The Paleo Doc – Appointment Two

I had my second appointment with the Paleo doc (technically a physician’s assistant).  She went over my adrenal test results.  I’m in Stage 1 Adrenal Fatigue, which turns out to not be fatigue at all.  In the early stages, your adrenals are cranking out stuff big time.  At 2 of my 4 measurements, I was very high, at one I was moderately high, and 1 I was normal.  Interestingly, the time of day I tend to be most tuckered out (3:00 – 5:00 PM) I have NORMAL cortisol levels.  That can’t be good, but it also probably explains why I’m not sleeping well.

The Plan:

  • Supplements (magnesium, vitamin d, vitamin b complex, vitamin c)
  • Gaia herbs
  • Phosphatidylserine
  • Go back to AIP Paleo, but make sure I’m getting plenty of carbs
  • Mild/moderate exercise
  • Meditate at least 10 minutes per day

She wants me to add these things in one at a time with the Gaia herbs last as they are most likely to cause trouble with autoimmune conditions.  She wants to see me again in 2 months to see how I’m doing.  I’m going on vacation tomorrow, so AIP will have to wait until I get back.  I think I will try to implement magnesium, vitamin d (both of which I’ve used off an on before) and the b complex while on vacation, then get the others when I get home.

Hope everybody is having a stellar summer.  Oh hey, did I mention I got a message from Everyday Health and they want to do a story on Paleo?  Ha!  We’ll see if it happens.  Very exciting!  Take care!

 

RA – Thyroid Update

Ok, for those of you following my craziness, this may be repetitive.  For those who lurk once in a while, here’s the scoop. For 3 years, I had my RA in remission with use of exercise, Paleo, and decreasing medications (down to only 1/2 dose Enbrel).  For the last 18 months or so, however, I’ve been having thyroid issues.  I have Grave’s Disease (hyperthyroid), and my thyroid was radiated and killed off in 2007.  I will have to take supplements for the rest of my life because of this.  Up until April, I was taking levothyroxine or Synthroid (brand name) only for this.

Despite my thyroid issues, I was having the best inflammation markers ever (on 2/20/14: 0.7 CRP with 0 – 1.0 normal and 17 SED with 0 – 20 normal).  Still, I felt like my RA wasn’t as happy.  After 12 months of thyroid issues, my thyroid got really unhappy, and my T3 dropped significantly.  Now, if I understand this correctly, my levothyroxine/Synthroid is predominantly a T4 medication.  My body’s tissues will convert T4 to T3, which is the more active form that makes me feel normal.  For whatever reason, my body was not converting T4 to T3.  My symptoms?  Heavy long periods, insomnia, dry skin, weight gain, fatigue, feeling really cold all the time, my RA got more active (no longer in remission and sometimes inflammation markers elevated), etc…  I went back to the endocrinologist, who I hadn’t seen in several years.  Here’s the story with the numbers.

From the rheumatologist on 12/30/14:

  • TSH 0.81 (0.34 – 5.60)
  • TOTAL T3 32 (60 – 181)
  • FREE T4 1.73 (0.89 – 1.76)
  • CRP 17.3 (0 – 10) inflammation marker
  • SED 31 (0 – 20) inflammation marker

I hadn’t seen all of these results, but was told them over the phone.  I thought I only had 1 elevated inflammation marker, but they both were elevated.  I decided I needed to go back to the endocrinologist.  The endo started me on a T3 supplement.

From the rheumatologist and endocrinologist on 3/26/15:

  • TSH 0.22 (0.34 – 5.60)
  • TOTAL T3 54 (60 – 181)
  • FREE T4 1.66 (0.89 – 1.76)
  • CRP 9.8 (0 – 10) inflammation marker
  • SED 27 (0 – 20) inflammation marker

As a result, we decreased my T4 (levothyroxine/Synthroid) medication, as my TSH got too low.  TSH gets lower when your body thinks it has too much thyroid hormone, yet that’s not what the tests show.  Go figure.

Part of the test results from the paleo doc on 5/21/2015.  Please note test variations in what is normal:

  • T3 Uptake 41 (30 – 39)
  • Thyroid Oeroxidase Autoab 2.2 (0.0 – 9.0)
  • Reverse T3 22.4 (9.0 – 27.0)
  • CRP 13.1 (< 3.01) inflammation marker
  • SED 19 (1 – 20) inflammation marker

Results from 6/15/15 from the endocrinologist:

  • TSH 0.41 (0.34 – 5.60)
  • TOTAL T3 62 (60 – 181)
  • FREE T4 1.49 (0.89 – 1.76)

Changes from today are to lower T4 (levothyroxine/Synthroid) another level and increase T3. I am still very symptomatic of low T3, but interestingly having a couple of high thyroid symptoms too.  I’m hoping to get my T3 a little more solidly in the normal range to see if I feel better.  My T4 has room to come down still, and my T3 room to go up.  I am also having an ultrasound done of my thyroid as I have a small lump in my neck.  I’m hoping it’s nothing, but it’s been going on for about 3 months, so it’ll be good to have it checked out.  After feeling my neck, the doc said he didn’t feel like I had any thyroid tissue left, but he couldn’t account for this lump, and he didn’t feel a lymph node there, despite thinking that’s probable.

