# Question for RLC Naturethroid patients



## I DClaire (Jul 31, 2011)

I've been feeling infinitely better since the latest round of antibiotics for the symptom-less UTI. The Librax I take before meals has stopped all anxiety attacks - I haven't had one since I started the medication. I feel better in some ways than I have in months..._but_...

the lingering fatigue has me convinced that maybe 105 mcg Armour, even though I'm slightly in the normal range for TF3 and TF4, is just simply not supplying something my body needs. I've been told that TSH means nothing for an Armour patient...which has led me to the conviction that maybe being on another thyroid hormone replacement where the TSH can be monitored and will indicate how the drug is working might help.

I've tried 120 mcg Armour several times - I cannot tolerate my heart racing like that. It is so uncomfortable that I cannot function.

Am I wrong in thinking without knowing the TSH test result, taking Armour and hoping to feel better is like shooting in the dark.

I know several here have said they've tried other medications and feel well or better with Naturethroid. In what way? Can TSH be monitored with a Naturethroid patient? Has anyone been on Naturethroid and perhaps switched to Armour or another drug? Does anyone have any firsthand experience with Tirosent? If you take Cytomel, how did you get prescribed?

I feel like I've fought long and hard with all of this and I'm going to find some answers or die trying! I KNOW something, and I can't help wondering if it's the Armour, is not supplying my body needs to function normally. I have to believe TSH has to be too important to say it doesn't mean anything with an Armour patient - I want to benefit from the blood tests I get.

I'm also still fuming about my internist insulting/mocking my Armour saying it was no telling what was wrong with me considering "that stuff" I take. I wonder if he thinks Premarin is "stuff"? I'll bet he prescribes that!

Feeling better has put new wind in my sails - I'm going to try to keep pushing for answers I know are there but I've got to understand fully what I'm trying to find.


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## jenny v (May 6, 2012)

Glad you are feeling better!

I'm new to the Cytomel bandwagon but I got my endo to prescribe it by creating a spreadsheet of my labs over the last 6 months that show my FT4 increasing as we increased my Synthroid but my FT3 staying stuck below the midpoint of the range. She's cut back my Synthroid (from 75 mcg to 50 mcg) and added 5 mcg of Cytomel. We'll see how it works--I go back for labs in 8 weeks.


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## StormFinch (Nov 16, 2012)

I know that AACE and the ATA insist that the TSH is the all knowing, all seeing test but it really isn't. You can have a completely dead thyroid and still have a normal TSH test. TSH is produced by the pituitary gland, not the thyroid. Basically it's the pituitary's messenger boy, running to tell the thyroid to make more T3 and T4. The only way to tell if the thyroid, or in our case the medication, is working properly is to look at the Free T3 and Free T4, especially when taking any natural thyroid replacement. Doctors tend to freak over the supressed TSH that is the nature of desiccated thyroid, yet if they would look at the Frees they would know that a properly titrated individual has normal amounts of T3 & 4 and more importantly FEELS GOOD with no hypo or hyper symptoms. In other words, it's not the tests that are the problem, it's the doctors. If they treated the patient and not the tests, life would get a whole lot better for us.

Although I haven't taken the Naturethroid, it is my understanding that where Armour's 1 grain is 60 mg, Naturethroid's 1 grain is 65 mg. If you feel hypo on 105 mg and hyper at 120 mg, then Naturethroid might be the way to go. You can get their 1 & 3/4 grain which is 113.75 mg, almost halfway between Armour's 105 and 120. Just be aware though that most anti-biotics can cause exhaustion, and Librax has tiredness/drowsiness listed as a possible side effect, so there might be another influence going on if the symptoms have been going on in conjunction with your other meds.

As for your internist, I know where you're coming from. It's unfortunate that a lot of doctors take that view with desiccated thyroid replacement. Some days I wish I could go back in time 50 years to when doctors treated symptoms and didn't look down their noses at anything that wasn't made in a lab.


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## I DClaire (Jul 31, 2011)

I appreciate the input so much. Thank you! I don't have a spreadsheet but I do faithfully keep a list of my thyroid test results. I know my results from my #1 labs on Synthroid on November 10, 2011 through the latest ones on December 6, 2012. I don't know if I totally comprehend the numbers but I do have them.

