Started Naturethroid & Adrenal results

[1Kel12]

Hello,

I found a new doctor (yea!!) who has started me on 32.5 mg naturethroid (I was on a 10/2.5mcg T4/T3 compounded which did nothing from what I could tell).

It has been 3 weeks and I can't feel any difference other than my arm tingling is better. I just got my saliva adrenal panel back and everything is normal except;

Cortisol 11am-1pm - 11 (5-10nM)
DHEA + DHEA S - 14 (3-10ng/ml) *elevated may indicate exogenous intake
Total salivary SIgA - 5 (5-20) *borderline low
17-OH progesterone - 50pg/ml (optimal range 22-100) **but I take 40mg progesterone cream cyclically during the month)

I'm thinking all seems reasonably normal except the DHEA but I'm not sure what it means if anything. So far my iron is normal, no hashi's but I will have the second antibody tested next week. The doc suggested possible B12 test but since my arm is getting better, I suspect it is ok.

I don't know what is causing my thyroid issues, other than I am in perimenopause?? Is that possible?

Any feedback is appreciated, thanks so much for your time!

Kel

[gimel]

You should be sure to get tested for Vitamin d and B12, and supplement as needed to optimize.  As for ferritin, here is some info.

" Iron deficiency

Iron deficiency is shown to significantly reduce T4 to T3 conversion, increase reverse T3 levels, and block the thermogenic (metabolism boosting) properties of thyroid hormone (238-242). Thus, iron deficiency, as indicated by an iron saturation below 25 or a ferritin below 70, will result in diminished intracellular T3 levels. Additionally, T4 should not be considered adequate thyroid replacement if iron deficiency is present."

Yes, it would be worthwhile to get the second test done for Thyroglobulin antibodies, to rule out or in the possibility of Hashi's.  Also important to get the doctor to continue to test for Free T4 and Free T3 each time you go in and continue to increase your NDT med as necessary to relieve symptoms.  

[1Kel12]

Thank you for getting my prior ranges!

My other cortisol tests throughout the day were in normal range, just the one time frame was high.

The DHEA saliva exact wording;

DHEA + DHEA-S (dehydroepiandrosterone Free), pooled value result =14*
*elevated may indicate exogenous intake, normal range adults M/F 3-10ng/ml

I have not tested Vit D or B12, ferritin was 46 but all doctors said it was normal including naturopathic doctors. I also had SIBO test done and it was negative so they are not concerned with the SIgA result.

I can check Vit D/B12 but so far every test they run on me comes back fine except this adrenal test but the doc said it wasn't conclusive for any problems.

I do not supplement DHEA. I don't take any medication other than OTC progesterone cream and now my thyroid meds. I tried thyroid supplement w/iodine earlier this year but stopped after a few months as it didn't seem to help.

Is it important to know the cause of hypo? I am going to have the 2nd anti body test done as well just in case but it seems my tests come back normal except for thyroid panel and a few oddities on this adrenal test.

Thanks again for your time, Best, Kel

[gimel]

Since you have a prior thread, I went back and got these test results so that we would have more info to assess.  These results came from the time you were on the low dose of time release med, I think.  

TSH 4 mIU/L (0.35-5.5)  
FRT4 0.89 ng/dl (0.61-1.64)
T3 Free 2.8 pg/ml (2.3-4.2)
TPO AB 35.4 U/ml (0-60)

Both your Free T4 and Free T3 were way too low in their ranges.  So the switch to 1/2 grain of NatureThroid is okay.  Now you will need to keep testing every 4 weeks or so and gradually raise your dosage to increase your Free T4 and free T3 levels as needed to relieve hypo symptoms.  Note the following quote from a good thyroid doctor.

"The TSH level tells us nothing about the physiology of a person on thyroid replacement therapy. In tests done about 24 to 28 hrs after their last daily dose, most people on adequate NDT therapy have a suppressed TSH. They usually have FT4 levels that are 1 to 1.3ng/dL, and free T3 levels that are rather high in the range or even slightly above the range. The higher FT3 level compensates for the lower FT4 levels on NDT."

Regarding the other tests, were the other cortisol tests in the high end of their ranges?  Also, that range seems strange for the DHEA test.  Please confirm.  Do you supplement DHEA?  Did the doctor explain the SigA result and what it possibly means?  

Hypo patients are also frequently too low in the ranges for Vitamin D, B12 and ferritin.  A deficiency in either can cause symptoms that mimic hypothyroidism.  You really should test for all three and supplement as needed to optimize.  D should be about 55-60, B12 in the very upper end of its range and ferritin should be about 70 minimum.  A low D or ferritin can also adversely affect metabolism of thyroid hormone.