# More confusion!



## Kattakko (Mar 19, 2013)

I'm slowly reaching the end of my rope here.

This morning I went to see my regular doctor because I'm having serious Hypo symptoms. She agreed to retest TSH and finally test FT3 and FT4.

TSH 0.52 (0.27-4.20) (You gotta be kidding me!!!)

FT4 1.77 ng/dl (0.94-1.72) (Over the range, seriously?!?!?!)

FT3 3.24 pg/ml (2.34-4.17) (First time ever having it tested...)

I don't know what to do anymore. I came home, sat down at my desk and cried. Shouldn't I be feeling "good" ? The only Hyper symptoms I have and insomnia at night (I could sleep all day though, hubby has trouble getting me out of bed at 10am on weekends, usually I get to sleep at about 2am when its at its worst) and diarrhea... of the joys, its been that way for the past 6 months.
I'm exhausted, all the time. My fingers hurt, my feet and lower legs hurt, depression is starting to creep up, my hair is still falling out.

Anyone have any thoughts?

Thanks!!


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## bigfoot (May 13, 2011)

I see from your signature line that your TPO antibodies back in April were up over 1000. That is pretty darn high. From my understanding, ultimately by having your TSH suppressed, that will suppress the antibody attacks. This stuff is part art, part science. I know how frustrating it is to see your labs in a good spot and wonder, "What the...?"

According to your FT4, you are a little over-medicated. Especially if that diarrhea and insomnia is persisting. I will say that hyper symptoms and hypo symptoms can blend together, which is why the lab work is essential. It's always possible that you could be getting too much RX and feel like crap, even resulting in fatigue. But each person is an individual case.

Other things the doc should be checking for are, in no particular order:

- Vitamin D-25
- Vitamin B-12
- Anemia / Iron Levels
- G.I. Issues (Celiac disease, H. pylori, gluten sensitivity, liver panel)
- Reverse T3
- Sex Hormones (Estrogen, testosterone, SHBG, etc.)
- Making sure your recent ultrasound / nodules are OK (see an ENT?)

If they would check TSI (Thyroid Stimulating Immunoglobulin), not to be confused with "TSH", that might shed a little light on things, too. Folks with skyrocketing levels can actually potentially be dealing with Graves' disease or Hashitoxicosis. Trouble is, very few docs know what TSI is, or to even test for it. So it might take a little sleuthing around.

I harp on this a lot, but think about trying to go gluten-free for a period of time and see what happens. Gluten is nasty stuff with some people, and can trigger autoimmune reactions. It's in practically everything -- medications, shampoo, food, salad dressing, stuff you wouldn't think about. It can take weeks to fully work its way out of your system. If you tried going totally GF for 1-2 months, you might be surprised at the difference. I did, and I sure do miss my sourdough bread, but I wouldn't go back knowing all the trouble it was causing me.

hugs6


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## Kattakko (Mar 19, 2013)

Thank you Bigfoot for your thoughts!!

TPO was high on 2 occasions. 24/3/2011 and 16/4/2012, Greater than 1000 both times. I had 2 increases in hormones between those dates and the number stayed the same. From 125mcg to 150mcg and then up to 175mcg. The more I look at my numbers the more I get confused!

My doctor didn't call me yesterday, she did last time to increase my dose because my TSH was at 4.75 (0.27-4.20), I was sure she would tell me to go back to just 200mcg, but she hasn't called. So this morning I just took 200mcg. Since we moved from Canada to France I switched from Synthroid (that I took for 3.5 years) to Levothyrox. It's been 7 weeks since I switched. Maybe my body is using it differently.

In March I had my 2nd ultrasound, see details in my signature, and I had one 2 years ago, that I now have the results from because I went back to Canada April 19th. The old US says that they see "septums"(?) and many tiny hypoechoic images (? Translating from french again).

So even with the increase in hormone as mentioned above, Nodules still grew, and there was no decrease in TPO either.

Here is a list of blood test I brought her that I think would be good to do :

TSH, FT4, FT3, rT3, Anti-TPO, Anti-TG, Anti-Trak, TRH, Cortisol, TBII, Ferritine, Calcium, Vitamin B12, Vitamin D, anti-transglutaminase, anti-endomysium.

