Hashimoto's Thyroiditis

I went back to my endo on Tuesday. My results are long and very telling.

First the bloodwork. My free T3 and T4 were within normal range, despite my TSH being at 0.013. At this point, TSH is meaningless as a diagnostic tool. Free T3 and T4 are really the only numbers that will tell me anything. As long as I can keep both within the upper part of the range I will be doing ok.

Second, the glucose tolerance test said I was not diabetic nor prediabetic. No shock there. I knew my weight gain was due to thyroid, not diabetes. People with poor thyroid function tend to store fat easily and lose weight poorly. She did have some dietary tips - mostly to cut back on sugar and have more protein and carbs.

Third, and I found this a bit surprising, my sex hormones - estrogen, testosterone, and progesterone were within normal range. I had expected that to be off.

But the most important test results were these.

I have Hashimoto's Thyroiditis. That means I have antibodies that are attacking my thyroid. It is an auto immune disease and it is the reason I have a non functioning (or poorly functioning) thyroid. The blood test showed the antibodies and the thyroid ultrasound showed that my thyroid has a rough surface. The surface should be smooth, but mine is being damaged by the antibodies.

The result that was important was the Stim test. It showed poor adrenal function. In a normal person, when given a shot of ACTH, their cortisol levels rise, usually doubling within an hour. Mine dropped. Yep - my adrenals were so poor that the ACTH didn't stimulate anything.

So I got a scrip for hydrocortisone - which I was already on but now my insurance can pay for it.

I have another blood test scheduled for mid April followed by another appointment with the endo to check my levels and such. More then!

4 Hours

This morning I had my stim test that I told you about last post. Here's the story.

I had to stop taking my hydrocortisone for 48 hours prior to today. I also had to fast and not take my thyroid medication this morning. So I was hungry and tired when I left.

I had an hour drive to the hospital where I was having the test done. Mental memo: stop allowing doctors to schedule tests at places so far away unless necessary. I'm certain this was not necessary.

I got there with about 5 minutes to spare. I checked in at the correct desk and they told me they were backed up and sent me to another building where the other lab was because it would be quicker.

Of course, I got there, checked in, waited 15 minutes and then they told me I was in the wrong place. They said they could only draw blood - they were not allowed to do the stim test.

Yep - back over to the original place I went. By the time I got in there, got charted (all those questions they ask), and was ready to go it was almost 45 minutes late.

Ugh.

So I had to have a baseline test done, plus some other lab work had been ordered. The nurse, who was super good and I appreciate good nurses, had to start an IV line then draw no less than 5 vials of blood. After that, it was time for my cortisol shot.

I was anticipating some reaction to having a sudden influx of this hormone after being off my meds for 2 days. Sweating, flushness, whatever.

I almost fell asleep. I was lying on that bed with nothing to do but wait and I was tired. I felt nothing at all.

After 30 minutes the nurse came back and took 2 more vials of blood. Then 30 minutes later 2 more. Then I was done.

They gave me a bit of orange juice since I had been fasting and sent me on my way. It was after 11 by the time I got in my car.

I hope it wasn't all for nothing.

See, everything I had read said the closer to 7 am you get the test done the better. It was 10 when they started. But I don't think I would go through all that again unless I could do it locally. The whole process from leaving home to getting home took 4 hours. If I had done it locally it probably would have been less than 2.

Stim Test

Next up for me, on Wednesday, is the cosyntropin test or 'stim' test which is used to determine how well the adrenal glands are working.

My own saliva test I did this summer showed that I had low cortisol levels. Cortisol is produced by the adrenal glands and is necessary for taking the active T3 in your blood and getting it into your tissues. Don't ask me to explain the process as I only have a layman's understanding of it. But if you don't have enough cortisol then your T3 goes nowhere and does you no good. That much I get.

The stim test goes like this: I have to be off my hydrocortisone for 48 hour and fast the night before. Then I go get some blood drawn as a baseline. Then I get injected with ACTH(adrenocorticotropic hormone), which is the hormone normally produced by the pituitary gland to tell the adrenals to release cortisol. I get blood drawn in 30 minutes and again at 60 minutes after the shot.

What this will tell the doctor is if my adrenal gland is working (cortisol is produced) or not. If it is working, then I have a pituitary problem. If not, then I have an adrenal problem.

Frankly I don't see what the difference is. Either way, my body doesn't produce cortisol either because the adrenals are bad or the pituitary is bad. I guess the adrenals can recover but not the pituitary.

Side effects look unpleasant: nausea, anxiety, sweating, dizziness, itchy skin, palpitations and facial flushing. Good thing I'm having it done in a hospital.

I'll let you know how it goes.

Flat Over Sugared Orange Soda

I had my blood test this morning. I left the house before 6:30 to arrive at the lab as they opened at 7:00. In 30 degree weather, no less.

But I was second in line (yes, some crazy lady was there ahead of me) which was good because one of the tests I had to take was two hours long.

I speak of the glucose tolerance test. Basically you have to fast (nothing for 12 hours - I was hungry!) and then get your blood drawn. They you have to drink this flat, over-sugared orange soda like stuff in 15 minutes. Then you wait an hour and they draw more blood. Then you wait another hour and draw even more.

This test is given to check for diabetes (which I know I don't have so I don't know why she wanted to test it). It measures how well your body responds to sugar.

