Monday, January 31, 2011

WBC Differential Results

My WBC Differential blood test showed an overall increase, from 3.0 over two weeks ago to 3.4 three days ago. I suspect that WBC score varies from day to day. However, any increase tells me the Low Dose Naltrexone helped improve my immunity. Because I doubted whether LDN was helping, I abstained from taking that for one night. I STILL slept poorly. Since LDN does not have a lasting effect, abstaining for one night prevents any LDN side affects. So I realized that my afternoon T3 dose (and possibly my longer lasting T4 dose) were affecting my sleep, not the LDN.

My neutrophils were the only form of white blood cells which were below the normal range. My neutrophils (absolute) were 1.93, whereas the standard range is 2.00 to 7.30. That's considered mild neutropenia. My monocytes were in the mid normal range. All the other white blood cell differential scores were in the low normal. That included lymphocytes (1.06 vs. a 1.0-3.4 normal range), eosinophils (0.03 vs. a 0.0-0.5 normal range), basophils (0.01 vs. a 0.0-0.2 range).

I researched causes of neutropenia and found that taking antibiotics frequently lowered white blood cells and especially neutrophils. One website listed antibiotics which usually caused neutropenia. Vancomycin (which I took for 6 months during 2009) was near the top of the list. Metrodiazonale (Flagyl), which I took for 17 days before I started Vancomycin, is lower on that same list.

Thursday, January 27, 2011

Letter to My Doctor

Here's what I wrote to my doctor, after receiving her request for more blood tests (WBC differential), just before our scheduled appointment to discuss my previous blood tests. I do not want to pay for another appointment to discuss the new test, because I understand exactly what caused the abnormal results on the previous tests. So I explained to her what happened which influenced those abnormal results in the following email:

Today I received your Lab Order Request for WBC differential and will have that done at my local Group Health Clinic tomorrow. I'll ask GHC when you (and I) should receive those results. Then I'll reschedule our appointment to discuss those results as well as my other January test results. However, I may need new prescriptions for both the T3 and T4 before our next appointment. I'll run out of the T4 in 4 days. I'll run out of the T3 in 10 days.

I received the results of all my recent blood tests over a week ago. I was disappointed to see that my white blood cell count remained low after taking LDN for over 6 weeks. The other abnormal test results (low T4, increased TSH, high Vitamin D and possibly low MCHC) reflect what I did during the past 2 months (1) to avoid the side effects of LDN. which interacted with my thyroid hormones to cause hyperthyroid symptoms, and (2) to fight chronic cold symptoms (with vitamin D).

As I previously mentioned, I experienced hyperthyroid symptoms (overheating and palpitations which prevented and/or disrupted sleep) soon after beginning the LDN. So I initially reduced my thyroid supplements so I could continue the prescribed dose of LDN without hyper symptoms. Then I got severe constipation, an impacted stool and bleeding hemorrhoids, all hypothyroid symptoms. So I increased the T3, which had previously improved regularity, and abstained from T4, which did nothing for regularity, while I decreased the LDN dose to 1.5-2.0 mg. However, even the lower doses of LDN continued to disrupt my sleep.

I took the arabinogalactin and 6000IU of Vitamin D daily for 2 months, because I experienced cold symptoms (sinus pain, sore throats, runny nose) between arabinogalactin doses (4-6 hours after taking IAG). I usually get colds when I don't get enough sleep. So I suspect insufficient sleep caused by the LDN negatively affected my immunity. Although I had normal regularity while I took just T3 supplements, I again developed increasingly severe constipation (about a month after the impacted stool incident) before I saw the high vitamin D results and decreased my vitamin D supplments. I'm now slowly returning to normal regularity, but still have bleeding hemorrhoids.

Despite continuing to eat high iron content foods, my MCHC decreased. I wonder whether daily bleeding hemorrhoids could have affected that number.

I hope the WBC differential tests will give you more information my low leukocyte results. I think the LDN caused more problems than it resolved. I believe abstaining from the LDN and getting a few weeks of solid sleep while taking my thyroid hormones and arabinogalactin could improve my imunity.

Wednesday, January 19, 2011

January Blood Test Results

My recent blood test results contained both good and bad news. Although I understand exactly how my other results changed, I don't know why my white blood cell count didn't increase after taking LDN for 6 weeks. Here are the latest results with my comments about differences current and previous test results:

CBCs: Everything was normal except Leukocyte count and MCHC, which were both low again.

Leukocyte (white blood cell) level remained at 3 (normal is 4.0-10.7). That did not increase despite taking Low Dose Naltrexone and arabinogalactin to fight viral infections for over 6 weeks. I don't know why the LDN didn't improve my immunity and raise my white blood cells. However, I haven't slept well very often since I started taking LDN. As mentioned, LDN interacted with my thyroid supplements so that I awoke overheated with heart palpitations. Those symptoms decreased when I abstained from thyroid, but then I got severely constipated (a hypothyroid symptom). So I decreased the LDN to minimum 1.5 mg dose and slept well for a few nights. When I took a higher LDN dose (1.75-2mg), I slept poorly.

