Bridget,
Thanks for your post. My endo will agree to most anything within reason, I
have Addison’s Disease to manage and he depends upon my ability to interpret
symptoms. He says he can offer guidance, however the patient must find best
levels of these hormones for him or herself. We do follow labs for any
outlandish numbers, however symptoms TRUMP labs every time.
I have zero adrenal cortex function, autoimmune destruction of adrenals was
the cause. And so we replace all my adrenocortical hormones –
glucocorticoids, mineralocorticoids, DHEA. With hypothyroidism as well
(glad that I have some thyroid function left!), I have found that my labs
cannot be tracked for ‘absolute’
Numbers. Hoping that makes sense. The TSH, Free T4 and Free T3’s will all
vary, based upon my adrenal replacement at the moment. AND my ACTH,
cortisol, etc. will vary, based on my thyroid replacement at the moment!
For years I would get labs, look at them and say, What?? How can my TSH be
X now, with these Frees… and last time my TSH was higher than ‘X’ with
Higher Frees?!
It just didn’t makes sense, endo said, perhaps your pituitary is going… and
then we figured out that the numbers all change based on… my glucocorticoid
dosing, most likely! It was just crazy.
My plan to get to compounded Armour, was in my mind last fall. My heart has
sensitive sinus node I guess, and as I attempted to wean down a bit on
steroids, I went quite hyperthyroid. Then my sinus node just had a fit.
Heart raced every evening up to 138+. Finally endo said, skip afternoon
armour dose just one day, see if it helps. Sure enough. And over a couple
months, weaned down a bit on the armour. Then decided not to go on beta
blockers unless I really have to, and wean down JUST enough on the armour so
my heart is happier. It worked.
But then I was at ½ grain of Armour, and wondered if my TSH was a bit high,
and my gland was getting ‘whipped’ too much to maintain the level I needed.
(I did try dropping to ¼ grain to see if my gland could unsuppress even
more, but it didn’t. I went very hypothyroid. Actually glad I did check
that last thing out.)
I had read that heart issues with Armour are sometimes due simply to the
variability—the ups and downs of the T3, etc. So it made sense to me, to
get a bit more T4 in the picture, as a base. (my T4 blood levels on armour
were always low, the t3s were good). And I read online that some do combine
synthroid and armour, to very good effect. It made sense to me, and my
heart might be better off that way. So added in a tiny one quarter tablet
of 25 mcg synthroid, upping just by that much, every four weeks. Bloodwork
then next raise. It has taken from January til now to get it done. My
heart would race like crazy if I upped by more than that at a time! and
THEN decided to compound my ¼ grain armour cause of afternoon slump. Now,
no more slump! No more second dosing of armour through the day!
Anyway, that is the story if it helps at all. My endo uses Target tsh range
of around 0.8 to 1.0, for thyroid dosing, so a tsh of ‘3’ he would consider
actually quite high.
Care,
Holly
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