After many years of hypothyroid symptoms, I finally found a doctor who tested more than my TSH levels. However, those had been higher than normal since the TSH normal scale was revised downward in 2003. Unfortunately, my HMO neglected to advise their docs to revise their TSH normal scale. So my hypothyroid symptoms progressively increased along with my TSH level during the past 10 years. I felt progressively more fatigued, I felt very sensitive to cold temperatures and I needed 900 mg of magnesium to stay somewhat 'regular'. However for me 'regular' meant a daily bowel movement, which was harder than normal, with frequent inflamed and/or bleeding hemorrhoids. (I had hemorrhoid surgery in 1999, but more hemorrhoids developed during the past 10 years.) My daily fatigue crisis usually occurred in late afternoon. So I often craved and binged on sweets in my attempt to get some energy to function for a few more hours. I also lost the outer third of my eyebrows, which I later learned was a hypothyroid symptom.
However, last June I saw a new naturopath who tested me for anything that could have influenced my 8 gastrointestinal infections during the previous 4 year period. One test for thyroid hormones showed the my TSH was higher than normal and my free T4 was low normal. So she prescribed a T4 supplement. I chose Levoxyl, because it didn't contain any of my allergens. However after 3 months on Levoxyl I still did not notice much decreased hypothyroid symptoms. I still felt cold, tired and constipated. So my doc told me to increase my dosage from 50 to 75 mcg daily. That increased dose caused hyperthyroid symptoms of tachycardia, palpitations, sweating and diarrhea. I didn't mind the diarrhea, but I certainly worried about tachycardia. So I abstained from thyroid supplements until those hyper symptoms disappeared and returned to my original 50 mcg dose and my hypothyroid symptoms.
My experiences with T4 (all or nothing symptoms) made me wonder whether I had difficulty converting T4 to T3. T4 is the 'carrier' hormone, but T3 is the 'worker' hormone which controls various metabolic functions. Because T4 is converted to T3, the body usually makes less T3 than T4. However, if people can't convert T4 to T3, T4supplements won't resolve their hypothyroid symptoms. So I asked my doc to request blood tests for free T3, total T3, free T4, total T4, TSH and TPOab (Hashimoto's antibodies). Those tests showed that my free T3 was very low, my T4 was normal, my TSH was low normal (good) and Hashimoto's antibodies were high normal.
So my doc prescribed a T3 supplement, generic Liothyronine, which was free of my allergens. The combination of 10 mcg of Liothyronine and 50 mcg of Levoxyl resolved all my hypothyroid symptoms. I was 'regular', warm and energetic.
I did well for a few weeks on the T3/T4 therapy UNTIL I began taking LDN (low dose naltrexone) to increase my white blood cells (immunity). LDN positively affects all autoimmune diseases, including Hashimoto's thyroiditis. So within 3 days of starting LDN I again experienced hyperthyroid symptoms (overheating, palpitations and diarrhea). LDN had decreased my need for so much thyroid supplement by decreasing Hashimoto's antibodies (which damage the thyroid and decrease its production of hormones).
Because I needed the LDN to treat mild neutropenia, I decided to abstain from the T4 supplements, because I don't easily convert that anyway. That immediately resolved my hyperthyroid symptoms. I returned to my normal 'warm, energetic and regular'.
However, another blood test showed that my vitamin D levels were higher than normal. One of the results of vitamin D overdose is constipation, because vitamin D uses magnesium. Because magnesium keeps the stools soft, I take daily magnesium. Nevertheless, I noticed I became progressively more constipated, before I saw the vitamin D overdose test results. So I immediately abstained from vitamin D supplements. Yet the severe constipation continued and my hemorrhoids bled daily.
So I took more magnesium and a bit more T3. (I cut my liothyronine tablets into small pieces so that I could take 1-2 mcg more than my original prescription.) About that time I got a very bad sinus infection. So I also took more vitamin C. All those extra supplements helped resolved the constipation. However, I had to just wait for the excess vitamin D to leave my body, which stores extra vitamin D in the muscles.
For 2 months I juggled extra supplements (T3, C and Mg) to counteract the constipating effect of excess Vitamin D. Then I began to notice softer and softer stools. So I cut back on the C and Mg and still had normal stools. I believe that I finally have normal levels of vitamin D in my body. However, I won't take any supplemental vitamin D until I see the results of my next blood test, which I'll take after I finish my LDN prescription.