I just got access to most (maybe all) of my records from my rheumy and endo back to 2011.  It’s interesting to see the results on paper, as typically I get a phone report.  I’m realizing that the numbers are not always accurately dictated over the phone, and some numbers were not what I thought I was told (unclear if it was not given to me correctly or if I wrote them down incorrectly).  It appears that the SED rate is the same test between both the hospital (rheumy and endo are in the same hospital) and paleo doc (different facility).  I am encouraged that the SED rate seems to be coming down as my T3 goes back up.  With the CRP, it’s hard to tell.  It seems all over the place, but part of that seems to be that it’s a different test.

I’m doing my adrenal function test today.  I will FedEx it tomorrow and should have results in a couple of weeks.  Maybe that will tell me something.  The endo did mention that it’s possible that I have developed Hashimoto’s Thyroid Disease in addition to Grave’s, making me both hyper and hypo despite not having a thyroid anymore.  My dad, brother, uncle, and grandmother all have Hashimoto’s, so this would make sense, although part of me likes to think I’d be invincible to such things due to following Paleo.  It’s possible it’s been there a long time, as my thyroid numbers have historically been really hard to control. I’m thinking that might be what the paleo doc is looking into also. I’m feeling a lot more hopeful and like another remission could be just a few months away.

Paleo – Blood Test Results from the Paleo Doc

I got the results of my blood work, but not of my adrenal test, as I’ve had a mild cold and was told to do the test on an average day, not a day when real lazy or real stressed.  I would think having a cold would be a stress on my body, so I’m waiting to get the most accurate results.

Because it would take forever to type in all of these results, I am going to summarize on some.  My comprehensive Metabolic Panel was all normal minus some slightly high protein/globulin. So, calcium, glucose, bilirubin, etc…all within range.

I had an estimated GFR (not sure I ever had that before). It appears to be a measure of kidney failure.  My level was 107.  It says <60 for 3 months is chronic kidney disease and <15 is kidney failure, so I guess that looks good.

Cholesterol profile.  See this post for previous cholesterol comparisons.

  • Total 157 (<200 is good)
  • Triglycerides 57 (under 150 is good according to the print out, but there’s debate that 150 is way too high)
  • HDL 68 (40-59 is normal.  HDL is the “good cholesterol” so I am not concerned at this high number right now).
  • LDL 78 (<100 is normal)
  • VLDL 11 (no range given, but last test said 7-32 was normal, but not sure if units are the same.  New test does not give unit of measurement.)

Vitamin D, 25 hydroxy 19 (30-150 is normal. This has been an ongoing problem for me.  The best I’ve ever had, even with supplementation is 26).

Inflammation (previous comparisons here):

Sedimentation rate 19 (1-20 is normal.  This is an inflammation marker and has been at the high end of normal the last 3 times it’s been tested).

CRP 13.1 (<3.01 is normal.  This is another inflammation marker, and it has been high, although not this high, since December.  This is concerning, and I think it has to do with my thyroid being off.  When this number is above 3.00, it puts you at greater cardiac risk.  CRP is not just a measure of RA inflammation, but a level of body inflammation.  I knew it would be high, but it had been normal for 3 years on Paleo.  I REALLY want to get this down.)

Sugar:

HgB A1c 5.0 (normal is 4.0 – 5.6. My understanding is that this is a diabetes risk factor.  It measures the amount of sugar that has been stuck to your red blood cells over their lifetime. My understanding is that this number can be inflated in Paleo folks, as their blood cells typically live much longer than people following the standard American diet. I was happy to see it in the range. Chris Kresser has a good post about it here.  

My estimated average blood glucose was 97.

My fasting blood glucose was 80 (70-99 is normal).

Insulin 4 (2-27 is normal.  I’m not sure if I ever had this done before, but from everything I read, it seems like 4 is awesome.)

All of my white blood cells, red blood cells, hemoglobin, platelets and stuff (including everything that ended in “phils” or “cytes” were all within normal ranges.

Thyroid:

Ok, now here’s where things get interesting.  She didn’t do a T3, T4, or TSH since the endocrinologist is doing those next week.  She did order some additional tests that I don’t think the endocrinologist ever ran before.  I’ve been trying to read up on the meaning, as I don’t go back to the Paleo doc until after I’ve got adrenal results and after I see the endocrinologist.

Reverse T3 22.4 (9.0 – 27.0 is the normal range.  From what I’ve been reading online, having a T3 at the high end of normal can be indicative of some issues, possibly related to adrenal function).

Thyroid Peroxidase Autoab 2.2 (0.0 – 9.0 is normal.  I have big questions on this, and I can’t seem to dig up any answers.  I think this is a measure of the antibodies to my thyroid.  Here’s the kicker.  My thyroid was radiated and killed off.  Is this test still valid? I am having some mild swelling in my neck, which I am concerned is a goiter forming, and I have a lot of inflammation around my eyes, which is supposedly from thyroid antibodies.  Is 2.2 really high for a dead thyroid?  If it could still be the same, this seems really low for the symptoms I’m having.)

T3 Uptake 41.0 (30-39 is normal.  So, this is high, yet my T3 is really low.  What does that mean?  Could it mean my adrenals are toast?)

