Hi Paul. Poor Nic. I really feel for you both.

I agree with Mrs J totally. 200mcg is a very hefty dose and it sounds like it's not truly working because on this sort of dose, I'd expect to see some weight loss/water loss, less sleeping, less symptoms all round... and possibly a bit hyper to be honest. I'm 5'10" and actually, the only time I ever got up to that sort of dose was when the Thyroxine wasn't working. There are a few things to look at for you both.
However, thyroxine on its own truly isn't a complete medication for the thyroid. It might bring the TSH level down in the test results, but it may not actively fix the problem until Nic's on a more effective drug with T3 in it!


One of the most common causes of T4 not converting is due to something called 'Reverse T3'.

Now, imagine the cell as a hexagon shaped thing with walls on each side. In normal circumstances, the T4 (thyroxine) passes straight through these walls without a blip, and sits inside the cell where it's converted to T3. T3 is what gives us the energy within our cells. Without that, we're stuffed.

In some circumstances, such as stress, adrenal fatigue (which is really partially what we call 'stress') or long term mineral depletion (very common with us thyroid girls), those walls on the cell get blocked up by something called Reverse T3 or rT3 as it's written in biology.
That rT3 sits there and it won't let any of the thyroxine (T4) into the cells. This means hardly anything's converting to T3 and therefore, there's no energy.

Now the only way to get rid of the rT3 situation is to increase T3 going into the body!
Weird or what?
Here's a nice diagram for you to view.



(Cut along dotted lines, roll up, take to doctor and beat over head)

Anyway, instead of taking Thyroxine, or T4, and hoping it will convert, you get either something called 'Armour' or 'Natural thyroid'... or you get the other synthesised form of T3, which Wendy takes ... (this is made in a lab and isn't a natural form of T3, but just copies it)
After a few weeks or months of using this, the difference should start to become noticeable more and more as more T3 enters the cells and the rT3 dissipates.

You keep taking the T3 meds instead of the T4 meds. Like Mrs J points out, some people just can't take T4.

You might want to read this on Thyroid Hormone Resistance... it's also a possibility:
http://en.wikipedia.org/wiki/Thyroid_hormone_resistance

Other reasons that might be an issue are that the brand of T4 Nic is taking might not work for her. She might try changing brands. I think that's slim, to be honest, but it might be worth a try to see if she's constantly on a named brand, or whether she's being given a generic copy (cheaper) by the chemist when she gets her script. I know that changing brands at one point helped me... different filler=more uptake of drug/reduction in an allergy to said filler (latter is rare). But the difference was just a couple of pounds weight loss. Didn't make any difference in the long run. I know some cases where it has though... so it's worth trying.

Now, I guess the other thing to look at would be adrenal fatigue.
Here's the best site on it, which I always post:
http://www.drlam.com/a3r_brief_in_do...al_fatigue.cfm

Dr Lam truly rocks.
The theory which is widely accepted now by many docs, is that the thyroid is the line of 'last defence'... It's the thing which goes when everything else is shot. That 'everything else' is the adrenal system. You know when you're ill or stressed, you pump out a load of cortisol? You get that 'fight or flight' thing going on with your adrenalin?
Well once that mechanism is disturbed, you end up getting it all the time and eventually, you just get knackered. Cortisol is what puts all that weight on around your middle... That's why people who are stressed and their adrenal system's up the creek get that paunchy middle fat - very common in women too... and it's an unhealthy place to put weight on because it's sitting around the major organs.....
Anyway, adrenal issues should ALWAYS be treated BEFORE the thyroid... but in many cases, this doesn't happen and the patient gets put straight onto T4 without a glance at the adrenals.

One of the most telling things is when said patient moves to T3 only and gets a whole heap of weird symptoms... if the adrenals are out, then this is how you find out, but ideally , it's better to find out by blood test.
A good doc will test DHEA levels, cortisol, etc. Cortisol is usually done by a blood test but that's not very reliable because as soon as most people see a needle, their cortisol zooms up from the fear factor... so the most reliable test is to test the cortisol level throughout the day within the saliva ... simple to do and easily available if ordered by your doc. You can even order it online yourself and send it away to get your own results, but a good doc should be testing this anyway.
Either way, you can treat adrenals on your own without your doctor... have a look at Dr Lam's page and see what you can do from his big list of things that will help.
Nic should be treating her adrenals regardless.