I have a paper for tests for next month with the following :

TSH, FT3, FT4, Cortisol at 8am, NFS (?), Ferritine, calcium, Vitamin D, Vitamin B12, Folates, CPK (?) and anti-transglutaminase.

The rest she says is best to leave to the Endo, and she knows we aren't covered by and by any insurance yet (they "lost" our file"!) and some of these can be rather expensive.
I never thought about the sex hormones though, I'll add them to the list for when I go see the Endo!! I've already added TSI!

As for a repeat ultrasound I already have a paper for it. I went on the 18th of March, so I'll try to get an appointment around the 18th of June, my regular doctor wants a 3 month wait for it.

I understand how Hypo and Hyper symptoms can blend together, and I know that when I travel I tend to swing between the 2. I think it's probably because of the stress and anxiety that travelling alone puts my through!

I've read a bit about going gluten free, but from what I've read it's best to be tested first for the possibilities because if you go gluten free it won't show up on the tests?? Another confusing thing for me!! loll Is this true, or will the tests be positive even without gluten in the system?

The diarrhea has been happening since we moved here 6 months ago. Food is food but it's really different here in France. It's hard to explain. A potato is a potato, but everything that is already prepared (canned spaghetti sauce for example) is different. Hotdog sausages are different too. I'm still getting used to everything. Once I have all of the small appliances I need I will be able to prepare everything from scratch. It's too much for me to everything by hand with 4 kids!!!

The insomnia comes and goes with the swings!

I'm just seriously confused and fed up with all of this. I didn't respond yesterday because I was too emotional and mad at the world. I asked hubby to buy me a shovel so I could dig myself a hole to crawl into! But he won't loll (note: I want a Hole to hide in, not to be confused with a Grave to be buried in!)

I am very grateful for this site and all of the people here! You guys really help sort out everything and help led those that need help in the right direction!!

Thank you!!!!


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## Kattakko (Mar 19, 2013)

Anyone have any suggestions for me? Especially regarding going gluten free now or waiting until after testing?

I don't know who else to get an opinion from..... my parents still think it's all in my head (if it can't be seen I must be lying), and no one around me knows what I'm talking about. 

Thanks again!


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## Lovlkn (Dec 20, 2009)

> I'm exhausted, all the time. My fingers hurt, my feet and lower legs hurt, depression is starting to creep up, my hair is still falling out.


You changed brands - any movement in thyroid hormones will make your hair fall out.

With your labs you may need a slight reduction in your current dose - you could also wait a month and re-test to see where you are then

I would put my bet on being low Ferritin based on these symptoms.

Since you have no insurance why not have that tested 1st and see if that is the issue. Next would D then B-12.


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## surge (Aug 15, 2012)

In my experience, when the antibodies are high and it's hard to read where you are in the spectrum, you just feel bad. I also learned that when the antibodies are high, my numbers were really unreliable-- my tsh always said I was low, my FT4 said I was perfect and my FT3 was perfect or a little low, but I felt crazy hyper. I just recently had a documented hyper bout and it was fascinating to see that I really did have all the same symptoms as when I was saying I was hyper, but this time, I had the tests that agreed.

If you are getting tested for celiac's, not eating gluten does make the results unreliable. I didn't see it on your list of tests...when are you planning to be tested? If it's within the next 6 weeks or so, I guess I'd wait.

Some people with autoimmune disorders are sensitive to wheat, especially when inflamed, though it isn't celiacs. At some point, considering your symptoms, I would think taking 6-8 weeks off would be a good idea, especially if you use that time not to just buy gf pasta/products, but rather to upgrade on food in general-- lots of lean protein, fruits and salads. and just watch to see how you feel.


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## Kattakko (Mar 19, 2013)

Thank you LovIkn and surge!!!

