Friday, October 2, 2015

T to the 2.

Who is to say that I am "normal," or that my body is functioning "normally"?  I certainly don't think normal is how I feel.  If the way I feel is normal, or baseline for all human beings, than the world is fucked.  I'm usually halfway between Exorcist head spinning, and laying on the floor crying with my brain puking, and nothing seems to help once one of the two, or both set in.  I'm just fucked.  And I feel like people around me are fucked, and overall, things are pretty fucked up.

I don't even have a doctor right now.  And I'm writing about something I've written about at least 4 times already... but there's a reason... nothing changes, nothing gets better, and healthcare goes around in circles or goes backwards.

My lifetime doctor retired, and then my new Nurse Practitioner lady left the area.  They don't contact you and tell you they have set you up with a new medical professional.  You just fall away from their radar and out of the system.  When I was being treated by my actual doctor, before he left the practice, I was just at the beginning stages of the decline in my general health.  And then I started seeing a Nurse Practitioner, who listened to me, after the 3rd or 4th appointment, and finally tested my blood.  And the tests didn't come back in normal ranges.  My body functioning normally?  It certainly wasn't, clearly, at one point when my blood tests showed very low Iron and Ferritin levels.  That meant I wasn't storing any iron... And I was exhausted beyond anything I would consider normal for someone my age. My iron stores were running almost on empty, even though my consumption of the stuff was normal.  I mean, I eat healthily. I even started making spinach smoothies.  Yum.  (They weren't so bad with lots of apples and pineapple juice). My Ferritin level was less than 5, and I was so tired.  I was exhausted all the time.  I felt like I was 100 years old and trying to run a marathon, just walking around my house. 

"Treatment of iron deficiency
When ferritin values ​​are less than 15, ferrous oral salts are prescribed at a dose 3 mg Fe ++ / kg / day on an empty stomach for 60-90 days" (Source).

(Hi.  I can't fix this indentation, which should not be here, and spending an hour on HTML messing with it is just frustrating.  I'm going to leave it). Hmmmmm... I didn't get any of that stuff up there. I was just tested for all things that might cause low iron. Then I was given some iron serum. Then I was told I was back in normal range. I was still really tired all the time. But I was all better. Exhausted. Not better.  And one of the causes of low Ferritin levels and exhaustion is hypothyroid disease.  Duh.

My thyroid was tested a few times, and the TSH levels were in normal range.  I understood that.  I saw the tests.  I also knew that thyroid disease runs in my family and I had all the symptoms of a lower functioning thyroid gland.  I was on T3 to augment my antidepressants, and I had read that once you start taking T3, TSH tests aren't accurate anymore.  

        The basic screening test for hypothyroidism is the TSH test, which is short for thyroid-stimulating hormone. TSH is secreted by the pituitary gland when it senses that thyroid levels in the blood have dropped too low, so low levels of TSH generally mean that there is plenty of thyroid hormone in circulation. But for a variety of reasons, the pituitary can sometimes fail to produce enough TSH (even though thyroid levels are low), in which case a low TSH level would give the false impression of having plenty of thyroid. And even under optimal circumstances, TSH levels can fluctuate.
      In 2002, the American Association of Clinical Endocrinologists (AACE), recognizing that many patients are misdiagnosed, lowered the upper end of acceptable TSH levels from 5.0 to 3.0, doubling the number of people needing treatment for hypothyroidism. Under the old guidelines, these people had been considered totally normal, and many had been denied treatment despite predisposing family histories and symptoms such as weight gain, depression, fatigue, hair loss, constipation and high cholesterol, all of which can be caused by low thyroid.
       Is it any wonder that best-selling thyroid author Mary Shomon’s motto is, “We’re patients, not lab values”?
Speaking of the acceptable TSH ranges, Shomon notes:
This narrow-minded means of diagnosis has been the “standard of care” for conventional doctors and endocrinologists for decades, based on a near-slavish reliance on the TSH test—often to the exclusion of clinical evidence, symptoms and medical observation.
On, Shomon has questionnaires to assess the risk of both hypothyroidism (too little) and hyperthyroidism (too much).  Another approach followed by some integrative doctors is to use an underarm temperature test, which may be more reliable than the TSH test. One simply measures underarm temperature before getting out of bed. A temperature below 97.4 for several days running generally indicates a problem."

