# "The numbers don't lie." True or false?



## I DClaire (Jul 31, 2011)

I pretty much lost it talking to my endocrinologist's PA this morning. I had labs done yesterday morning _(should receive written copy of test results_ _tomorrow)_ and the PA first called yesterday afternoon to tell me everything looked good...keep on taking 90 mg Armour then be re-tested and see the doctor in one month.

I told her irregardless of the test results, I do not feel well and I believe I am under-medicated. I like and respect this young PA and we have a good relationship. She said she would express my concerns to the doctor _(who had already left the office yesterday)_ and call me today.

This morning the PA called. She said she had talked at length with the doctor BUT the doctor could not justify raising my 90 mg dosage because my numbers were so good - because *"the numbers don't lie*." I tried in vain to discuss what I believe about thyroid test results but to no avail.

One month before I had a total thyroidectomy on September 23, 2011, my test results were normal. The endocrinologist told me I was "biochemically euthyroid" - Methimazole had my numbers so good that I was deemed biochemically normal..._and I could not have felt any worse! _I had every hyperthyroid symptom I'd ever had plus I suspect the Methimazole was making me feel even worse...by, hey, my numbers were great!

The surgeon found my thyroid to be three times bigger than normal, "filled with" cysts and nodules and a tiny papillary cancer...but one month prior to that my lab results were normal!

I say all this to set the stage for one question. How much reason is there to believe the lab tests I had yesterday are all that indicative of how I feel? I feel under-medicated, my energy level is poor...right now I'm wondering if the tests yesterday are actually anymore accurate than the tests were a month before my surgery? If I repeated the tests this afternoon, would the results match yesterday's numbers? Do I just sit here and accept that this is as good as it's going to get because my test results are good even though I feel like I'm under-medicated as far as energy, stamina, mental focus, etc.

Who is lying - the test numbers OR the way I feel?

How do I fight city hall, _or my doctor as the case may be? _

Another question...what is the worst thing that could happen if my doctor took whatever the big gamble is with my overall health and bumped my 90 mg dosage up another smidgen amount? What is it that she seems to think prohibits her from taking that leap of faith that maybe, just maybe, the numbers don't know the whole story??? What is SO questionable in her mind that she will not give me the benefit of the doubt? Is there a risk that the next highest dose might kill me?

I'm not being rude - I'm trying my best to understand this situation. I'm now six months post surgery. I've not had one negative side effect with Armour. The very first day I was bumped up from 60 mg to 90 mg (a month ago) my palpitations dramatically improved...to the point where I only notice them late in the day or at night. My blood pressure is more stable - those numbers are improved.

What am I missing? I've heard and read many times that the best endocrinologists treat symptoms, not numbers. If I try to find a new doctor it'll mean closing the door on this one and I don't see any guarantee that the end result from doing that wouldn't be another gamble. I basically like this doctor and I honestly believe she likes me...but I feel like I'm banging my head against a brick wall.

I feel like I've been the most patient patient a doctor could have but I simply cannot understand the hesitance to at least see if a larger dose of Armour might have a positive impact on my level of fatigue.


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## lainey (Aug 26, 2010)

> Who is lying - the test numbers OR the way I feel?


I'll be honest, from my own experience, I have no idea about the numbers and I never trust how I feel. People examine the numbers with calculators and analyze them and want them to be something specific when they are known to change. I've known others to build spreadsheets around their symptoms, trying to tie them to specific numbers.

Why?

Maybe the focus is misplaced. Allow me to share a little.

My TSH has been .05 and it has been 5.0 and I have basically felt the same. As a result, I gave up worrying about it a couple of years ago, because apparently I am no gauge of my own numbers.

I have felt really hypo and had the TSH come in around 1. What a disappointment--I know I don't need a dose adjustment and I have to move on.

And when I get a dose adjustment, even a small one, for the first few weeks I feel so hyper it's all I can do not to climb the walls and bite off peoples' heads. I am convinced that people must be able to see my heart beating beneath my shirt, the palpitations are so forceful. That, and there was always the expectation--when would it stop--and then the delay, and then the day when it must have gone away because that was when I stopped paying attention to it. Frustrated, I've changed "feeling good" to "functioning well" or "functioning poorly" and my target became more reachable, because I can "function well" if I am technically not "feeling good" although truth, I am feeling good/functioning well most of the time--okay, but not 100% of the time--is that even reasonable?

