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Hi

I just posted a reply to your other thread pointing out that the Synacthen test

tomorrow will NOT be accurate due to you being on HC since the last test.

What they should be doing is putting you on Dexamethasone for a period & THEN

retesting.

I also gave this link to seek advise from. http://www.addisonssupport.com/

They are familiar with ACTH Stims, ITT stims for GH evealuation,

Aldosterone/Florinef etc. The mod Dusty is also very knowledgable.

Having a test tomorrow will be inaccurate & a complete waste of time.

Not to mention stopping HC cold turkey is VERY dangerous & could well

precipitate a crisis.

Thyroid meds are the least of your worries. personally I wouldn't be taking any

as Thyroid meds require Cortisol & you have none at present. I am PMimg this as

well to ensure you read it before your appointment.

Lethal Lee

>

> Hi all

>

> I started the HC on saturday after the GP gave it me after a synacthen test.

>

> At first i felt ok on it, but then think i got a thyroid dump. I am off HC

today as need a synacthen retest tomorrow.

>

> However, today I am really struggling. I have gone really tired, no

motivation, feel like sleeping, struggling to think. All symptoms I had

previously, and which thyroid hormone seemed to fix in hours (T4 seemed to help

me more).

>

> Question is this:

>

> If i take a small amount T4 today will that in anyway affect my adrenal

results tomorrow? My cortisol level went up by about 4 points in the test, from

207 to 211. I'm thinking the HC has used up all the thyroid in my blood and

left me very low on it and my body isn't responding.

>

> Please does anyone know if any form of thyroid hormone will affect the results

tomorrow?

>

> Thanks

>

> Chris

>

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According to Professor Weetman, taking ANY form of thyroid

hormone replacement should not be taken 24 hours before the tests. Each one of

responds differently to whatever dose has been prescribed. for some, T4 gets

into the system very quickly, for others, it does not. You don't take the risk

of your thyroid function tests results being flawed, so take Weetman's

recommendation Chris.

Luv - Sheila

Question is this:

If i take a small amount T4 today will that in anyway affect my adrenal results

tomorrow? My cortisol level went up by about 4 points in the test, from 207 to

211. I'm thinking the HC has used up all the thyroid in my blood and left me

very low on it and my body isn't responding.

Please does anyone know if any form of thyroid hormone will affect the results

tomorrow?

Thanks

Chris

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Hi Sheila

Thanks but they are adrenal tests not thyroid tests tomorrow. was thinking if t4

is now low (and t3 of cours) because of a thyroid dump, that'd give my adrenals

an easier ride, right? if cortisol is burnt up getting thyroid into cells then

i don't want low levels of thyroid do i?

>

> According to Professor Weetman, taking ANY form of thyroid hormone

> replacement should not be taken 24 hours before the tests. Each one of

> responds differently to whatever dose has been prescribed. for some, T4 gets

> into the system very quickly, for others, it does not. You don't take the

> risk of your thyroid function tests results being flawed, so take Weetman's

> recommendation Chris.

>

> Luv - Sheila

>

>

>

>

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Thanks Lethal Lee

Well i don't know what they're playing at or why; whether they just don't know

what they're doing, or what, i don't know.

i don't have much faith in them, not least of all because i've been told i'll be

fine to wait . i'm appalled .

chris

>

> Hi

>

> I just posted a reply to your other thread pointing out that the Synacthen

test tomorrow will NOT be accurate due to you being on HC since the last test.

>

> What they should be doing is putting you on Dexamethasone for a period & THEN

retesting.

>

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> > Well i don't know what they're playing at or why; whether they just don't know what they're doing, or what, i don't know. > > i don't have much faith in them, not least of all because i've been told i'll be fine to wait . i'm appalled . >

Crikey - has nobody explained to you what is happening here ??? Please tell us - which test is planned for tomorrow, and what are doctor's instructions for you re the test? Are they planning another ACTH stim test or something else? Forget about your thyroid for the moment - most people with 's also suffer from hypothyroidism, but before doing anything about that, first and foremost your adrenals need to be stabilized (or rather you need to get properly diagnosed so you can be properly treated).