I have written about the thyroid, and thyroid testing before, but in further research, after my mom offered me some of her Nature Thyroid, I learned that even people diagnosed with hypothyroid disease, and are just treated with Synthroid and Cytomel, don't feel that much better.  Armour Thyroid, which was discontinued at one point, worked miracles for many people.  The difference between Synthroid and Armour Thyroid (or Nature Thyroid, which is the same thing), is the naturally derived stuff contains T1 and T2.  Do T1 and T2 matter?  Most doctors and scientists say no... yet it looks like T2 does do something in our bodies... and maybe that's the key to some people feeling better, and others going through their lives never knowing they could feel better.   

"The conversion of T4 to T3 is accomplished through the action of two enzymes known as D1 and D2. When D1 and D2 activity is low, conversion of T4 to T3 is insufficient to meet the body’s needs and signs and symptoms of hypothyroidism appear. In recent years it has been discovered that D2 activity is enhanced by the presence of T2, a form of thyroid hormone that has traditionally been considered inactive and of no importance.
It has also been found that T2 plays a crucial role in energy production in the liver, heart, and skeletal muscles. T2 acts quickly and directly to increase the metabolic rate by facilitating oxygen use, while T3 acts more slowly and indirectly through the activation of various enzymes. While very little is known about T1 activity, it now appears likely that it too is an active hormone, and not simply a breakdown product of T4 and T3.
It is not necessary that all forms of thyroid hormone be present for pituitary release of TSH to return to normal levels. Any form of thyroid hormone is independently capable of telling the pituitary gland that thyroid activity is adequate. Therefore administration of T4 alone, T3 alone, or even T2 alone will effectively normalize TSH levels.
This presents a serious challenge for individuals who have lost normal thyroid function. If levothyroxine (T4), the storage form of thyroid hormone, is supplemented the TSH level will fall. It is therefore possible to normalize levels of both T4 and TSH with supplementation of levothyroxine alone. In the absence of T2, however, T4 will not be efficiently converted to T3 and thyroid hormone activity will remain low. This is why many people who take levothyroxine alone continue to experience signs and symptoms of hypothyroidism while exhibiting perfectly normal and balanced TSH and T4 blood test results.
Desiccated thyroid, which is extracted from animal thyroid glands (predominantly those of pigs slaughtered for pork products), contains all forms of thyroid hormone produced by a normally functioning thyroid gland. Since T2 is available, the body can effectively convert the T4 that is present to T3 and normal thyroid function is restored.
Very few physicians are aware of the role of T2 in the body. Some recognize that T4 conversion to T3 must take place for thyroid function to be restored, but most do not. They prescribe levothyroxine, check T4 and TSH blood levels, and assume that anyone who continues to complain of feeling tired, cold, constipated, and losing hair is suffering from depression or some other malady totally unrelated to thyroid activity.
The ignorance of physicians in regard to desiccated thyroid is astounding. Many patients who have come to me in search of an answer to their symptoms have reported being told that taking a drug that contains an ingredient from an animal source is inherently dangerous. It is difficult for me to believe that the physicians proffering such advice are vegans who never consume any animal substance. Some patients have been advised that they will put themselves at risk of mad cow disease if they take a whole thyroid product. How a substance derived exclusively from pigs is supposedly capable of producing mad cow disease is a mystery to me. Nevertheless, the vast majority of physicians steadfastly refuse to prescribe desiccated thyroid to individuals who continue to exhibit signs and symptoms of hypothyroidism with levothyroxine therapy."  (Source)
Many people, including my aunts and my mother, were switched to Synthroid when Armour Thyroid was no longer distributed, and felt terrible.  And even today, many patients are switched back to the synthetic medication by new doctors, which is a tragedy for so many people.  