In December, my TSH was 3.9 and on a whim he ran it 3 weeks ago and it was....6.53. WTH?????

I kept thinking to myself--was that some kind of mistake and why didn't I have any idea (okay, eighteen months ago when it came in again at almost 6 I didn't really have any idea either)? I mean, I'm so busy that I'm only sleeping about 5 hours a night so, that would explain why I'm a little tired, right? The palpitations are really just because I also have an arrhythmia, and any little stimulation sets it off, right? I'm anxious because, well, life is busy and there's a lot going on, no?

So, take "that leap of faith that maybe, just maybe, the numbers don't know the whole story???"

They don't. There are a lot of other factors. There are always plenty of other reasons for it to be something other than the numbers.

When you get the numbers, post them. We'll all be here to overanalyze them.

Sorry if this seems like a rant. I feel your frustration--we all do, we all live it and it is ongoing. I am not saying that you don't need a dose adjustment. You should advocate for yourself, and have a doctor that is willing to work with you, not just dictate. But I am saying that regardless, you have to find a way past that because it isn't always in the numbers.


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## desrtbloom (May 23, 2010)

Hi!

Regarding your fatigue, you might try taking 5000 mg of Vitamin D. Since my thyroidetomy, my Vitamin D gets depleted quite fast. I was taking 1000 mg and now 17 months later I am up to 5000 mg daily. Also, you might take B12 as that seems to get depleted too. I am taking 5000 mg of B12 a day too. It has all made a world of difference to my fatigue levels.

As for the levels, I agree that only you know your body. You haven't got the results yet, so I would see what the results say. What's "normal" for one isn't normal for ALL. So post your levels and ranges and lets see what's going on.

Hang in there. :hugs:


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## Andros (Aug 26, 2009)

I DClaire said:


> I pretty much lost it talking to my endocrinologist's PA this morning. I had labs done yesterday morning _(should receive written copy of test results_ _tomorrow)_ and the PA first called yesterday afternoon to tell me everything looked good...keep on taking 90 mg Armour then be re-tested and see the doctor in one month.
> 
> I told her irregardless of the test results, I do not feel well and I believe I am under-medicated. I like and respect this young PA and we have a good relationship. She said she would express my concerns to the doctor _(who had already left the office yesterday)_ and call me today.
> 
> ...


Please read this! http://www.mercola.com/Article/hypothyroid/diagnosis_comp.htm

You need to find a doctor you don't have to fight with and that is no joke. Your veterinarian could do a far better job.


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## Gwen1 (Sep 3, 2011)

I thought labs needed to be done no sooner than 6 weeks to be accurate. IDClaire has been on this dose for 1 month.


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## lainey (Aug 26, 2010)

> I thought labs needed to be done no sooner than 6 weeks to be accurate. IDClaire has been on this dose for 1 month.


Yes, and that would also be a good reason not to increase it right away, but to give it a little more time.


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## I DClaire (Jul 31, 2011)

I love you guys! I am not kidding - I do not know what I would do without you. The PA called me again this morning at 8:00. She said she and my endocrinologist had been discussing my case again this morning. There is not one doubt in my mind at this point that they're concerned and want to help me. She said they're worried about me...and I told her I'm worried about me also!

With the copy of my lab tests from Wednesday she is also sending orders for new labs two weeks from now instead of a month from now.

I said that using printed material they had given me plus countless things I've printed online, I am convinced I am under-medicated, I have too many symptoms of hypothyroidism not to believe I am under-medicated.

The PA replied that there are other medical and psychological reasons one can feel hypothyroid and I agreed...but I also said I was not about to start making the rounds of every specialist in town like I did for the symptoms I now know were hyperthyroid-related.

Then I calmly asked, "What is it the doctor fears, what is it that makes the risk of giving me a little more Armour than my recent tests indicate I need so threatening that she cannot work with me?"

The PA said Armour is a powerful drug - that I could easily get too much and become hyperthyroid.

I replied that after all I've been through for the past 4 years, if there is one thing I believe I truly understand and recognize it is hyperthyroidism, I would know in a minute if I had hyperthyroid symptoms...and I would contact the doctor immediately. I told her as sincerely as I could that I am not interested in being biochemically hyperthyroid, I just want to feel healthy, I want enough energy to function like a normal human being.

