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Dosing difficulties based on labs/symptoms. Heart Palpitations!
Last Post 02 Jul 2019 05:10 PM by Elaine Moore. 1 Replies.
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PaddingtonBearUser is Offline New Member New Member Posts:
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28 Jun 2019 07:06 AM
    30 year old Female. Also taking: ALCAR, CO Q 10, Selenium, LDN, vitamin D, E, CBD oil. LDN, just started Tocilizumab Biologic for TED. No gluten/soy/beans + legumes/minimal red meat and diary/ Diagnosed Sept 2018

    I would sincerely appreciate any and all advice, Elaine, for my dosing rec's. Whether 5 mg or 7.5 mg MMI, different set of symptoms. Dont know what to do! I have learned so much from your books, and website already. Have recommended your books to women with graves in my church, the ones with gumption have really appreciated them! I have a science background, so your detailed advice is understood and very welcomed.

    Non-Recent history (if needed at a glance).

    TED STARTS AND WORSENS
    10/30/18: 20 mg MMI
    Anti TG ( thyroglubulin autoantibodies 2526 H range: <115 IU/mL
    Thyroid stimulating IMM 25.10 H range: <0.55 IU/L
    Anti TPO AB >1300 H normal: <60 IU/ML

    12/4/18 10mg MMI
    TED GETS BETTER

    Anti TG ( thyroglubulin autoantibodies 2230 H range: <115 IU/mL
    Thyroid stimulating IMM 27.140 H range: <0.55 IU/L
    Anti TPO AB >1300 H normal: <60 IU/ML

    Recent History

    Hair starts shedding massively, start Vitamin E and Biotin per your Recs.

    3/9-4/17 7.5 mg MMI mostly, a burst of 10 mg MMI (avg 8.25 mg)

    4/17 lab:
    TSH 0.9L normal range: 0.4-4.5
    T4 Free 1.0 normal range: 0.8-1.8ng/dL
    T3Total 95 normal range: 76-181 ng/dL

    4/17 onward: STAY ON MMI 7.5 mg for SIX WEEKS w/ no change in dose and retest.
    Heart palpitations/bounding pulse at rest , sleep issues, pulse wont reduce w excersize for 2 days. Metoprolol 25 mg bid mildly helps with this. Always Cold! TED WORSENS!

    5/31 lab after MMI 7.5 6 weeks:
    TSH 0.76 L normal range: 0.4-4.5  May be incorrect, as forgot to stop Biotin.
    T4 Free 1.0 normal range: 0.8-1.8ng/dL  NO CHANGE
    T3Total 101 normal range: 76-181 ng/dL  SLIGHTLY UPWARD

    6/1: Change to MMI 5 mg/day

    6/21 Labs: (shortness of breath starts! Stop hair shedding and cold body, TED DOESN’T Worsen and doesn’t get better)

    TSH 0.31 L normal range: 0.4-4.0  slight downward.
    T4 total 7.6 ug/ dl normal range: 4.9-11.7ng/dL upward movement
    T-uptake: 1.02 TBI range: 0.69-1.41 TBIFree Thyroxine 7.5 ug/dL Range: 5.06-9.42 ug/dL
    T3 Total 113 normal range: 76-181 ng/dL  upward movement
    Thyroglobulin Antibody 120 WHO units Range: <138 WHO units
    Thyroid Peroxidase AB 958 WHO units range: 0-100 WHO units

    6/24: Start Tocilizumab for eyes (cross border) at 8 mg/kg IV.

    Summary

    --On 7.5 MMI for 6 weeks, my TSH lowered slightly, T4 stayed 100% same at lower end of spectrum, T3 goes slightly upward from lower end of spectrum.
    During that time: Hair shedding massively, massive palpitations (heart rate 70 constantly+ bounding pulse even at rest, unless exercise mildy, then it wont go down for 2 days!), sleep disturbances

    --On 5 mg MMI for 3 weeks, TSH lowered mildly, T4 upward end of spectrum from lower end before, T3 upward movement slightly from previous lower end. hair stopped shedding, palpitations decreased a bit, slightly less sleep disturbances, less cold, shortness of breath onset~!

    questions:
    M-y Main concern is my constant palpitations on 7.5 mg MMI. They felt like I was 25% close to getting a heart attack. Very slightly less on 5mg MMI, BUT shortness of breath started. Should I just be on 5 mg mmi with a beta blocker? What do you recommend my dose to be at this point? Doc wants 7,5 but different set of issues at each dose level!

    It seems I just cant get it right and it is really impacting my life, my ability to want to do anything for my future (not as much hope….) Want a plan of action ! :D
    Looking at labs, antibodies have fallen a lot?
    During this time, also on allergy shots.
    Elaine MooreUser is Offline Veteran Member Veteran Member Posts:3039
    --
    02 Jul 2019 05:10 PM
    Hi,
    Palpitations are generally considered benign. They can occur in hypothyroidism as well as hyperthyroidism. I get them from histamine when I use mega strain probiotics and some people get them from garlic.
    You want to be on the lowest dose needed to keep FT4 near the high end of the reference range even if . so an FT4 of around 1.7 or 1.8. If your results are within range, but are too low for your body's need you can have symptoms of hypothyroidism including palpitations. best, elaine
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