A good part of the first hour I wanted to hurl. I tell you, I don't know how pregnant women do this test (gestational diabetes). I know I would have tossed it all if I had had this test while pregnant.

Still, I managed to survive. I'll let you know the results.

Scanning

I had my thyroid scan on Wednesday. It was very quick. From registration to leaving (I had to have it done in a hospital) took about 30 minutes.

I won't know the results until March.

Glass Half Full and Half Empty

I went to the endocrinologist last week. I was less than impressed. She doesn't like natural thyroid replacement - that's the medicine that has been used for over 100 years successfully. She doesn't believe in adrenal fatigue. She wanted me to change my medications to synthetic and get off the hydrocortisone.

Not likely.

But, she did order some blood tests and a thryoid scan, both of which are coming up soon. I'll do that.

I go back to see her next month. At which time I'll get my test results, tell her I don't want to switch meds and probably never see her again.

I'll let you know what the tests say.

One Step Further

Time for an update.

I've been on 20mg of hydrocortisone and 3 grains of dessicated thyroid for a while now. I recently had my blood drawn and my main results are:

TSH 0.015 (normal range: 0.450-4.500)

Triiodothyronine,Free 3.2 (normal range: 2.3-4.2)

T4,Free(Direct) 1.06 (normal range: 0.61-1.76)

Now, a regular GP would look at the TSH and scream that it's too low. But someone with knowledge would see that the important information is that both my free T4 and T3 are within range.

This means my thyroid medication is at the proper dosage. This is why TSH is meaningless without having the frees tested at the same time.

A friends wife gave me the name of her endocrinologist and I'm going to get an appointment to see her. It would be nice if I can start getting the proper medications with a scrip and not on my own.

I went to my GP today and had to do a little dance with her. She didn't realize that A) my scrip from her ran out months ago; B) that I stopped taking the depression meds she gave me too; and C) I was basically saying that I wanted to see another Doctor because she wasn't cutting it.

I think it sucks that you have to get a referral from your GP to see a specialist. I realize it's to keep from wasting the Doctors time but it wastes mine instead. I know I have a thyroid problem. My GP knows I have a thyroid problem. Just call the specialist and say, 'Yeah, she's got a thyroid problem' and don't make me come in and spend $20 for nothing.

Stupid rules.

I also talked her out of doing any testing. She wanted to draw blood and have recent labs from me, but I didn't tell her I was A) dosing myself and B) had done my own labs a couple of weeks ago. I told her I was afraid that insurance wouldn't pay for it.

Now all I have to do is wait to for the referral to be called in - the endo's office is closed today due to weather - and make an appointment.

Wish me luck.

Better Late Than...

Ok - that's just a lie. I should have posted something, anything, long ago. I've just not been motivated.

So here's the scoop. I'm up to 20 mg of hydro cortisone a day now. I'm getting ready to go up to 3 grains of Armour daily too. I have noticed some improvements - better concentration, less sleepiness, better mood - but not all symptoms have gone away.

I don't really expect them all to go away. But the most important one is still with me - lack of libido. That one has to improve and I'm still working on it.

In the mean time I found an online group that I have been learning from and have some new areas I need to explore - vitamins deficiency, salt intake, and something called aldesterone. I'm still reading up before I do anything about it.

As for my weight I'm still stuck around 140-142. My skin is clearing up, though, and that really pleases me.

The First Day Towards A New Me

My much needed meds arrived in the mail yesterday.

Today, this morning, I took my first dose of adrenal support medication - 2.5mgs of hydro cortisone.

I will be on the following schedule for this medication:

• Day 1-3: 2.5 mg first thing in the AM (2.5 mg total)
• Day 4-6: 2.5 mg first thing, 2.5 mg in four hours (5 mg total)
• Day 7-9: 2.5 mg first thing; 2.5 mg in four hours; 2.5 mg in four hours (7 1/2 mg total)
• Day 10-12: 5 mg first thing; 2.5 mg in four hours; 2.5 mg in four hours (10 mg total)
• Day 13-16: 5 mg first thing; 5 mg in four hours; 2.5 mg in four hours; 2.5 mg bedtime (15 mg total)
• Day 17-20: 10 mg first thing; 5 mg in four hours; 2.5 mg in four hours; Bedtime 2.5 mg (20 mg total)

I will also be working on my thyroid medication, my natural thyroid hormone and not the synthetic I had been using. Right now I am taking .5 grains of Westhroid and will be increasing that along with the hydro cortisone.

Progress.

Internet Woes

As I said earlier, I'm working on self medicating for my issues. To do so, you have to use a supplier that doesn't require a prescription.

That doesn't always go as planned.

I ordered some thyroid medication, natural dessicated thyroid, from a place overseas. About a week after I placed the order they emailed me and said they could not accept credit card payments and to please pay via western union.

Huge red flags went up as western union is the place of choice for money scams. I told them no and immediately informed my credit card company that my card might have been compromised. So far all is well.

I had also ordered some adrenal medicine from a place in Mexico. It arrived and it was not the right medicine. I have been trying all week to get them to respond to me about this wrong order. I have over $100 in useless medications and I am not going to be stuck with it. If I don't hear from them by tomorrow I'll have to make another call to my credit card company and get them to stop the charge.

On a bright note the replacement thyroid medication, this time from England, arrived and is just fine. Now I'm waiting on the replacement adrenal medication from Canada to show up.