Urine:

My urine looked pretty good.  Glucose, blood, nitrite, and all that good stuff was negative.  I did have ketones in my urine, but I’m not surprised by that.  I need to learn more about it, but I think that’s normal if you’re not eating tons of carbs and staying somewhat ketogenic.  I’ve never measured for ketosis, but lots of Paleo folks do.  My limited understanding is that you’re fat burning and not sugar burning, and most of your body preferentially burns fat. Dr. Terry Wahls talks about it here.  I will ask further details about it at my next appointment.  My urine pH was 7.0 (5.0 to 8.0 is normal).

Ok that’s about it!  Hope it helps somebody.  I really want to fix this inflammation thing, which I really think is being caused by my thyroid problem, but the thyroid problem might be caused by an adrenal problem…. something I don’t think my endocrinologist will tackle.  More to come when I know it!

 

 

 

Paleo – The Doc Who Speaks Paleoenglish

Well, I finally did it!  I went to a Paleo doctor. Well, in this case, she was a physician’s assistant.  It doesn’t matter to me.  I think this has potential to be life changing good.  The coolest thing ever was just speaking to a member of the medical establishment who spoke Paleoenglish.  I could understand her.  She could understand me.  I didn’t have to explain my diet to her (although I did take a list of foods I eat and avoid).  It was just cool.

Here’s the bummer part.  I had to go in a fasted state, which also meant no morning medications.  I’ve been taking a medication for low T3 (for some reason my body is not converting T4 to T3, and this has caused some major symptoms like long heavy periods, severe word retrieval problems, weight gain, poor sleep, fatigue, etc…)  Low T3 was the main reason for my visit.  Anyway, the T3 med is apparently the only way I function in the morning now.  I didn’t take it until after the appointment and EEEKS!  By the time I got to the doc’s office (90 minutes away for a 9:30 appointment), I was almost crying (for reasons I don’t know).  My brain was going 100 MPH, but I couldn’t pull up the words I wanted, so I was talking in circles a lot.  I’m sure I came across as a bit nutty. That’s ok.

Lots of tests… some new thyroid ones that I don’t think were done before (reverse T3, thyroid antibodies, A1C, insulin) and some old ones for inflammation and such.  I also have some scheduled by the endocrinologist in 2 weeks, so there will be other test results coming in too.

She recommended a thyroid scan.  If the endo doesn’t order one on the next visit, then she will.

She asked me if I had ever heard of or tried low dose Naltrexone (I heard of it, haven’t tried it).  She asked if I ever had a stool culture done (nope, despite having some extreme bowel issues about 5 years ago).  She asked me if I ever had my adrenal function tested (I hadn’t, and I brought home a kit to do so).

So, we’re starting with some blood work, a urine sample, and adrenal function.  No changes to what I’m doing yet.  She did mention trying AIP again, but when I mentioned that that was the first thing I tried when I started not feeling well, and it made me worse, we cancelled that plan for now.

I hope this post make sense.  The lack of T3 is still messing with my brain a bit, and I’m finding it hard to think and type.  More to come, I’m sure!

RA – Paleo Doctor?

So, for well over a year I’ve been thinking about seeing a functional medicine practitioner.  The one I found last fall looked great and was all about Paleo, but then she raised her rates to over $800 just for the first visit (no testing, as I’m sure would come up, was included in that price).  I put the whole thing on hold for a while.

In the meantime, my thyroid (specifically T3) has gone all crazy, which seems to have made my RA more active, and one of my two inflammation markers has been slightly elevated for the first time since going Paleo 3 years ago.  Or is it that my inflammation has gone crazy and made my T3 nutso? The endocrinologist thinks it’s the latter, but then she also said she has no idea why this is happening or how to fix it other than to add a T3 medication.  Ugh.  I’ve been feeling like my thyroid was off for well over a year, but the inflammation marker only went up 4 months ago.  I don’t know.  Maybe it doesn’t matter.

Did I ever mention that my husband has a biology degree from Johns Hopkins?  Although he decided to not go into medicine, he’s retained all that knowledge well, and is probably the most intelligent well-educated person I know, brilliant, in fact.  And he’s not a fan of alternative medicine.  Double that when insurance won’t cover it.  Still, I highly value his opinion, and he has seen what Paleo has done for me (and him), and he can’t argue that (and doesn’t).  When I bring these alternative things up, he’s much more supportive of them than before we went Paleo.  He’s still not totally on board though.

So I’ve decided that I really want to pursue the functional medicine piece.  My understanding is that they look at you much more as a total, not as a list of diseases.  Let’s face it.  Modern medicine sees me as a list of diseases, and it’s easily understood when I say that I have or have had a primary care doctor, an optometrist, opthamologist, dentist, oral surgeon, allergist, occupational therapist, certified hand therapist (yeah, they’re different than an OT), physical therapist, hand surgeon (he probably had a more sophisticated name than that, but I’ve forgotten), orthopedist (different than the hand surgeon, but same clinic), dermatologist, gastroenterologist, podiatrist, endocrinologist, and oh yeah, rheumatologist. Wow.  That’s 16. That’s embarrassing.  I didn’t even include things like pediatrician, cancer specialist (wow, that was an overblown drama as a kid…. no I didn’t have it <phew>), ER docs (3 of those I think… anaphylactic shock, miscarriage, and liver failure), boob squish technicians,  Xray technicians, radiologists, MRI technicians, CT technician, ultrasound technicians, OB-GYN etc…  OMG, this is mortifying when I list it all out.  This is seriously upsetting me! 

