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MZZCHIEF's Photo MZZCHIEF Posts: 9,410
3/7/08 12:01 A

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Thank you Goodie! I wish I was a genius, or at least that my teenager thought I was!

Also check that Stop the Thyroid Madness site for their doctor locator, that might be of help to you as well.

But its just silly to go to a doc if you only want Armour, without finding out first if they're willing to prescribe it, given the prejudice of doctors against the brand.

Keep in good spirits, and good luck!
: )
Mzzchief

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3/6/08 8:04 P

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MZZCHIEF, you're a genius. ("...best way to get a doc to prescribe Armour, is to flat out ask them if they would prescribe it BEFORE you waste your time and money on an appointment with one who flat out refuses...) Why didn't I think of that? (... mutter, mutter, mutter....) Thanks again.

I'm going to go down the doctors list when I get home Monday and I won't stop until I find one who'll prescribe Armour. I'll keep y'all posted.

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MZZCHIEF's Photo MZZCHIEF Posts: 9,410
3/6/08 4:29 P

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Bnemom!

hey, ya mean ya can't decipher my misspellings? hahaha Sorry, I meant to say : thyrotoxicosis. By the time I got done writing that explanation my mind was as crispie as an order of MckeeDeees fries.

Thyrotoxicosis is when your thyroid goes nuts and releases all sorts of thyroid hormone, its also called a thyroid storm. Its like hyperthyroid disease in the extreme.

Your proposed treatment plan of Cytomel and T4 sound reasonable to me, but I'm not your doctor... thats a decision the two of you must make together. Alternately you may want to try Thyrolar or Armour, or Armour with some T4.

4 to 6 weeks after your chosen therapy you may want a T3 test, since you are introducing free T3 into your body and it may be too much if your thyroid is already producing it on its own.

Its my understanding that too much free T3 can induce symptoms of hyperthyroid disease or thyrotoxicosis. There's less of a chance of that, if you're on straight T4, because the T4 is frozen... not ready to be used until its taken into the individual cells of the body and deiodinased.

IMO if you are still having unresolved hypo symptoms, and you've given your body a year or so to adjust to current meds, then its worthwhile to look at options, as you are doing. But do be aware that thyroid hormone replacement has its limitations.

Nothing on the market today will take the place of a properly functioning, healthy thyroid.

: )
Mzzchief



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BNEMOM's Photo BNEMOM Posts: 69
3/6/08 3:33 P

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Mzzchief writes "Thats why if you are hypo, with no signs of thyrotoxicis, your doc doesn't want to waste your time and money with a Free T3. Its safe to assume that your T3 is okay."

Ok, I hate to sound like a total moron, but I'm not sure I follow the end of the T3 discussion. What are signs of thyrotoxicis??

I am preparing to see an Endocrinologist for the first time. I have been diagnosed hypothyroid for about 5 years. My PCP currently treats my condition, but I am not happy with my treatment. I actually think he gives me too much levothyroixine, because my TSH is 0.24. However, I still have a lot of hypo symptoms that have not been resolved. What I think I'd like to try is backing down from my 125mcg T4 to 75mcg and adding 10mcg Cytomel. I've never had a Free T3 test though. Is one appropriate for me?


 
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MZZCHIEF's Photo MZZCHIEF Posts: 9,410
3/6/08 3:23 P

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hey Goodie!

I'm glad you made it thru my T3,t4 and French Fry analogy! LOL

I think the best way to get a doc to prescribe Armour, is to flat out ask them if they would prescribe it BEFORE you waste your time and money on an appointment with one who flat out refuses. Why pay to annoy yourself and leave frustrate, poorer and without what you came there to get? Stop the thyroid madness has a doctor finder on their site that you might consider using.

Alternately, if you have health insurance, I'd get a list of participating physicians, start dialing. Call, tell em you've got thyroid disease, and are only considering a doctor that will prescribe Armour.
Do not make an appointment unless your doc will prescribe it. Your mission is to get what you want,as hassle free as possible, not make converts!

There is a HUGE prejudice against its prescription in the medical community. You can make the best argument in the world for its use, but if your prescribing physician won't prescribe it then its falling on deaf ears.

Remember who's handing out the candy.
Hint: It's not you. LOL

: )
Mzzchief


New decade. Big world.
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Never underestimate the value of getting out of your own way.