I think I just needed someone to tell me that the brand change would cause problems, I feel like a child who needs mommy to hold her hand to walk her through all of this!
I think I will stay on this dose, until my next blood tests, which would be in about 5 weeks unless the Endo orders them sooner.
We might not have insurance but we do have the money to pay for tests (fortunately). If I say I think I need more tests, hubby pushes me out the door to get them. He sees what I'm going through and I think he's as tired as I am! I should have asked her to test more things at the same time, but I become helpless and almost scared in front of the doctor when they are resistant to do anything at all. I will not be going to the Endo alone that is for sure!
My antibodies haven't been checked in over a year now, so I have no idea if it is that causing the problems or not. I have NEVER had a TSH so low! Nor has my T4 ever been so high! I can't say that I feel Hyper either, the only real thing would be the insomnia, as I blame my (Oh so Joyful) diarrhea on food changes.
One thing that does concern me now that I think about it is that one week before going to Canada I was having pretty bad headaches everyday, most of the time I was there I felt dizzy everyday, mostly after standing (shopping with my 14 year old) and walking for about 45-60 minutes. Now it's the pain and insomnia. (Hashitoxocosis?)
As for Celiac's, she was ok to test anti-transglutaminase. I'll see with the Endo about further testing, or more complete testing. I will also wait until my appointment before making any changes to my diet. Even if I test negative for Celiacs/gluten sensitivity I plan on making changes as I eat pretty much whatever I feel like eating right now, not the best idea in the world!

Thank you both for your thoughts!!!


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## bigfoot (May 13, 2011)

Sorry I missed this over the last couple of days. Yes, I agree with the others, if you are planning on getting Celiac and/or gluten sensitivity tested, you won't want to go cold turkey on gluten just yet.

As far as your symptoms, I can totally empathize with them. Things will eventually get better, just try to remain focused on getting answers and proper treatment. It might be a little bumpy in the meantime, but try to remain positive and distract yourself with family, friends, pets, hobbies, activities, mild exercise, etc.

Diarrhea... check.
Headaches... check.
Dizziness/Faintness... check.
Insomnia... check.
Emotional... check.
Fatigue... check.
Stiffness... check.

Glad your doc is willing to order up some tests, and hopefully the upcoming endo visit will go well, too. The dizziness could possibly be from something else, so be sure to mention how/when you are dizzy or feel faint at your appt. They can check for blood pressure issues, heart issues, and so forth.

Rock on! arty0030:


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## Kattakko (Mar 19, 2013)

Thanks everyone! Your thoughts and comments are appreciated!!

On monday I took my 225 mcg and regretted it all day, I was really jittery! So I have cut back to 200mcg, it's only been 2 days so we'll see how it goes.

I can say that there have been a few positive developments though. I don't hurt as much as I did last week, still stiff but not as painful. I go to bed around 11:30 and I fall asleep relatively fast. I'm still a zombie in the morning but I haven't been up till 2am for a few days. And the diarrhea seems to be subsiding. (knock on wood!)

I'll wait until after my next round of blood tests before deciding whether or not to go gluten free. I've been doing some research, as my 3 year old son seems to be showing signs of Asperger's syndrome, which may or may not be linked to mothers autoimmune diseases (depends on where you read the info) and a gluten free diet would be beneficial for him too (he does have some digestive issues to begin with)... I'm obviously putting the cart before the horse here but he will be assessed soon, and we will move forward from there.
And the Mayo Clinic website supports my thoughts of my 19 month olds heart defect being directly caused by my uncontrolled hypothyroidism/autoimmune problem during early pregnancy.
The joys of being me! I feel like a complete failure as a mother after learning all of this, which doesn't help with Hashimoto's mental symptoms. 
Anyways... I'll keep everyone updated with my endo appointment in 16 days and more blood tests.

Thanks again!


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## CA-Lynn (Apr 29, 2010)

The jury is still out [re connection between autism and thyroid]. Very little support in the medical community.


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## Kattakko (Mar 19, 2013)

CA-Lynn said:


> The jury is still out [re connection between autism and thyroid]. Very little support in the medical community.


Oh I know. I just came across the possible link while doing research.

Even came across a study that someone wanted to do (don't know if they actually did it) where they wanted to take hypothyroid pregnant women, give half hormone treatment, the other half placebo and wait to see what would happen with their babies, if they would develop a problem or not. I'm sure that my opinion on this would be too strongly worded to post here, so I'll keep it to myself!