The other thing is that she could really be just not on a high enough dose! Some docs stop at a certain amount and won't go over.... but I'm sceptical. If she still wants to sleep all day, it doesn't sound like anything's working.

You might want to read the following from Dr Lowe... This guy is a brilliant bloke... have a nosey and see if anything rings bells here:

http://www.drlowe.com/QandA/askdrlowe/t4therapy.htm

The only clear pic we'll be able to get is with a full thyroid panel, measuring TSH, FT3, FT4 and rT3. Also, she needs thyroid antibodies checking.

Then we'll be able to see what's working or isn't working.

Now, vitamins:

Selenium - vastly important. If she takes nothing else, make her take this. Take high dose until starting to feel better.

Here's a good link to see what other people take:

http://www.stopthethyroidmadness.com/supplements/

Also, she should have NO wheat/gluten in her diet whatsoever. Even check sweeteners from wheat and other fillers.
She needs to cut out fluoride too. VERY BAD FOR THYROID!!! This means limiting cups of tea as it's high in fluoride or finding a brand which isn't so high. Think about getting a filter on your tap to get rid of fluoride in drinking water... or get bottled water for her. Spring water=no or little natural fluoride.
Also NO SOY PRODUCTS EVER!!! VERY BAD!

No GOITROGENIC foods:
http://www.stopthethyroidmadness.com/goitrogens/

Coffee not good for thyroid either.... limit caffeine.

Now, is her GP treating her? Or is she seeing an endo? I suspect that it's a GP from what you say and you need to bypass him immediately and get a qualified endo working on your wife's issues. A GENERAL PRAC is just that... general medicine. Nic needs an expert in endocrinology.

Here's a list of top docs in Australia. Have a look to see where the nearest is for Nic and get an appt of one you like the sound of:

http://thyroid.about.com/gi/dynamic/.../australia.htm


Oh, and I want you to get all her blood test results from that doctor regardless. She needs a history to present to a new doc.


That's all I can think of for now hon but if anything else occurs, I'll post it.

It's not her fault... she's doing everything right. She IS sick, she CAN be well again and you are a good, good man to be helping her like this.
She won't have the energy to push for her own treatment, so you're going to have to do it, but I tell you it'll be worth every effort because she'll get back to normal eventually.
My advice... don't be fobbed off. Keep pushing for her and better health.

Kick some ass, my friend.

x

Also you are not far from Dr Broom,Dennis road ,Springwood.32904566.
She is worth a visit,i go to her she is very understanding of Thyroid problems as she is also a sufferer.She will also prescribe NTH as well.
good luck
donna

Oh, and the other thing.

Can you get Nic to take her temperature every morning? First thing before she gets up... digital thermometer under the tongue should do it... or under arm...
Basal temp is a good tool to track improvements or decline or just provide doc with proof.

http://www.regaininghealthnaturally....yroidism.shtml

I posted last year about feeling depressed and exhausted whilst taking thyroxine, and being anaemic. I am still on 50mg thyroxine, and still feel the same, although apparently I'm not anaemic anymore. At the time I put it down to recently emigrating, having the stress of finding a new house and having the 2 kids at home 24/7 (who just seem to shout all day...)

My life SHOULD be all good now - the kids are settled in school/kindy. Husband is settled in new job, we have a lovely new house - all is good. So, why do I feel like sometimes I could burst into tears at any given moment? I don't think it's depression, as I CAN get happy, and have the odd moments of laughter - but I'm sure it's to do with my thyroid.

The Dr has kept me on thyroxine, and says the levels are 'normal'. I struggle to get out of bed and find myself exhauted at the smallest thing, my brain is foggy, and given that I've got so much to try and concentrate on, this leaves me just feeling like I'm treading water and not getting anywhere.

I'm off to see the Dr this afternoon. I'm taking a list of questions. I've tried to work out what to say - can anyone tell me if this list of questions is ok?!

1. Have I had a full free T3/4 panel count plus antibodies check?.

2. Can I have a adrenal function test with a 24hour adrenal saliva test (please)?.

Also, if he tries to palm me off with anti-depressants, do I say "no thank you".

