Medical researchers are only beginning to scratch the surface of the implications of various gene mutations, and most of the information currently available tends to be confusing and somewhat ambiguous, because one gene mutation will increase or decrease the probability of a significant negative effect on some important body process or disease risk, while another gene mutation will probably cause a positive effect. Yet other gene mutations will have similar effects, but at various lower probability levels. So interpreting that stuff is rarely easy.
Probably in about a 100 years, if the current rate of growth of medical and computational technology continues, humans may begin to develop a reasonably good understanding of how all this stuff works. In the meantime, we just have to do the best we can. We might be better off if we just ignored it all, until the technology matures, but sometimes we just can't justify doing that, because of the long-term (or even short-term) health consequences. Here's an example of what I'm talking about:
About 2 or 3 months after my first major surgery (in November, 2005, a little over 9 years and 4 months ago) I began to notice that I was frequently short of breath. I was in good physical condition when I went into the hospital, so I couldn't figure out why I was short of breath all the time. I noticed that I suddenly had a lot of hypothyroid symptoms, such as hair missing from the outer third of the eyebrows, dry hair, low body temperature, etc. I asked my PCP for thyroid tests. He wanted to order the usual total T3 and total T4 tests, but I finally talked him into ordering the Free T3 and Free T4 tests. My TSH and Free T3 were both mid-range, but my Free T4 was slightly below range. So he suggested a minimal dose of synthroid. A couple of months on that dose seemed to have helped very little, so he OK'd doubling the dose. That helped the FT4 a little more, but still didn't do much for any of the clinical symptoms. So he agreed to a change to Armour. That actually helped. It didn't resolve all the symptoms, but the improvement was noticeable. So I stuck with that dose (60 mg).
In July, 2009 when I got out of bed one morning and began to get dressed, I noticed that the fingers of my right hand had suddenly become numb. Normally, using them should cause them to "wake up". Instead, the numbness was slowly climbing past my hand, and up my arm. And then I noticed that the right side of my face was beginning to become numb. That's when I interrupted the dressing process to take some time to dig out an aspirin and swallow it. I finished dressing and waited a few minutes to see if it would become any worse. After the numbness reached my ear I took another aspirin and headed for my vehicle and drove to the ER (about 20 miles away). Interestingly, even the right side of my tongue was numb, split right square down the middle. I apologize for including all these details, but they may be important when we get to the chase.
Long story short, they couldn't find anything wrong with me (my enzymes didn't show the markers of a heart attack and my limbs still showed almost normal strength, and no drooping of facial muscles), but since those areas were still numb (and some of them remained that way for several days), and they noted that I seemed to slur a few words, the doctor pronounced it a TIA, suggested a daily baby aspirin, and sent me home. Some of the numbness (at a reduced level) persisted for a week or so, but finally faded away everywhere except for some light tingling at the outer end of my lower lip, which appeared to be at least semi-permanent. I had to be very careful when eating for a day or 2, because if the food was too hot for example, and I put it into the right side of my mouth, I would never know that it was too hot, risking a severe burn without even being aware of it. Likewise, I could taste absolutely nothing on the right side of my tongue. But if I shifted the food over to the left side of my mouth, every thing worked normally.
Following the TIA, a neurologist gave me some samples of Metanx (a blend of the active forms of vitamins B-12, B-9, and B-6), after he diagnosed me with Parkinson's disease.
In February of 2010 I had to have another major surgery, and maybe it's just my imagination, but my shortness of breath issues seemed to increase again after that. I decided that something about the anesthetic must be causing some sort of damage, somewhere. But of course that was strictly a wild guess.
May, 2010, another TIA-like event, same side, same symptoms, this time it began about 11 at night while I was taking a shower. I finished the shower and pondered what to do. After about an hour with no change, I called the night nurse's desk to ask if she thought there was any point in me going to the ER. Of course that was like asking a bear if he poops in the woods. Naturally she said that such things should always be checked out, and since this was my second event, this time they might do more tests and track down the cause. They kept me overnight and the next day did an MRI brain scan, but nothing conclusive was found. So this time the ER doc prescribed Plavix, Simvastatin, and metoprolol and lisinopril to lower my BP and lower my heart rate (though my BP and heart rate were normal).