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## Kattakko (Mar 19, 2013)

Well, Only a few more days before I go see the Endo! I'm excited but super nervous at the same time!

I had cut back to 200mcg after my last blood tests, then I tried 225mcg again but it was too much. I waited a few days and tried again, but still too much so a few days later I tried 212.5mcg and I've been fine with this for almost a week now. (I will tell the Endo about this!!)

I'm super nervous all the time now, and the anxiety is almost out of control. The past month has been really hard emotionally even if there isn't anything out of the ordinary going on. I feel like I'm going crazy really.

Anyways, that's all that's new with me!!


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## bigfoot (May 13, 2011)

Just try to keep relaxed and do enjoyable activities to take your mind off of things. The anxiety and roller-coaster of emotions is more than likely being caused or influenced by all the hormone changes, both thyroid and otherwise, and medication changes. Something as small as a 12.5 mcg change up/down in your levothyroxine could be enough to cause this stuff. FYI -- if you are or were over-medicated, it can take some time for your body to settle down. It won't happen overnight. Good luck and you will do great! Just remember to advocate for yourself and don't take "no" for an answer!

hugs6


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## Kattakko (Mar 19, 2013)

So I went to see the endocrinologist....

The Good...

She took the time to (somewhat) listen to me, explained the Hashimoto process. Had me sit on the exam table, took my pulse and pressure. 130/80 and 68bpm. She felt my thyroid and my neck. Small swollen gland, didn't feel the lymphnode on the right. I showed her the one on the left that has "developed" over the past 2 months. She says it's about 1.5cm in size, and to me it feels round, hard, and it doesn't move around.
She was okay with the next blood tests that my regular doctor has me down for. (Cortisol, Ferritine, Calcium, Vit. D, Vit. B12 and folates, CPK (dunno what that one is), and antitransglutaminase). I go for those monday morning.
She has ordered another ultrasound, as my reg. doctor did but she is sending my to a different radiologist, almost saying that the one I went to the first time is a quack and doesn't know the neck at all! On the paper she gave my for the ultrasound she gives specific instructions to do a FNA incase of suspicion on a nodule or lymphnode. That is scheduled for tuesday morning.
She was okay with the fact that I take 212.5mcg of Levothyrox. Didn't care that I tuned things myself. Retesting THS and T4 at the beginning of July.

The Bad...

She tests TSH and T4 only. Clearly said that T3 is good for nothing and that you get all the answers you need from TSH. Won't test RT3, anti-TRAK, TRH, TBII, or TSI (She doesn't know what TSI is, but I don't know what it is in french so I couldn't say more about it). She says there's no use testing for any other antibodies. 
She says that my dose of hormone is so high because that's what my body needs. A smaller person would need less, bigger person needs more. A polite way of telling me I'm fat I guess!
She also said that when you have one autoimmune disease it doesn't mean you'll have any other ones. It opens the door for more, but it doesn't mean any others will walk in.
This is the one that got to me the most. She said that my symptoms that I have now, the ones that have been lingering for the past 4 years, are in no way caused by my hashimoto's now. The brain fog, concentration problems, slight depression, weight staying on, pain everywhere, none of it is because of my thyroid.

Still more confusion for me I guess... she wants copies of next weeks tests, but basically transferred me back to my regular doctor. 
I guess I'll know more next week.


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## Kattakko (Mar 19, 2013)

Yesterday I went for my blood tests, I'll have the results Thursday at the latest.

I went for a repeat ultrasound this morning.

Right lobe : 14mm x 14mm x 48mm
Left lobe : 15mm x 15mm x 45mm
Middle section is almost non-existent.
No nodules. 
2 large lymph nodes on right, largest being 20 mm long.
The one on the left is flat measuring 22 mm x 5mm

Nothing looked out of the ordinary.

I just don't know what to make of all of this anymore. And I'm so tired, tired of not knowing, not understanding, not feeling any better....

Anyways, that's all for now.


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## bigfoot (May 13, 2011)

Kattakko said:


> This is the one that got to me the most. She said that my symptoms that I have now, the ones that have been lingering for the past 4 years, are in no way caused by my hashimoto's now.


