Increased Dosage / ACTH Stimulation Test

April 26, 2004

I would appreciate any input that you all might have. I have not had

any energy for about three years. My last Free T3 and Free T4 tests

showed me to be exactly at midpoint on both, then my dosage was

changed from 88 mcg synthroid and 15 mcg cytomel to 120 mg (2 grains)

armour (76 mcg T4 and 18 mcg T3) for about 6 weeks. At that point, I

really tanked - no energy at all for several days so I made another

appointment with my doctor. I had to really work to get an increase

in dosage, but to my amazement he increased my dosage all the way up

to 3 grains (180 mg) of armour. This was on April 20th.

My doctor ordered new bloodtests which I have not taken yet. They are

all the basic ones like B12, FSH, CBC, etc. that I have had recently

with other doctors. He also asked for a ACTH Stimulation test. What

is this test? How does it work and what will it tell me?

My doctor is still really hung up on the TSH test. When I told him

that it was suppressed because I was already on hormones, he told me

that couldn't be so because then normal non-hypo people would have

the same problem with their TSH values. I did not know how to answer

him. Did I get the reason for the TSH suppression wrong?

I have been tested for anti-bodies and it has been negative. My

theory is that my thyroid was damaged severely because I had strep

throat over and over when I was young. I had it every 6 to 8 weeks

for at least a couple of years. Would this explain the suppressed

TSH? I really need to find a plausible explanation because my doctors

just can't get past my suppressed TSH.

My last question has to do with the dosage. It seems like a jump from

2 grains to 3 grains is pretty big, but I have had such a hard time

getting medicine that I was not about to ask him to reduce it to 2

1/2 grains. The increase (4/20/04) pulled me up from feeling

lethargic, but otherwise has made no difference at all in the way I

feel. I am more motivated to get things done, but I don't have any

extra energy either. Do you think 2 1/2 grains would have been a

better dosage? What should I be watching for to make sure I am not

too high? I plan to get more bloodtests in 8 weeks.

Thanks,

Jill

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