# parasthesia



## fireball (Jun 9, 2014)

I am new here!

I have experienced a lot of tingling numbness and vibrations from my core for the past 6 weeks. I'm wondering if this will go away? I think if it was anxiety It would come and go but this persists. especially at night. Any insight?

27/05/14 FT4 15(10-22) TRab<.9 armour 1/4 three times a day(total dailyT4 28.5/ T3 6.75) Calcium 2.42 (2.18-2.58)

12/05/14 TSH 1.84(.27-4.2) FT417 (10-22) FT34.2(3.5-6.5) switched to armour 1/4grain twice a day(total dailytT4 16mcg/t3 4.5mcg) symptoms parasthesia, insomnia, vibrating core 
07/04/29 TSH 1.15(.27-4.2) FT4 16 (10-22) FT33.4(3.5-6.5) stopped MMI .62 synthroid 
07/04/14 TSH 1.95(.27-4.2) FT4 15 (10-22) FT3 3.8 (3.5-6.5) 0.5 MMI .625 synthyroid
10/03/14 TSH 1.63( 10-22) FT4 16 (10-22)FT3 3.7 (3.5-6.5) 1.25MMI .05synthyroid
21/02/14 TSH 3.25 (.27-4.2) FT4 15 (10-22) FT33.7 (3.5-6.5 1.25 MMI .05 synthyroid
27/01/14 TSH 3.45(.27-4.2)FT4 16 (10-22) FT3 3.6 (3.5-6.5) 2.5 MMI .05 synthyroid 
08/01/14 TSH 1.8 (.27-4.2 )FT4 16(10-22) 5mg MMI and .05 Synthroid TRAB <0.9 
26/11/13 TSH 2.08(.27-4.2) FT4 12(10-22)5mgMMI .o50 synthroid
29/10/13 TSH 1.36 (.27-4.2) FT4 12 (10-22) 2.5 2xdaily MMI 5mg total
01/10/13 TSH 0.11(0.27-4.2)FT4 11(10-22) 10mg x7day 7.5x3weeks divided into 3
03/09/13 TSH<0.2(0.27-4.2)FT4 15 (10-22) 15mgMMI divided into 3
12/08/13 started 20mg MMI divided into 3
31/07/13 TSH <0.2(0.27-4.2)FT4 34(10-22) TR ab 2.5(<1.8) Iodine uptake 40%


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## Andros (Aug 26, 2009)

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test
(Copy and paste into your browser)

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583
(Copy and paste into your browser)

Substances not found in normal serum (scroll down to autoantibodies)
http://www.thyroidmanager.org/chapter/evaluation-of-thyroid-function-in-health-and-disease/
(Copy and paste into your browser)

Myopathy from hyper.
http://www.medicalonly.com/2007/07/27/thyrotoxicmyopathy_hyperthyroidism
(Copy and paste into your browser)

Myopathy from hypo
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1010480/
(Copy and paste into your browser)

peripheral neuropathy
http://www.ninds.nih.gov/disorders/peripheralneuropathy/detail_peripheralneuropathy.htm
(Copy and paste into your browser)

http://www.suite101.com/content/thyroid-disease-and-neuropathy-symptoms-a140669
(Copy and paste into your browser)

It appears that you have some TRAB where you should have none. This is the antibody to TSI so I am going to urge you to get a TSI test.

It would appear that you may be hyperthyroid and boy does that ever cause peripheral neuropathy.

Enclosing information for you and Welcome to the board!

It really looks like you are hyper but I enclosed some links for hypo as well. Symptoms can and do cross over.

Was anything else noted when you had your RAIU? Any nodules or vascularity? I ask because the uptake is low and that could suggest some solid nodularity.

And what has your doctor commented?


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## fireball (Jun 9, 2014)

Hi as you can see I do have graves but am in remission as the blood work clearly indicates. If you look at 07\04 you see my FT3 dip below range and thus I switched to armour. Parasthesia is one of the symptoms of having not enough thyroxine to meet the bodies needs. It is bloody uncomfortable and anxiety provoking.

Please look at the FT4 and FT3 Clearly I am not hyper.... LOL

Any hopeful stories of getting rid of the tremor and pins and needles?


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## bigfoot (May 13, 2011)

fireball said:


> Any hopeful stories of getting rid of the tremor and pins and needles?


Short answer: YES.

Longer answer: While I can't say that I have Graves' (or at least, it's never been diagnosed), I do have Hashi's and have dealt with the numbness and pins & needles feeling. I had that extensively when I was under-medicated and using only synthetics. Especially in the arms, legs, and lower body. Heck, one doc wanted to send me for an expensive nerve conduction study (thanks, but no thanks). Once I addressed a very high Reverse T3 level (via a naturopath), and subsequently switched over to Nature-Throid, the numbness and tingling all but vanished. Every now and then it might pop up for a few minutes, but it seems very rare now.

