Jump-starting My Immune System

Today I picked up Low Dose Naltrexone (prescription), IAG (arabinogalactan supplement), and intramuscular B12 and folate (injection at my doc's clinic). The injection didn't hurt at all. I took the first teaspoon of IAG dissolved in water. That tasted like soapy dishwater. UGGHH!! I may take the next dose dissolved in apple juice tomorrow morning. I have yet to take my first LDN capsule, but will take that just before going to bed. LDN should stimulate white blood cell production. IAG should fight my respiratory infection. B12 and folate will address a possible deficiency which could affect my white blood cell count. So those 3 things should jump start my immunity and help me recover from this 3-4 month long respiratory infection.

I've now taken 3 days of liothyronine (2x daily 5 micrograms of T3 supplement) and feel nothing, no side effects, no obvious improvement. I wonder whether that dose is too low (10 mcg daily) to make any difference in my hypothyroid symptoms (cold intolerance, fatigue, irregularity, etc.). I suspect my doc prescribed a very conservative dose, because T3 supplements can easily cause overdose symptoms. Because I believe I did NOT overdose on T4, but really just reacted to cane sugar with tachycardia, I know I won't OD on such a low dose of T3. I emailed my doc about my realization about 5 weeks of cane sugar reaction symptoms. Maybe that will reassure her that I can tolerate a higher T3 dose.

Allergen Reaction vs. T4 Overdose??

This morning I realized I have consumed cane sugar (one of my diagnosed allergens) every other day for the past 4-5 weeks. I put almond butter in my cooked breakfast cereal. The manufacturer changed the ingredients of my regular almond butter brand to now include evaporated cane juice. We neglected to read the label when we bought that jar. This morning I also noticed my usual cane sugar reactions of tachycardia and slight nausea (which typically last 24-36 hours). Yesterday, I did not eat cooked cereal. I did not experience obvious tachycardia, despite taking my first 2 liothyronine (T3 supplement).

I checked my calendar and noticed that I began to experience severe tachycardia about 5 weeks ago, which was about when I opened that jar of almond butter. At that time I believed the increased (75 mcg) dose of Levoxyl caused my tachycardia. However, I usually react very strongly to an allergen after abstaining from that for a long while. So I could have also reacted to the cane sugar. The severe tachycardia did subside after reducing the Levoxyl dose. As I continued to consume cane sugar in the almond butter every other day for the past 5 weeks, during the time I thought I was reacting to Levoxyl, I also noticed more intermittent gut cramps, my usual reaction to my other allergens.

When I saw my T4 levels on my last blood tests, I wondered how I could have experienced overdose symptoms without increasing my T4 levels very much. When I saw my low total and free T3 levels, I realized I wasn't converting T4 to T3. So I wondered how enough of the supplemental (Levoxyl) T4 was converted to cause overdose symptoms. After realizing that I consumed cane sugar, to which I react with tachycardia and slight nausea, at the same time I took the increased (75mcg) dose of Levoxyl, I wondered whether how much of my tachycardia was caused by cane sugar and how much was caused by Levoxyl.

After reading more about T4 to T3 conversion problems, I now wonder: if my body doesn't easily convert T4 to T3, do I need the same (50mcg) dose of T4 (Levoxyl) while I take a T3 (liothyronine) supplement?

I experienced some nausea after taking each of 2 Liothyronine tablets yesterday. However, I won't know whether the T3 causes tachycardia until I stop reacting to the cane sugar. Since I found the source of the allergen reaction and can now abstain from cane sugar, the reaction symptoms should subside after a few more days. Then I can assess whether the T3 supplement has more benefits than side effects.

Now I Get It

I emailed my doc this morning to ask why she no longer thought B12 deficiency caused my low white blood cell count. She told me that my last CBCs (blood test results) indicated that I WAS absorbing the B12 and folate supplements I took. However, my white blood cells still decreased. So it's now time for a more powerful immune stimulator (low dose naltrexone), which I will get on Monday from a custom pharmacy, because that supplement will be compounded. Also I'll go to my doc's clinic on Monday to get another supplement (arabinogalactan), which treats chronic infections, and a B12/folate injection to boost my energy levels while I'm waiting for the other drugs to stimulate my immune system.

I picked up my T3 supplement (liothyronine) this afternoon. So I'll start taking that tomorrow morning with my T4 supplement (and one more T3 two hours after lunch). That T3 supplement will improve all my hypothyroid problems, like fatigue, cold extremities, low immunity, regularity, etc. I'm looking forward to FINALLY resolving all my hypothyroid symptoms. I need to research why I don't easily convert T4 to T3. Maybe that's also related to Hashimoto's thryoiditis, which is linked to celiac disease ...

