Post by aurelius on Jan 26, 2009 14:40:42 GMT -5
Hello everyone!
My wife has a hormonal imbalance. I am trying to determine the nature of this imbalance.
My wife is 43 years old. She had a hysterectomy about 15 years ago, but still has one ovary. She is a heavy smoker. She has been diagnosed with Bipolar Illness and Borderline Personality Disorder. She has had polycythemia in the past. She has also had carpal-tunnel syndrome in the past. Her white blood cell count is always high. Her temperature is always low. Although she has taken almost every psychiatric drug in the pharmacopoeia in the past, she now only takes 20mg. Prozac a day.
As we have struggled with her mental illness over the years, we have often suspected hormonal imbalances to be at the root of the problem. We have had little luck in getting help form the numerous doctors we have consulted.
Previous tests have revealed extremely low progesterone levels, very high testosterone levels, and thyroid tests were low, but "within normal limits". We had to really work on the doctor to get him to treat her for this. Trials of oral progesterone and Synthroid had mixed results at first, and then negative results and were discontinued. Her situation was obviously more complicated than any of her doctors were willing to explore. All her doctors downplayed the importance of hormonal imbalance and wrote her problems off to her mental illness. Eventually, after meeting so much resistance, we gave up that approach.
Recently, though, my wife has had an increase in her symptoms that is impossible to ignore, and I am filled with determination to figure out what is going on with her hormones.
Signs and Symptoms:
Fatigue
Cold intolerance (and, paradoxically hot flushes sometimes)
Puffy eyelids
Thin, weak fingernails
Hair on head dry and brittle
Hair loss on head
Hirsutism
Intermittent Pain in right side of abdomen, feels like Kidney pain (Adrenal?)
Low temperature
Water retention, abdominal bloating
Constipation
"Brain Fog"
Memory problems
Difficulty losing weight
Numerous body aches and pains
Reactive hypoglycemia (without actual low glucose, just the symptoms)
Severe panic attacks
Migraine-like headaches
Difficulty swallowing, sometimes full-on esophageal spasm (EXTREMELY painful)
Depression
Irritability
Mood lability
Light sensitivity
Eye tics
Dry, gritty feeling eyes
"Sewing-machine leg"
Blood pressure on the low side
Now, she has always had these symptoms to some degree, that's why we suspected hormonal problems in the first place. Only after being discouraged by so many doctors did we give up on pursuing it. The symptoms are so pronounced now though that they are undeniable, and we have decided to take things into our own hands.
I started research on the internet, and found several excellent sources, including these boards. I am convinced that my wife has a hormonal imbalance.
As evidence mounted, I told my wife I thought she was hypothyroid. She reminded me of how the doctors scoffed at that idea, and how they said her tests always showed her to be in the "normal range". She also reminded me about the failure of the trial of Synthroid. I told her I was convinced, and that I wanted to to get better tests. As far as I knew, she had never had FREE T3 or T4.
Well, as I was trying to figure out how to get the doctor to test again, with FREE T3 and T4 besides TSH, my wife dug through her old pill bottles and found the synthroid we had badgered her doctor into prescribing for her. In her desperation, she took two 125mcg tablets. Within 1 hour, ALL her symptoms disappeared, and for 24 hours she felt better that she has her entire adult life.
She was confused as to why the Synthroid hadn't worked before. I said "I think you might have Hashimoto's , and it can have the reverse effect sometimes, and in that case the synthroid would have made you feel worse."
I found out that we could get tests without a prescription from Labcorp. Even though I thought the results would be skewed from her taking the Synthroid, I scheduled a TSH, Free T3 and Free T4 test for 4 days later. Here are the results:
TSH: .765
Free T4: 1.21
Free T3: 2.6
We are going to repeat this panel soon, it has been a couple of weeks since she took that single dose of Synthroid.
My Questions:
1. Do you think that single dose of synthroid (250mcg) 4 days before the test
could have caused that TSH to be so low?
2. If the repeat of the test shows similar results (low TSH, mid-range T4, low
side T3) how should I interpret this? Is the low TSH with a seemingly poor T4
to T3 conversion more consistent with adrenal fatigue, Hashimoto's, or
hypopituitary? I know Chris' rule of thumb is that TSH below .8 is indicative of
hypopituitary. If so, why would the T4 be normal? Why would T3 be less than
T4? Isn't that more indicative of Hashimoto's? Or adrenal fatigue? Low
ferritin?
3. What would be the quickest, least expensive route to distinguishing
between these possibilites (hypopituitary, Hashimoto's, adrenal fatigue)?
Is it better to rule out Hashimoto's with antibody tests, or to do a ACTH
stimulation to determine pituitary/adrenal function?
We have no insurance, so the least expensive route is important.