Ok, going back to my first list of 16, the ONLY ones that don’t necessarily relate to inflammation (for me) are my primary care physician and optometrist.  I NEED AN INFLAMMATION DOCTOR.  You can’t tell me that my gum inflammation isn’t related to my RA and Grave’s Disease and Thyroid Eye Disease and Asthma and Allergies, and weird freaky rashes, and (twice) a complete inability to poop for more than 30 days!  Why can’t all of these doctors get together and help me decrease my inflammation?  I strongly believe (and there’s certainly lots of scientific data to support) that all of this inflammation is related.  Why don’t all of these doctors of inflammation get together and have a little chat?  Because they don’t, and to think otherwise is insanity.  Really, there’s no good reason.

Last week, I called and had a free 15 minute phone consult with a registered dietician/functional medicine practitioner/Chinese medicine expert. Although she said a lot of good things (she’s heavy into food sensitivity testing), I decided to sit on the decision for a week, as I just wasn’t quite sure she was the one worthy of all of my out-of-pocket expenses.  By this week, I was less excited, as I want somebody more into Paleo expertise (she was neutral about it), into more than just food sensitivity (although I do think this could be a help, it’s not a primary focus for me), more into neurotransmitter status, and more knowledgeable about nutritional deficiencies. 

So, I went back to Google and started looking again.  I hadn’t looked at the Paleo Physicians Network recently (yeah, isn’t that cool?)  Lo and behold, there was a medical doctor with Paleo expertise (he was into Paleo before it was called Paleo). He also does functional medicine.  He had an online video talking about several things I want to learn more about.  He’s hired a Paleo Nutritionist to work in his clinic.  I made an appointment and go in 2 weeks.  And my health insurance just might cover it. I hope.  We’ll see.  Think happy thoughts, as I need to start getting on track again.  Despite modern medicine’s best efforts, I’m not getting there.  I still think Paleo is the right path, but I need some tweaks.

Going Solar

Ok, yeah, this is supposed to be a blog about rheumatoid arthritis and Paleo. Since I’ve gone Paleo though, I’ve realized how challenging it is to get good healthy food and how our planet is in such a polluted state.  Our house is in a town that is surrounded by north-south running railroad tracks. There is one set of tracks 2 miles east of us, and another set 2 miles west of us.  On the east set of tracks, there are mile+ long trains filled with coal that run south to the coal burning power plant ALL THE TIME.  I see them almost every time I am on that side of town.  It’s depressing to think about all of that air pollution.  Quite honestly, all of the pollution weights heaving on my mind (driving my car, heating my house, buying a new appliance).  There’s only so much I can control though, so I can only bite off so many things at a time.  Here is my latest chomp.

We went solar.  It’s something I’ve been wanting to do for years, but it’s been unaffordable until now.  My local co-op power company does not allow a program for leasing solar panels.  To hook them up to the grid, you have to be the owner of the panels.  Thankfully, after many years, a solar company came up with a plan.  It’s still expensive in a way, but in the long run I think we’ll break even or come out slightly ahead.

6 panels on the front of the house, facing east.

6 panels on the front of the house, facing east.

 

24 panels on the back of the house, facing west.

This is 24 panels on the back of the house, facing west (from our neighbor’s porch).

We bought a 7.65 kWh system. It was very expensive (think about the price of a car).  The solar company financed us by giving us a 30 year loan, similar to a mortgage.  We pay our monthly electric bill (starting at the same rate we normally pay to the electric company) to the solar company, and they use that money to pay off our solar loan.  They increase the electricity rates slightly over time (just like the electric company does) to make sure the loan gets paid off within 30 years.  Now, the federal government is offering tax rebates until the end of 2016, and we hope to get almost 1/3rd of the cost of our panels back in our 2015 taxes (this is dependent on how much tax you pay the feds.  You can’t get back more than you pay into federal taxes).  We will sign that money over to the solar company, and that will drastically drop the amount of our loan.  We hope to be able to stay ahead of the loan and perhaps get it paid off in about 5-6 years.  If we can’t, we’ll stick with the 30 year plan, and pay it just like our normal electric bill.

We are NOT off-grid.  We do not have batteries.  We are staying grid-tied.  We still must pay a monthly fee, a fee we’ve always had to pay of $13, to stay connected to the grid.  We feed into the grid, and the electric company has to pay us for any excess we produce that we don’t use.  They pay us at wholesale electric rate (I think 4.9 cents per kWh), not at the price we pay for electricity (10.9 cents per kWh).  The solar company guarantees a certain solar output each year for 30 years.  If we fall below, they pay us the difference at the 10.9 cents/kWh rate.  They also insure the panels against damage for 30 years. Not a bad deal.

