Re: New - Meds not helping my symptoms and having heart palpitations

[Guest guest]

>

> I have Hashimotos and have been treated for 6+ years with

> Levothyroxine. About two years ago I noticed heart palpitations.

I've

> had no improvement since then. I've discovered that the

palpitations

> are not from the thyroid meds (however they make the palpitations

> worse), but still cannot get to the root of the problem. My doctor

> has tried Synthroid, Levothyroxine, and Armour. He also put me on

> Iodoral. I chose not to take thyroid meds and just take the Iodoral

> for 9 months without doctor follow up (not wise). When I finally

went

> in for blood work, my TSH was 150+!! My doctor retested to make

sure

> it wasn't a lab error. I retested at 150+. I was devastated,

although

> I wasn't feeling any worse. I have been on and off thyroid meds

over

> the last couple years and I've had my TSH as low as 2 and as high

as

> 150+, and I can honestly say that I don't feel any difference. I

> don't understand this???

>

> Right now I'm on Cytomel and gradually increasing my dose. It

> doesn't seem to aggravate my palpitations as much. I notice the

> palps more when I increase my dose, but then they seem to settle

> down. My TSH is now down to 75. I just went in for more blood work

> to see where I'm at. I could use any suggestions. I'm really

> frustrated and confused about the meds not helping my symptoms and

> about my palpitations.

>

> Thanks so much,

> Tammy

>

You have to understand what Hashi's is, how Hashi's works and what

the labs mean..

TSH is just what it stands for..thyroid stimulating hormone.. it is

not a thyroid hormone but a hormone sent from the pituary gland to

the thyroid to either produce more or less hormone..

The thyroid produces two main hormones..T4 and T3.. mostly T4 as this

is considered the storage hormone, the body then converts T4 into T3

on a as needed basis. T3 is considered the active hormone.

Synthroid and generics is a synthetic T4 only replacement hormone.

The idea is to give enough T4 replacement for the body to convert to

T3.

Armour is a natural( desicated pig thyroid) form of T4 and

T3..although some find the ratio ( 25%) T3 too high for them as the

thyroid itself only produces 10-14% T3.

Cytomel is a synthetic T3 only hormone.

Now both Hashi's and Grave's are considered autoimmune disorders.

With Grave's the antibody is called TRAB..thyroid receptor antibody..

it does not destroy the thyroid, and they have since realized TRAB

comes in two forms..TSI which is Thyroid stimulating and causes the

hyper symptoms, and TBII which is thyroid blocking.. the reason why

some Grave's patients spontaniously go hypo.. the antibodies block

the TSH receptors so they can not receive the TSH signal. This is

also why some people hypo suddenly go hyper and develop grave's.

With Hashi's the antibodies attack the thyroid themselves. This

antibody has technically not been identified. TPO is an enzyme

contained only in the thyroid gland. During cell destruction it is

released into the blood stream, now being foriegn to the blood stream

the body develops antibodies against it. With a range of 0-35 those

with Grave's commonly have a TPO less than 35 but above 0 because of

inflammation. With Hashi's a positive test is considered 10 times the

normal range so 350, although it is common to see some people post

they are in the 1000's..

Now a thyroid with Hashi's, has inflammation caused by the cell

destruction..this cell destruction releases stored hormone.. this

extra burst of hormone tends to confuse some people, it is a

temporary hyper phase.. then the thyroid settles back down.. because

of damage the thyroid is producing a little less hormone..so the TSH

steps up and says produce more hormone..now remember TSH is thyroid

stimulating hormone..so a little extra TSH stimulates the thyroid, it

increases inflammation, antibodies destroy more thyroid cells, stored

hormones are released, thyroid calms back down, TSH increases..

you get the idea, the cycle goes on and on, until the thyroid bites

it. For some people this is a short cycle, for others it takes over

20 years..

You can see what a TSH of 75 or even a TSH of 2 is doing to this

cycle. With Hashi's the treatment suggestion is to supress the TSH

under 1 by going on a full replacement dose..This is done for two

reasons..lowering the TSH rests the thyroid, lowers antibodies and

cell destruction and slows or halts the hypo/hyper swing commonly

seen in Hashi's. The other reason it is done is most docs are under

the assumption that you will eventually end up hypo anyways (5% per

year)..and will need replacement hormone.

Now the Iodoral really has me confused..the general though is iodine

deffiency causes hypothyroidism..this is true if you live in some

third world countries where the food supply has not been arifically

iodinated..if you live in North America, although rarely it can still

happen it has not been common since the 1940's. The RDA is 150mcg and

the average diet contains 600-700mcg daily.. throw in fast food or

Ocean fish, seafood and you get numbers over 2000mcg daily. This

increase in Iodine consumption is thought to be the reason autoimmune

thyroid disorders both hyper and hypo are on the rise.

