Drugs

It's that time of the year where I get the courage to go to a new doctor and try something new for the fatigue, muscle weakness, muscle pain, and all-encompassing feeling of blah. The diet has helped a lot and I think that is the reason I'm rarely totally exhausted now, but it's not quite enough. I want to be able to function better and not feel so...blah...all the time.


I've been reading a lot on thyroid hormone prescriptions lately, but I'm definitely not an expert on this information. Here are the basics: There are two categories: natural and synthetic. The natural sources are dessicated thyroid or thyroid extract and the source is from porcine or bovine thyroid. Yep, real thyroid from pigs or cows. The brand names are Armour, Naturethroid, and Westhroid. Because they are from natural sources, they have natural levels of both T3 and T4 and seemed to be well-tolerated by many.


The other category is synthetic or derived from laboratory-produced chemicals. Levothyroxine is the most commonly used and well-tolerated by most. Brand names include Synthroid, Levoxyl, Liothyronine, and Levothroid. These are often just T3 as it is expected the patient will convert the T3 to T4, but based on my recent readings not everyone is capable of this conversion and some are even sensitive to T3 which can cause problems.


In the past I've tried Armour dessicated thyroid and various forms of levothryoxine. I've not tolerated any thyroid replacement hormone well. Armour made me nauseous for six straight weeks, sustained -released levothyroxine kept me away all night and made me nauseous all day long, and non-sustained-released levothyroxine made me so ill and in pain I almost took myself to the hospital. Through all the discomfort I continued hoping it would improve my energy level and fatigue, but nothing did. These prescriptions are very expensive so each failure is incredibly frustrating and financial discouraging.


According to Dr. Datis Kharazzian who saved my life with his dietary protocol and book Why Do I Still Have Thyroid Symptoms When My Lab Tests Are Normal, intolerance is often caused by the fillers used in these pills. I attempted to correct this by using compounded pharmaceuticals so I could control what goes into each pill. Still, adding something like a time-released feature takes an extra chemical and the pills must have some kind of filler. This came as a surprise to me. You can't just put the drug in the capsule without a filler? No. I'm learning.

Unfortunately I wasn't told this until after I received pills filled with Avicel, a filler that made me feel like I was painfully digesting shards of glass. I know it was the filler because I replace the sustained-released pill with this one and I assumed they would have the same ingredients minus the time-releasing chemical. Nope, someone thought they needed to add an unknown filler without consulting me first. When I called the pharmacy and asked why I was so sick, I found out I should have had a choice of fillers. You can't imagine how irritated I was to throw a $100 bottle of pills away. So...what is Avicel? Wood pulp. It sounds fairly harmless. Another pharmacist told me problems with Avicel are rare unless I have an allergy to pine. Well, there you have it. My whole family is allergic to pine so it stands to reason I would be as well. Also, I always hear about how rare side effects are and I can state with absolute certainty if there is a "rare" side effect of any kind, I will have it. I'm just that sensitive.

Recently I read not only should you watch for fillers, but prior to thyroid therapy, one needs to make sure their adrenals are working properly to allow the thyroid medication to be effective. I tried licorice root, but it didn't seem to make a difference. Astragalus, another herb, is also used for this but according to Dr. Kharazzian, if you are TH1 dominant, this will worsen an autoimmune condition. Based on information, I thought I was TH2 dominate which is common with chemically sensitive people. Astragalus made me crash with exhaustion.

DHEA is another method to support adrenal function. You can buy DHEA supplements over the counter, but they are often high dosages and filled with additives and fillers. My new doctor said she avoids prescribing DHEA because it stores to toxic levels very quickly. Dr. Kharazzian suggests sublingual DHEA as it is less likely to store as quickly and is more effective. He suggests not to ever take it for longer than four weeks. It's only to jump-start the adrenals and once you feel a difference, stop taking it or your adrenals will shut down and stop working on their own. I found this to be interesting since so many of my friends take it continuously as an adrenal booster. The sources for DHEA are synthetic (chemical), wild yam or soy. My new pharmacist says the company uses yam. Perfect. I don't want chemicals or soy.