Where we live is one of the sunniest places in the country.  Well, it was until we got our panels hooked up.  We haven’t had a full-sun day in over a week since.  I won’t complain though, as April is too early to have wildfires, and we’ve already had several.

So, keeping in mind that it’s been pretty cloudy and rainy since we got this up and going, you can check out our solar production online, if you’d like.  We’re getting rather addicted to watching how much energy we’re producing.  Has anybody else taken the solar plunge?

Rheumatoid Arthritis – An Experiment in Fasting

So, I had a weird thing happen yesterday.  I had the most exhausting day at work, came home, took off my shoes, and felt like I had a splinter on the bottom of my right big toe.  I couldn’t find anything though, so I just went on with my evening.  A few hours later, my whole right leg (foot, angle, knee) was in extreme pain, and my foot was very very swollen.  I could barely put any weight on it, so sat on the couch, keeping it elevated.  I suspected that I had been walking funny since my toe hurt.  I don’t know about you all, but I can adapt to pains like that without even thinking about it.  Even changing shoes can cause a flare up my leg by slightly changing the way I walk.  See this post.

I went to bed fearing I would wake up a mess and have to miss work.  I guess in a way, I was hoping for that to happen, as Monday and Tuesday were REALLY exhausting days at work. Sometimes you just need a break.  Anyway, I woke up and my leg was normal, but the bottom of my big toe hurt pretty bad.  The skin hurt, not the joint. It isn’t warm.  It doesn’t look injured.  It’s just really really swollen and sore on the bottom.  It’s so swollen that it’s changing how I walk.  I took a shower, woke my husband, and asked him to look at it.  I was debating staying home, knowing that my whole leg would swell if I was walking weird on it all day.

In the end, I decided to make it to work.  I only work 4 hours on Wednesdays, and I know my coworkers would really need me if Wednesday was anything like Monday or Tuesday (thankfully, it was a much better day).  To get through the day, I decided to try something I used to do quite frequently, but not much at all in the last 10 years.  I decided to fast.  Sometimes when my body hurt and nothing else worked, fasting helped.  Today, I did it more as a test.  I didn’t take any pain medication (no ibuprofen, etc…)  I did drink water, and I did take my thyroid medication. Other than that, I didn’t eat anything from about 6:00 Tuesday night until 4:30 Wednesday afternoon, almost, but not quite 24 hours. 

So, what happened?  Well, I made it through the work day.  My right ankle swelled and hurt a little, but not nearly as bad as Tuesday night.  I even made it to the grocery store after work, something my husband insisted I not do after seeing my foot Tuesday night.  I was very tired, although I’m not sure that was related to the fast.  It was the sleepy kind of tried, not the lack of energy kind of tired.  I took a nap for a little over an hour when I got home.  Amazingly, I wasn’t hungry, and I didn’t get the shakes until about 4:00 PM.  Then I was absolutely starving.  I think I have Paleo to thank for the not being starving all day long.  I’m no longer the sugar addict I used to be.  This was reassurance that my hunger cycles are very different now than they used to be.  I suspect I could have gone longer had the afternoon not been crazy.  My son has a huge project on Abraham Lincoln due on Friday, and it has to get done by tonight, as he has a baseball game tomorrow.  Sometimes, it’s like pulling teeth to get a 9 year old to get his butt moving on such a big project.  He was needing constant supervision and encouragement to keep going on the project.  I soon realized how irritated I was getting with him and how hungry I was becoming.  I wonder if I would have done better if our evening had been more relaxed.  This was not the case though, and I suddenly went from feeling fine to feeling very stressed.

So, how did I break my fast?  I made myself a shake minus the greens.  Probably not my best choice.  I was already hungry and cranky.  After the shake, I was still hungry, cranky, and cold!  2 hours later, I’m sitting here eating some plain turkey we made in the crockpot Sunday night.  I’m feeling pretty normal.  My foot is not bugging me much, but the skin on the bottom of my big toe is still very sore.  I may need to see the doctor about it, as it seems very unusual, and I have no idea what’s wrong with it.

Next time, if I can get some less-stressful days, I may try for a 2 day fast.  Supposedly fasting helps reset your immune system, and I heard something recently that a 2-4 days fast can do really good things.  http://www.eurekalert.org/pub_releases/2014-06/uosc-fts060214.php

Rheumatoid Disease – An Update

I haven’t made an update in a while, and that’s sort of purposeful. When I encounter challenges, I like to know the solution before I talk about it.  Unfortunately, I’ve been having a battle for a while now, and the solution is evading me.  Hang on!  This might be a long post!

A little over a year ago, I was 133 pounds and feeling really well.  Then, things started to change.  My RA was a smidge more active.  I was feeling tired and having symptoms like my thyroid (which was radiated and killed off in 2007, so I take supplements) was too low.  At a rheumatology appointment, it was tested, and it was low.  I called the results into my primary care doc, and she increased my thyroid medication.  This seemed weird to me though, as this is the highest dose I’ve ever been on (even having lost all of this weight).  The increased dose helped for a a few months, and then I started showing signs of being too low again… weight gain (up to 149 without changing my diet), my periods were coming about every 24 days (normal for me is 30) and lasting 7-9 days (normal for me is 3-5), my RA was more active, and my thyroid eye disease was too.  My sleep had become really poor too.  My sleep was becoming so poor that on mornings I worked, I was needing caffeinated tea to get out the door.