Ugh, sorry to hear that. It's hard not to feel a little let down after looking forward to an appointment like that, then not necessarily finding a sympathetic ear. Just have to keep on chuggin' along -- something that works for me is to always have a backup plan. (I guess that's a nice way of saying I'm more pessimistic about doctor's appointments than I used to be.) For you, you've got the Cortisol, et al, tests coming up. That's a good backup plan. See where those results take you. Have to keep reaching for the next rung, looking for another puzzle piece, etc...

The signs & symptoms you mentioned can absolutely be caused by Hashimoto's. That doesn't mean that it _is_ causing all of them in your case (or any of us here), but I think it's a pretty safe bet to say something is obviously amiss. And since you know you have Hashi's, that's a good starting point to look at.

Since this endocrinologist only tests by way of TSH and T4, IMHO, this is not the person to see to manage your thyroid issues. Run an ultrasound or order a FNA? Sure. But manage your medication(s)/care in order to optimize things for you on a daily basis? Nope. It sounds like your regular doc might be a better candidate for this, especially if he/she is the one who ordered the Cortisol test and so forth.

hugs3


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## Andros (Aug 26, 2009)

Kattakko said:


> Yesterday I went for my blood tests, I'll have the results Thursday at the latest.
> 
> I went for a repeat ultrasound this morning.
> 
> ...


Are you saying the isthmus is missing in action? And what about the lymph nodes? I happen to think both those things are out of the ordinary?

Let us know, will you? Have you talked to your doc about the results?


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## Kattakko (Mar 19, 2013)

Sorry, I chose the wrong words! loll In my (very short) ultrasound report from 2 years ago there's no mention on the isthmus. From the ultrasound in March it says that the isthmus region measured 2.8mm wide (transverse), and yesterdays report says "Isthme atrophique", which translates to Isthmus atrophic, very simply. No measurements were taken.
As for the lymph nodes, I don't know what to say. I felt certain that they would look more into them but I guess they don't see a need to. I thought that since they seem to be large enough that they would go ahead with a FNA. Maybe they just don't have any characteristics that would justify one?
Tomorrow is Thursday already, so hopefully my blood test results will explain some of my symptoms. Finally the sun has come out and the rain has stopped, it helps to keep me calm and collected. It was really cold and rainy last week and the week before so it didn't help. It always helps when the sun is shining  
I'm gonna "Keep on keepin' on". I know that the road ahead will continue to be rocky though as we are trying to plan a move back to Canada for the end of the summer. Hopefully I'll be able to find an Endo that treats me based on more than just numbers. I know I'll have to switch medication again... They prescribe 3 months at a time here so I don't know how much I'll be able to stock up before we leave. I have copies of every test I've done here, and from before too. Yes I am stressed, but I'm also happy (at the moment). I wouldn't stay with this Endo here, so finding a new one here or back in Canada doesn't really make much of a difference to me.

Thank you both Bigfoot and Andros  I really appreciate your thoughts, questions and comments! Hugs to you both!!


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## surge (Aug 15, 2012)

I know this is frustrating and I'm sorry. Your notes from your conversation with the endo sounds like several conversations I had with my old endo, who always felt we couldn't credit my thyroid with all the symptoms-- which is why my primary and I really tried to rule out other causes...nothing else explained it and she thought I was just a really stressed out individual, though I'd had no history of anxiety.

As I mentioned earlier, I had my thyroid removed in November. Post-surgery, it is so interesting to watch my body slowly stop oscillating. I still have some of the same old symptoms-- we're having trouble finding my dose-- but they are becoming more and more very clearly JUST thyroid symptoms-- bowels slow down, skin especially under eye looks bad, hair loss and heart palps, but a lot of the other stuff is fading (though it's taken 6+ months) and I feel a little better every day, despite the fact that in the last three months I've been hypo, then hyper and now, hypo again. My best guess has been my guess all along, that all the antibodies in my system initially made it really hard to medicate me, then as they slowly started to fade, my lab work finally started to match my symptoms, which I cannot describe to you how delightful I find that.