Now the thyroid uses iodine to make thyroid hormone, if you are low

in iodine and hypo this increase is like filling up your gas

tank..runs much better on a full tank of gas then it does on empty.

Now lets assume you are not low on iodine..but you have an autoimmune

disorder..over flowing the gas tank and giving your thyroid all the

fuel it wants to make thyroid hormone stimulates the thyroid.. this

stimulation increases your antibodies which allows you to continue to

cycle.

A few sites to look at www.merck.com and www.thyroidmanager.org .

The standard treatment for Hashi's is to suppress the thyroid. This

is done by keeping the TSH under 1..it is also done by keeping your

iodine consumption as close to the 150mcg daily reccommended.

Generally speaking this is done by using T4 medication..Now T4 takes

6 weeks to build up to the optimal level for that dose in the body.

So in 6 weeks you do labs..and then increase if needed, 6

weeks ..labs this done until your TSH is under 1, you feel good and

your T4 is in the upper end of the range..close to the top..

Now a word on labs.. both T4 and T3 can be effected by Estrogen and

other hormones..there is labs available called Free T4 and Free T3 (

FT4 , FT3) you want to make sure your doctor is ordering the free

versions and not the older total values.

Now all of this sounds simple..but what happens when the TSH is under

1, the T4 is above range and you feel like crap? This is where the T3

comes into effect..some people have a problem converting T4 to

T3..and remember what I said about T4 being the storage hormone and

T3 being the active hormone..some people even need extra T3 because

the body does not use it efficently.

T4 has a half life of 7 days..it takes a while to build up in your

system, and it takes a while to clear your system..but it converts to

T3 on a as needed basis..so the higher you can get your T4, the more

smoother ride you are going to have on a day to day basis.

T3 has a half life of about 1 1/2 -3 hours..menas when yuo take your

Cytomel..the body feels the T3..and then in 3 hours all that T3 is

gone..

Now if you take a lot of T3 in one dose..it causes hyper

symptoms..you are not hyper..but its like driving a car and flooring

the gas pedal..you get that rush..you get heart palps etc..but in 3

hours that is all gone..with no T4 left for conversion it is like

slamming on the brakes..this swing also causes heart palps..

I intended to make this short..sorry if it is too long..my brain is

stuck in the on position tonight..but I hope yo uunderstand some of

it so you can see why you are feeling rough.. how the meds effect you

and how you can feel better.

Kats3boys

[Guest guest]

kats:

Thanks for that wonderful explaination. You sure have

a handle on some of the finer more elusive points!

You always make it such a joy to read your posts!

~E:)

--- kats3boys kats3boys@...> wrote:

>

> >

> > I have Hashimotos and have been treated for 6+

> years with

> > Levothyroxine. About two years ago I noticed heart

> palpitations.

> I've

> > had no improvement since then. I've discovered

> that the

> palpitations

> > are not from the thyroid meds (however they make

> the palpitations

> > worse), but still cannot get to the root of the

> problem. My doctor

> > has tried Synthroid, Levothyroxine, and Armour. He

> also put me on

> > Iodoral. I chose not to take thyroid meds and just

> take the Iodoral

> > for 9 months without doctor follow up (not wise).

> When I finally

> went

> > in for blood work, my TSH was 150+!! My doctor

> retested to make

> sure

> > it wasn't a lab error. I retested at 150+. I was

> devastated,

> although

> > I wasn't feeling any worse. I have been on and off

> thyroid meds

> over

> > the last couple years and I've had my TSH as low

> as 2 and as high

> as

> > 150+, and I can honestly say that I don't feel any

> difference. I

> > don't understand this???

> >

> > Right now I'm on Cytomel and gradually increasing

> my dose. It

> > doesn't seem to aggravate my palpitations as much.

> I notice the

> > palps more when I increase my dose, but then they

> seem to settle

> > down. My TSH is now down to 75. I just went in for

> more blood work

> > to see where I'm at. I could use any suggestions.

> I'm really

> > frustrated and confused about the meds not helping

> my symptoms and

> > about my palpitations.

> >

> > Thanks so much,

> > Tammy

> >

> You have to understand what Hashi's is, how Hashi's

> works and what

> the labs mean..

>

> TSH is just what it stands for..thyroid stimulating

> hormone.. it is

> not a thyroid hormone but a hormone sent from the

> pituary gland to

> the thyroid to either produce more or less hormone..

>

> The thyroid produces two main hormones..T4 and T3..

> mostly T4 as this

> is considered the storage hormone, the body then

> converts T4 into T3

> on a as needed basis. T3 is considered the active

> hormone.

>

> Synthroid and generics is a synthetic T4 only

> replacement hormone.

> The idea is to give enough T4 replacement for the

> body to convert to

> T3.