In December, I had my thyroid tested again as well as my inflammation markers.  One inflammation marker was normal and one was slightly elevated.  This was a huge disappointment, as that hadn’t happened since they normalized 3 months into Paleo.  My thyroid tests showed a normal (at the low end) TSH, meaning my body thinks it’s making plenty of thyroid hormone.  My T4 was at the high end of normal, meaning my medication level was almost too high.  My T3 however, was very very very low. Because of the elevated inflammation marker, we increased my Enbrel back to full dose.

I made an appointment at the endocrinologist’s (who I hadn’t seen since 2008).  My rudimentary understanding of this is that the medication I take (Synthroid) is mostly (maybe all?) T4 and that there are different tissues in my body that convert T4 to T3.  For whatever reason, my body is not doing that.  Why?  The doctor had no answer and said this is very rare.  The answer was to start me on a T3 supplement in addition to my Synthroid.  While Synthroid takes weeks to build up in your system, this T3 med is immediate, but doesn’t last long.  I was supposed to take one in the AM and one in the afternoon.  The morning one was great, but the afternoon one kept me awake all night long, so I wound up only taking the AM dose.

This new T3 med seemed to help for a while, then it almost seemed like it was too much.  I had 2 weeks where my RA was more active than it has been in 3 years.  I was waking at night from pain, although still functional during the day.  I began taking ibuprofen at bedtime, and that helped a lot (although is completely contrary to what I should be doing, as I know ibuprofen sets off my RA.  At some point I’ll have to deal with the ramifications of that).  Two and a half weeks before a new rheumatologist appointment (appt was in late March), I was still feeling poorly, and I was needing to fly to Pennsylvania for a funeral.  Worrying about my inflammation markers and my ability to hold up on this trip, I cut out ALL sweeteners.  I don’t eat tons of sugar, but I do have some non-dairy chocolate, honey mustard chicken, Paleo pancakes with maple syrup, and tea with honey sometimes.  I went cold turkey on them all, and walked into the rheumy’s having had no sweets for 2.5 weeks. 

My inflammation markers showed one normal, and one a smidge high (sorry, I don’t have the numbers…. the test they used changed anyway, and doesn’t run on the same scale as previous tests I had done).  The smidge high one was less high than previously, so I guess that’s good.  Why?  I don’t know… more Enbrel, no sugar?

The next week, I had a follow-up with the endocrinologist.  My T4 was still at the high end of normal.  My T3 hadn’t really moved from being really low (although I was told that it drops out of your system so fast that the time of day has a lot to do with it).  My TSH was low now (0.22) meaning that my body now thinks that I have too much thyroid hormone.  This doesn’t make sense to me as my T4 is in the normal range, and my T3 is still very low.  Course of action is to stay on the T3 and decrease my Synthroid.  I’ve been doing that for almost a week now.

The good news in that my weight is down to 139, but I fear that may be because I have too much thyroid hormone.  I am starving (also a sign of being too high) and am eating a little more than I usually do.  Over Easter weekend, I blew it on the no sugar and had a piece of Paleo applesauce cake 3 days in a row.  That actually seemed like it had an immediate poor effect, so I might be onto something with the sweets.  I am now on day 3 with no sweeteners again.

So, my RA, my thyroid eye disease, and my general feeling of well-being is not the greatest as of late.  I have some plans to address it further once summer comes (I don’t work in the summer).  I am thinking this is diet and/or stress related.  I am also wondering if this means that I am eating something that I shouldn’t be or I need to be eating something that I’m not.  I stopped taking supplements almost a year ago (except occasional magnesium).  I have now started them up again (vitamin D, fish oil, and turmeric).  When summer comes, I am going to try to do Terry Wahl’s version of Paleo (which includes 9 cups of veggies from 3 categories daily).  In the meantime, I’m going to plug through the rest of this school year and keep my fingers crossed. 

To end on a positive note, one exciting thing in our lives that I hope to post about soon…. we got solar panels last week.  They’re on our roof, but are not yet attached to the grid, so we’re not generating power yet.  I’m sure I’ll have some interesting things to say when that happens.

Love to you all!

Paleo – What I Wish I Knew When I Started

I sometimes get asked questions both online and in person about starting Paleo.  It’s a big step to totally change your diet.  I thought this might be an interesting post for some.

What I Wish I Knew When I Started:

  • You’re going to be hungry the first several days.  Have Paleo more snacks available.
  • Ibuprofen causes intestinal permeability and is comparable to eating white potatoes.
  • Don’t eat white potatoes.  They’re going to cause extreme RA pain ridiculously fast.
  • You really do like the Paleo food you eat now, and you don’t crave junk food very often.
  • You don’t have to count calories, and you’re gonna lose some serious weight.
  • Milk products clearly cause you acne.
  • Your blood work is going to look so much better!
  • Your doctors are going to be happy and encouraging.
  • Your triglycerides are going to drop 100+ points.
  • You’re going to need some physical therapy because your inflammation goes down so much you have loose joints.
  • Too much high histamine food is going to cause you to itch, especially balsamic vinegar, green tea, and chocolate.  Dammit!
  • Starting with AIP was a really good choice.
  • Trying new foods you never liked before almost always ended well, including mushrooms, pecans, pork, brussels sprouts, coconut products, and sausage.
  • Just lose tomatoes.  The hives aren’t worth it.
  • Cooking is a lot of work.  Make big meals with lots of leftovers.
  • Buy nuts in sealed containers (you’ll bring home a ton of moths when you scoop your own from the bulk section).
  • You’re going to be bored with drink options.  Screw the green tea.
  • One little cheat won’t hurt you for long, but two will!
  • Bacon is awesome.
  • You will meet wonderful farmers.
  • Chocolate will make you itch, but it’s still kinda worth it!
  • Nondairy Chocolove chocolate rocks!
  • Most dark chocolate still contains dairy.  Beware!
  • You will eat a lot of bacon, and your cholesterol will go down!
  • You’re going to feel so much better, but there will still be things you need to figure out.
  • You don’t know you’re addicted to bad food, but you won’t be after a couple of months.  Your cravings will change to good stuff.

 

You should not expect the same results.  Each person is different and has different reactions to food.  Consult your doctor as appropriate before making changes to your diet.

Christmas in Germ City

This Christmas has been crazy.  Maybe they all are, I don’t know.  To explain our Christmas, I have to jump back to Halloween.  Yeah, sit back, this might be a long (but entertaining) story.

My son has been 80+% Paleo since the start of the school year.  He caught a bad cold early on in the school year, and I made him 100% Paleo for a while.  He got over his cold quickly with little other intervention, so we’ve been trying to keep it up.  Then Halloween came, and not wanting to be the Paleo Monster, I let him have standard Halloween junk.  The Thursday after Halloween, we went to a friend’s house for dinner.  We were there for about 2.5 hours, had a great Paleo meal, then left.  On the way home in the car, my son started complaining that his eye hurt.  To make a long story short, a drama unfolded quickly that involved his eye swelling shut, lung inflammation, a trip to urgent care, a nebulizer, and steroid shot.  What caused it, we didn’t know.  We suspected that he had developed a cat allergy (the home we visited had 2 cats, and he was petting them).  Previous allergy testing was negative for cats.

To backtrack even more, my son had horrible allergies and asthma when younger.  He would literally get pneumonia or bronchiolitis every 2 weeks.  This went on for 2-3 years. He vomited frequently (choking frequently with extremely enlarged tonsils that no ENT would take out).  He got to the point where he wouldn’t eat much and got very thin.  Life got better when at age 5, he got those tonsils out.  He’s eating much better (still very picky, but we’re working on it), and the asthma symptoms have been pretty much gone for over a year, and very good the 2-3 years previous to that. Cavan is currently 9.

Back to Halloween.  We went for new allergy tests after this incident to the clinic we’d always gone to, but there was a new doctor.  Tests revealed a very serious cat allergy, a moderate dog allergy (we have a dog that sleeps in his bed, but no cat).  His other seasonal allergies had also worsened, which was surprising given his lack of symptoms this last summer.  This new doctor sent us out the door with 8 medications and orders to find the 4 that best work for him (2 oral, 2 inhaled), plus epipens for the cat allergy, should it happen again.  I was not at all prepared for what happened during this appointment. It was upsetting to say the least.  Cavan needed these medications in the past, but I wasn’t convinced he needed them now.  We’re rarely near cats, and it’s winter (no outdoor allergens).  The other point is that these medication make him cranky, irritable, and sometimes even aggressive.  I don’t want him on 4 medications year round unless absolutely necessary (which this doctor thought it was).

I went for a second opinion with our former allergist who still works for the clinic, but a different office an hour away.  She didn’t think he needed that many medications, but he did have a problem that doc #1 never told me about.  Apparently when Cavan is healthy, he can blow 129% of the lung volume a child his age and size should be able to.  A week after the cat incident, he was only at 86%.  It would have been nice to know that, as he didn’t appear at all sick.  At the allergist #2 appointment (a full month after the cat incident), he could blow 104%.  This is good, but not his baseline.  They gave him 2 puffs on a fast acting inhaler, and he blew 116%.  In other words, a month after the cat incident, he still had inflammation in his lungs.

Allergst #2 (who we love dearly in our family) explained that when boys grow, their bronchial tubes open, and they’re better able to ignore symptoms.  Couple that with the lack of tonsils and adenoids, and it’s very hard to tell when he’s sick.  This doesn’t mean he’s healthy, and she recommended an air flow meter to test him to see if he’s having trouble to determine when he needs an inhaler, as we don’t want to lose lung capacity. She wanted him on a maintenance inhaler for 2 months to see if we could get back to baseline, then we could try to stop.  We started this inhaler (he’d taken it before without issue, but this was a smidge different… inhaled powder instead of liquid) about 2.5 weeks ago.

On Sunday, Dec 14th, we let Cavan have a doughnut at church (something we don’t typically have at our Paleo home, but we let him enjoy such things).  When we got home, he had stomach pain and nausea.  Gluten intolerance, I wondered???  No diarrhea or vomiting.  It passed in an hour or two.