As far as the "vibrating core", I did have that for a while when very under-medicated. As we ramped up dosages in synthetics, it seemed to get worse and worse, until I hit some sort of threshold. Perhaps it was the nasty Hashi's flare up.


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## fireball (Jun 9, 2014)

Thank you BIGFOOT,

I can't tell you how powerful a drop of hope is.

I don't know what my reverse T3 is as I've never had my bound T3 done. I imagine it is very high as I have been deliberately keep on the low side of the ranges for 8 months. Also my liver enzymes were high from being hyper. What is kinda interesting is that my naturpathic guy put me on kidney detox about 4 months ago. This was in addition to the liver detox and various other stuff. This would support the "stop the thyroid madness "theory of using only T3

Can you tell me more about your story... the ramping up of synthetics. I think this is exactly my story. I tried to go to 75 of thyroxine but the vibrations increased. I switched to armour and initially thought I felt better but it has again increased in intensity to the point that I" vibrate" at night and can't sleep. Are the vibrations a symptom indicating I need a higher dose or that I need more time. LOL I know you can't answer that but if you could share how you "fixed this"I would love you forever!!!

PS I am getting my B12 done as well as seeing a neurologist to rule out MS. My calcium is within range so I don't think this is parathyroid. Have I missed anything?

Thanks so much for your response!


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## bigfoot (May 13, 2011)

I'll try to remember as best I can, although as well all know, sometimes our memory isn't what it used to be. 

I went hypothyroid after battling liver disease and going through chemo. I suspect that I had Hashi's (or an autoimmune component) prior, as looking back now, many things seem to piece together. At any rate, I was kept on (as I now know) a very low dose of generic levothyroxine at 50 mcg. This went on for over a year, all the while my TSH was hovering in the 3.0-4.0 range, my FT3 and FT4 (when they ran them) were not that great. I had some good days, but plenty of crappy ones. Eventually something gave way, and I had a really bad flare-up, and a doc discovered Hashi's. They quickly ramped me up from 50 mcg -> 75 mcg -> 100 mcg over the course of a couple of weeks (waaay too fast). I was having the vibration feeling, along with lots of other issues from titrating up too quickly. We throttled back to 62.5 mcg and I slowly worked my way up to 88 mcg of levothryoxine. The vibration feeling subsided, however, I still had lots of weird signs & symptoms, including the neuropathy, stiff fingers, strange muscle aches & pains, joint aches, etc. Around that time I discovered this forum and realized I was still under-medicated and not optimized.

Finally I had enough, changed docs, and they discovered a sky-high Reverse T3 (in the 500's). We did a burst of the T3-only treatment (compounded, slow release) similar to what they do for the so-called "Wilson's Temperature Syndrome" (not to be confused with Wilson's Disease). This finally dropped my Reverse T3 to a normal level, and we switched to a T4 + T3 combination by way of using Nature-Throid. Once I switched to the Nature-Throid the neuropathy was largely gone, virtually overnight. Body temps starting looking better, the weird signs & symptoms improved somewhat, and I finally made a little progress.

FWIW, I would suggest seeing a gastroenterologist for a consult if your liver numbers are high. It may be something else completely, or in addition to whatever is happening -- in fact, I developed an autoimmune liver disease (on top of previous one, no less) during all of this. It took a lot of turning over stones before it was discovered on a hunch by a good doc. I wouldn't doubt if it contributed in some way to how things were, as the liver is closely tied into thyroid hormones.

Other random thoughts:

* Adrenals / Cortisol -- best checked via a 24-hr. urine or saliva collection, broken into different time periods.

* Catecholomines

* Allergies / Sensitivities -- example, Celiac and gluten sensitivity (which are not the same thing). Mold can be a doozy, too.

* Sex Hormones -- testosterone, estrogen, SHBG, E2 Estradiol (for guys), etc.

* Diseases / Infections / Conditions -- Lyme, Mono/EBV, MS as you mentioned, Lupus, RA, Sjogren's, etc.

* Vitamin D-25, B-12, Ferritin, CMP, CBC labs.

* Calcium -- good call on getting that checked for parathyroids.

* Prolactin Level -- roundabout way to check for pituitary tumors.

* Thyroid Ultrasound -- this is critical to get a baseline for future comparison.

* Sleep Study -- if you snore, trouble breathing, thick neck, extra weight, fatigue upon waking after plenty of sleep, tired during day.


