Oy vey, as we say....

I am so sorry to hear what you (and family) are going through.

I am not one of the Amazing Ones on this site, but I am sure someone will get back to you with better knowledge than me.

One thing really strikes me as odd.... Cortisol is well-known to fluctuate according to its own odd little circadian rhythm throughout the day, so I am wondering why and how a once-a-day reading can possibly be valid....

We have all had our "fun" with doctors, but for me, the MOST fun is taking things into my own hands and finding out how to help myself without them....

There are labs who will happily administer a "spit test" for you to check your cortisol levels. You do not need a doctor. Going direct also saves you a bit of money because you don't have to pay for an office visit. The test is done through the mail. You can then waive the results in front of the doctor and HOPE that she/ he will be reasonable enough to actually TREAT you when or if you get results that indicate something is "off."

Unfortunately, I do not have a link for you, but I have a feeling you might find one on the Stop The Thyroid Madness website.

Hope you feel better!!!

http://www.stopthethyroidmadness.com/adrenal-info/

Here it is....

Um,

I see alot of testing, but not the ones you really need for thyroid health OR adrenal health.

TSH doesn't tell you much after you begin medication (or before in many, many cases). You need a FREE t4 and FREE t3 test. Insist on it. Without that I can't really tell you what's going on with you.

I can tell you that the ACTH stim test is the "gold standard" for testing for Addison's disease. Do you have those results yet?

PS This site has an annoying issue where it cuts off your post if you use a greater than or less than sign. You have to spell it out.

Man.. it did cut off :(

Here are the rest:

Reverse T3, Serum 22.7 ng/dL 9.2 - 24.1 ng/dL
Thyroglobulin Ab

DAM

ACTH Stimulation:
CORTISOL BASELINE 13.0 ug/dL 2.3 - 19.4 ug/dL
Cortisol Stimulated 38.2 ug/dL Not Estab. ug/dL

tsh 0.834 0.450-4.500 (this result was one week after he up'd the dose on the results below)
TSH 4.240 uIU/mL 0.450 - 4.500 uIU/mL (up'd dose here)
t3 uptake 29 24-39
T3 free 2.5 2.0-4.4
reverse t3, serum 22.7 9.2-24.1
t4,free(direct) 1.73 0.82-1.77
vitamin b12 906 211-946
estradiol 127.2
testosterone, serum less then 3 8-48
free testosterone(direct) 1.5 0.0-4.2
thyroglobulin antibody less then 1.0 0.0-0.9
selenium, serum/plasma 161 79-326

Hopefully this will work... thoughts?

I would ask for a saliva test to accurately measure cortisol levels.

DAM is correct! I had a huuuuge post for you with lots of info and the blasted site lost it!!!! Grrr....

Anyway, let me try again...

Your TSH was absolutely too high, so, yeah, you have hypothyroidism and you absolutely needed more meds. You're on alternating between 100 and 112 mcg synthroid, right? No cytomel, right? For how long? For three weeks you've been on synthroid only? Based on the labs you listed, right? If not please correct me as that will change what I have to say by a great deal.

Here's your Free T4/Free T3 breakdown:

Free T4
Range: 0.820 -1.770
Result: 1.730
Percent of range: 95.79%
This is a good range for many people. You'll have to decide if it's good for you or not. I strongly advise you to keep a thyroid symptom journal by date. That way you can look back at your labs (which you will also keep) and determine where you felt ok.

Free T3
Range: 2.000 -4.400
Result: 2.500
Percent of range: 20.83%
Ok, you WERE on cytomel, but you're not anymore (right?). How long ago did you stop the cytomel? I ask because your Free T3 is LOW! You should have a Free T3 in the upper 1/2 of the range (over 50%). You don't.
Note: Cytomel has a lot of bang per mcg. Most people can take only 5 mcg splitting it into TWO daily dosages to begin with. If they put you on a bigger dosage than that...well, all I can say is I'd be like a chipmunk on crack.

I also noticed you had a hysterectomy fairly recently and are on MONTHLY injections for estrogen, right? I read, "Levels have stayed pretty consistent with some changes here and there until I had a total hysterectomy..... I am receiving monthly estradoil injections for. "
Have you tried estradiol patches? What's the dosage of injections you're on?

I'm asking about your hysterectomy because you stated that your Hashimoto's was pretty well under control med-wise until your hysterectomy. Then, BAM, you had a melt-down anxiety wise, correct?

Here's how a total hysterectomy works (taking all of your ovaries, tubes, and uterus) - about six weeks after you lose your ovaries your estrogen gets utterly depleted...as does your progesterone. Here's what I suspect:

Your anxiety has two part solution, and I would try to resolve it in this order:
1) Talk to your doctor about giving you estradiol patches - place them on your tummy (I know that sounds crazy...but I paid ALOT of money to find that and what I'm about to tell you out).
2) Ask, nay, demand politely that you be put on 100mcg of progesterone and take it just before bed. It IS suspended in peanut oil, so if you're allergic, ask for an alternative. But do NOT skip this step. Here's why:
Progesterone is the yin to Estrogen's yang. I know, I know, your doctor told you that estrogen is "all you need" since you no longer have a uterus. WRONG. Unless you have a clotting disorder, are at very high risk for heart disease, or have a certain type of cancer...Honey, you need it! Or, you'll constantly feel like a chipmunk on crack...minus the energy.