And as some of that inflammation fades out, I find in general I have more energy, no leg pain, no anxiety, still have runs of heart palps and hair loss, but uh, my tsh is all over the place, so that's expected. This just teaches me how overall inflamed I was. my whole system was reacting/overeacting and it maybe isn't completely accurate to say it was all thyroid, but it certainly also wouldn't have been happening if I didn't have thyroid issues. To me, it seems like you're on top of the thyroid as much as you can be, and I don't know what success you'll have getting your body to calm down, but I would widen your approach to really consider eliminating other inflaming agents-- which just means trying to manage anxiety-- even though it comes to you courtesy of thyroid-- in any way you can. Favor exercise like stretching/walking/golf that doesn't pump up the system too much, but try to get a lot of exercise (I know this is exhausting to even contemplate some days). Consider giving up wheat for a substantial time-- 6 weeks- 3months and evaluate your symptoms (also exhausting to contemplate). Consider taking a magnesium supplement like "CALM" to help with stress, too. Drink lots of bone broths-- beef, chicken, turkey-- again to help calm and balance the system. And lots of deep breaths! You are enduring a lot, and you probably have more to endure before it's all settled, but try to take care of yourself in any single moment with lots of rest, forgiveness, gentle exercise.


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## Andros (Aug 26, 2009)

Kattakko said:


> Sorry, I chose the wrong words! loll In my (very short) ultrasound report from 2 years ago there's no mention on the isthmus. From the ultrasound in March it says that the isthmus region measured 2.8mm wide (transverse), and yesterdays report says "Isthme atrophique", which translates to Isthmus atrophic, very simply. No measurements were taken.
> As for the lymph nodes, I don't know what to say. I felt certain that they would look more into them but I guess they don't see a need to. I thought that since they seem to be large enough that they would go ahead with a FNA. Maybe they just don't have any characteristics that would justify one?
> Tomorrow is Thursday already, so hopefully my blood test results will explain some of my symptoms. Finally the sun has come out and the rain has stopped, it helps to keep me calm and collected. It was really cold and rainy last week and the week before so it didn't help. It always helps when the sun is shining
> I'm gonna "Keep on keepin' on". I know that the road ahead will continue to be rocky though as we are trying to plan a move back to Canada for the end of the summer. Hopefully I'll be able to find an Endo that treats me based on more than just numbers. I know I'll have to switch medication again... They prescribe 3 months at a time here so I don't know how much I'll be able to stock up before we leave. I have copies of every test I've done here, and from before too. Yes I am stressed, but I'm also happy (at the moment). I wouldn't stay with this Endo here, so finding a new one here or back in Canada doesn't really make much of a difference to me.
> ...


Hugs back at you and we will be anxious to see the lab results and ranges when you get them.

Definitely a sun person here but I do not suffer from SAD; thankfully!


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## Kattakko (Mar 19, 2013)

Got results!!!!

Calcemie (calcium) *2.29* (2.15-2.50)

Ferritine *33* (15-150)

Vitamine d-25 OH - D2+D3 *10* (30-100)

Vitamine B12 *251* (141-489)

Folates *10.1* (10.4-42.4)

Cortisol *744* (Morning 7-10am *171-536*) Done at 8am

anti-transglutaminase <3 Negatif <7 
So negative for Celiac's, I'll check to see if I can have the one for intolerance or sensitiviy in the future just to rule it our as well.

My doctor will probably call tonight to go over these, I hope she does anyways. In the mean time what does everyone think? loll

Thanks!


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## bigfoot (May 13, 2011)

*B-I-N-G-O.*

I see low Vitamin D (which can cause quite a bit of trouble itself), low Folates, lower-end Ferretin, and the huge elephant in the room -- a very elevated morning Cortisol level. That, to me, plays into the excellent advise Surge was giving about trying to limit inflammation and help your body help itself.

Something is causing your body to over-produce Cortisol. Could it be a problem with your adrenals, such as Cushing's syndrome? Or perhaps there is a disease or inflammatory process in the background that your body is fighting? Either way, this is something significant that needs to be investigated ASAP.


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## Andros (Aug 26, 2009)

Kattakko said:


> Got results!!!!
> 
> Calcemie (calcium) *2.29* (2.15-2.50)
> 
> ...