The PA was genuinely sympathetic. She said they'll look at my lab tests in two weeks and see if my numbers hold, etc. I don't see the doctor again until May 2 but will have these new labs two weeks from now and then they'll call me again.

I have to be honest. I have to be honest with the doctor and I have to be honest with myself. My lifestyle is not conducive right now to giving something like Armour a fair test. If I were younger, maybe busy with a family and/or a job and had more things to enjoy maybe I would feel more energetic. Instead, I'm not in a good place right now - my brother-in-law's mother who is close to us is going into hospice care any day now, my 90-year old mother generates one crisis on the heels of another, Paul is having heart symptoms and aggressive treatment for the wet form of macular degeneration...plus the refrigerator has gone out and the roof leaked this week when we had 48-hours of rain!! :anim_03:That's a lot for any little pill to overcome!!

You know, this is a bit off-topic, but sometimes (often actually) I wish there were little DIY blood testing kits for thyroid patients like diabetics use. IF I could test my blood daily or maybe when I feel particularly good or noticeably bad, maybe I could figure out what the triggers are.

I guess y'all have all noticed I'm a person of few words!! :anim_63: Right? Right?? Seriously though, I feel like eventually things will improve...one way or another. To say this is not what I thought my "Golden Years" would mean is a major understatement but I guess we all have to carry whatever load of problems life hands us. Having friends, even if they're online, who'll listen and share their feelings absolutely helps lighten the load.


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## I DClaire (Jul 31, 2011)

desrtbloom said:


> Hi!
> 
> Regarding your fatigue, you might try taking 5000 mg of Vitamin D. Since my thyroidetomy, my Vitamin D gets depleted quite fast. I was taking 1000 mg and now 17 months later I am up to 5000 mg daily. Also, you might take B12 as that seems to get depleted too. I am taking 5000 mg of B12 a day too. It has all made a world of difference to my fatigue levels.
> 
> ...


I've had a problem with Vitamin D my whole adult life. I've taken a prescription Vitamin D for 50,000 IU. It made me sick as a dog! My "D" has only been tested once (I believe) since my surgery and it was still low but I think it was up from what it had historically been and the doctor now has me on 2,000 IU daily, which I take faithfully.

I wish I knew more about supplements. At one time I actually was going to a doctor's office several times a week for B-12 shots and they made me feel wonderful...but the feeling would not last. I'm taking SuperiorSource MicroLingual B-12 tablets right now but I don't know whether they help or not.

After my father died unexpectedly in 2008, I told a close friend that nothing seemed normal anymore. Nothing about the life I'd always known, because I was so close to my dad, seemed normal. My friend said in time we formulate new "normals"...and maybe that's true with thyroid disease also.

Sometimes I get so down that I simply do not know how much more I can tolerate...then something encouraging happens. Baby steps? No matter how small or insignificant whatever it is, it seems like my very soul reaches out to grab it and try to run with it. I've come a long way the past few months but it's been really slow. I guess even a snail eventually gets wherever he wants to be if he doesn't give up and die!! arty0049:


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## Andros (Aug 26, 2009)

I DClaire said:


> I've had a problem with Vitamin D my whole adult life. I've taken a prescription Vitamin D for 50,000 IU. It made me sick as a dog! My "D" has only been tested once (I believe) since my surgery and it was still low but I think it was up from what it had historically been and the doctor now has me on 2,000 IU daily, which I take faithfully.
> 
> I wish I knew more about supplements. At one time I actually was going to a doctor's office several times a week for B-12 shots and they made me feel wonderful...but the feeling would not last. I'm taking SuperiorSource MicroLingual B-12 tablets right now but I don't know whether they help or not.
> 
> ...


Born and bred Southern Women do not give up!


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## I DClaire (Jul 31, 2011)

I said I've got to be honest, didn't I? Something happened yesterday afternoon that probably means I'll have to make a mark on the wall in the doctor's column!!

I've been asked to write something - actually a story about the cast iron coffin I told y'all about, that may very well be published. I've been asked to do something that, almost like flipping a switch, gave me something new to think about.

Kinda' interesting, huh?

I've felt rejuvenated at the prospect of actually having a project, a goal, something that does not involve my goofy family in any way, shape or form! I've been in a happier, lighter mood since last night.