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3/6/08 2:47 P

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MZZCHIEF, Heartfelt THANKS for the best free T3 description I've ever read. My diagnosis was only multinodular goiter and thyroiditis, but my hunch, based on symptoms, not tests, is that I'm hypothyroid and would like to start on Armour pronto. The free T3 test would just be evidence to justify the prescription for Armour. What's the easiest way to get Armour, with or without a prescription? (Don't worry. I'm a data-junkie. My intention is to start slow and jot down all my "symptoms" observations daily, then try over a 6-month period to correlate observed changes with dosage magnitude and rhythm. What do you think?) Thanks again for the terrific T3 discussion.

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MZZCHIEF's Photo MZZCHIEF Posts: 9,410
3/6/08 12:46 P

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I think its important to understand the diff between T3 and T4 and how they work in the body, before we wade in too deeply. hmm. I will take a stab at it here, and share my understanding of it with ya.

First off, the T in T3 and T4 stand for a protien made only in the thyroid called thyroxine. The numbers are the number of iodine molecules attached to the thyroxine. So T3 is one thyroxine molecule plus 3 iodines, T4 is ....? Okay. Ya got it!

T3 is the ONLY biologically active thyroid hormone. What does that mean? It means its the ONLY thyroid hormone that unlocks the various metabolic processes within the cells.

So how come docs don't just give us T3? Well, cuz T3 is not a very long lived substance. Why? Cuz its not designed to last, its made ALL OVER THE BODY, in the individual cells from circulating FREE T4, and only on an "as needed" basis.

Just like Mcdonalds doesn't make a whole bunch of french fries at 3:30 in the afternoon when there is no one there to eat them...your cells don't make T3 unless they are gonna use it. T3 doesn't have to last cuz its meant to be made and used up right away.

For lasting power, there's T4. Often called the RESEVOIR thyroid hormone because its just cruisin around in your body, hanging out waiting to be called into use. Using the McDonald's analogy, it would be frozen french fries.

With me so far? Cuz i'm gonna have to take a little side trip. The thyroid DOES make some T3, its not ALL made in the cells. But only about 30% of the total thyroid production is T3, the rest of it is T4.
Okay, back to the thyroid hormones and Micky dees. LOL

So how does the Free T4 get made into T3? There are 3 different enzymes for that, called deiodinases. If you look at that word, and break it down, the word says what the enzyme does. De-(from) iodin-(iodine) ase-(a suffix meaning enzyme). Got it? The Deiodinases are enzymes that take an iodine molecule from the "T"...thyroxine... so T4 minus one iodine = T3. Again using the MickyDee analogy... the deiodinase is like the fryolator that prepares the fries for eating.

You may have noticed I said "FREE T4". That's because MOST of the T4 is bound to protiens, and can't be used. Kinda like if the frozen fries were locked in the freezer. There there, but so what? They might be in the restaurant, but they can't be used, cuz they are locked up.

This is why its important to have a FREE T4 test done,as it will tell you how much RAW hormone is available to your cells to be made into T3 on an as needed basis.

TOTAL T4 test is useless.
Why? Cuz we don't care how many french fries are locked up in the freezer, we just care about how many are available to cook and serve.And that's what Free T4 is, frozen fries, ready to be put into the fryolator and served to the cell as T3.

Since T3 is made mostly in the cells, on an as needed basis from free T4...its used and bound there..its not avaiable for measuring in the blood cuz its not IN the blood, its in the cells. It can't be in two places at one time.

So all Free T3 is really useful for is to see if:
1. you are becoming hyperthyroid,
2. how bad your thyrotoxic state is,
3. or if your thyroid is still making T3 on its own.


Free t3 doesnt' measure how effectively its being used by your cells, or even if its being made in your cells, cuz that T3 is in use and can't be counted, its locked into the cell, turning on the metabolic processes of that cell. Just like how you wouldn't be able to know how many fries were made,or how yummy they were, once they were in everyone's stomach. YO!

: )

Thats why if you are hypo, with no signs of thyrotoxicis, your doc doesn't want to waste your time and money with a Free T3. Its safe to assume that your T3 is okay.

: )
Mzzchief


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3/6/08 10:09 A

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PIXIGRL76, I sympathize. I've twice now gotten the same rejection of my request for a free T3 test, once with simple arrogance, the 2nd time with overt hostility. Both times, I'd asked the receptionist to pass the request to the endocrinologist, not to the jerk-PA. Both times, it was the jerk-PA who answered the request.

What do these people fear from just getting the T3 information?!

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MZZCHIEF's Photo MZZCHIEF Posts: 9,410
3/4/08 3:56 P

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hey Pix!

Great! That's out of the way then. Let us know what your results are. Generally they have them within 5 days.