"Such a misunderstanding might be excused in a physician-in-training, but it is difficult to do so when it comes from a high-ranking government official. Mary Parks, M.D., is Director of the FDA's Division of Metabolic and Endocrine Drug Products. She has been with FDA for 10 years. Dr. Parks graduated from Georgetown University Medical School in Washington, D.C., where she completed a residency in internal medicine and a fellowship in endocrinology and metabolism.
In response to the question, “What medications are approved to treat hypothyroidism?” she states, “Medications for underactive thyroid work by replacing hormone that's missing. The approved medication for this indication is levothyroxine sodium, which is identical to the natural thyroid hormone produced by the body.”
Her statement reveals a profound lack of understanding of thyroid function. Levothyroxine is not the natural thyroid hormone produced by the body; it is one of the natural thyroid hormones produced by the body. Levothyroxine is not the active form of thyroid hormone at the cellular level, and replacement of levothyroxine alone is often ineffective in restoring normal thyroid activity.
Synthesized levothyroxine may be chemically identical to that produced by the body, but it is not energetically identical. All substances are composed of atoms. Each atom has a nucleus made up of protons and neutrons with electrons in orbit around the nucleus. The electrons in the atoms of living organisms, and substances derived from them, are spinning counter-clockwise as they revolve around the nucleus. Atoms in substances that are manufactured or refined have a clockwise or a mixed spin direction, and are not viewed in the same manner by the human body.
Unfortunately, while all medical schools require that students complete a course in biochemistry, none require them to take a course in biophysics. Nearly all physicians are therefore blissfully unaware that the drugs they are prescribing are capable of adversely affecting the electromagnetic nature of the body.
Since desiccated thyroid is the only available thyroid replacement product that provides all forms of the hormone required for proper use in the body its disappearance from the marketplace is a matter of grave concern. Tracking down the reasons for the shortage has been challenging, but I have identified several factors that appear to explain the mysterious disappearance of desiccated thyroid from the marketplace. I am cautiously optimistic that the current situation will be resolved and that individuals who depend upon desiccated thyroid for their well-being will once again be able to obtain it without difficulty."  (Source...)

And maybe T2 and T1 matter, and people just don't know it yet, or even care to research it thoroughly.  I don't know.  I just know something's not right in this girl's head, and body and it's not getting better.  I research, and research, but without a doctor, what am I left with?  A lot of information that maybe someone else can use to stop their own heads from spinning or puking?
T2 and T1 are thought to play minor roles in the thyroid and rest of the body, primarily serving as precursors to and byproducts of T4/T3 formation. They may be more involved in thyroid function, but as far as we can tell right now, they have little impact beyond that noted. Calcitonin is a thyroid hormone that, along with parathyroid hormone (PTH), regulates calcium, and it is another measure that can be too low with hypothyroidism.
T2 and T1 aren’t measured because they have no demonstrated clinical value. Calcitonin is sometimes measured as part of an “extended thyroid panel”, when trying to settle on a definitive diagnosis where none is clear, especially in the cases of some suspected endocrine tumors. Values for the latter are considered normal below 10 pg/mL in men and 5 pg/mL in women. Unlike the standard medical treatments for hypothyroidism, desiccated thyroid supplements often contain T1, T2, T3, T4 and calcitonin.
Both human and pig thyroid glands (from which DTE is derived) produce T1, T2, T3, T4, and calcitonin. T4 is a storage hormone that must be converted into T3 to be metabolically active.Calcitonin regulates blood levels of calcium. And T1 and T2 seem to be a mystery and are widely believed to have no clinical value.
Mainstream medicine preaches that it is sufficient to supplement only with T4; that the body will convert an appropriate amount of T4 into T3; and that T1, T2 and calcitonin aren’t needed. While this may be true for some hypothyroid patients, clearly there are many others who get better only when they take DTE. Mainstream exponents such as Wikipedia disparage DTE, saying, “The use of thyroid extract became associated with those whose medical practices deviated in many ways from standard care,” and “Those prescribing it were considered to be unscientific and irrational practitioners.” Right—considered by whom?
Much rests on the assumption of conventional medicine that the body will convert enough T4 into T3, although many things can interfere with the conversion process. The health site for Discovery Communications reports:
Nutritional deficiencies such as iodine, iron, selenium, zinc, vitamin A, riboflavin, pyridoxine, and B12, along with the use of certain medications including beta-blockers, birth control pills, estrogen, iodinated contrast agents, lithium, phenytoin, and theophylline, can inhibit the conversion of T4 into T3. Other factors that can cause this inhibition include aging, alcohol, alpha-lipoic acid, diabetes, fluoride, lead, mercury, pesticides, radiation, stress, and surgery.
Another problem is that too much T4 can convert to something called “reverse T3,” which has only 1% of the effect of T3, but also binds to the T3 receptor, thus blocking T3 from doing its job:
Factors that may lead to a preferential conversion to reverse T3 include high cortisol, glucocorticoids, stress, excess estrogen, and nutritional deficiencies such as selenium, iodine, zinc, and iron.
All of these factors are common. Some—such as aging, stress, fluoride, and pesticides—are so ubiquitous that it is easy to imagine that a large percentage of thyroid patients are inadequately converting T4 to T3, and thus need a thyroid preparation that contains some T3. There is also the possibility that T1 and T2 are performing functions in the body that we are not yet aware of, and that they need to be supplemented along with T3 and T4 (as they are with DTE).
The basic screening test for hypothyroidism is the TSH test, which is short for thyroid-stimulating hormone. TSH is secreted by the pituitary gland when it senses that thyroid levels in the blood have dropped too low, so low levels of TSH generally mean that there is plenty of thyroid hormone in circulation. But for a variety of reasons, the pituitary can sometimes fail to produce enough TSH (even though thyroid levels are low), in which case a low TSH level would give the false impression of having plenty of thyroid. And even under optimal circumstances, TSH levels can fluctuate.

