Amiodarone.....again! Sorry....

[waveylines]

Hi Everyone,Appreciate your thoughts suggestion on this as am stuck....thank you.

I was put on Amiodarone for 4 weeks post surgery last September. So Amiodarone was stopped 7 months ago. I was on 3 3/4 grains of Armour Thyroid for Hypothyroidism before surgery. Been stable for years on this dose. 16yrs on NDT. Amiodarone completely messed up my thyroid hormones and I had to drop to one grain which was scary as my thyroid hormones shot way over range. Amiodsrines secondary effect is that it inhibits up take of thyroid hormones and conversion at cellular level. Effectively it creates a sort of blockade. Amiodarones half life is 150days approx. Its not really know when it leaves the body finally. Some report 8-12months. Many say it stays in the body for years! My endo (whose poorly now) told me its an unknown.

Nice says its contrary indicated for people with existing hypothyroidism but it was still prescribed for me....lol.

I'm stuck on 2 1/2 grains, been like it for about 3 months. I feel terrible keep crashing with typical hypo symptoms.

I've tried splitting the dose into two in the hope that more would get into cellular level. Helped with night time palpitations.

My blood test results just done are;

TSH: 0.005 supressed as usual.

Ft 4 19.6 (upper range limit 21.6)

Ft 3 5.4 (upper range limit 6.8)

6 weeks ago:

TSH 0.002

Ft4 20.4

Ft3 5.8

Same range

Not really a lot of room to move unless I try adding a bit of T3 in. Thoughts? But if it's a blockade would that make a difference?

I'm trialling changing split dose to 2 1/4 grain, plus 1/4grain at night. Still 2 1/2 grains per day.

Pulling my hair out with sheer frustration!

Any thought suggestions welcome.

Ps: B12, vit D etc all optimal. Take vit D with k2, b12 injection, b complex with folate. Vit C. I'm gluten free.

[greygoose]

I've tried splitting the dose into two in the hope that more would get into cellular level.

That's the wrong way round. Splitting the dose means there's less chance of getting some into the cells. You need to flood the receptors by taking it all in one go, to force some into the cells.

A blood test only tells you what's in the blood, not what's getting into the cells. So, reducing the dose on the basis of what's in the blood - where it doesn't do anything - when you know it's not getting into the cells, is illogical because it reduces the chance of any getting into the cells and actually doing something. Personally, I would not have reduced if I felt well on that dose. So, now that you've reduced and are not feeling well, maybe it's time to put the dose up again. Blood tests can be false friends at times like this, and should not rule over common sense.

[waveylines in reply to greygoose]

Thanks. I didn't feel wellGreygoose. My heart was racing, I was shakey on my usual dose. I could only tolerate 1 grain. Everytime I increase I get side effects which is why I'm stuck. I was post heart surgery so had to be careful. All good on the heart front. So I've tried three times to go to 2 3/4 but each time my heart races etc... its taken me ages to get this far. That's why I'm wondering about Liothyronine on top of my current ndt dose.....

I don't know anything about how to get past Amiodarone. Is it the same as cellular resistance? What I read was that amiodarone reduces conversion of T4 to T3 with in the cell as well as uptake. Nothing about how you manage it!!

[greygoose in reply to waveylines]

I don't know anything about Amioderone, either. I was just going by what you said. But, yes, if it affects conversion adding T3 might do the trick.

[waveylines in reply to greygoose]

Thanks Greygoose. I'll give T3 a go. I've found this situation very confounding!! Lol....

[waveylines in reply to greygoose]

I tweaked the same daily dose and reduced night time and increased morning......feel a bit better. Though now getting palpitations early morning again. All a balance. I think ure right a little bit of T3 in the morning could help.

[arTistapple]

I was wondering why we had not heard from you recently. Sounds like you have been working away at the problem in the background.

What GG says makes sense but the proof will be in the pudding. Get back to us ASAP and update us on your experiment. I am dealing with cardio now too. It’s a nightmare no-one seeming (especially NHS trained medics) to have a handle on thyroid issues underpinning (or not) our health.

I see the glee with which GP surgeries are being congratulated for cutting down on T3 prescriptions and instructions on NDT falling into the same category. It’s a bloody nightmare.

Really their drug bill (excluding off course all the other drugs they then need to prescribe due to lousy treatment of thyroid) is reduced by very little it seems to me.

Good Luck to both of us.

[waveylines in reply to arTistapple]

Sorry to hear you're having to deal with cardio now. I found my EP very good but the cardiologist was just hell bent on beta blockers!!

Yes am fighting on. Tedious and long winded......... still no thyroid meds!!! But been sent off to Wales by local nhs endo to see another Endo....Turns out you start the wait all over again if your nhs endo sends you elsewhere..... so am told it will be 2025 before I'll get seen!