Thank you so much for providing these forums, and thanks in advance for your replies!
Aurelius
My wife has a hormonal imbalance. I am trying to determine the nature of this imbalance.
My wife is 43 years old. She had a hysterectomy about 15 years ago, but still has one ovary. She is a heavy smoker. She has been diagnosed with Bipolar Illness and Borderline Personality Disorder. She has had polycythemia in the past. She has also had carpal-tunnel syndrome in the past. Her white blood cell count is always high. Her temperature is always low. Although she has taken almost every psychiatric drug in the pharmacopoeia in the past, she now only takes 20mg. Prozac a day.
As we have struggled with her mental illness over the years, we have often suspected hormonal imbalances to be at the root of the problem. We have had little luck in getting help form the numerous doctors we have consulted.
Previous tests have revealed extremely low progesterone levels, very high testosterone levels, and thyroid tests were low, but "within normal limits". We had to really work on the doctor to get him to treat her for this. Trials of oral progesterone and Synthroid had mixed results at first, and then negative results and were discontinued. Her situation was obviously more complicated than any of her doctors were willing to explore. All her doctors downplayed the importance of hormonal imbalance and wrote her problems off to her mental illness. Eventually, after meeting so much resistance, we gave up that approach.
Recently, though, my wife has had an increase in her symptoms that is impossible to ignore, and I am filled with determination to figure out what is going on with her hormones.
Signs and Symptoms:
Fatigue
Cold intolerance (and, paradoxically hot flushes sometimes)
Puffy eyelids
Thin, weak fingernails
Hair on head dry and brittle
Hair loss on head
Hirsutism
Intermittent Pain in right side of abdomen, feels like Kidney pain (Adrenal?)
Low temperature
Water retention, abdominal bloating
Constipation
"Brain Fog"
Memory problems
Difficulty losing weight
Numerous body aches and pains
Reactive hypoglycemia (without actual low glucose, just the symptoms)
Severe panic attacks
Migraine-like headaches
Difficulty swallowing, sometimes full-on esophageal spasm (EXTREMELY painful)
Depression
Irritability
Mood lability
Light sensitivity
Eye tics
Dry, gritty feeling eyes
"Sewing-machine leg"
Blood pressure on the low side
Now, she has always had these symptoms to some degree, that's why we suspected hormonal problems in the first place. Only after being discouraged by so many doctors did we give up on pursuing it. The symptoms are so pronounced now though that they are undeniable, and we have decided to take things into our own hands.
I started research on the internet, and found several excellent sources, including these boards. I am convinced that my wife has a hormonal imbalance.
As evidence mounted, I told my wife I thought she was hypothyroid. She reminded me of how the doctors scoffed at that idea, and how they said her tests always showed her to be in the "normal range". She also reminded me about the failure of the trial of Synthroid. I told her I was convinced, and that I wanted to to get better tests. As far as I knew, she had never had FREE T3 or T4.
Well, as I was trying to figure out how to get the doctor to test again, with FREE T3 and T4 besides TSH, my wife dug through her old pill bottles and found the synthroid we had badgered her doctor into prescribing for her. In her desperation, she took two 125mcg tablets. Within 1 hour, ALL her symptoms disappeared, and for 24 hours she felt better that she has her entire adult life.
She was confused as to why the Synthroid hadn't worked before. I said "I think you might have Hashimoto's , and it can have the reverse effect sometimes, and in that case the synthroid would have made you feel worse."
I found out that we could get tests without a prescription from Labcorp. Even though I thought the results would be skewed from her taking the Synthroid, I scheduled a TSH, Free T3 and Free T4 test for 4 days later. Here are the results:
TSH: .765
Free T4: 1.21
Free T3: 2.6
We are going to repeat this panel soon, it has been a couple of weeks since she took that single dose of Synthroid.
My Questions:
1. Do you think that single dose of synthroid (250mcg) 4 days before the test
could have caused that TSH to be so low?
2. If the repeat of the test shows similar results (low TSH, mid-range T4, low
side T3) how should I interpret this? Is the low TSH with a seemingly poor T4
to T3 conversion more consistent with adrenal fatigue, Hashimoto's, or
hypopituitary? I know Chris' rule of thumb is that TSH below .8 is indicative of
hypopituitary. If so, why would the T4 be normal? Why would T3 be less than
T4? Isn't that more indicative of Hashimoto's? Or adrenal fatigue? Low
ferritin?
3. What would be the quickest, least expensive route to distinguishing
between these possibilites (hypopituitary, Hashimoto's, adrenal fatigue)?
Is it better to rule out Hashimoto's with antibody tests, or to do a ACTH
stimulation to determine pituitary/adrenal function?
We have no insurance, so the least expensive route is important.
Thank you so much for providing these forums, and thanks in advance for your replies!
Aurelius