Now I'm enjoying the effects of just enough T3 (feeling consistently warm, energetic and regular). However, I take T3 twice daily, because it has such a short half life (8 hours). I need to take the first dose when I wake up, but can't eat breakfast for at least an hour after that dose. Then I need to wait 3 hours after the T3 dose before I can take Magnesium supplements. Because I take Mg with breakfast, I had to wait 3 hours to have breakfast, until I realized I could just take the Mg after breakfast.
Nevertheless, I still 'crash' before my afternoon T3 dose takes effect. I usually don't get hungry for lunch until 4 hours after breakfast. Then I have to wait an hour after eating, before I can take my afternoon T3 dose. By that time 8 hours have passed since my morning dose. However, I don't feel the effect of the second T3 dose until 2-3 hours pass. That causes me to 'crash' with low energey and feeling cold until the second dose increases my thyroid hormone levels. I'm working at getting my breakfast earlier (and taking Mg after breakfast) so that I can get lunch earlier so that I can take that 2nd thyroid dose before I totally crash. Nevertheless, I still 'crash' every afternoon. At least I now understand the cause of the crash so that I don't believe bingeing on sweets will resolve my energy crisis. So I plan relaxing activity (like checking emails) during my low energy time.
After I finish the LDN (about 2 more weeks), I may ask my doc for another Levoxyl prescription, but at a lower dose. Even though I don't easily convert T4 to T3, I do convert some. Since T4 levels rise slowly and decrease slowly, I didn't begin to get the afternoon energy crash until after I abstained from T4. So perhaps a lower dose (25 mcg) T4 combined with my current T3 or maybe a higher T3 morning dose could prevent my afternoon energy crisis.
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4 comments:
Hmmm, that sounds unpleasant. I hate afternoon crashes. I had one yesterday for other reasons. Ha. I hope the levoxyl works if you ask for it. If not, it's great that you were able to pinpoint what was happening and respond without food...
Compared to my former condition of being exhausted most of the day, a 2 hour energy crisis is a breeze. If I could get my after T3 earlier, I probably wouldn't crash. However, trying to juggling meals and magnesium supplements and eating when hungry makes that afternoon dose between 3 and 4 pm. That's usually 8 hours after my first dose. T3 has an 8 hour half-life. So I'm crashing.
At least I now know what causes those energy lows, when to expect them and how to handle those. Levoxyl could give me more 'staying power'. However, seeing benefits of T4 takes so long that I'm not sure the T4 would make much difference. Meanwhile I'm back to a higher T3 morning dose. (I cut one of the pills into 4-5 pieces and take one of those 'crumbs' with a whole tablet in the morning.) Nevertheless, I won't even consider a T4 supplement until after I finish the LDN, which can easily exacerbate the effects of Levoxyl and cause hyperthyroid symptoms (mostly palpitations and sweating). So the juggling continues ... LOL
I'm just curious, do you or your mother have amalgam fillings? Your symptoms sound very much like my children and myself, it's all due to mercury toxicity stemming from my grandmother/mother's and my own amalgams. You should consider reading Amalgam Illness from Andrew Cutler.
Have you ever been checked for low iodine? Most cases of hypothyroidism, Hashimoto's and Grave's disease are low iodine and treatment with the iodine protocol reverses it! But again, the root cause is often heavy metal toxicity. The thyroid and thymus are two of the first organs effected by it.
I also wanted to ask how things are with the D. Fragilis infection. I have a two year old with this nasty parasite and I don't know what route to take, we've tried natural a few times and it doesn't seem to be going well.
Since Blogger doesn't notify me of comments added to this blog, would you be willing to contact me directly at luckylot@ptd.net?
No. Any amalgam fillings were replaced years ago. Besides my reverse T3 levels are normal. People with mercury (amalgam) problems usually have high reverse T3 levels. I don't.
Low iodine rarely causes autoimmune thyroiditis. Also few people in this country suffer from low iodine levels, because we use iodized salt, unless they have other iodine absorption problems.
However untreated celiac disease and gluten intolerance does cause Hashimoto's thyroiditis. I was diagnosed with celiac disease in 2004, but not diagnosed with Hashi's until 2010. Nevertheless, my Hashi's has not worsened (needing more thyroid supplement), because I abstain from gluten. Also my Hashi's antibodies decreased after 6 weeks on LDN. I'm on a very low dose of T3 thyroid supplement. Most people with Hashi's need greater and great amounts of thyroid supplement as time passes, because they continue eating gluten which damages their thyroid.
I eliminated my d-frag parasite by taking Iodoquinol for 2 months. Subsequent stool tests were free of d-frag and I no longer have any symptoms of infection.
I'll copy and paste this post in an email to you.
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