# Andros, more advice, please!



## Gam87 (Feb 5, 2011)

Hi Andros, I had my appointment today with the doctor whose name I got from the Georgia thyroid girls. He came very highly recommended and I did like him and I think he is probably very knowledgable on hypo but I am wondering about his expertise in Graves/hyper. When I showed him my TSI of 100 he said it means nothing and that I was normal. No further testing...RAIU, ultrasound needed. He did give me a prescription for Armour because he said my RT3 is too high and FT3 is a little low. He said that my increased heart rate and palpitations are being caused by rushes of adrenaline. I was just wondering your thoughts on all of this? From everything I have read here and other places I know that TSI does not mean normal. I know it has some significance to how I am feeling. Do you think taking the Armour will be ok? I don't know what to do at this point? Thanks so much!


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## Andros (Aug 26, 2009)

Gam87 said:


> Hi Andros, I had my appointment today with the doctor whose name I got from the Georgia thyroid girls. He came very highly recommended and I did like him and I think he is probably very knowledgable on hypo but I am wondering about his expertise in Graves/hyper. When I showed him my TSI of 100 he said it means nothing and that I was normal. No further testing...RAIU, ultrasound needed. He did give me a prescription for Armour because he said my RT3 is too high and FT3 is a little low. He said that my increased heart rate and palpitations are being caused by rushes of adrenaline. I was just wondering your thoughts on all of this? From everything I have read here and other places I know that TSI does not mean normal. I know it has some significance to how I am feeling. Do you think taking the Armour will be ok? I don't know what to do at this point? Thanks so much!


Oh, geez!!! Unbelievable. I am so so sorry about this.

Here is the info and the link. The healthy person should not have TSI.

Dang!

Are you saying he denied you getting RAIU???

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://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

rT3
http://thyroid-rt3.com/whatis.htm

What did the ladies on the Ga. site have to say about all this? I could not be more upset.

As you know, I am not a doctor and I cannot advise you on whether to take the Armour or not. How much Armour did he Rx???

copy and paste
The treatment for too much RT3 involves stopping more being made and waiting for what's in the body to decay or be excreted.

This is relatively easy but there are pitfalls along the way. A lot of Drs are worried by people doing this as things happen too quickly to be done by lab tests, patients need to adjust dose by symptoms and vital signs.

RT3 is only made from T4. If you get rid of T4, both from your own thyroid and from supplements, then no more RT3 gets made. In order to do this and stay alive an alternative source of the bio-active T3 is needed and this is readily available in the form of synthetic T3 hormone.

The basic treatment is to stop all meds containing T4 and start T3 instead, The dose of this is slowly increased week by week as the T4 levels in your body diminish. After 6 weeks or so the T4 and RT3 levels in your blood will be very low. You need to keep going longer than this though as it takes around 12 weeks for the RT3 to clear the receptors as well.

During this time you may not be able to take enough T3 to fully clear hypo symptoms though some people may feel pretty well at this stage. It all depends on hy hypo you were, how high the T3 and RT3 levels were, and your iron and adrenal status. We do not recommend going above 125 of T3 during this clearing process, there is no improvement in clearance achieved with a larger dose, provided there is enough to suppress TSH and stop T4 production then clearance will occur. (updated 10/10)

http://thyroid-rt3.com/howisit1.htm


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## Gam87 (Feb 5, 2011)

He didn't really refuse me RAIU but I just didn't push it which was stupid of me. He was really rushed in the appointment and I think I just got overwhelmed and couldn't focus on everything. I think he probably does know his stuff on hypoT just not so sure about his knowledge of Graves. His nurse gave me a form to fill out with a list of hypoT symptoms and I was to circle the ones I am experiencing but the problem is I am having more hyper symptoms none of which were on that list. When I asked her if he deals with hyperT she said that once you are medicated you sometimes become hyperT so he does deal with it. It seems to me that dealing with someone who is hyperT from over medication is a little different from someone who has Graves. I have this huge notebook with tons of research that I have printed along with all of my labs, symptoms, medications, etc. I gave him my list of symptoms but honestly I do not even think he read it. Again I think his "specialty" is hypoT which is why I think he was so highly recommended. He told me to take 1/2 grain the first week then increase 1/2 grain each week until I reach 2 grains. I have no idea if this is appropriate or not. I am just concerned if I do have Graves how the Armour will effect me. I think I need to find someone who is knowledgeable on graves but that seems hard to find.


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## Andros (Aug 26, 2009)

Gam87 said:


> He didn't really refuse me RAIU but I just didn't push it which was stupid of me. He was really rushed in the appointment and I think I just got overwhelmed and couldn't focus on everything. I think he probably does know his stuff on hypoT just not so sure about his knowledge of Graves. His nurse gave me a form to fill out with a list of hypoT symptoms and I was to circle the ones I am experiencing but the problem is I am having more hyper symptoms none of which were on that list. When I asked her if he deals with hyperT she said that once you are medicated you sometimes become hyperT so he does deal with it. It seems to me that dealing with someone who is hyperT from over medication is a little different from someone who has Graves. I have this huge notebook with tons of research that I have printed along with all of my labs, symptoms, medications, etc. I gave him my list of symptoms but honestly I do not even think he read it. Again I think his "specialty" is hypoT which is why I think he was so highly recommended. He told me to take 1/2 grain the first week then increase 1/2 grain each week until I reach 2 grains. I have no idea if this is appropriate or not. I am just concerned if I do have Graves how the Armour will effect me. I think I need to find someone who is knowledgeable on graves but that seems hard to find.


THAT is not appropriate. Patient should be started on 1/2 grain if no myxedema. If myxedema, starting dose is 1/4 grain of Armour.

Then patient is to get labs every 8 weeks and if needed, dose increased either by 1/4 grain or 1/2 grain "depending." Truly;what the doctor has instructed is much to fast. For one thing, you could easily overshoot your euthyroid spot and become hyper. This is probably why this doc is so good at treating hyper from over medication! Something to think about! Aaaaaaaaaaaaaaaaaaaaaaaaaack!!!

http://www.armourthyroid.com/

Read the prescribing information. You can even call Armour toll-free if you so desire.

That nurse; tch! People like that should not say anything. LOL!

Now, the $64,000.00 question...................

Did this doctor take any lab tests? I have to know this. It does not sound like it as you did not mention it. Let me know, please!


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## Gam87 (Feb 5, 2011)

Nope no labs ordered. He said that my previous labs were ok for a baseline. My last TSH, FT4,FT3, and RT3 were done before Christmas...12/18 and my TSI was done in mid January.


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