Looking at your estradiol levels, I also have a theory about that - you're probably getting a huuuuuge dosage at the outset of the injection (not good) and toward the end of the month it starts to peter-out (also not good) and you don't have the progesterone to balance it out (which is what happens in a normal cycle)...and voila - ANXIETY!

Until you get that done (estrogen adjustment in the form of patches - like .1 or so AND progesterone in about 100 mg pills - your doc should base it on your weight..unless you're heavy..that should do it) then wait a few months - like 2-3.

THEN come on back with new thyroid numbers, K? If your Free T3 isn't up, THEN you can consider switching to armour or starting on a very small dosage of cytomel.

I'm a BIG proponent of changing ONE THING AT A TIME.

If you simply MUST start cytomel...then ask your doc to give you 5mcg and no more...and take 1/2 of 1/2 of that pill in the am to begin with...and the other 1/4 that afternoon (total of 1/2 of that pill) and build your way up to 1/2 pill in the am...1/2 in the afternoon. Frankly, your Free T3 number is low enough for "most people" that I'd tell them to start cytomel...but hormones are mean little buggers and hard to balance if we switch all the knobs on blast at once, ya know?

I hope this helps and I swear if this cuts off my post I'm coming to australia to hunt down the bleeper who has the error in the code!

PS Mariposa...there are not "Amazing Ones" only those who share...and in that, you are amazing.

bleeping bleep bleep...

100 mcg should be 100MG for progesterone. Ugh.

Last one...I promise:

Progesterone is a natural "sedative" .

I've had hypothyroidism for 22 years. Ugh.

Getting my gyn to add progesterone is going to be like pulling teeth.

I am having a colonoscopy and endoscopy today because of my 20 lb wt loss. I have gone from 144 to 126 in 4 months unintentionally.

I have so many hands in the pot that I'm lost: endo, PCP
Gyn, psychiatry.

I'm so lost and sick of this sht. :(

I feel I'm doomed

Aw BebeNp, Do I *ever* know how you feel. I've been in your shoes. I was the primary caretaker, only source of income, highpower/high-stress career, and terribly sick with too many doctors in the "kitchen". It did NOT end well.

Knowing what I know now...I would have found ONE GOOD GP and stuck with them. And, use this mantra often, "I know you may not think this is a good idea, but why not let me try it? If it ends in tears, it'll be my fault, not yours and we can back off that therapy and try something else."

That seems to work most of the time with REASONABLE GOOD doctors.

Endo's sucked in my case. They made matters worse, not better.
Shrinks were USELESS!!!!!
And my gyno was an idiot and I'm pretty sure enjoys torturing his patients as a past-time.

I know it'll be like "pulling teeth", but find ONE doctor that you trust and fire the rest....at least for now. Then press gently but firmly and politely for the progesterone.

I had many of the same symptoms your describing and the progesterone worked to lessen the anxiety and allow me to sleep and eat. My thyroid...well that was a different animal altogether, but I had to get the progesterone working before I could balance my thyroid. It sucked, and I wouldn't wish that experience on anyone, but I've been where you are and it is NOT hopeless.

Give it a try...and buck hard for the progesterone and a SMALL dosage of T3 (cytomel). Don't give up...keep trying...and explain that you are a "man" for all intents and purposes - the main breadwinner. And you cannot afford to be "down".

Good luck and keep us posted.

BTW: I lost 30lbs in 4 weeks and about 40lbs in about 5 weeks after my hysterectomy. I also have Hashi's and have probably had it since I was a kid. But, the hysterectomy FREAKED my body out. I needed the progesterone and T3 to feel ok. I hope you find your answers.

I know what it's like to be so weak, and need help that doesn't seem to be there.

Thanks, Butterfly!

I know it is so infuriating to have to keep going through these little dances with doctors - and since many of us have inadequate insurance coverage, it makes it even worse to have to keep going back.

It is a very long process.

I know several people who just decided to go into debt and find a really good functional medicine doctor who doesn't even take insurance. All of these people now feel 100% better and are optimized.

I am not yet one of them. But once I have gotten a handle on the debt from last year's "adventures," I will make an appointment with one of those great doctors.

There really ARE decent physicians "out there," but it is difficult and expensive to try to find them.

Hope you feel better!

Yes. It is expensive - at least in the USA. Looking back, I really should have told all the "ists" to f-off, and just held strong with my MD, but as they say...hind sight is 20/20.

I have an appt with one this Thurs....

89.00 for first eval... Wonder how much after :(

I agree with MButterfly..who while we are all amazing, is the Amazing-est!! :) I am on Armour, hashi's diagnosed 5 hrs ago..
I take estradiol and micronized progesterone. 0.5 estradiol 100 mgs progesterone. I take it 3 times a week. I tried to cut the progesterone down to once a month for a week..but my anxiety (that I have had for decades) was off the charts without the prog.. It's definitely nature's calmer.. I hope your doc listens to you BeBenp..
Keep us posted..