Monday, February 6, 2017

"...put de lime in the coconut, she drank 'em both up...she call the doctor, woke "im up.. said, " doctor, ain't there nothin' i can take, doctor, to relieve this belly put de lime in de coconut, drink 'em both together, then you feel better...yes, you call me in the morning and i'll tell you what to do" coconut song, by harry nilsson

honestly, if you have not heard this song, it pretty much describes  what thyroid patents go through just trying to get our lab values correct for us, so that we feel more " normal". i say more normal, because even the best hormone replacement drug or dose does not come close to a healthy functioning thyroid gland!

so i have been on the new drug- Nature-throid, for about three months now. i just had an office visit, and blood work with my endocrinologist to determine if this is working better for me. i had previously been on Levoxyl- which is a synthetic, t4 only drug. the Nature-throid is a naturally derived combination of t3 and t4. just to give you an overview of some of my labs, previously- in october, my tsh was 0.025( essentially zero), my t4 was 1.79 ( this is a little on the high side), and my t3 was 2.4 ( a little on the low side). my anti- thyroglobulin antibodies were less than 1.0 IU/ml which is considered negative. without going into a detailed explanation of anti- thyroglobulin antibodies, i will just say that in the thyroid cancer world this is considered being thyroid cancer free. for 3 years, my anti-thyroglobulin antibodies were elevated. my endocrinologist had almost decided that i needed another dose of the I-131. my body must have heard her, and said "no, no, no" because my levels went down to normal after that. thankfully. i hope never to glow in the dark again, ha ha ha.

this is what my labs were this time: t4- 0.74 ( now, this is low!)  tsh- 0.332 ( still considered low, but up quite a bit from october. this makes me nervous- i will explain why later). t3 was 2.7. this is up a little, but still lower than i had hoped for. i feel that i need to be a little over  3, to be feeling less hypo. ( the range is 2 to 4.4). i had hoped that with the nature-throid, having the t3 in the drug,it would raise my t3 more than it actually did. i am going to explain my feelings on each of these three lab values. what i think they should be to enable me to feel better. i will also explain my endocrinologists thoughts, which are not always in sync with mine.

first, t4. at times, my t4 has been 2.0. i will admit that this is too high. (the range is 0.82 to 1.77). when a person's t4 gets too high, one could have heart palpitations, and be more susceptible to osteoporosis, as well as having other HYPER thyroid symptoms. i felt fine when mine was 1.79. i actually  felt fine at 2.0, which it has been on occasion,  but my endocrinologist was nervous. she was afraid that i would develop some heart arrhythmias. ideally, i would like for this to be 1 or over. this is where the "not quite in sync" with my endocrinologist's thoughts come in.

next, t3. this is the "energy" part of the thyroid hormone. t4 is metabolized to t3 and gives you energy, helps with weight loss, as well as other wonderful things. too much of this could also cause osteoporosis, though. bummer. i have had a love/hate relationship with t3 since i started my journey. my endocrinologist said that i can take additional t3, in the form of cytomel. i am taking the lowest strength, 5mcg, once daily. i think that it is already making a little  difference in my energy levels, among other things.i had been hoping that the combo drug would be enough to raise my t3 level, thereby causing me to feel better, but it did not. too much t3 can also cause heart arrhythmias, and can make you feel jittery. it is a slippery slope, folks.

last, but not least, tsh. my endocrinologist has been keeping my tsh at essentially zero, these past 6 years. i will give you the quick reason for this. tsh ( thyroid stimulating hormone) does just that- stimulates thyroid production by the thyroid gland. only thyroid cells can make thyroglobulin(TG). by measuring anti-TG antibodies,one can determine if there are any thyroid cells present. now if you do not have a thyroid gland, like me, and your anti - TG antibodies are positive ( over 1), then the thyroid cells are not contained in your thyroid gland, but are thyroid CANCER cells. these rogue cells can take up residence anywhere in your body, but especially like to stay in your lungs or bones. ( perhaps they get more frequent flyer miles if they stay here?).

 PROS to having a low, or near zero, tsh: does not stimulate any remaining thyroid cancer cells to go on vacation. CONS to having a higher tsh: could possibly stimulate any thyroid cancer cells to go forth and multiply. a very low tsh ( near zero ) is also associated with heart palpitations and osteoporosis. my endocrinologist said that she was comfortable with my tsh even being 1. me, not so much. i worry more about stimulating any thyroid cancer cells than i worry about heart problems. and by the way, my bone density test has actually improved over the last one! i attribute this to taking a prescription dose of vitamin d, but this could be a whole other blog.

there are several other tests that a patient would want to get from their doctor, especially if that person has a functioning thyroid gland. i am not going to discuss those other tests, but you can look them up on a reputable web site, such as the one hosted by mary shomon, called about ms. shomon also has several really good books on thyroid function, tests,etc.

so what now for me? well, i am not giving up on the nature-throid. it is a naturally sourced drug, and considered hypoallergenic, which means that it is free of a lot of binders, colors, and other artificial things that i do not want. for whatever reason, i have trouble getting a high enough t3 value, and this has contributed to me not feeling well. so, i am also going to be taking the cytomel at least once a day. my endocrinologist said that i could take it twice a day if i needed to do that. i am proceeding slowly with this. sort of titrating up to a dose that hopefully works for me. i have to have blood work done again in may. the results will be sent to my doctor- no office visit this time. in august, i will have more blood work done, and an office visit as well as my usual six month ultrasound( to make sure that i do not have any hob goblins hiding out in my throat).

at the end of this month, i will be getting different  blood work done  and have an office visit with my oncologist. i still have to see him every 4 to 6 months for my breast cancer check ups. i think that i will just add some lime to my coconut and call all my doctors later. much later.

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