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## Andros (Aug 26, 2009)

I DClaire said:


> I said I've got to be honest, didn't I? Something happened yesterday afternoon that probably means I'll have to make a mark on the wall in the doctor's column!!
> 
> I've been asked to write something - actually a story about the cast iron coffin I told y'all about, that may very well be published. I've been asked to do something that, almost like flipping a switch, gave me something new to think about.
> 
> ...


You should be writing. You "are" a writer........................to the max. I am so happy about this!


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## I DClaire (Jul 31, 2011)

Just as I got up to leave the computer, Paul came in with today's mail. I have my latest lab results from three days ago (March 21, 2012). I'm going to attempt to Copy & Paste them in with my older lab results.

Lab results since surgery on September 23, 2011. All labs app. 10:30 A.M. at the same hospital lab.

*T4 FREE - Ranges 0.8-1.5*

November 10, 2011 - 1.4 (taking 125 mcg Synthroid)
December 22, 2011 - 1.4 (taking 125 mcg Synthroid)
February 22, 2012 - 0.6 (taking 60 mg Armour) 
_*March 21, 2012 - 1.0 (taking 90 mg Armour since February 22, 2012)*_

*T3 FREE - Ranges 2.0 - 3.6*

November 10, 2011 - 2.9 
December 22, 2011 - 2.5
February 22, 2012 - 1.8
_*March 21, 2012 - 3.8*_



*TSH - Ranges 0.37-4.55*

November 10, 2011 - 0.059
December 22, 2011 - 0.455
February 22, 2012 - 28.900
_*March 21, 2012 - 1.750*_

*Thyglobulin Tumor Mrk - Range 0*

November 10, 2011 - 0.3
February 22, 2012 - 5.5

I was switched from 60 mg Armour to 90 mg Armour on February 22, 2012.

Thyroidectomy - September 23, 2011


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## miguel (Jul 18, 2011)

Do you took your armour before lab work?


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## Andros (Aug 26, 2009)

I DClaire said:


> Just as I got up to leave the computer, Paul came in with today's mail. I have my latest lab results from three days ago (March 21, 2012). I'm going to attempt to Copy & Paste them in with my older lab results.
> 
> Lab results since surgery on September 23, 2011. All labs app. 10:30 A.M. at the same hospital lab.
> 
> ...


Well, the FT3 is a little high but that fluctuates throughout the day and I wonder if you took your Armour right before you had your labs? T3 will peak in 4 hours after you take it.

Let me know and we can discuss this further if you like. Would like to see your TSH down a whole lot since you are a cancer patient.

Let me know what time you took your Armour and what time you had the blood draw as it is important.

Don't like that tumor marker. What did the doctor say about that?


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## I DClaire (Jul 31, 2011)

Andros said:


> Well, the FT3 is a little high but that fluctuates throughout the day and I wonder if you took your Armour right before you had your labs? T3 will peak in 4 hours after you take it.
> 
> Let me know and we can discuss this further if you like. Would like to see your TSH down a whole lot since you are a cancer patient.
> 
> ...


I take my Armour every morning around 7:00, then I faithfully wait at least an hour before eating or drinking anything.

I do take my Armour on the days I have lab work - same schedule. I also eat breakfast.

I have had all four of these labs done between 10:00-11:00 A.M. - all at the same hospital in the same lab.

The tumor marker was from the previous tests, the ones where my TSH was 28.900! When (I believe) she saw that, my doctor had me get the ultrasound on my "thyroid bed", which was deemed just fine. The doctor said I'd be followed for 5 years with this test and ultrasound.

I honestly believe the tests on February 22, 2012 were somehow flawed. I cannot see where it would make any difference but I vividly remember the lab technician dropped something on the floor while she was drawing my blood and I believe it was another vial of blood but I can't swear to it. That was the same morning the hospital lab called my doctor because the numbers were so weird. I wish I'd thought to ask if I could just turn around and go have the tests repeated but I didn't.

A longtime, highly experienced lab person used to do my labs. She did them most of the time while I was hospitalized and I thought of her as my guardian angel because she was so good...then her husband got sick and she started working night shifts. The last two times I've had blood tests it has been done by young women who appear to me to be students. They're nice but I don't get good vibes that they're totally familiar with what they're doing.

Should I be taking my Armour on the days I have labs or not? I thought someone here had said one time that it wouldn't make that much difference but maybe I dreamed that. What does everyone else do?


