In a message dated 8/15/2007 9:07:51 PM Eastern Daylight Time, [log in to unmask] writes: I had a positive start and have seen a significant decrease in fatigue, but I have had some stalls along the way--one week at 45 mcg per day and now 105 mcg per day. If I take more, my temp and pulse go up. Have you seen this with patients? >>>>> I wish I had seen this a few times before; unfortunately, I have lost count of how many times I have seen this kind of thing in my patients. Two things come to mind immediately: 1. You might be a "Rapid Compensator." This is Dr. Wilson's term for those folks who, initially seem to be on the right amount of sustained release Liothyronine (SRT3); but after days, weeks, or months, they need another increase. Don't worry, this is common. Once people get the "Right" amount; they are usually fine on that amount, allowing for slight increases in cold weather. or 2. You may be suffering from some degree of Adrenal Fatigue. Adrenal Fatigue is a condition usually due to excess stress or regular stress while Hypothyroid. With Adrenal Fatigue, thyroid hormones don't behave properly. Either they do nothing at all, or a relatively low dose of thyroid replacement gives over dosage symptoms. The best discussion I have found of Adrenal Fatigue is the book, "Adrenal Fatigue: The 21rst Century Stress Syndrome," by (the other) Wilson. Dr. Rind also has a good Web Site that discusses this overlap between Adrenal Insufficiency and Thyroid problems. If temperatures bounce around a lot or don't go up nicely, but increasing SRT3 causes problems; people sometime do well with "Thyrocare" that they sell on the Wilson Syndrome site. I hope this helps. Doc Don ************************************** Get a sneak peek of the all-new AOL at http://discover.aol.com/memed/aolcom30tour _______________________________________________________________ Snip, Please If you "Reply" to a message, and *you* fail to erase or delete the previous message, *your* message cannot be distributed. Why not ask a question? If we're not currently talking about what *you* want to hear about, ask about another topic! Or make a statement. To be prepared, you might want to search the Thyroid Archives http://www.Emissary.Net/thyroid/index.html to see what has been said before about any thyroid-related topic. _______________________________________________________________