As much as the realization that I KNOW I do not feel as much energy and stamina as before my surgery, it concerns me that nobody (other than my endocrinologist) understands the test results OR has any respect whatsoever for Armour. I go to the ER, they run TSH only (said they cannot test T3F nor T4F) and say my results are ridiculously low. I go to my internist who runs the TSH test and says the same thing...while I'm sitting there trying to say the TSH doesn't mean anything because I'm on Armour. I know these doctors want to help me but they're bound to be frustrated and maybe irritated with me when I say I'm taking a drug that cannot or does not test accurately with TSH.

I'm having mixed emotions - looking at the only two labs I ever had with Synthroid, I find myself wondering why my endocrinologist changed me to Armour so quickly. I had read so many wonderful things here about Armour and went to her office prepared to ask about Armour and she beat me to the punch, she suggested Armour. I remember she had had me skipping days on Armour and taking different doses on different days but the major symptom I remember was the racing pulse and anxiety. I remember telling her that one afternoon I'd been so shaky and anxious that I accidently broke a huge vase in a giftshop and then driving home I sideswiped a plastic recycling bin on a curb. Considering the level of anxiety I've been dealing with since last July, maybe Synthroid didn't have anything to do with it.

Left to my own devices, I'm hesitant to try something other than Armour BUT I feel like it would be more practical if I were on a drug that other physicians could test and readily understand the results...what if I were somewhere or in such condition that I couldn't try to explain what little I know about Armour? Even where I live, there are perhaps five endocrinologists, two are semi-retired and one or two more are associated only with a charity-type state hospital.

I truly do like my endocrinologist as a compassionate, caring doctor and we've become friends BUT she does not and probably never will treat my symptoms - she is 100% by the book. She has told me she has more than 1,000 patients on Armour but of the numerous friends I have who take thyroid medication, I'm the only one not on Synthroid and really the only one having so much trouble.

My TSH results have been as follows:

11/10/11 - on Synthroid - 0.059 *(Range for all is 0.37-4.55)*
12/22/11 - on Synthroid - 0.455

2/22/12 - on Armour - 28.900 (these results will be going from 60 mcg up to 105 mcg) Also, I believe the lab totally messed-up this test - the technician dropped the vial of blood on the floor)

3/21/12 - on Armour - 1.750
4/4/12 - on Armour - 0.904
4/27/12 - on Armour - 0.427
5/31/12 - on Armour - 0.030
7/6/12 - on Armour - 0.012
9/11/12 - on Armour - 0.010
10/18/12 - on Armour - 0.010
11/1/12 - lab mistakenly did not run TSH
12/6/12 - on 105 mcg Armour - 0.010

Looking at my Armour TSH results and the normal range, naturally doctors think I am absurdly hypothyroid and want to address that as a diagnosis while my endocrinologist apparently thinks the TSH means little if anything.

On 12/6/12, my T4 Free was .9 (normal range being 0.8-1.5)

On 12/6/12, my T3 Free was 2.7 (normal range being 2.0-3.6)

Even to me, it appears my results are low with 105 mcg Armour but I cannot tolerate the 120 mcg dose. I've even tried splitting a 15 mcg Armour to try and creep-up on 120 with 112 mcg but I still get the elevated heart rate and blood pressure.

An Ear, Nose & Throat specialist told me long before my thyroidectomy that thyroid surgery was often like "opening Pandora's box". I think I understand!!

I don't have new labs until mid-February. With the above test results on 12/6/12, my endocrinologist dismissed me for two months because I was so _improved!_


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## Gwen1 (Sep 3, 2011)

Hi IDClaire, maybe you were just on too high of a dose of Synthroid. I was on 125 mcg. during my mid-30's to mid-40's. I am now 51 and am on 88 mcg. The reason is because our estrogen levels decline and we do not need as much thyroid because estrogen blocks thyroid.
As estrogen starts to decline, there is less estrogen to block thyroid. Therefore, our dose needs to be lowered.
Maybe you only needed 75 mcg. or 88 mcg.


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## I DClaire (Jul 31, 2011)

Gwen1 said:


> Hi IDClaire, maybe you were just on too high of a dose of Synthroid. I was on 125 mcg. during my mid-30's to mid-40's. I am now 51 and am on 88 mcg. The reason is because our estrogen levels decline and we do not need as much thyroid because estrogen blocks thyroid.
> As estrogen starts to decline, there is less estrogen to block thyroid. Therefore, our dose needs to be lowered.
> Maybe you only needed 75 mcg. or 88 mcg.