Actually I have a doctor that's similiar to yours, he's minimally involved in my care, so I get to make the decisions. But I like it that way.

Its VERY important to do what YOU are comfortable with. We are all different.

I think you've been doing an admirable job making sure you get proper care and keeping your wits about you, in what is a very confusing time for most people...when they recieve a hypo diagnosis. Way to go!

I would still encourage you to get a notebook, and keep your medical records in there. When you do get a new doc, you'll have a package to give him with your prior history. I'm assuming you are planning to spend several decades on the planet. Best in this world of erratic health care and one doc in one doc out, moving all over the place, that you keep your own records. I sure wish someone would have given me that advice decades ago.


And any good Doctor will appreciate a well organized,well informed patient. Think of it from their point of view. Who'd you rather deal with?

take care of youse!
: )
Mzzchief

Edited by: MZZCHIEF at: 3/4/2008 (15:56)
New decade. Big world.
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Never underestimate the value of getting out of your own way.

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PIXIGRL76 Posts: 149
3/4/08 3:28 P

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I went at 7:30 this morning and had the one test. I figured something is better than nothing. I think I'm going to start shopping around for a new doctor though.

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MZZCHIEF's Photo MZZCHIEF Posts: 9,410
3/4/08 12:16 P

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Pixie!
I understand your discomfiture with having to be your own doctor, but after talking to some of the other Sparkers here, you may well begin to enjoy that power. Lots of us have to figt with our docs to get what we need.

IMO its important to know what you need, and to be able to have access to it. Unfortunately, that does mean you have to do a bit more work, since YOU are the one making the decisions now, guiding your own ship, not your doc.

This means educate and organize yourself.

My advice it to read what Sandy (hippie girl) has linked here, print them out as well as any other articles you may see online that interest you.

Buy a loose leaf folder and a 3 hole puncher, keep all your test results, articles, questions you have in it using dividers. Just like back when you were in school! That way you'll be organized, have things in one spot for ready access, and if you ever do decide to go to another doc, you'll have all your records together for him to copy.

Back to the ideal time to test... I had a similar question when I first was being tested. Yes, do what your doc suggests... but I think I hear ya saying he's not exactly offering any guidance.

My advice would be to test your levels under "normal" conditions.... because that's what we want to know, right? So take your meds, eat your meals, get tested whenever its convenient for you that day.

What Jakirinna says about T4 building up in your body, taking weeks to do so and staying at a stable level is correct. Thats why they only test you very 6-8 weeks. If you are taking a synthetic like Synthroid that is pure T4 and it really doesn't matter when you have your test.

With Armour or meds with T3 then you do have a spike for a few hours after ingestion, that's why docs recommend that the dose is divided into day and nite... to keep the T3 at more consistant levels thruout the day.

In the case of Armour, take your meds in the morning, eat, and get tested in the afternoon, 12-4pm. Otherwise it may appear that you have too much T3 in your blood, when in fact all you are having is a spike because you've just taken your meds.My understanding is that T3 remains high for about 3-4 hours.

IMO whatever you do, it might be a good idea to get tested under the same circumstances, at the same time of day each time you have a test. That way you will be comparing apples to apples, instead of apples to oranges.

Hope this wasn't too confusing.
So what did you wind up doing?
: )
Mzzchief

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PIXIGRL76 Posts: 149
3/4/08 11:59 A

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So,bad news. I left the gym last night and had a message from someone at the hospital representing my doctor (not my doctor herself..ugh) telling me that the doctor was not approving me for Free t-3 and 4 tests and only the general thyroid test (once again..ugh.) I was actually pretty upset about it last night. So,I went in this morning and gave them a bit of my blood. I'll see on Monday what she says. I have a feeling she may not be up for going the Armour route. I'm really going to push for Armour. I know for a fact that this hospital also goes by the old scale for the #'s range. I do have the article with the new #'s in tow though. I really am starting to feel for people on here when they vent major frustration. I'm starting to have some frustrations of my own. BUT,with that said.. I'm keeping all my fingers AND toes crossed ;)

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KATHCME's Photo KATHCME Posts: 467
3/3/08 9:49 P

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Hello
Good luck w/ your test!
I just did my test this evening@5:30pm-after
I found out the lab is open late. I go to school ftime had a class till 3:00 ,so I figured I wouldnt have to rush if I went in the pm.*
Came home picked up kids + went to lab,it's about an hour away. I cant wait for results and am hoping my dose be upped if need be. I havent even seen my doc(he'sa good 1) for long while-b/c 1test delayed +1 bad reading cuz lack of meds before_ so Im counting on this one.

