Sunday, July 25, 2010

Thyroid Update: Post Naturopath

I just got laboratory results back and it's been a busy few months, so I thought it was time for an update on this saga.  The good news, I'm making progress!  Since the last update, I saw a naturopath who looked at me and my labs and concluded: 
- I have refractory celiac disease (significant malabsorption issues that haven't resolved with removal of gluten)
- I should start on the T3 thyroid medicine without further delay.
- I should take Melatonin to help with sleep.
- I should take Betaine HCl with meals to improve absorption and continue with a multivitamin / fish oil/ Iodine (add amino acids).
- I might have B12 deficiency (They gave me a trial injection which had inconclusive results.)

I decided to tackle those recommendations one at a time to see if they made any difference.  It's taken several months to do the trials.

Celiac
There wasn't really a change with the celiac diagnosis and I admit that I'm not 100% convinced he had sufficient data.  However, I have no desire to go through an intestinal biopsy to prove it, I'm content continuing to avoid grains based on other data I've seen.

Melatonin
It's been wonderful!  I can sleep so much more solidly through the night.  Last week, I tried to wean off of it and not only had sleep problems, but also a return of the h/a, nausea, fatigue symptoms in the evening for the first time in two months.  Lesson learned!  I wasn't ready for that and restarting has worked fine.

Betaine HCl
This is basically just extra stomach acid to help with digestion.  I didn't notice any difference in symptoms, but I think it's helped me absorb iron!  I was thrilled to find my Ferritin is now optimal which (usually takes a long time and) should significantly help with thyroid issues.  

T3
I'm afraid this has been inconclusive and it's all the fault of the weather!  Summer came and I have no clue if I'm feeling less cold, lethargic because it's warmer and I've had a glorious vacation.  My free T3 went from 2.1 to 2.5 which means I've made it to low normal, but my doc didn't test reverse T3 as I'd requested.  So... I'm not sure if I should be switching to regular desiccated thyroid.  

Now that I've tried all his recommendations, I'm planning a trip back to the naturopath to discuss next actions.  I still often fatigue early in the evening, need the melatonin to rest, and can have funky temperature differences.  I'd like recommendations on what to do about the thyroid medication and if I should test iodine.  It's been several months now that I've been supplementing and I don't want to get too much.  I'm taking half an Iodoral tablet (6.75 mg) and my serum Iodine  was normal, but I've heard that test is a very poor indicator of Iodine status.  Finally, I want to ask about my lipid profile.  I've got my regular doc worried because my cholesterol has gone up, but the naturopath was worried because my triglycerides were so low.  
January to July
Cholesterol 202 to 254
Triglycerides 30 to 59
HDL 79 to 74
LDL 117 to 168 (This is calculated and I've heard it's inaccurate with triglycerides bellow 100.  The preferred equation yielded a level of 139.)
Hgb A1C 4.9
So, I have my regular doctor talking about medication in 3 months if the labs don't improve and the naturopath who is probably going to tell me it's wonderful that my absorption is so much better.  

Finally, I'm still pleased that the weight gain stopped, but I still have the same 30 pounds to lose that this hormone roller coaster left me with.  Body By Science workouts and paleo eating haven't changed the status.   I love doing our long family hikes and today we canoed 10 miles down green river... excellent for fun, but no scale results.  Recently, I've been trying to eat earlier in the evening (instead of 8:30 or 9p when my husband gets home) as recommended for decreasing cortisol.  It's only been on trial for a week, but it seems to be helping. 

I know that's a rather ambiguous status with so much still up in the air, but I'm thrilled to not be getting ill several times each week and I am making progress in understanding what helps.  

1 comment:

  1. My answer with further information from the PaleoThyroid list:
    I think you can get Betaine HCl at most health food stores. My
    naturopath has a dispensary in the office. Amazon has it too and this
    is the one I use:
    http://www.amazon.com/High-Potency-HCl-Pepsin-Capsule/dp/B00020I13Q/r...
    There's a protocol starting with one at each meal and working up to
    three with the largest meal / two with smaller meals. It's important
    to take it after your first bite of food and not at the end of the
    meal. You don't want any burning / gastric upset (I didn't have any
    issues).
    My ferritin was 36.2 in January and is now 98.2. I only ate paleo and
    took one 325mg tablet of iron (Slow Fe) each day.
    http://www.amazon.com/Slow-Fe-Release-Tablets-90-Count/dp/B000052YTI/...
    I expected it too take much longer, but I think that extra acid just
    really helps. I remember learning in nursing school that it was best
    to take iron with something acidic like orange juice. I guess a bit
    of extra stomach acid breaks it right up for absorption :)
    Hope that helps,
    Rachel

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