MCHC decreased to 32 from a previous 33 (33-37 is normal) in November and 32 in September. I suspect the MCHC levels decreased again, because I've had bleeding hemorrhoids almost daily for the past 6 weeks. That began after an impacted stool episode which occurred after I decreased my thyroid supplements to prevent hyperthyroid symptoms caused by interaction between LDN and thyroid supplements.

THYROID HORMONE TESTS:

TSH increased from 0.797 in November to 1.72 in January (normal range is .3-3.0). Both those results are normal, but I suspect my doctor prefers a lower TSH score. Decreasing my T3 and T4 supplements to prevent hyperthyroid symptoms caused by interaction with LDN affected my TSH.

Free T3 increased from a previous 2.0 in November to 2.7 in January (normal range is 2.4-4.4). Because T3 decreased my hypothyroid symptoms (constipation, low energy, low body temp) more effectively than T4, I continued taking T3 while I eliminated T4 to avoid hyper symptoms. Despite having no improvement in hypo symptoms while taking only T4, I can more easily overdose on T4. So I cut T4 and continued T3.

Free T4 decreased from a previous 1.19 in November to 0.67 in January. Not taking T4 while continuing to take T3 could have caused that decrease. So I recently resumed taking 25 mcg (1/2 prescribed dose) daily.

Anti-TPO (Thyroid Peroxidase AB) decreased from 53 in November to 47 in January (normal range is 0.0-60). That decrease may have been the one positive effect of taking LDN.

Thyroglobulin Antibodies remained less than 0.9, as they were in November (normal range is 0.0-4.0).

Vitamin D3 (25 Hydroxy) increased from 33 in September to a higher than normal 93 in January (normal range is 30-80). I suspect taking 6000IU of D3 daily for 2 months increased my blood levels of D3 too much. However, I took the D3 to improve my immunity (ability to fight off viral respiratory infections), while my white blood cells were (are) low. That high Vitamin D level explained why I experienced increaseingly severe constipation (more bleeding hemorrhoids) during the week before I received that test result. Since then I've cut waaaay back on Vitamin D to let my blood levels decrease and restore regularity to let my hemorrhoid heal.

I received the last of those results at least a week ago. Then I made an appointment to see my doc to discuss what to do about those results. Actually I know how to resolve everything except the white blood cell levels. I can take more T4. I can take less vitamin D3 supplement. However, I also need new prescriptions for both my T3 and my T4 supplements. If I weren't taking the LDN I would request a compounded slow release T3 supplement to eliminate taking a second T4 pill one hour after lunch, which sometimes occurs rather late in the afternoon.

I didn't notice any benefit to taking the LDN. That did not increase my white blood cells, but it did disturb my sleep for many nights as well as cause hyper thyroid symptoms. Insufficient sleep can also lower immunity. (I notice I catch more colds when I don't get enough sleep.) Rather than start me at a low dose, my doc prescribed an LDN dose appropriate for my weight. Then I began waking up in the middle of the night feeling overheated and having palpitations. After I recognized those as hyperthyroid symptoms caused by interaction from the LDN, I decreased my thyroid. Then I got severe constipation with an impacted stool which caused bleeding hemorrhoids. So I resumed my thyroid supplements at a lower dose, which restored regularity UNTIL high levels of vitamin D again caused constipation and bleeding hemorrhoids. Decreasing the vitamin D eventually restored regularity, but I still have bleeding hemorrhoids. I suspect eliminating the LDN and increasing my thryoid supplements will help me sleep better and recover from bleeding hemorrhoids.

Monday, January 17, 2011

Our Birds Are BACK!!

Perhaps because Seattle had warmer (and rainier) that usual weather in January, the Redwinged Blackbirds returned to their usual spot on Greenlake. Usually they migrate South (Mexico?) in early winter and don't return until February or March. So we were overjoyed to see (and hear) them when we passed the traditional RWB bush on Greenlake. For many years my husband and I (among many other Greenlake walkers) hand fed the Redwinged Blackbirds, who land on our outstretched hands to eat chopped peanuts or other seeds. (We just bring peanuts.)

In recent years some Blackcapped Chickadees had joined the feeding frenzy at the bush. Actually the BCCs approach us (land on our hands to eat) much sooner than the RWBs. Usually the RWBs watch us warily until the first of their flock bravely lands on our hand to take a peanut. The braver RWBs (or birds who remember us from previous years) will remain on our hands up to five minutes as they gorge on peanuts. Most Chickadees prefer to eat in private. So they take one peanut, fly off to eat and return often for more peanuts. more often bravely approachthan the RWBs.