I just can't believe what I am reading here about how much you are left in the dark - are you at least under the care of an endocrinologist or is your GP casually ordering tests for you? - please give us some more info, perhaps we can help to clarify what is going on.

Off for an hour now, but will check for more info as soon as I am back....

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Hi Chris

The paper last year? by Ross and Weetman et al explained the circadian

rhythm:

The sequence of events (overnight for dayworkers) is TSH rises about

midnight, then T4 rises about 2.00 am, then T3 rises about 3.00 am; the

adrenals get on with turning out and storing steroids to peak about

7.00-8.00 am.

In other words, the thyroid function determines the output of steroid

hormones for use during the daytime.

You need enough cortisol to deal with adrenalin for stress response.

Bob

>

> Hi Sheila

>

> Thanks but they are adrenal tests not thyroid tests tomorrow. was

thinking if t4 is now low (and t3 of cours) because of a thyroid dump,

that'd give my adrenals an easier ride, right? if cortisol is burnt up

getting thyroid into cells then i don't want low levels of thyroid do i?

>

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it's another short synacthen test 250mcg, they've said to be off hc for 24 hours

before if possible, if nothing else don't take the evening dose tonight. (this

contradicts what instructions i was sent in email to be off hc for 24 hours)

so the results will go back to endo unit and be interpreted there

waiting for other tests now like gh, igf-1, testosterone.

going to get some fags as i need them! i recently had the dexa 1mg test and

since then have been smoking like no tomorrow, gone from about 3-5 aday to 20.

won't smoke or have coffee tomorrow morning.

perhaps the results will be lower tomorrow (i hope so that'll make them listen).

" higher,lower? " do you get anything for going lower? " not in this game! "

feel so run down today, really tired and no energy at all. reminds me how bad i

was most of last year. either it's low cortisol and or low thyroid.

i will push to be seen much sooner if my results are low again. knowing that lot

thye'll prob say i took something to make the results low and say i have

munchausens or something!

Chris

> Crikey - has nobody explained to you what is happening here ???

> Please tell us - which test is planned for tomorrow, and what are

> doctor's instructions for you re the test? Are they planning another

> ACTH stim test or something else? Forget about your thyroid for the

> moment - most people with 's also suffer from hypothyroidism, but

> before doing anything about that, first and foremost your adrenals need

> to be stabilized (or rather you need to get properly diagnosed so you

> can be properly treated).

>

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Hi

I opt for " they don't know what the hell they are doing " !!!

You do realise that cigarettes & Caffeine affect both Adrenaline & Cortisol?

Your Stim will also be very inaccurate due to having 20 fags a day. I would

think you would have to be off Cigarettes for at least 2 weeks (the same as HC

& other steroids) to get accurate results. Caffeine affects Adrenaline & hence

indirectly affects Cortisol too. Would need to be off that at least 24 hours or

more.

Not to mention that they tested incorrectly the first time around (should have

been done early am, fasting 12 hours, tested ACTH as well as basal Cortisol,

tested 30 mins AND 60 mins).

Lethal Lee

> > Crikey - has nobody explained to you what is happening here ???

> > Please tell us - which test is planned for tomorrow, and what are

> > doctor's instructions for you re the test? Are they planning another

> > ACTH stim test or something else? Forget about your thyroid for the

> > moment - most people with 's also suffer from hypothyroidism, but

> > before doing anything about that, first and foremost your adrenals need

> > to be stabilized (or rather you need to get properly diagnosed so you

> > can be properly treated).

> >

>

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>> it's another short synacthen test 250mcg, they've said to be off hc for 24 hours before if possible, if nothing else don't take the evening dose tonight. (this contradicts what instructions i was sent in email to be off hc for 24 hours) > so the results will go back to endo unit and be interpreted there

Question is this:If i take a small amount T4 today will that in anyway affect my adrenal resultstomorrow? My cortisol level went up by about 4 points in the test, from 207 to211. I'm thinking the HC has used up all the thyroid in my blood and left mevery low on it and my body isn't responding.Please does anyone know if any form of thyroid hormone will affect the resultstomorrow?

