Raising the dose

[Rudegirl]

So I started 1 grain on Saturday, by day 3 had to raise to 1 & 1/2 grain.. Been great since Tuesday.. But t'day ive gone shivering & my under medicated heavy arms are making a slight presence.. So maybe a raise of 1/4 by t'mora & another 1/4 if need over the weekend.. On the plus side ive lost 4lbs in 6 days!

[Clutter]

Rudegirl, I think you're raising too quickly. Half a grain a fortnight is usually recommended. It takes time for NDT to be absorbed and metabolise and six weeks to get the full impact of a dose.

This link explains how and why dose should be adjusted gradually.

thyrophoenix.com/adjusting_...

[shaws Administrator]

Also take note of your temperature and pulse about 3 times a day and keep a record. An excerpt re taking NDT. Two excerpts from Thyro-gold for info.

1. How Best to Test for Overstimulation. If your family doctor and you suspect that you're overstimulated by Thyro-Gold—that is, that you're thyrotoxic—she and you can verify or refute the suspicion easily enough. You can test at home to see whether your basal temperature is too high and your basal pulse rate too fast. And you can lightly touch the palmar parts of your finger tips to your chin to see whether they tremor. (Many of my consulting patients and I called this latter procedure the "Tammy fingertip test" for overstimulation. Tammy discovered and introduced me to the test, and I've never found where anyone else described the test before.)

2. The TSH and thyroid hormone levels are virtually useless for learning whether a patient is on his or her optimal dose of thyroid hormone. It's far better to use the types of tests I suggested above for your doctor and you to perform.

P.S. I do know you are taking another make of NDT but it's the same rules.

This is another excerpt from the same page:

I prefer that my patients use at least four physiological measures, not just the temperature. The other three measures are the patient’s basal pulse rate, basal blood pressure, and fasting body weight.

naturalthyroidsolutions.com...

[Rudegirl in reply to shaws]

I'll soldier on with 1 & 1/2 for now & raise next weekend.. My symtoms had gotten severe before the 1/2 grain raise.. Actually had to crawl like a dog upstairs because I was too exhausted to climb, sttm advised me to raise ASAP.. I've been fine, just got cold & heavy arms t'day.. My temp before rising this morning was 35.6 & my pulse is 75!

[waveylines]

The weight loss will be water loss due to the water retention that occurs with untreated or under treated hypothyroidism. You may fine that you will loose up to a stone due to this over time.

If you follow the guidelines to monitor your symptoms as a above you should be fine. However after this weekend increase I would be careful over making rapid increases as the problem you will hit will not having the full impact of an increase before increasing again. This will make it more difficult to evaluate the optimimum dose and the most likely effect of this will be that you will be far more likely to overshoot making your self hyperthyroid ( I knOw this must feel extremely unlikely given how you feel at the moment but honestly I have done the same thing in the past myself!!) the problem then is that you may not only have to lower but even stop for a few days to allow your body to settle and then restart again-very frustrating!!! You have all my sympathy!!! Hope this helps.....and good luck 😊 am sure you will have invested in a couple of good thyroid books? Dr Peatefield book is a good one and Dr Skinners book is very amusing as well as useful too.

[waveylines]

Ooh and I also forgot to say that your body has to be woken slowly from its hypothyroid state as too many fast increases can be too much for it -Both Dr Peatfield andDr Skinner talk about this. I kept a simple daily log alongside by doses and supplements noting down my own check results as above and comments -found this useful to look back on over time as it gave me a clues. Really hope you start to feel much better but in all honesty you will have to allow time for to get fully better.....sadly and so annoying as am sure if you feel like I did you're sick of feelingsick but you are on the road and will get there. Xx

[Daffidols]

Of course, we all want to be on our optimal dose NOW, and when told that we have to wait 6 weeks between dose changes, many of us groan. Is there a valid medical reason behind the wait? Yes there is, and it has to do with the feedback between the different thyroid hormones, TSH, the deiodinase enzymes that perform conversion, etc. When you change your dose, TSH and all the conversion enzymes shift around until thyroid levels reach a new equilibrium. That takes time, and sometimes it takes more than 6 weeks.

The best analogy would be workers at a factory, who produce T3 on demand. They can only produce the required T3 if the T4 supply is adequate, and the boss, TSH, gives the command. The TSH boss determines the production of T4 by screaming louder (TSH rises) to get more T4 produced. This screaming will also result in more T4 being converted to T3. Even if someone has suboptimal T4 levels, there could still have sufficient T3 (the more active thyroid hormone) if their TSH is high enough to keep T4 to T3 conversion up. Once T4 and/or T3 levels rise, the boss will quiet down (TSH will drop). Taking any form of thyroid hormone replacement (levothyroxine or desiccated thyroid) will cause TSH to drop.

If T4 ↑ or T3 ↑ then TSH ↓

(relationship is usually inverse, meaning TSH moves in the opposite direction from T4 and/or T3)

If T4 ↓ or T3 ↓ then TSH ↑

If TSH ↑ then T4 conversion to T3 ↑

T4, T3, and rT3 know and interact with each other, since they all work at the same factory. They constantly check in with each other to determine if they should increase or decrease their own production, based on the others’ levels. When T4 is high, the enzyme that’s responsible for T4 to T3 starts to slack off, and less T3 is made. This prevents a person from becoming hyperthyroid. It also explains why patients don’t usually see improvement when prescribed more and more T4.

If T4 ↑ then TSH ↓ and T4 conversion to T3 ↓

If there’s already a lot of T3 available, then available T4 will convert to rT3, and available T3 will convert to T2, again, to prevent T3 from becoming even higher and the person from becoming hyperthyroid.

If T3 ↑ then TSH ↓ and T4 instead converts to rT3, and T3 converts to T2

Whenever there’s a dose change, all the conversions above must reach a new equilibrium, and that takes time. Using the factory analogy, layoffs and/or new hires would change work schedules, and production goals might change for some workers. Some workers could have their breaks reduced. Factory output would be variable until all the new employees could perform their job. Hair loss is a common side effect after a dose change and illustrates this concept....from 'they told you WHAT' on this website

[Rudegirl in reply to Daffidols]

Thanks for that.. U know I Totaly understand the way u put that.. So what's happening inside of me is actually what's happening to me at work too.. I've actually been identified as the weak link at my work place, which really angers me as I've always been the strongest until this bloody illness hit me.. Thank you!

[Daffidols in reply to Rudegirl]

Dear Rudegirl....You are so welcome! please note however that these are not my words, I just copied /pasted from .from 'they told you WHAT' on this website. I would provide the link but I am v new here, and have not quite figured out how to do that without losing your post [and 'reply' button], ..perhaps someone would enlighten me. It is a well worth reading the complete article. Keep well and you know, it will come right...eventually. Love D

[humanbean in reply to Daffidols]

tiredthyroid.com/blog/

Is this the link you are referring to?

[Rudegirl in reply to Daffidols]

Oh god I'm realy not got good with these things.. im a hands on creative person..