He was fine until Wednesday.  Wednesday, he had his school Christmas party at the end of the school day.  Lots of junk food.  He came home on the bus, immediately parked his butt on the toilet, again complaining of stomach pain.  No diarrhea, no vomiting. It passed in a couple of hours.  Hmmm, gluten intolerance, I REALLY wondered???? 

Friday night into Saturday, he had extreme stomach pain for a much longer period of time.  He had nausea and a little vomiting.  No diarrhea.  He hadn’t eaten any non-Paleo foods.  Weird, I thought.  I managed to get him into the pediatrician on a Saturday.  She thought stomach flu, but couldn’t rule out appendicitis.  She said to give him 5-6 more hours. If he didn’t improve or got worse, she told us to take him to the ER.  About an hour after we left, he was fine. He stayed fine all of Sunday (no doughnuts at church!) and Monday until Monday night.  He and dad returned early from playing racquetball because his tummy was starting to hurt.  Moments later, he was on the bathroom floor in the fetal position, screaming.  We went to the ER.

He walked into the ER, and the nurse took one look at him and handed him a barf bag.  Good call, as a few seconds later, he filled 2 of them.  Sorry to be gross here, but he was in terrible pain, and the vomit was no ordinary vomit.  It was the “out the nose and mouth, forceful, can’t breathe” kind of vomit.  I guessed he would have pneumonia within 24 hours, as this is what he used to do a few years ago.  You could almost set a timer.  The ER did an xray of his belly.  Lot of gas, no obstruction. They did bloodwork. No sign of infection.  His pain was subsiding, but his nose and throat hurt from the vomiting, and he was very stuffed up in his nose.  We went home with the recommendation to see a pediatric gastroenterologist.  The best guess was crohn’s disease (autoimmune inflammatory intestinal disease), which my grandmother had.  NOT good.

After we got home, it occurred to us that perhaps his new inhaler could be causing this.  I googled side effects, and there it all was…. stomach pain, nausea, vomiting.  We stopped it immediately.  Tuesday, he had some slight diarrhea (new symptom), but it stopped quickly.  Stomach pain was decreasing, but he was TERRIFIED to eat anything.  He stuck with gatorade, water, applesauce, bananas, and graham crackers (yeah, I know, graham crackers).  He developed a slight cough, which I had expected to come, given the forceful vomiting.  His Poppop (my dad) came to visit Tuesday for the holiday.  Wednesday (Christmas Eve), he had a good day, good energy, ate a bit for dinner.  We had a party with friends, all went to the zoo lights, and had a great time.  When we got home around 9:00 PM, Cavan promptly stated he didn’t feel well and wanted to go to bed instead of church.  His temp was 100.0.  Oh boy, I thought.  I gave him some ibuprofen and sent him to bed.  He slept well.

He woke us in our room at 6:15 AM, happy it was Christmas and ready for the excitement of the day.  15 minutes later, his temperature spiked, and he literally wouldn’t get off the couch.  Pneumonia in the making, I thought.  He stopped opening presents and started reading his books.  Ibuprofen kicked in a while later, the presents got opened, and life moved on.  Later Christmas day, he started looking very unwell.  103.6 on the thermometer. Time to add Tylenol to get through “the end of ibuprofen, but ya can’t have more yet” time.  We were out of Tylenol.  It was Christmas.  We muddled through.  He ate a little.  No stomach pain.  Harder coughing leading to vomiting started that night. Add to that, my husband started getting some sort of stomach flu.  He spent the night on the bathroom floor (massive vomiting and diarrhea).  What the hell is this?

Friday was a bit better with fever management (Haha!  Tylenol was our first after Christmas purchase).  He had some vomiting episodes that did not appear to be stomach pain related, but rather coughing so hard he vomited.  The pediatrician’s office was not open.  Ugh.

Saturday got a bit worse.  He started complaining his chest was tight (pneumonia?  asthma?) He didn’t sound wheezy though.  His cough was hard and dry and leading to vomit.  His inhaler (not the one we suspected of hurting his stomach) seemed to make him worse.  Urgent Care Saturday night. We had to explain our long story, which ironically started at Urgent Care from the cat incident almost 2 months ago.  His lungs sounded clear (something that would happen as a kid too… hard dry cough, but then would loosen with steroids and eventually you could hear wheezing/pneumonia).  The nurse thought he had picked up the flu from the ER, but he tested negative.  He’s lost 6 pounds (10% of his body weight) in a week. I begged for an oral steroid since he wasn’t tolerating the inhaled stuff.  She gave us that and a cough suppressant.  Cavan spent last night sleeping on a mattress on the floor of our bathroom with 2 humidifiers and intermittent running of the hot shower to keep the steam level up. He slept fairly well, all things considered.  The cough is starting to loosen.  You can hear some phlegm, but there’s also a slight barky quality to it too.

In the midst of it all, I’m the healthiest person in the house (who would have thought?), but am exhausted.  At least there’s tons of Paleo leftovers, and we don’t have to cook! Hubby is feeling better, but not 100% yet.

Hey, if anybody else has heard of these weird symptoms, please let me know.  I’m hoping the pediatrician is open tomorrow.  We NEED some answers.

Love to you all!  Merry Christmas!  Happy almost New Year!