Good News, Bad News Again

I finally got a phone consult with my doc today. The bad news is that low white blood cells can mean lymphoma, specifically Non-Hodgkins Lymphoma, which is highly correlated with longterm celiac disease. The good news is that several medications can increase my white blood cell count. One drug is low dose Naltrexone, which is often used for patients withdrawing from opium addiction. No, I've never taken opiates and can't tolerate any narcotic drugs. I get very ill and vomit immediately, unless I take antiemetics to prevent throwing up. (I took antiemetics when I took Demerol for 8 weeks after hemorrhoid surgery.) However, Naltrexone suppresses Endorphins temporarily. Then, after that drug wears off within 2 hours, the body releases a flood of endorphins which stimulate the immune system to make more white blood cells. Similarly aerobic exercise stimulates endorphins and improves immunity. No wonder I feel good after walking or doing any aerobic exercise.

More bad news ... I do have swollen submandibular (below the jaw bone) lymph glands. Those were quite swollen before I was diagnosed with celiac disease and went off gluten. However they shrank over the past 6 years. Then more recently they became swollen again. Swollen lymph nodes can also mean lymphoma. So I may need to see an endocrinologist about my decreased immunity.

More good news ... my doc agreed that I also need a T3 supplement. My low Free T3 and Total T3 results (on my last blood test) were low enough to suggest that my body doesn't easily convert T4 to T3, which explains my lack of improvement on a T4 supplement. The most appropriate T3 drug (Cytomel) contains sucrose (which could be from cane sugar, one of my allergens) as inactive ingredient. However my HMO pharmacy advised me to consider the generic T3 liothyronine sodium. I checked that drug's ingredients and found none of my allergens. I told my doc about that generic choice. So she can prescribe generic T3 and save me lotsa $$$.

Hopefully I can pick up prescriptions for T3 and LDN on Friday. I'm seeing another flicker of light at the end of my illness tunnel ...

Here We Go Again

After another day of really cold weather, frozen streets and treacherous driving, weather people predict exactly the same for tomorrow (when I have my doctor appointment). So my doc's clinic called tonight to say that the clinic will be closed for the next 3 days (one day of inclement weather and 2 days for Thanksgiving holiday). I asked to convert my appointment to a phone conference, because my doc plans that for her appointments tomorrow. However they booked someone else in the appointment time they gave me on Monday for tomorrow. Either they put the wrong name or they actually gave away my appointment time. GRRRRRRR!!! That also means my doc does not have my file with her at home.

Again I explained that I really needed to talk to my doc asap, because I've been sick and getting sicker since I saw her last. So the clinic receptionist promised to find a time for me and fax my last 2 lab (blood) test results to my doc. Actually I have those results and can inform my doc. I could have just emailed her. However, most clinics assume patients are clueless about their condition and lab tests. So I need to wait until tomorrow morning to learn whether I can even talk to my doc on the phone.

Snow Day Cancellation

After waiting a week for an appointment with my doctor, her clinic called to tell me she would not be there today due to snowy weather. Ironically we were prepared for a 2 hour drive (one way) with studded snow tires to keep both appointments (for my husband and I). However, my doc decided to take a 'snow day'.

When I requested another appointment the receptionist offered one next week 7 days later. She didn't have anything for my husband that day. However, my husband said he could do a phone consult with his doc. Nevertheless, I told the receptionist that I had been sick with one cold after another (or the same cold?) for 3 months, because my white blood count was low and dropped lower over 2 months. So I needed to see my doc ASAP and hopefully get something to replenish my white blood cells. Magically the receptionist came up with 2 overlapping appointments this week (2 days from today) for my husband and I. I'm glad I persisted and didn't accept the 7 day delayed appointment. I'm always amazed by the appointment openings that magically appear when I persist.

Since my husband took the week off, we enjoyed walking in the snow to do errands. I'll get a head start on Thanksgiving preparations by making cranberry relish this afternoon. Tomorrow we will celebrate his birthday by seeing a movie. Then I'll make his favorite dinner (liver and onions, green beans and yukon gold potatoes).