Hello again

As I said in my previous post, I haven't got the full picture of your history, so can only go by the snippets of information I drew from today's postings.

I don't know if anybody has explained to you what the result of your synacthen test means... IF this result were accurate, then you might be suffering from 's disease. This is a very serious autoimmune disease - however, it can be treated very well (although not cured). With the right medication you can lead a perfectly normal life, although you would need steroid medication for life (probably Florinef and HC).

However – in order to establish whether or not this result had been valid, we need to know exactly what went before that .... have you taken HC or Prednisolone or any other steroids before the Synacthen test – if yes – what, how much and for how long.... and precisely how many days or weeks before the test did you stop taking steroids?

The validity of the test result depends on the above information. Without knowing the above, it is impossible to draw any conclusions. If you had been on steroids just before the test and then stopped them, the test result would be worthless. If however you have stopped all steroids for 6 weeks before the Synacthen test, this result will probably be accurate and that means you might suffer from 's. – so please can you tell us which.

If you suffer from 's, then taking any thyroid hormone right now would be the wrong thing to do. 's and Hypothyroidism more often than not go hand in hand, but you should not take any thyroid hormone unless and until your adrenals have been stabilized. Taking thyroid hormones on top of unsupported adrenals can send somebody suffering from 's into crisis.... so it is of the utmost importance now to establish whether or not this Synacthen test result has been valid or a red herring.

I know, you must be a bundle of nerves right now, and the last thing you want to hear is someone telling you to stop smoking.... but please, please try. Nicotine is not helping at the moment, even if your subjective feeling is that it does. It could make things even worse. You need to minimize your stress levels, but nicotine does not actually do that.

Look at it this way .... if (and it really is a big if) the test had been valid and you do suffer from 's, then at least now you can relax. Although 's is a very serious condition, it is very treatable... and extremely quickly with the correct medication. You probably are hypothyroid on top, but again – that is also very treatable. The only big question remaining for the moment is – was this first Synacthen test valid or not....

Like Lethal Lee, I too cannot see how on earth a second Synacthen test can tell them more than the first – in particular now that you have been put on HC (how much, btw !??) . Why on earth did they not give you Dexamethasone instead of HC??? It looks to me like your GP, or whoever put you on it, is less than versed with the protocol for ACTH stim tests....

So please speak to your GP or Endo about that today – now – before you undergo the second test and let him/her explain how they will correctly interpret the next results if you are taking HC. As I say, perhaps things have changed and this is indeed possible, but best to make sure. – Also please ask again – as far as I know an ACTH stim test is best performed and most accurate early in the morning (before 9 am) and you should be starved since the evening before .... no food, no drink, no fags....

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Hi Lethal Lee

yes i do realise about cigs and coffee; how else do you think i've been able to

cope, and i use the term loosely. i won't be on any fags tomorrow or coffee

first thing. that's best i can do. it's all very difficult, crap care with

waiting isn't a good combination.

took 10mg hc earlier, and feel like crying with relief now. not much i can do is

there really

chris

>

> Hi

>

> I opt for " they don't know what the hell they are doing " !!!

>

> You do realise that cigarettes & Caffeine affect both Adrenaline & Cortisol?

Your Stim will also be very inaccurate due to having 20 fags a day. I would

think you would have to be off Cigarettes for at least 2 weeks (the same as HC

& other steroids) to get accurate results. Caffeine affects Adrenaline & hence

indirectly affects Cortisol too. Would need to be off that at least 24 hours or

more.