Any help would be great.

Mrs Urno

Hi Mrs U.
Sorry you're feeling crap. Yes, it sounds like your thyroid.

1. Excellent question. If no, ask him to order one, as well as thyroid antibodies. If he says you don't need one, ask him how he can therefore estimate the uptake and conversion of T4 to T3 in your cells? And without that, how will he know that the thyroxine is working.
And he'll say cos your TSH is within range... and you can say 'Yes, but it's commonly accepted by experts that thyroxine will bring down TSH levels without having any direct causal effect on the thyroid and the conversion of T4 to T3.'



2. Peachy.

3. Absolutely NO antidepressants. They won't help you and can make your thyroid sicker.

4. I would like a complete list of all my previous test results please for my records (if you haven't got them)

5. Here is a list of my symptoms written down for you to look at, Mr Doc sir. Include your digestive situation, your skin and hair condition, nails, brain responses, sleep, emotions, energy... all of it.

6. I have looked at the top docs list from TP's post above and have found this excellent doc near me, so would like a referral please. Thank you. (You might not need a referral... just check by ringing said top doc)

PS - you're on 50mcg of thyroxine, not 50mg... But that's way too low. Your doc is a 'results' doc and you need an expert who can treat you until your symptoms go.
You can increase your own thyroxine by cutting your 50's in half and going for a 25mcg increase, but I would never recommend you do this because I am not a doctor and therefore am not qualified to give out that sort of advice, but from what I hear, many thyroid patients dose themselves when faced with doctors who can't or won't help them.
It's easy to do, and you would get a pill cutter or a sharp knife and split your tablet down the little line it has..

You would also be taking your tablets last thing at night on an empty stomach to increase T3 production overnight, and you wouldn't be taking any vitamins within 5-7 hours of taking your thyroid medication.

You might also have a very late night before you have your bloods done.... and forget your medication that night to give yourself a higher TSH reading. ... which makes the doc sit up and take notice.

Also, that big post about vitamins and adrenals? You should be doing that too.

Find yourself an expert hon. Your doctor sucks.

Excessive use of smileys in that post.

Thank you - amount of smileys fine

Have written your questions down word for word, so you are to blame if he strikes me off his list and boots me out for being so cheeky.

He's actually a locum, as my usual Dr is on hols - thought I might try and sneak in a different one whilst she's away.

I've just phoned some Drs specialising in Thyroid problems and they are not taking on new patients. It takes a lot of getting used to, all this power to pick and choose Drs. In the UK, I had the same one for 30 years, and although he was probably, in retrospect, a bit rubbish - I felt obliged to see him.

Anyway, thank you for saving me HOURS looking for the right questions - I can now spend some time with the kids (both off school today) Or go and put my feet up

Mrs urno

Thats a couple of excellent posts there TP - good on ya!

Helped me understand RT3 too. I've ordered my copy of Stop the Thyroid Madness - cant wait for it to arrive! Trouble is, in my brain fog, I cant for the life of me remember where I ordered it from!! haha I 'think' it was The Book Depositry?'! I'll go check lol

On a side note...Dans off school today cos she was throwing up for 24 hours...shes fine now...but I've just had to run to the sink I havent been sick, without it being alcohol related in years! In fact, I havent been sick due to alcohol for years either...I dont like it

She knows her stuff doesnt she

The link TP gave for the minerals, is a great source of information for other stuff too so check it out. www.stopthethyroidmadness.com

Ah, good plan. Going to see locum is excellent stratagy.
I went to see my doc's partner after the receptionist told me that they didn't see eye to eye on some things.

Top docs might be full for private patients, but referral will get you in there.

Do not feel obligated... your health is the most important thing you have.

In the meantime, check your karma.

I've checked my Karma and theres f*** all in there! Sort it TP!!

S'all right.

I will go and take my own excellent advice now...

Just took my temp and I'm 36.1

Hmmmmm.

Not you! Mrs Urno.

Oh, ok then.

Oh and by the way... exercise boosts thyroid activity...

For those suffering, introduce some gentle walking or whatever... helps you feel much better...

Does running to the sink to throw up count?? If so...I'm done for the day