I hope the weather is improved enough on Wednesday, because I don't want to play the rescheduling game again. Besides I expect my doctor to change my thyroid supplement prescription. I'll have to get that at my HMO pharmacy the day after Thanksgiving. Meanwhile I'm still fighting cold symptoms with massive doses of Vitamins C and D and eating anything I crave, which usually means foods high in Vitamins C and A. Today I had fresh tomatoes and lettuce on my sandwich at lunch with candied ginger for dessert. Ginger stimulates the bodies immune system. I always feel better after eating ginger, but can only tolerate a little, because it's soooo hot and spicy.

Blood Test Results

My CBCs were all normal, except the WBC (white blood count). My naturopath doc believed the low WBC was caused by B12 and/or folate deficiency, which was caused by long undiagnosed celiac disease. However, after 2 months of taking high doses of folate and B12, my WBC went from 3.2 to 3.0. The normal range is 4.0 to 10.7. Over the past 3 years my WBC dropped significantly. That suggests multiple gastrointestinal infections, not vitamin deficiency, decreased the WBC.

The CBC good news is that my MCHC (mean corpuscular hemoglobin count) increased into the 'normal' (albeit low normal) range. So eating more iron rich foods was enough to raise that result. If raising B12 levels can increase my WBC, I suspect I will need B-12 injections, because taking supplements did not work.

I also wonder if I have some other latent bacterial infection. I tested positive for TB as a child and again in my late 20s for TB. Fortunately my lung x-rays never showed signs of TB infection. (My last lung x-ray was in late February of this year.) Nevertheless, I wonder whether carrying that latent bacteria could affect my WBC results.

My thyroglobulin antibody test (TAB) was <0.9 (normal range is 0.0 to 4.0). That score says I don't have antibodies attacking my thyroid. My thyroid peroxidase antibody (TPOab) test result was 53 (normal range is 0.0 to 60). That result suggests I have some antibodies, but within the normal range. People with celiac disease often have Hashimoto's thyroiditis in which antibodies attack their thyroid. Gluten reactions create antibodies which attack the intestines in celiac disease as well as other parts of the body for other autoimmune diseases. Because I have not consumed gluten for over 5 years, I assumed those scores would be low.

My other thyroid results were both good and questionable. My THS was much lower (after taking Levoxyl for 2 months), going from 3.71 to 0.797. However my free T4 did not increase much (from 1.09 to 1.19), even though I've been taking a T4 supplement. The 'normal' T4 range is 0.9 to 1.8. My total T3 was 66, which is lower than the normal range of 70 to 170. My free T3 result was 2.09, which wasalso lower than normal range of 2.4 to 4.4. Those T3 scores make me wonder whether my body has difficulty converting T4 to T3. Perhaps that difficulty explained my lack of significant improvement after taking a T4 supplement for 2 months.

I made an appointment with my doc to discuss my low results. I especially want to ask whether B12 injections will increase my WBC and prevent my chronic respiratory infections. I get cold symptoms (sore throat, runny nose, fatigue) every afternoon. I also want to discuss the low T3 scores.

CBCs and Thyroid Function Retests

After reminding my naturopathic doc that I need signed order to get blood tests at my local HMO clinic, I received her order for the following tests:

CBC
TSH
FT4
T3
FT3
TAB
TPOAb

I need to recheck my CBCs, because my previous test showed low WBC (white blood count) and low MCHC (mean corpuscular hemoglobin concentration). I suspect those have increased after eating high iron content foods for 2 months and recovering from that parasitic infection which can cause low WBC.

After taking a T4 thyroid supplement for almost 2 months, I want to know whether that changed my TSH and free T4 scores. I requested some T3 tests because I'm not doing as well as I expected with a T4 supplement. (50mcg wasn't enough to resolve all my symptoms, but 75mcg was too much and caused hyperthroid symptoms.) So my doc ordered the free T3 and total T3. Those should tell her whether I have difficulty converting T4 to T3. If so, I may also need a T3 supplement.

The TAB (antithyroglobulin antibody?) and TPOAb (thyroid peroxidase antibody) tests look for antibodies which cause Hashimoto's thyroiditis. That autoimmune condition is linked to gluten intolerance and celiac disease. I suspect those tests will be negative because I strictly followed a gluten free diet for 6 years. So I may not have any thyroid antibodies. However, my failure to improve (esp. regularity and immunity), while taking a T4 supplement, made me wonder if I have something else going on (like Hashimoto's or T3 deficiency).

I plan to get those tests done next week. However, I'll request a lab tech who doesn't usually puncture veins when drawing blood. I'll especially decline a blood draw from the person who punctured 2 of my veins in September. I had a large bruise for over a month and sensitivity (throbbing pain) in those veins for almost 2 months.