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## fireball (Jun 9, 2014)

thank you so much ...you have given me a lot to work through.


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## fireball (Jun 9, 2014)

HI,

TSH 1.43

FT3 4.1(3.5-6.1)

FT4 14 (10-22)

The letters TRab indicate in Canada both blocking(TB11) stimulating(TSI) and binding. The lowest my scale goes is <.9.Unfortunately the TSI test is not done in Canada. I would have to pay for it and get it sent to the USA. Since I am hypo and on replacement I can only surmise I have a small amount of powerful TRab (TBII)blocking my TSH receptor sites.I also have a goitre which may be hiding a suitcase full of TRab. My very limited understanding is that the blood test only picks up on the TRab circulating not those stuck on the receptor site.

I have an ultrasound booked for July 10/14. The RAIU test did indicate vasularity and an enlarged rt globe but no nodules.The endo who palpated my goitre now believes it is soft.

My vit d level was 25 but now is 80(75-200)

Pending are my selenium levels and B12.

Interesting enough I did find out that Graves patients are at risk for B12 deficiency due to autoimmune gastritis. I am further at risk from working in an environment which used Nitrous oxide and those fumes were shunted into the environment I breathed daily. I have begun supplementing with a sublingual version of B12 3000mg in divided doses.

When I was first diagnosed I started the autoimmune paleo protocol which introduces food after a 6 month cessation. I believe I am sensitive to gluten, all beans including peanuts(fungus) , soy and all dairy.

I was on the drug tapazole for 8 months gradually tapering until I became hypo. Along the way Levo was added. I expect to need replacement for 6months to 3 years. I have had a lot of difficulty with each med change but nothing prepared me for horror of the recent period where I feel psychomotor agitation, parathesia, emotional lability, insomnia and core vibrations(for lack of a better term)

The endo plan is to keep my TSH below 1 for I year to rest the thyroid.

Today I have increased my armour to 60mg per day divided into 3 doses.I am concerned with the rapid titration( going up a 1/4 grain every 2 weeks) yet want to get rid of the parenthesis.

2 GPs believe I have MS. I believe I am hypo and recovering from the tapazole.

My liver enzymes went back to range 3 months after starting the tapazole.But these same GPs told me I had hepatitis then a viral infection then a fatty liver.

I have become a smarter patient and no longer believe everything a gp tells me. The endo is compassionate but doesn't say too much.

Thank you for responding to my posts. Listening to others stories has been priceless. Any advice is always appreciated.


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## bigfoot (May 13, 2011)

Yeah, this thyroid stuff can be very complicated. Add in the autoimmune component to the mix, and suddenly things get even more difficult to sort out. I think mis-diagnosis are really common.

Going paleo can be really helpful, that's awesome to hear you have already done that! One more tool in the toolbox, and there are some good recipes out there. You've probably got a bunch already, but one you might check out is called "Nom Nom Paleo". No connection to the author, but she has some great ideas.

IMHO, if I was in your situation (and I'm not), I'd probably press for TT surgery or ablation. It can't be any fun dealing with both Graves' and then swinging hypo. At least then you'd know where you stand, and be able to work on just the hypo aspect.

I have also heard of the titrating upwards on Armour by 1/4 grain every 2 weeks. I believe that was mentioned in the "Stop the Thyroid Madness" book, but for when you are dealing with Hashi's and trying to keep the antibodies from flaring up. I have mixed feelings on the book, though there is a copy on my bookshelf. On one hand, it's nice to have something to quickly educate yourself without medical jargon, on the other hand not every problem is a nail waiting to be fixed with the hammer of Armour.


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## fireball (Jun 9, 2014)

Yes the thyroid is soo easily misdiagnosed or mismanaged!

Avoiding my food sensitivities was initially hard and I still struggle on days I'm unprepared. For me it is impossible to rush out and buy something except fruit. I really struggled with the sauces but I now make ketchup, mustard and homemade mayonnaise. It is easy once you find recipes like nom nom. There are so many fillers in food. This entire experience has made me more aware of where to get magnesium, zinc, and other trace minerals. I do believe my diet was lacking iodine. I am even questioning whether the edict that graves patients should take in no more than 150mcg per day is true. But right now I am not going to challenge that just make sure I take in 150mcg through natural food sources. This is a work in progress.

I forgot to mention that I have thyroid eye disease (TED). It is mild so no prisms or prednisone. I was fortunate that my optho seems generally interested in fixing this. He started me on Low Dose Naltexone last month. I take 1mg per day. I notice slight flushing,a slightly higher heart rate for 10 minutes and definitely more energy about 3 hrs after I take it. No sleep issues or colourful dreams.