>

> Lethal Lee

>

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I have also had a dexamethasone suppression test and before that a urinary free

coritsol test (24h), so i'm hoping the UFC test might also confirm the

addison's-esque results too. the dr did the dexa test too because i had symptoms

of both low and high cortisol. of course, neither test has come back yet, both

are over due.

chris

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>

> Hi

>

> I provided more info in:

thyroid treatment/message/7081\

3

>

Hi

Yes, our mails must have crossed - sorry .... and i have just had a

nightmare experience - I have replied to you in detail, and just as I

was to send it, I must have pressed the wrong button and the whole lot

went up into thin air....can't retrieve it .- I'll try to write it all

out again - just gimmi some time. - If ever there was a time to swear

!!!!

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You have my permission - it will make you feel a lot

better *grin*

Luv - Sheila

I have replied to you in detail, and just as I

was to send it, I must have pressed the wrong button and the whole lot

went up into thin air....can't retrieve it .- I'll try to write it all

out again - just gimmi some time. - If ever there was a time to swear

!!!!

No virus

found in this incoming message.

Checked by AVG - www.avg.com

Version: 8.5.445 / Virus Database: 271.1.1/3175 - Release Date: 10/04/10

18:35:00

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If you are having Adrenal Tests tomorrow, the results will be

flawed if you are taking hydrocortisone today. You need to be off C for at

least a couple of weeks. It matters not that they kept you off HC for 11

weeks previously and you felt so bad you started to take some more - THE TESTS

WILL BE WASTED.

If you want to continue with the HC and get yourself feeling

somewhat better again, then telephone the hospital and give them this

information so they can advise when to go for another test. I know how bad you

are feeling and this, right now, might be the best route for you to

take. No amount of thyroid hormones either your own or synthetic is going to be

able to be properly absorbed into your cells unless your adrenal function is

working better.

Luv - Sheila

Hi Sheila

Thanks but they are adrenal tests not thyroid tests tomorrow. was thinking if

t4 is now low (and t3 of cours) because of a thyroid dump, that'd give my

adrenals an easier ride, right? if cortisol is burnt up getting thyroid into

cells then i don't want low levels of thyroid do i?

---

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>> You have my permission - it will make you feel a lot better *grin*

Thank you Sheila .... I did <g> - and believe you me, I can swear like a trouper ! - learned it all from Pete, who is no shrinking violet. Swearing in your not-native tongue is easy. I shouted words I'd never utter in German! It wasn't a very ladylike display, and my dear dog tucked his little tail between his legs, thinking it was all his fault !! Bless him....

love,

xx

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Glad you enjoyed it , and felt better for it too. I

guess folk would be quite surprised if they were a fly on the curtain listening

to the language that goes bouncing round the walls of my little office

sometimes.

Luv - Sheila

>

> You have my permission - it will

make you feel a lot better *grin*

Thank you Sheila .... I did <g> - and believe you me, I can swear like

a trouper ! - learned it all from Pete, who is no shrinking violet.

Swearing in your not-native tongue is easy. I shouted words I'd never utter in

German! It wasn't a very ladylike display, and my dear dog tucked his

little tail between his legs, thinking it was all his fault !! Bless

him....

love,

xx

No virus

found in this incoming message.

Checked by AVG - www.avg.com

Version: 8.5.445 / Virus Database: 271.1.1/3175 - Release Date: 10/04/10

18:35:00

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Hi Keep careful notes on what you are taking, what and when tests were performed- and any comments made, and by whom- you may need this later!!! > thyroid treatment > From: chrisjtaylor46@...> Date: Tue, 5 Oct 2010 12:17:28 +0000> Subject: Re: Help please - urgent question> > Thanks Lethal Lee> > Well i don't know what they're playing at or why; whether they just don't know what they're doing, or what, i don't know. > > i don't have much faith in them, not least of all because i've been told i'll be fine to wait . i'm appalled . > > chris> > > >> > Hi > > > > I just posted a reply to your other thread pointing out that the Synacthen test tomorrow will NOT be accurate due to you being on HC since the last test.> > > > What they should be doing is putting you on Dexamethasone for a period & THEN retesting.> > > > > > ------------------------------------> > TPA is not medically qualified. Consult with a qualified medical practitioner before changing medication.> >

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