Sometimes other people, who walk the Greenlake path, see us with birds eating on our outstretched hands and ask: "Is that your bird?" I always answer: "NO, but he thinks I'm his human." After many days of feeding and increased familiarity, a few male RWBs become very possessive of their human feeders. They definitely have a 'pecking order' and can scare lesser RWBs from our hands. Usually males dominate the pecking order. However, a few familiar females will watch and wait for the dominant male to finish feeding. Then the female will take her turn and feed for a long time.

I most enjoy feeding the RWBs when they are raising families. The male and female birds will individually approach me, take one peanut and fly back to their nestlings. Their feet are often wet, because they land on wet water lily pads to catch bugs to take to their nestlings between peanut feedings. One summer my favorite female RBW (whom we named 'Rita') visited me many times as I sat on the grassy shore along the lake. She flew to me, took a peanut and then returned to her nest to feed her babies. Then I would see her fly to the water, return to the nest and feed her babies again. I realized she was feeding insects to her babies, beause she landed on my hand and 'traded' a dead insect for peanuts. Maybe she was trying to take peanuts and insects to her nestling, but realized decided to leave the insect with me and return after feeding her baby a peanut.

Feeding the Redwing Blackbirds and Blackcapped Chickadees (who land on our outstretched hands), American Coots (who come running to me while madly flapping their wings to get peanuts) and Crows (who recognize me no matter what I wear) motivates me (and my husband on weekends) to walk 3 miles around the lake rain or shine from early spring to early winter every day. They are not really 'our' birds, but we are some of the humans who feed them every year and make Greenlake home for migrating RedWinged Blackbirds and Coots. (Crows follow us year round but Chickadees only approach us when they RedWinged Blackbirds return.)

Tuesday, January 11, 2011

6 Week LDN Blood Tests

I've taken low dose naltrexone daily for over 6 weeks. My doc prescribed LDN to improve my immunity and hopefully raise my white blood cell level. So this week I will get a blood test to check my CBCs (esp. WBC), thyroid hormones, and vitamin D. I really don't know whether my immunity improved, because I still catch colds very easily. I seem to develop new cold symptoms everytime I am with large crowds of strangers. Last week I went to my local HMO pharmacy to pick up my liothyronine (T3 hormone supplement). After 2 days I had obvious cold symptoms (sore throat, sinus pain, runny nose), despite taking arabinogalactin to fight viral infections.

Taking T3 permanently resolved my chronic irregularity. This is the first time I've had consistently normal regularity for over a month since I had daily diarrhea while taking vancomycin to fight C-diff. I suspect my daily probiotics (100 billion of live good bacteria cells) also improved my overall gut health. However, despite everything I previously did (probiotics, fiber, fluids, magnesium, etc.), I was constipated before taking enough T3.

However I'm still not as warm as I'd like to be or as energetic as I used to be. So I plan to increase my afternoon T3 dose from 2.5 mcg to 5 mcg (as my doc originally prescribed). I decreased my T3 from the orginal dose, because LDN enhanced my thyroid supplements to cause hyperthyroid symptoms and sleep problems. Now that I've taken LDN for over 6 weeks, I'll try increasing my T3 and see how I do. I'm still taking a little over half my originally prescribed LDN dose (1.5-1.75mg daily). That amount does not interfere with sleep. Nevertheless, I'm uncertain whether that amount increased my WBC count. Only blood tests will tell.

Saturday, January 1, 2011

Just One Resolution

My previous post described what I intend to continue doing (medications and stopping when full). Actually I intend to stop when I feel full more consistently at meals. If I overate at every meal, I'd probably be overweight. However, I didn't mention in that post one intention to change in 2011.

I intend to let my hair grow into a short bob with bangs. I'm sooooo tired of this pixie cut, which I've worn for 5? years. All too often I see myself (my pixie cut) coming and going in other people's hairstyles. I'm tired of having my hairstylist thin my healthy, thick (dense) hair to conform to a pixie. I'm tired of FREEZING after every cut, except on very hot days (which are rare in Seattle). I'm tired of worrying about whether my style deemphasizes my short forehead and larger than 'pixie' sized ears. So I intend to cover those features with longer bangs and longer sides. I may wear the bob shorter in the back and longer in the front, but I definitely want the bangs and front hair to frame my facial features (large eyes and prominent cheek bones).

With that intention I may suffer some 'grow out' discomfort as I let my current cut grow long enough to create some sort of bob for at least the next 2 cuts. Last Friday was 8 weeks since my last cut. If I can endure another 4-5 weeks of this cut, the shortest hair (originally above my ears) will almost reach my earlobes for a short bob style. Maybe I should call my hairstylist and book an appointment 4-5 weeks from now. So if I waiver in my 'growout' intention, I'll have to call and reschedule that appointment.