I wasn't offered RAI because it is know to increase the eye problems. Apparently it exacerbates the production of bad cytokines in the eye. Also my graves responded too well to the tapazole becoming chemically euthyroid in 2 weeks.

I'm saving TT surgery for down the road. At present the endo has hinted that I will recover a fully functioning thyroid as early as 6 months. Iit is my opinion that I took too much tapazole too long. 20% of graves patients go hypo... some for a short periods others for ever. I do know the hypo phase is the last stage in Graves disease so it is statistically hopeful.

My symptoms wax and wane but I may be slightly better with less tingling and numbness since the start of armour. It is too early to say.I have slept the past 4 nights without taking gravol and beta blockers. This was my homemade cocktail I use instead of benzos. (My pet peeve is when Drs diagnose this as anxiety or depression)

One of my challenges is to find a GP who is invested in my recovery, not afraid to say I don't know but knowledgable and willing to order tests. Over and over again I encounter GPs who are afraid of T3 or as one lab doc stated only "whinners need t3 supplementation" somehow thyroid issues have become associated with hypochondriacs.

My B12 came back slightly above the range which is normal for b12 supplementation.

Well I am in a holding pattern for the next 6 weeks. I don't think my parathesis will resolve quickly but I am hopeful. In the mean time I may have to go outside the sanctioned GPs and pay for one. I have a list of GPs to be interviewed.

Thanks again for your response!


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## bigfoot (May 13, 2011)

fireball said:


> I was fortunate that my optho seems generally interested in fixing this. He started me on Low Dose Naltexone last month. I take 1mg per day. I notice slight flushing,a slightly higher heart rate for 10 minutes and definitely more energy about 3 hrs after I take it. No sleep issues or colourful dreams.


EXCELLENT! I, too, was recently started on Low Dose Naltrexone. From the reading I've done, and the questions to my docs and pharmacist, a dose of 1 mg / day seems a little low for any therapeutic affect. (But it also depends on how somebody tolerates it.) I think the ideal dosage is somewhere between 3 mg and 4.5 mg. I did have some vivid dreams for the first week or two, but honestly, it was kind of fun. Especially since I can't remember the last time I had any dreams! Also, like you, I noticed better sleeping patterns.

Your frustrations are right-on. It's so moronic that doctors want to skip right on past a dysfunctional gland that is critical to the entire body, and instead think people are just bored and making up ailments. Honestly, we have about a zillion better things to do with our time.

Good to hear you are working on solutions and that your docs are open-minded! Keep us in the loop.


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## fireball (Jun 9, 2014)

HI,

I have read surprising accounts of LDN having quick results especially with regards to the thyroid. I was told not to go too fast or I could find myself hyper again. The LDN can suddenly knock out the antibodies. On a very few accounts people no longer need replacement so it is advised not to start above 1.5mg per day. I wanted to be conservative in case I was one of those people. LOL Wishful thinking I know! Anywho I have found 1mg to bring increased energy. I will probably increase the dose after my next eye appointment. Thyroid patients usually start at 1.5 and gradually go to 3.5. People with ms seem to start at 3.5. All my info tends to be personal accounts. I don't believe there have been any scientific trials with thyroid patients so I really have no idea.

When I was on levothyroxine I took the dose at bedtime. I eat a lot in the morning and levo had to be taken away from food. Plus there were the 2 studies showing better absorption at night due to the slowing of parastalsis. I wonder about the armour? Everything I've read suggests best absorption through chewing the tabs , absorbing them sublingual 30 minutes after meals and dividing the doses. Does anybody take them at night? T3 has a shorter half life. What would happen if I took armour away from food at night time? Would I have enough T3 during the day? I haven't noticed any jags, palps or really any effects of taking it. II don't notice it at all.

Any advice or response is always welcome. Thankyou so much for your replies.


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## bigfoot (May 13, 2011)

Yep, supposedly the LDN will reduce the autoimmune side of things, potentially leaving you over-medicated all of a sudden. I've been taking the LDN for 4-5 months now, slowly working my way up to 4.5mg in 0.5 and 1.0 mg increments. Unfortunately, I can't say that it has yet lead to a reduction in thyroid meds, but like you, I have also noticed a little more energy. Guess I'll take what I can get!

I think if you're comfortable in making changes, you can play around with dosing times and see what works best. I don't take Armour, but I did read that anecdotal info that chewing it was helping some folks. I believe it had to do with the re-formulation of the pills. Can't comment personally, as I take Nature-Throid, but I do split the dose between 1 grain (at bedtime) and another 3/4 grain (right before lunch). Doesn't seem to give me insomnia at all.


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