drugs Hashimoto's into a tizzy. It sent my arthritis in a tizzy [I'd been stable on Methotrexate for 17 years] and the AS announced itself with a bang. My glucose went crazy [by then I had to take Pred, so that played a large part of it]. My endo and rheumy were in concurrence: get the Vitamin D normalized and then see where we're at. Sure enough, once the Rx Vitamin D was two months in, all my other autoimmune stuff started stabilizing to normal [for me] levels.

This might not be the case for you.....but I was flummoxed at how the hormone Vitamin D could hit with a bang.

With respect to the AS - and any autoimmune arthritis for that matter - exercise, exercise, exercise. And if there's excess weight, get it off [though I'm not in favor of diet pills].

Keep us posted.

Lynn


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## Andros (Aug 26, 2009)

Elvis12345 said:


> Hi Andros-
> My result was... T3 Reverse 27 (11-32). This is what you are referring to, correct?
> 
> Thanks again, I really appreciate everyones help in this - it can be a stressful process.


Yep; and I was not quite sure. I thought I read that in your labs but could not remember.

There are several causes for this ratio getting disturbed, the principal ones that we know of are:-

Extreme dieting, the RT3 increases to slow the metabolism and make better use of the available food 
Low Ferritin 
High cortisol, this disturbs the balance of the thyroid hormones 
Low cortisol, this again disturbs the balance of the thyroid hormones 
Insulin dependent Diabetes 
Low Vitamin B12 levels

Here is the rest of the article and I do suggest you read it ...........

http://thyroid-rt3.com/whatare1.htm

I think you should avail yourself of further testing as per the article.


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## Elvis12345 (Jul 25, 2010)

That is very good news about the Vitamin D. I am hoping that getting my Vitamin D and B12 at a normal level will help some of this. As for exercising I know that is a very important role in maintaining a healthier life. Although it is very frustrating for me... When I finally decided to change my habits, I started walking everyday for about 45 minutes... and I gained ten pounds over two months (with the EXACT same eating habits.). So for whatever reason my body likes to pack on the pounds when I am not having a flare with Crohns.

Andros - You have introduced me to some great resources. I am definitely going to read the site links you have provided. I will be discussing further testing with my doctor.


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## Andros (Aug 26, 2009)

Elvis12345 said:


> That is very good news about the Vitamin D. I am hoping that getting my Vitamin D and B12 at a normal level will help some of this. As for exercising I know that is a very important role in maintaining a healthier life. Although it is very frustrating for me... When I finally decided to change my habits, I started walking everyday for about 45 minutes... and I gained ten pounds over two months (with the EXACT same eating habits.). So for whatever reason my body likes to pack on the pounds when I am not having a flare with Crohns.
> 
> Andros - You have introduced me to some great resources. I am definitely going to read the site links you have provided. I will be discussing further testing with my doctor.


Good and I sure hope you get to feeling better. Please keep us abreast.


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