In addition, it is advised to do a liver cleanse before starting these drugs and this will help avoid any side effects and assist in the effectiveness of the drug. There are many herbal remedies that will detox your liver, but I like avoiding drugs when possible especially since I react to so many. Instead I started drinking beet juice and eating beets.

The reluctant patient

My new naturopath doesn't seem to be very knowledgeable and as a friend recently said, that is the concern with naturopaths or any doctor: will they know more about my condition than I already do? Not usually. But I need them to be receptive to my requests and at least respectful to my knowledge. Even this is difficult as most doctors want to be put on a pedestal and worshipped for their expensive advice. They often treat patients as stupid subordinates who are expected to nod politely, not talk too much, and be very compliant. Too much power play which for me ends up to be a waste of money and a personality conflict. This new doctor, however, was receptive. I told her exactly what I wanted, but left it open to her advice. In the end her "plan" for me was to eat vegetables at every meal and at least one fruit a day. Really? Was she not listening to me when I went into great detail about my diet? I pretty much kindly, but assertively bullied her into some prescriptions. She also suggested astragalus tea and I decided to try it since it only cost $1.50, but it didn't go well. I know I don't do well with herbs. I should have known better.

She was hesitant about DHEA, but I think my own concerns about its toxicity and proper usage must have given her some confidence. She agreed to prescribe a very low dosage (1 mg), for a short time (30 days), sublingual form, just to jump-start the adrenals. I interrogated the pharmacist so much that when it came time to make the sublingual tablets she waited to ask me about which kind of filler to use. (THANK YOU!) My choice was gelatin (horse hooves) or ethyl alcohol. I started to laugh when she said ethyl alcohol. Really? After all the questions I asked about chemicals, fillers and toxicity why would anyone think I would choose ethyl alcohol?  I'm so glad she gave me a choice. I'm not excited about gelatin, but it is gluten-free and might even strengthen my fingernails. She also said they add a flavor. Hmmm...nope. I don't want a flavor. She said she didn't know if DHEA would be bitter, but I decided to chance it. The tablets are weird:

Little squares of colorless, wiggly JELLO. Put one under your tongue on an empty stomach and no swallowing until it dissolves. I was surprised they tasted sweet so I wonder if someone added something to it or if the gelatin comes sweetened. This is the issue. They can add anything without your knowledge. I don't even want to think about what is in the over the counter form. Thirty sublingual tablets were $50.

I also received a prescription for dessicated (pig) thyroid (Thyroid USP) which is much like the old Armour Thyroid that was re-formulated a few years back. My previous experience with natural thyroid was the stuff loaded with unknown fillers which may have caused the nausea. I asked about the fillers in advance and they gave me a list of types (this is when I found out about Avicel being pine-based) and then off hand it was mentioned they could use rice flour. Rice flour!? Although the thought of raw flour stuck to my stomach like glue wasn't appealing, I know I can tolerate rice flour. I'd have to buy a bag of rice flour myself and bring it in. I'm not sure why they don't have their own supply. I forgot to ask if I could use coconut flour as rice isn't on my diet, and later I was told it would depend on the texture so I'll try that next.


I think the capsules are gelatin and I wasn't given a choice. This is another question I failed to ask and I've found only with experience does one know WHICH questions to ask. I'm learning. Previous pharmacies have used tiny capsules that are about the third of the size of normal ones, but I received normal size which seems to be an excessive amount of rice flour. There is often a vegetarian or vegetable capsule, but again, I wasn't offered a choice. I requested an extremely low dosage of thyroid (30 mg.) to avoid shocking my system and I'll work up to find a suitable level. The doctor called it into the pharmacy, unfortunately, as I really wanted to double check what they were doing before they did it. I didn't really want to pay for a 90 day supply in case after my normal four days they made me ill, but they were already formulated by the time I went in. Ninety capsules cost $95. OUCH. But this is how the compounding pharmacy works. If I only received, for instance, 14 capsules they would have cost me around $70 due to the effort it takes to create the pills individually by hand.

So...

First step: liver cleanse with beet juice
Second step: jump-start my adrenals with DHEA
Third step: thyroid replacement therapy

I am ready for another pharmaceutical adventure, or, hmmm, experiment. At this point I feel like I've done everything in my power to be successful. Wish me luck!