Your iron is really low, it should be 50 to 100 and the closer to 100, the better. Try liquid Floradix and make sure to take it 4 to 5 hours away from your thyroid replacement med.

I would hold off on the Vitamin D and here is why.................

Vitamin D
http://www.eurekalert.org/pub_releases/2009-04/arf-vdm040809.php

Try to get a little sun and eat egg yolks.

Let us know what the doc has to say if you would like to do that.


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## surge (Aug 15, 2012)

The first thing the doc should address is the high cortisol. It does point to a system in STRESS. As you're investigating, limit all kinds of stress to get LOTS of rest, like 10+ hours a night if possible and only gentle exercise. How much caffeine are you drinking?

I also agree with Andros that supplementing iron is a good idea and I like the Floradix as well, though I'm not sure what they'll have in France, but look for a liquid iron since it's easily absorbed. Also, agree with Andros that the best way to get vitamin D is food and sunlight. Morning walks without sunscreen on your arms are great.

Have you looked at other auto-immune issues? Also, as bigfoot notes, has Cushings been ruled out?


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## Kattakko (Mar 19, 2013)

Thank you for your thoughts Surge!

I have tried to be as stress free as possible today, sat outside with the kids for a while. The sun is really hot though, and I feel like I'm absorbing the heat! The kids stayed cool to the touch and I feel like I've got a fever!
I will get my Vit. D from the sun, and I'll look into adding foods high in Vit. D to my diet.
I will look for a liquid iron supplement here. I doubt that they will have the same ones here but I'll look. My stomach is already sensitive enough so I'll look for liquid to make it as easy as possible for me to take.
My doctor didn't call yesterday and hasn't yet today. Since I feel like a scared little pup today I haven't been able to muster up the courage to call myself!!!
The cortisol does have me worried. I just don't understand it! I'll have hubby bring a copy of these result to the Endo on monday, since GP and Endo don't talk, maybe she'll want to test further to rule other things out. I'm just afraid that she'll say I'm just too stressed out and that will be it. 
Is it my system that is stressed? Or is it me who is too stressed out? That is what I don't understand the most.
I'll call for sure on monday if no one has called. I just need a few days to let it all sink in. I go for tests to get answers and every single time I have more questions. I really am on a rollercoaster aren't I?

Thanks again to all of you for taking the time to read my posts, to comment, and to help me try to figure some of this out! hugs to you all!!!


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## surge (Aug 15, 2012)

I don't think you're feeling this poorly because you can't manage stress. Obviously, you've been managing to keep putting one foot in front of the other, even though you don't feel well. When I talk about stress in this context, it is systemic stress.

For some reason, your body is on fire. It could be on fire because your thyroid has been imbalanced for awhile and it's caused reverberations. It's typical for hypothyroid patients to have vitamin d and iron absorption issues. It's also typical for hypothyroid and hashis people to have adrenal issues. So it could be that as you stabilize with your meds, the other symptoms will slowly calm down.

But it's important to rule non-thyroid issues out. So follow up on what's causing the adrenal issue, follow up blood work on other autoimmune issues, if you haven't had the test already. I know why you feel nervous about calling the doc, and it's okay to wait until Monday, but it's still your right to ask the doc to explain his/her readings and to question any easy answers. You have to live inside this body, the doc doesn't. The docs have lots of experience, but you can also help guide them in their responses by emphasizing symptoms that you are confused by. Also, don't be afraid to ask what the follow up plan is IF their plan of attack doesn't work-- if you continue to feel worse. Sometimes, I'm willing to entertain their plan IF I have an escape hatch.


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## bigfoot (May 13, 2011)

Surge is right-on. You aren't dealing with "stress" such as filing taxes or sleeping in too late on a workday. The elevated cortisol is your body telling you, on paper, that something is wrong.

The next step is your doc should be ordering a 24-hour urine or saliva cortisol test, ideally separated out into four collection periods. And then looking for what is causing the high cortisol in the first place. Could someone in theory have a high cortisol lab just because they were in a rush to the lab in the morning, and they don't like needles? Sure. But that's what the follow-up urine or saliva testing is for.

:hugs:


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