>

> Armour is a natural( desicated pig thyroid) form of

> T4 and

> T3..although some find the ratio ( 25%) T3 too high

> for them as the

> thyroid itself only produces 10-14% T3.

>

> Cytomel is a synthetic T3 only hormone.

>

> Now both Hashi's and Grave's are considered

> autoimmune disorders.

> With Grave's the antibody is called TRAB..thyroid

> receptor antibody..

> it does not destroy the thyroid, and they have since

> realized TRAB

> comes in two forms..TSI which is Thyroid stimulating

> and causes the

> hyper symptoms, and TBII which is thyroid blocking..

> the reason why

> some Grave's patients spontaniously go hypo.. the

> antibodies block

> the TSH receptors so they can not receive the TSH

> signal. This is

> also why some people hypo suddenly go hyper and

> develop grave's.

>

> With Hashi's the antibodies attack the thyroid

> themselves. This

> antibody has technically not been identified. TPO is

> an enzyme

> contained only in the thyroid gland. During cell

> destruction it is

> released into the blood stream, now being foriegn to

> the blood stream

> the body develops antibodies against it. With a

> range of 0-35 those

> with Grave's commonly have a TPO less than 35 but

> above 0 because of

> inflammation. With Hashi's a positive test is

> considered 10 times the

> normal range so 350, although it is common to see

> some people post

> they are in the 1000's..

>

> Now a thyroid with Hashi's, has inflammation caused

> by the cell

> destruction..this cell destruction releases stored

> hormone.. this

> extra burst of hormone tends to confuse some people,

> it is a

> temporary hyper phase.. then the thyroid settles

> back down.. because

> of damage the thyroid is producing a little less

> hormone..so the TSH

> steps up and says produce more hormone..now remember

> TSH is thyroid

> stimulating hormone..so a little extra TSH

> stimulates the thyroid, it

> increases inflammation, antibodies destroy more

> thyroid cells, stored

> hormones are released, thyroid calms back down, TSH

> increases..

> you get the idea, the cycle goes on and on, until

> the thyroid bites

> it. For some people this is a short cycle, for

> others it takes over

> 20 years..

>

> You can see what a TSH of 75 or even a TSH of 2 is

> doing to this

> cycle. With Hashi's the treatment suggestion is to

> supress the TSH

> under 1 by going on a full replacement dose..This is

> done for two

> reasons..lowering the TSH rests the thyroid, lowers

> antibodies and

> cell destruction and slows or halts the hypo/hyper

> swing commonly

> seen in Hashi's. The other reason it is done is most

> docs are under

> the assumption that you will eventually end up hypo

> anyways (5% per

> year)..and will need replacement hormone.

>

> Now the Iodoral really has me confused..the general

> though is iodine

> deffiency causes hypothyroidism..this is true if you

> live in some

> third world countries where the food supply has not

> been arifically

> iodinated..if you live in North America, although

> rarely it can still

> happen it has not been common since the 1940's. The

> RDA is 150mcg and

> the average diet contains 600-700mcg daily.. throw

> in fast food or

> Ocean fish, seafood and you get numbers over 2000mcg

> daily. This

> increase in Iodine consumption is thought to be the

> reason autoimmune

> thyroid disorders both hyper and hypo are on the

> rise.

>

> Now the thyroid uses iodine to make thyroid hormone,

> if you are low

> in iodine and hypo this increase is like filling up

> your gas

> tank..runs much better on a full tank of gas then it

> does on empty.

> Now lets assume you are not low on iodine..but you

> have an autoimmune

> disorder..over flowing the gas tank and giving your

> thyroid all the

> fuel it wants to make thyroid hormone stimulates the

> thyroid.. this

> stimulation increases your antibodies which allows

> you to continue to

> cycle.

>

> A few sites to look at www.merck.com and

> www.thyroidmanager.org .

>

> The standard treatment for Hashi's is to suppress

> the

=== message truncated ===

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Upon a painted ocean.

Water, water, everywhere,

And all the boards did shrink;

Water, water, everywhere,

Nor any drop to drink.

~The Ancient Mariner

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[Guest guest]

Thanks so much Kats. I'm still trying to digest all the information.

I have an appointment with my doctor next Tuesday and am trying to get

as informed as I can. I'm fortunate to have a doctor that will listen

to me and work with me, however I have to be a doctor myself--he's

playing a guessing game.

[Guest guest]

--

Tammy,

It is very common to have palpitations when you are in a hypO state.

At any time prior to taking yourself off of thyroid replacement, was

your TSH elevated? Cytomel is T3 opposed to a primary replacement med

of T4 e.g. Synthroid, ect. An increase in Cytomel often causes

cardiac problems and should be used with caution, normally in lower

dosages.

Hope this helps.

Vicky

- In The_Thyroid_Support_Group , " Tammy "

wrote:

>

> I have Hashimotos and have been treated for 6+ years with

> Levothyroxine. About two years ago I noticed heart palpitations.