I don't know that I've even mentioned it here but I do believe estrogen (or lack thereof) plays a big part in all this.

I actually had to have an emergency total hysterectomy and apendectomy in my early 40's and never could take estrogen replacement. Sometimes I wonder if there is an ounce of estrogen in my body!!

I'm 66 - my surgery was back in the 1980's when the big scare was estrogen vs. breast cancer and virtually every woman on my mother's side of the family has died with breast cancer...except Mother, my sister, my daughter and I have never had it.

If I thought someone would give maybe compounded estrogen to a 66-year old woman, I'd probably try it!


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## StormFinch (Nov 16, 2012)

Looking at your last Frees and your symptoms, it kind of sounds like you may be T3 sensitive, which could be suggestive of adrenal problems. Numerous patients have reported that when their adrenals are out of whack they have problems taking T3 or desiccated thyroid. Have you had your cortisol levels checked? If you discuss this with your Endo, ask for a 24 hour saliva test, not the blood or urine tests.


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## I DClaire (Jul 31, 2011)

StormFinch said:


> Looking at your last Frees and your symptoms, it kind of sounds like you may be T3 sensitive, which could be suggestive of adrenal problems. Numerous patients have reported that when their adrenals are out of whack they have problems taking T3 or desiccated thyroid. Have you had your cortisol levels checked? If you discuss this with your Endo, ask for a 24 hour saliva test, not the blood or urine tests.


I've thought the EXACT same thing and read umpteen online references regarding adrenal problems and I have virtually every symptom where sites offer lists of symptoms.

SO...I called my endocrinologist to ask if she would order the saliva test, that everything I'd read said the blood test was not reliable since it only measured cortisol at one particular moment, while the saliva test measured it four times in 24 hours. I also read that Medicare will cover the saliva test.

As God is my witness, my endocrinologist's PA called back to say that my endocrinologist wanted to send me something to read. My endocrinologist had major surgery herself at Thanksgiving and has been working shortened days.

When the information came in the mail it was 4-5 pages explaining that endocrinology does not recognize adrenal failure NOR the 24-hour saliva test. It said endocrinology recognizes a condition called adrenal insufficiency but only the one time blood test.

I was majorly disappointed and frustrated but it was probably 2-3 days later when I had the episode of abdominal pain and anxiety that sent me back to the ER. I never got back to it.

I have intended to chase down for certain whether or not Medicare covers the cost for the saliva test. If so, I have to believe they think it's a legitimate diagnostic tool.

In the ER, the young doctor ordered a battery of blood tests (I don't know what all he was looking at) but he told me my adrenal test was normal.

Whatever has been happening following a definite progression. I awake around 4:00 A.M. from nightmares that seem to instantly trigger abdominal pain so intense and excruciating that I can barely move. That triggers the anxiety and, needless to say, I feel like I very well could have a heart attack. My blood pressure will shoot sky high, my heart rate will be so fast I can barely catch my breath.

The G-I specialist told me one of two things _*could *_be happening - either something is triggering stomach pain/spasms so severe that I go into anxiety mode OR anxiety is triggering the nightmares and stomach spasms. I just know for a fact that even the attack that sent me to the ER last July began with a nightmare.

I have finished the antibiotics for the UTI and am following the dosing routine for the Librax faithfully and I actually feel pretty good. I'm fixing to go see an exhibit of artifacts from the Titantic and looking forward to getting out.

I feel like the fact that twice now I have responded dramatically to antibiotics (in October for H. Pylori, recently for the UTI) is a clue and the Librax relaxing my stomach...and my anxiety.

I think adrenal issues play into this somehow because my symptoms are always early in the day, by 6:00 P.M. I usually feel remarkably better, etc. I can take a list of 50 adrenal symptoms and probably have 48 of them!


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## StormFinch (Nov 16, 2012)

You know, I find it thoroughly ironic that your Endo recognizes treatment with natural desiccated replacement, something that most doctors turn their nose up at, but doesn't recognize the link between thyroid and adrenals. Too funny. I know she seems to be good in other ways, but if it were me I think I would be getting a second opinion if it turns out that Medicare will pay for it. Although kind of expensive, you could also order it online yourself.