Thursday, August 27, 2015

Hold your breath and jump.

My last several posts have been far too dark and depressing and pessimistic.  I wrote them one after the other, when I was in the luteal phase, which at least exacerbates my Major Depressive Disorder, if it isn't PMDD.  

You see, I stopped feeling... better...  See, I should feel relief once the follicular phase starts.  I started just feeling low all the time.   And it's not as bad as it is when I'm in Hormonal-Hell-Well, (I'm copyrighting that), but I don't feel alright.  I don't feel okay.  I feel sad a lot of the time.  There is some relief, but it's not
drastically noticeable.  And there are luteal days I feel not totally crazy.  

So my writing reflected, and reflects the darkness and sadness I can't shake.  

I've considered the drastic treatments for PMDD and depression:  I thought of refilling my Yasmin prescription and trying it again for a full three months.  I'm considering the idea of getting the Hysterectomy and Oophorectomy.  If this is for sure hormonal depression, and the rest is situational and just bearing down on me harder than I expected, it might help me.  I can't believe I'm doubting if I have PMDD, when it was so clear to me, and it's so obvious... but not feeling better...  Not having a baseline of happiness is how they diagnose these things, and they would now say my baseline sucks, so it's Major Depressive Disorder with a side of hormonal heck.  That would mean, since I have tried so very many medications, that I could try ECT.  I've heard wonders.  It affects memory.  I worry about that, but it also comforts me.  There are things I want to forget.  If ECT helped me be Joanna again, I would do it in a second.  It doesn't scare me.  I am ready to try anything.

But, here's the thing.  I--just moi, no Sam--went out on a boat with Sam's parents, and the kids on the river and we swam and fished and then met up with Sam after 5:00, and we went tubing.  Watching the kids tube was so sweet.  Their smiles... their beautiful smiles.  I have beautiful children.  And before tubing, I swam with my kids and their grandparents, and jumped off a dock, and off the back of the boat, and it felt good.  I felt "normal," and we ate snacks, and the sun was shining, and the water was warm, and the kids were thrilled... and I was PMDD at that point.  I couldn't find my Klonopin, to take an evening dose, but I didn't need it.  Actually, there was no anxiety and complete relaxation until 5:00ish. 

 It's not Sam's fault.  He has spent the day at work and is just getting to join the fun.  Yet, Sam's interactions with the kids are sometimes stressful for me...  He doesn't hear them and they say his name 10 times before he responds... and that makes me feel a little crazy.  He is in his own head, and I'm always in the kids heads, or trying to be, even when I'm in the worst state of depression.  I hear them.  I hear them and if I can respond, I do that.  

So, I have to understand myself, analyze myself, and try to figure out if this is hormonal, or major depression that is getting worse, or if it's just me... and my place in the world.  I've got to figure all that out on my own.  No one can tell me the answer.  I have to not only know it, but commit to it.  I fear I'll commit to a treatment for the wrong reasons, or...  No...  I'm smart.  I'll do what is best for my children.  I'll do what is going to work, and make me feel better.  I'll choose that.  I have to.