Perhaps I just like having something to look forward to or change. We didn't go to Maui last October. Likewise I don't imagine going to Maui in February, because I will still be on LDN treatment. Between the vitamins/minerals, thyroid, probiotics for good health, and LDN and arabinogalactin to improve my immunity, those are too many pills to schedule into a vacation. I want to at least wait until my WBCs are higher before I expose myself to airports, airplanes and other big crowds of people sharing their viral and bacterial infections. I wash my hands frequently during the day, but always feel worse after being with crowds of people at the mall. So I may still be susceptible to infection for another few months.

Sooooo ... I'm looking forward to a new hairstyle and a healthier 2011.

Doing What Works

I asked my husband what he intends to do in 20ll. He told me that he wants to continue taking the recently prescribed (late 2010) treatments that definitely work for him and closely monitor benefits vs. side effects of other treatments (which don't seem to make any difference). I recently convinced him to begin the thyroid supplement, which his doc recommended at the same time he prescribed other treatments. My husband initially wanted to just use supplements which improve his sleep. However, he still felt tired, even when he did sleep well. So he agreed to try the prescribed thyroid (Armour T3/T4 combo). Since he commenced using that supplement, he's felt more energetic and optimistic every day. So he's convinced that he needs a thyroid supplement.

Likewise I will continue to take my T3 supplements, which have given me more energy, increased core body warmth and normal regularity (for the first time in my life). I will continue my normal vitamin/minerals, esp. vitamin D, which helps immunity, and probiotics. I will also continue the arabinogalactin and low dose naltrexone, which stimulates my immunity (hopefully to raise my white blood cells).

However, after a week of taking 2.5mg LDN and experiencing interrupted sleep, I will lower that dose back to 1.75-2.0mg daily. At that previous dose, I had no sleep problems. My doc advised me to at least take 1.5mg of LDN daily. However, higher doses interrupt my sleep, which also challenges my immunity. So I'll resume the lower dose to get the benefit of LDN without losing sleep.

What doesn't work for me is my habit of eating past 'full'. I almost always eat when I'm hungry, foods which nourish my body. However, I regularly eat past comfortably full. Every year I vow to stop eating before I feel uncomfortably full. I don't need to lose weight, but I believe overeating and making myself uncomfortable is counterproductive. I've been uncomfortably full after many meals during the holidays!

I know exactly what thoughts persuade me to continue eating when I begin to feel full. I tell myself:

(1) The LDN affects my appetite and makes me feel full sooner than normal.

(2) If I don't eat everything on my plate, I'll feel starved before the next meal.

(3) I hate to throw out a tiny bit of food on my plate (if I stop eating now).

(4) I don't need to worry about weight, so it's okay to feel overly full sometimes.

However, those thoughts are not exactly true. Here's the truth:

(1) Amounts of LDN which affect appetite also affect sleep. An appropriate dosage will affect neither appetite nor sleep. So my stomach 'full' cues are accurate when I take the appropriate LDN dose.

(2) I determine mealtimes. I can eat breakfast and lunch anytime I feel hungry. If I need to delay a meal for any reason, I can always have a small snack or fruit juice or just drink herbal tea to save my appetite for the meal.

(3) I can save small bits of food in the freezer and add them to my own portions of soups or casseroles (which I freeze in individual servings).

(4) That 2-3 bits of extra food on my plate can make the difference between feeling comfortable after I leave the table and feeling miserable for the next 3-4 hours after I leave the table. I want to remember how miserable I felt after overeating last night after dinner. Although I don't have pancakes for dinner very often, I did freeze 7 meals' worth of pancakes for future meals.

Last night was not the last time I'll have pancakes ... maybe the last time during 2010, but I have 7 more pancake meals during 2011. After those are gone, I have another pancake mix. So I can make 8-9 more meals of delicious, syrupy pancakes. I tend to overeat the first time I have food which I haven't eaten in a long time (the 'Last Supper' Syndrome). I need to remind myself when I feel full and still have delicious food on my plate, that I can have that same food the next time I feel hungry and crave that food (the next meal, the next day, the next week or whenever).

I need to focus on physical comfort, more than 'nutrition' per se. I normally eat nutritious food. So I don't need to overeat to get enough nutrition. So I again intend to eat when I feel comfortably hungry and stop eating at the first sensation that tells me I'm 'full'.

Maybe the medications (like T3 and LDN) have affected my appetite somewhat. However, feeling miserably full also affects my energy level and mood. Taxing my body with unnecessary food also challenges my immunity. So eating for physical (not emotional) comfort, rather than nutritional guidelines, seems healthier for me.