Now is the Time*



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HIPPIEGURL's Photo HIPPIEGURL Posts: 4,953
3/3/08 8:32 P

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It's not at all necessary to fast prior to any thyroid
blood test. As for taking your thyroid meds prior, do
what your Dr. tells you to do.
I'll give you some research links to read and you can
copy what think is important to keep for yourself and
also make copies to take to your doctor for what you
want him to keep.

Sandy

www.thyroid-info.com/articles/tsh-fl
uc
tuating.htm


thyroid.about.com/cs/hypothyroidism/
a/
checklist.htm


thyroid.about.com/od/loseweightsucce
ss
fully/a/sleepdiet.htm


thyroid.about.com/gi/dynamic/offsite
.h
tm?zi=1/XJ&sdn=thyroid&cdn=health&tmR>=91&gps=266_655_1020_571&f=00&su=p72
6.
2.152.ip_p284.8.150.ip_&tt=-2&bt
=1&bts
=0&zu=http%3A//www.thyroid-i
nfo.com/ar
ticles/woliner.htm


thyroid.about.com/cs/hypothyroidism/
a/
undertreated.htm


www.altsupportthyroid.org/treatment/
hi
story.php


thyroid.about.com/od/gettestedanddia
gn
osed/a/testdiagnose.htm


thyroid.about.com/cs/newsinfo/l/blte
st
_values.htm


thyroid.about.com/cs/testsforthyroid
/a
/newrange.htm


www.mercola.com/1999/archive/armour_
th
yroid.htm



www.stopthethyroidmadness.com/


www.armourthyroid.com/

Edited by: HIPPIEGURL at: 3/7/2008 (00:15)
Sandy



Work like you don't need the money, love like you've never been hurt, dance like nobody's watching and NEVER fry bacon naked!

You are successful the moment you start moving toward a worthwhile goal.
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PIXIGRL76 Posts: 149
3/3/08 7:32 P

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Well, I just got a call back from someone in my doctor's office and they are doing a complete panel, both T-3 and 4 and one other test. I'm not sure what the other test is. It has to do with the thyroid though. And they were just ready to switch my medicine to Armour without me even talking with my doctor. Are you kidding me? The client choosing the medicine and telling the doctor what blood tests to run??????????????????? Oh well, at least I'm getting the blood tests run that I requested :) .

I'm seeing the doctor on Monday morning to discuss treatment. Ok,I'm meeting on Monday morning to educate my doctor ;) lol.



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JAKARINNA's Photo JAKARINNA Posts: 111
3/3/08 6:08 P

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I have been doing blood tests for about 12 years now and I have not found a better time during the day to take it than others. I usually go in just when ever I have a chance during the day since I work full time and I am a single mom, believe me that does not leave me a lot of free time for that stuff. I still take my meds the day of the test just because it takes weeks for your body to get the dosage going thru it and one pill is not going to make that big of a difference. If you are off you are going to be off regardless.

I hope this helps you.


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SHONADOG's Photo SHONADOG Posts: 1,864
3/3/08 5:56 P

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My endo wants me to get my blood tests 4 hrs after taking my meds. They say its best reading level. Just be firm on what you want. Be armed with info. Some Docs don't like us knowing more then they do but they went to school and should know.

Mary

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PIXIGRL76 Posts: 149
3/3/08 5:26 P

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Hi ALL! Ok, I have my second official blood test in the morning (fingers crossed) and last time I was at a 5.53 (.25 of generic synthroid) and I'm curios as to whether I should skip my med in the morning before the test (if it will affect the blood test) and if I'm supposed to fast tonight for t3-4 tests. I requested the Free T3 and T4 tests myself. I'm not even sure if my doctor has approved those or not.In fact I had to call myself and remind the hospital that it had been 6 weeks..bah! Ok,I'm done venting.

Also my doctor had NO CLUE about the scale being lowered and it's a HUGE hospital with really no one on one attention for the patients. Pretty much a # right now to them. Really frustrating. Anything else anyone can recommend before tomorrow? Anything at all? Also,if there is ANYTHING that I should know to arm myself to bring in to my follow up appt next monday that would be great. I already printed out the new "standards" for ranges and information on Armour. I'm also going to be firm with receiving NON GENERIC meds.

I'm just really frustrated. I couldn't even leave my doctor a voicemail. I had to have someone email the doctor for me.

Any info at all would be super appreciated and please keep posting.I am learning so much!

~Christina

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