I've

> had no improvement since then. I've discovered that the

palpitations

> are not from the thyroid meds (however they make the palpitations

> worse), but still cannot get to the root of the problem. My doctor

> has tried Synthroid, Levothyroxine, and Armour. He also put me on

> Iodoral. I chose not to take thyroid meds and just take the Iodoral

> for 9 months without doctor follow up (not wise). When I finally

went

> in for blood work, my TSH was 150+!! My doctor retested to make

sure

> it wasn't a lab error. I retested at 150+. I was devastated,

although

> I wasn't feeling any worse. I have been on and off thyroid meds

over

> the last couple years and I've had my TSH as low as 2 and as high

as

> 150+, and I can honestly say that I don't feel any difference. I

> don't understand this???

>

> Right now I'm on Cytomel and gradually increasing my dose. It

> doesn't seem to aggravate my palpitations as much. I notice the

> palps more when I increase my dose, but then they seem to settle

> down. My TSH is now down to 75. I just went in for more blood work

> to see where I'm at. I could use any suggestions. I'm really

> frustrated and confused about the meds not helping my symptoms and

> about my palpitations.

>

> Thanks so much,

> Tammy

>

[Guest guest]

Vicky,

While being on Levothyroxine I stayed fairly stable with a TSH

ranging 3-4. When my doctor upped my dose (at my request) to get my

TSH around 2, I started feeling palpitations. From that point on, no

matter what type of meds (Synthroid, Levo, Armour) I would feel

palpitations at the smallest dose. After two years of feeling

palpitations and being on and off meds, Cytomel is the only thing I

can seem to handle. I'm just a little concerned about taking only

T3. Do you know if there are any dangers? I'm seing my doctor on

Tuesday and would like to be as informed as possible.

Thanks,

Tammy

> Tammy,

>

> It is very common to have palpitations when you are in a hypO

state.

> At any time prior to taking yourself off of thyroid replacement,

was

> your TSH elevated? Cytomel is T3 opposed to a primary replacement

med

> of T4 e.g. Synthroid, ect. An increase in Cytomel often causes

> cardiac problems and should be used with caution, normally in lower

> dosages.

>

> Hope this helps.

>

>

> Vicky

>

>

>

> - In The_Thyroid_Support_Group , " Tammy "

tammy@> wrote:

> >

> > I have Hashimotos and have been treated for 6+ years with

> > Levothyroxine. About two years ago I noticed heart palpitations.

> I've

> > had no improvement since then. I've discovered that the

> palpitations

> > are not from the thyroid meds (however they make the palpitations

> > worse), but still cannot get to the root of the problem. My

doctor

> > has tried Synthroid, Levothyroxine, and Armour. He also put me on

> > Iodoral. I chose not to take thyroid meds and just take the

Iodoral

> > for 9 months without doctor follow up (not wise). When I finally

> went

> > in for blood work, my TSH was 150+!! My doctor retested to make

> sure

> > it wasn't a lab error. I retested at 150+. I was devastated,

> although

> > I wasn't feeling any worse. I have been on and off thyroid meds

> over

> > the last couple years and I've had my TSH as low as 2 and as high

> as

> > 150+, and I can honestly say that I don't feel any difference. I

> > don't understand this???

> >

> > Right now I'm on Cytomel and gradually increasing my dose. It

> > doesn't seem to aggravate my palpitations as much. I notice the

> > palps more when I increase my dose, but then they seem to settle

> > down. My TSH is now down to 75. I just went in for more blood

work

> > to see where I'm at. I could use any suggestions. I'm really

> > frustrated and confused about the meds not helping my symptoms

and

> > about my palpitations.

> >

> > Thanks so much,

> > Tammy

> >

>

[Guest guest]

There are no dangers, directly, from taking T3 only.. it's just that it

doesn't build in your system so you are VERY dependant on regular dosing,

skipping means that your body ends up being without hormone... When your

body is able to build up it's T4 storage then you have that stored

hormone to fall back on for conversion and it's less of a stress to the

body when you have skipped, or late, dose.

Topper ()

On Fri, 23 Mar 2007 01:51:57 -0000 " Tammy " jeff-tammy@...>

writes:

> Vicky,

>

> While being on Levothyroxine I stayed fairly stable with a TSH

> ranging 3-4. When my doctor upped my dose (at my request) to get my

> TSH around 2, I started feeling palpitations. From that point on,

> no

> matter what type of meds (Synthroid, Levo, Armour) I would feel

> palpitations at the smallest dose. After two years of feeling

> palpitations and being on and off meds, Cytomel is the only thing I

> can seem to handle. I'm just a little concerned about taking only

> T3. Do you know if there are any dangers? I'm seing my doctor on

> Tuesday and would like to be as informed as possible.

>

> Thanks,

> Tammy