But by about half a year later, my shortness of breath issues became more of a problem. At times I couldn't have taken a deep breath if my life depended on it. Sometimes the tips of the fingers of my left hand lost most of their feeling or tingled. I wondered if it might be the Metanx, so I stopped taking it for a while, couldn't tell any difference, then started taking it again.
For the first 9+ years, my thyroid lab test results were relatively consistent, with my TSH and FT3 typically about in the middle of the normal range, and my FT4 at the bottom limit of normal, or slightly below. Then for some strange reason last fall (October, 2014) my TSH crashed (to slightly below normal), while FT3 and FT4 remained basically unchanged. And by February, 2015 it had obviously crashed and burned (waaaaaaaaaay below normal at 0.07). FT3 was still mid-range and FT4 at the bottom of the normal range.
Now, back to the Metanx scene. Since at times during 2013 I began to notice increasing shortness of breath issues and the fingertips of my left hand showed signs of paresthesia more frequently, I stopped taking Metanx during the month of September. No change, so I started using it again. As the symptoms became worse by February, 2014, I stopped taking Metanx for 2 months. No change except that my balance seemed to be deteriorating again (which was the main reason why I was taking Metanx in the first place), so I resumed taking it every other day (IOW, a half dose). My balance didn't seem to be improving, so by October, 2014 I resumed taking it every day.
By sometime in January, 2015 the paresthesia in the fingers of my left hand seemd to be chronic, I was waking up within a couple of hours of getting to sleep, sweating like a pig, with shallow, rapid breathing, and rapid heart rate. I couldn't take a deep breath to save my life, even though I was constantly feeling the urge to do so. I decided that I was dehydrated, which was correct, but why was I dehydrated? I drank plenty of water during the day, but it went straight to my bladder, and the cells of my body continued to starve for water. Still, drinking water during the night would temporarily relieve the problem, so the symptoms were clearly caused by dehydration. But my systolic BP would be low in the mornings (as in below 100 mmHg). Clearly that was due to hypovolemia (low blood volume) and after drinking water all day, by bedtime it would be high (as in 50–60 mmHg higher). This was probably due to hypervolemia (high blood volume) caused by the combination of endothelial dysfunction and the inability of my body to properly regulate my blood volume (and therefore blood pressure).
But the TSH result showed a possible root cause — hyperthyroidism symptoms. So I've reduced my Armour dose by half and my BP is slowly getting back to normal and I haven't been waking up during the night with dehydration until the D started from the flu, but that's not surprising. But I wonder if the flu might be capable of causing a rebound effect on BP after one's temperature declines again, because yesterday my BP was 88/49 in the morning (lower than I've ever recorded) and 97/55 last night. I didn't take any lisinopril of course, and this morning my BP was 101/58, and it was 114/65 tonight (a few minutes ago). And since the D seems to have let up during the night, I didn't have any dehydration problems, either.
So why, after all those years, did my thyroid function change? My theory is that my original hypothyroid symptoms were probably not actually caused by hypothyroidism per se, but by methylation issues due to MTHFR gene mutations triggered by the anesthetic used during my 2 surgeries. Note that I never noticed my peripheral neuropathy symptoms (if they existed) and various other diagnostic markers of Parkinson's disease, nor shortness of breath, nor various hypothyroid symptoms, prior to the first surgery, in November, 2005. And interestingly, even thought I could be short of breath, and unable to draw a deep breath, my oxygenation rate was always excellent (except for when I woke up dehydrated, with shallow, rapid breathing and elevated heart rate).
So it appears that the Metanx may have remedied the methylation issues, causing my long-term Armour dosage to become an overdose. We won't check the thyroid labs again until a few weeks from now, to make sure that I've reached homeostasis, but so far things definitely seem to be headed in the right direction. And a couple of months ago, while researching the ingredients in Metanx for clues, I discovered that there is apparently credible evidence that if one takes excess amounts of B-6 long enough (which I have been doing), it can actually cause paresthesia.
Methylation (and apparently it's potential effect on the thyroid) is a complex issue. Eventually I'll probably figure out a dose that works optimally. In the meantime, life is getting to be pretty good again (if I could just get out from under this dang flu).
Thanks for taking the time to read this far. Again, I apologize for the length, but IMO the more details included in a post, the more valuable it might be for others who might be having similar issues (or who might have them in the future).
Of course this "logic" (as if it can be called logic) is little more than wild speculation. So what do you think? Am I barking up the wrong tree, or will this dog hunt?

Tex

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