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## I DClaire (Jul 31, 2011)

I've been thinking about all this. I actually do relatively well for 4-6 hours after I take my Armour, then I start sliding quickly into the most fatigued hours of my day. By 6:00 P.M., I am pooped!

Every lab test I've had since my surgery was done approximately 4 hours after I'd taken either Synthroid or Armour.

Since afternoons are the worst as far as fatigue, I'm thinking two weeks from now (when I have my next labs) I might just have blood drawn mid-afternoon. Maybe that's the key to what's happening...I think I'm under-medicated because while my test results are O.K., the blood is being drawn when the T3 is at its peak. Then I see the doctor mid-afternoon and she can't understand why I am totally exhausted.

I thought it was important that I stayed on the same schedule for all my labs for the sake of comparison but I may be shooting myself in the foot if I keep having blood drawn when my T3 is at its peak.


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## webster2 (May 19, 2011)

Sounds like a great plan, IDC! It would be interesting to see what the labs might be in the afternoon.


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## Octavia (Aug 1, 2011)

I agree - this sounds like a good plan. You may indeed be shooting yourself in the foot, as you suggest.

Also...I am SOOOOOO excited about you being asked to write the "Iron Coffin Story!" You were born to write, you really were! It seems like something you love to do, and you are very, very good at it! You keep us entertained here without even trying when you write your interesting stories.


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## I DClaire (Jul 31, 2011)

Octavia said:


> I agree - this sounds like a good plan. You may indeed be shooting yourself in the foot, as you suggest.
> 
> Also...I am SOOOOOO excited about you being asked to write the "Iron Coffin Story!" You were born to write, you really were! It seems like something you love to do, and you are very, very good at it! You keep us entertained here without even trying when you write your interesting stories.


I have been so energized since yesterday when I turned-in the story that I've about come to the conclusion that what I really need as much as more Armour is a whole new life!! I feel happy, I've had a lot of fun with it and it has hit me like a ton of bricks that my so-called life is in a worse place than I even thought it was. I was so exhausted last night I don't even remember going to bed and I slept like a bear!

Isn't it strange how things happen sometimes? If I never write another word, I've come to a HUGE realization that I've got to reclaim more of the life I used to enjoy; if getting my mind distracted by writing a story is THIS therapeutic then somehow I have got to get past the level and intensity of how things like stress and boredom are effecting me.

I was thinking earlier how we hear people say they'll never retire, they know themselves well enough to know they want and need the mental stimulation and physical demands associated with a job. I'm no slouch when it comes to soul-searching and I intend to try to mix more mental or emotional attitude in with my quest to get to feeling better.


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## Andros (Aug 26, 2009)

I DClaire said:


> I take my Armour every morning around 7:00, then I faithfully wait at least an hour before eating or drinking anything.
> 
> I do take my Armour on the days I have lab work - same schedule. I also eat breakfast.
> 
> ...


Oh, Lord.............you cannot drop the blood. It messes up the cells and skews the test.

Okay; you had labs exactly 4 hours after you took your Armour so they are not getting a correct assessment of your FT3 for the long term. Looking at your labs, the novice would say you are over medicated but you are not.

With the old Armour, I never had that problem but w/ the new filler which actually is great, it does absorb faster. You might want to try to take your Armour after your blood draw.

Just one person's input based on experience.


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## Andros (Aug 26, 2009)

I DClaire said:


> I've been thinking about all this. I actually do relatively well for 4-6 hours after I take my Armour, then I start sliding quickly into the most fatigued hours of my day. By 6:00 P.M., I am pooped!
> 
> Every lab test I've had since my surgery was done approximately 4 hours after I'd taken either Synthroid or Armour.
> 
> ...


Yep; that is a capital idea to the max. Can you do that?

Good analogy about shooting yourself in the foot!!! ROLF!!!


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## I DClaire (Jul 31, 2011)

Yeh, I can go anytime I want to. Nobody has ever given me any instructions whatsoever about when to take Synthroid or Armour prior to labs. I don't have to fast so I'm thinking I'm going to go mid-afternoon just to see what happens.

I've been so excited about the story and people calling and all that but by 4:00 P.M. I felt like I had hit the skids! I am totally exhausted!


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## Octavia (Aug 1, 2011)

As an alternative, can you get your blood drawn very first thing in the morning, before you take your Armour?


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