Here's something else I found just in the last couple of days. The Broda Barnes Foundation has a packet they will send out, along with a list of referral physicians in your state. Since Dr. Barnes advocated for adrenal testing, the doctors on their list should be willing to run the 24 hour test. The packet costs $18 but there's an order form on the foundation's site if you choose to try it. http://www.brodabarnes.org/gen_pymt.htm One caveat here though, the last modification to the foundation's website was in 2007, so if you're thinking of ordering the packet you might want to call them first and make sure they're still active. Dr. Barnes died in 1988 and I believe his wife set up and ran the foundation after that. I have no idea what their status is at this point.

Have fun at the exhibit!


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## piggley (Sep 15, 2012)

IDclare, have you thought about looking for an Holistic Dr, 
Anyone who treats a patients reasonable question with such contempt aint their friend,
Adenals have everything to do with Thyroid health, and there are many knowledgeable Drs out there who would probably tell your Endo she's up a tree and talking out of her left ear.
Sounds like you need more help than her skills can provide, although its awful changing Drs,
If I were in your shoes I would be looking furthur.


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## I DClaire (Jul 31, 2011)

In all sincerity, I do not know of any holistic doctors where I live. Several months ago I thought I'd found someone but she was a total flake.

Not long ago I heard about someone else who practices medicine app. 60 miles from where I live. This person (according to her website) is an internal medicine doctor but runs what she calls something like "Ageless Clinic" where she specializes in endocrine and hormonal problems. She does not take insurance and I worry about trying to pay for treatment without knowing what I'd be getting into but my husband says he thinks we should at least try it. This doctor does order the 24-hour saliva test - I read that on her website.

My endocrinologist is the premier one in this area - for whatever that's worth! I don't know why there are so few endocrinologists here but there are practically none. I drive at least 30 miles to see her.

It seems like I'm more of an advocate for my treatment than my doctor. If I ask questions, she'll answer them but she practically never suggests anything. Most of my other doctors are the same way - the G-I specialist shocked me when he said he wanted to aggressively look for what was causing my stomach pain, etc., and then scheduled 3-4 tests while I was still in his office. Most doctors here act like they're flying by the seat of their britches, they're rushed, not particularly attentive, usually add or change a prescription and say come see me in 3-4 months!

We have very, very limited specialized care here - even for pets. I have taken my dogs to Dallas, Texas for tests like MRIs or to see specialists. It is beyond frustrating!


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## StormFinch (Nov 16, 2012)

Sounds like the internist would definitely be worth looking into. My previous MD specialized in what he described as "regenerative medicine", pretty much the same thing as the doctor you're talking about, and he was excellent. Unfortunately he had a family crisis and then we had to move, but I would still recommend him to anyone in that area. One appointment certainly couldn't hurt anything more than your pocketbook with knowing how to be your own advocate.

The reason that there are so few Endos is because there is a national shortage of them. There's currently a push to get more graduates to go into the specialty, but unfortunately a lot of the current batch only want to specialize in diabetes since it's the high dollar practice right now. Then you get the ones that up and join AACE, which has some strange ideas about treating thyroid issues, and you end up with a bunch of TSH preachers. *sigh* It's disheartening.


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## piggley (Sep 15, 2012)

I know what you mean IDclare, some of the alternative people are just hopeless, frighteningly so-- what you need is an MD with good science behind them but open to the alternative approach when appropiate.
I saw this group who seem to be composed of both MD's and naturopaths, there is a practitioner search on the website, dont know of this is any help but i'll put the link here if anyones interested, they treat mainly by bioidentical hormones and herbs by the look of the Website, might be someone good there who knows,
http://restorativemedicine.org/blog/
Good luck, dont give up.


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## I DClaire (Jul 31, 2011)

This morning at church one big topic was practically cancelling the Sunday school teacher's lesson - half the class was venting because they suddenly cannot get doctors who'll take Medicare patients. We all have Medicare AND other insurers (Blue Cross/Blue Shield mostly)...but doctors are saying they're not taking anymore Medicare patients.

One lady recently retired from working over 30 years at our state run charity hospital and has Medicare in addition to some other private insurance. She has been diagnosed with a mysterious problem causing her to be anemic and she cannot find a doctor who will take her as a patient. She has been told she needs specialized tests and absolutely every doctor she has tried to contact for two weeks says they're not taking anymore Medicare patients.


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