While I wait for the legal document, now signed by M & S and B, to wend its way to us (please be in my mailbox tomorrow!), I would like to tell you of some good news. My thyroid function seems to be improving. Yay!
I have been on triiodothyronine (T3) for almost 18 months now. I’ve fiddled about with the dosage, and got varying results (and side effects). The blood test before last showed quite crap results (relative to previous tests and the dose I was on) and was rather disheartening. The blood test I took a couple of weeks ago shows the best result I’ve ever had, (and on the lowest dose so far).
For those of you who don’t remember (or never knew), my (self) diagnosis was Wilson’s Syndrome, or, Reverse T3 dominance. In short, this “is a condition that exhibits most hypothyroid symptoms although circulating levels of T3 and T4 are within normal test limits. The metabolism of T4 into rT3 is in excess when compared to T3 therefore it is a T4 metabolism malfunction rather than a straight forward thyroid deficiency. Periods of prolonged stress may cause an increase in cortisol levels as the adrenal glands respond to the stress. The high cortisol levels inhibit the 5-deiodinase enzyme and thus the conversion of T4 into T3 thus reducing active T3 levels.
The conversion of T4 is then shunted towards the production of the inactive rT3 via the 5′-deiodinase enzyme. This rT3 dominance may persist even after the stress passes and cortisol levels have returned to normal as the rT3:T3 imbalance itself may also inhibit the 5-deiodinase enzyme thus perpetuating the production of the inactive rT3 isomer….It is also very important that if elevated levels of cortisol are found (stage 1 adrenal exhaustion) it should be treated first because if it remains elevated it will only continue to inhibit the 5-deiodinase enzyme and thus continue rT3 production reducing the effectiveness of this treatment.
Low cortisol levels should also be treated because low cortsiol will reduce the number of T3 receptors and also prevent T3 transport within the cell, again impeding improvement while on this treatment. In addition some patients respond poorly to thyroid medication if adrenal fatigue is present. Therefore we recommend you test adrenal function and correct it before commencing this treatment. In summary you should have the following tested: DHEA, cortisol, TSH, T3, T4 and reverse T3.” (quoted from the link).
The ratio of T3 to reverse T3 should be between 1.06-2.2, and ideally within the upper range. When I first got tested, my ratio was 0.75, and that was BAD. It was good, in a way, though, because it vindicated my belief that something WAS wrong with my thyroid function, and it was also good because there was a fix. My next ratio was 2.04, and I thought I had sorted it out, so I tried to wean off the pills and the next one was 1.46-damn. Back on the pills, and a higher dose [40 micrograms], it was 1.77-hmm, how come not as good as the first test post-treatment? My most recent test a few weeks ago [on dose of 35 micrograms because the 40 was giving me palpitations] showed a ratio of 3.13- OVER the normal range now.
I don’t feel tired all the time anymore, which is fabulous, and best of all I have maintained my weight between 50-52 kilos (110-114 lbs) for over a year now, without too much hassle. I still feel the cold and my sex drive is low, but hey- you can’t have everything!
So. Given that doctors (my own and my husband included) know squat about this stuff, I am left to speculate as to what has caused the improvement over the last 3 months. [My cortisol levels were high at the outset of the testing 18 months ago, and I have been on adrenotone for more than a year to help the adrenal gland along. I didn’t retest the cortisol because it was horrendously expensive to do, so I have no idea what is going on there, I am just hoping that they went down and the T3 was able to do its job.] I am going to hazard a guess and say that taking 50mg of DHEA daily for four months may have had something to do with these latest results. I took myself off the DHEA last week, because I felt like I wasn’t using it for good eggs anymore and it isn’t that great to be on long term. I have lowered my dose of T3 to 30 micrograms this week. I will re-test my blood in 4-6 weeks and see where we are at. If it is lower again, I might go back on DHEA but a much smaller dose, say 10mg per day, and then see what happens. It is tricky being your own doctor, especially without a medical degree!
However. Something is causing the problem to be rectified, so that can only be a good thing. All we need to do now is pinpoint exactly what is working. (Perhaps I ought to do that saliva cortisol test, just so we have more information. I’m shelling out money hand over fist anyway, so what’s another two hundred bucks?) Maybe we’ll get there inside of two years. That would be nice.
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