WP thyroid vs tirosint

[phirestar]

After reacting to mylan levo and synthroid for over a year, was given tirosint. For the last - almost year- all the getting sick/weird stuff has stopped. I'm thinking of changing my Medicare plan for a number of reasons but concerned that I won't be able to get tirosint for a price that I can afford since it's not on any other formulary for a Medicare plan in my area. WP thyroid is more much more affordable if I have to look at retail price. I've posted my last set of labs (outside testing ) and don't seem to have a conversion problem. What would I need to be watchful of if I switched to WP thyroid? Thx

[Clutter]

Phirestar,

You don't need to be more watchful of WP than any other thyroid replacement. Just make sure that FT3 remains within range.

[phirestar in reply to Clutter]

Trying to think ahead. Based on charts that I've seen, from 75mcg of tirosint WP Thyroid would be about 48mcg. It's often suggested to split the dose bc ft3 has a much shorter half life than ft4. So, if my ft3 is at 3.6-3.7 , and ft3 is about 4x more powerful, should I consider 1) splitting the dose, 2) reduce the dose? Regardless of where tsh is, my ft4 hovered at 1+/- until this last test at 1.2.

[shaws Administrator in reply to phirestar]

This is a link with good rinformation and go to the date January 30, 2002 in paticular.

web.archive.org/web/2010103...

[phirestar in reply to shaws]

Thx read it and helpful. Doesn't sound like it's a big issue to consider switching. I may have to watch my heart rate bc I sporadically have it go up and then it comes back down. Don't know why though.

[shaws Administrator in reply to phirestar]

Sometimes it is T3 which elevates heart-rate slightly. Go to the date May 23, 2004 on the following link and it may be helpful.

web.archive.org/web/2010103...

[Clutter in reply to phirestar]

Phirestar,

Splitting the dose of a medication which has T3 in it can even out the peaks and troughs of T3. 75mcg Tirosint is roughly equal to 1 grain of WP. I'm afraid the results are meaningless without the lab ref ranges.

[phirestar in reply to Clutter]

The lab reference ranges are shown in the photo. I started 75mcg of tirosint at end of last year. This is an outside of Medicare plan test done by Quest bc I wanted to get a full panel done after -what I thought might be an optimal dose to see where things were. Plan will only test Tsh and ft4. Since I've been on tirosint for almost a year without getting sick or having weird stuff happen,I've titrated slowly, in part to see if I had symptoms. The only symptom I might have is slightly (like 2points) elevated ldl cholesterol. Test before starting 75 was a tsh of 7.56 (5 being over range)..internist wanted to start statin but per insert it's contradicted unless tsh is in range. Statin has been postponed until next test. Neither tirosint or WP thyroid are on the formulary for the plan I'm considering or any other formulary for any plan in N California. To some extent, it's a matter of where I want to swap dollars. I've been told that WP thyroid is pure and that it might be of assistance in helping cholesterol levels. If I gave you all the info re what I've been dealing w it would surprise you. Just one minor one, bc I reacted to mylan and synthroid, my allergy file states : allergy- levothyroxine sodium! My ft4 and ft3 are the most consistent numbers regardless of where tsh is. The conversion charts that I've seen are based on t4 (not including tirosint) so I'm guessing that 48mg which is 3/4 grain would be ok to consider. I've not found any relationship regarding taking WP thyroid and it's impact on increasing ft3. All my inflammation markers are high, which is the next thing that I'll be trying to address now that I have the thyroid med issue sorted out -some thx

[Glynisrose]

DO NOT do a direct swap. Start low and build up over a few weeks.

[phirestar in reply to Glynisrose]

How low ?

[Glynisrose in reply to Glynisrose]

I started by giving up levo for 2 weeks as it can stay in your system for up to 7 weeks! Then I started on 1/4 grain. When I gpt up to 1 grain I couldn't believe how well I felt so I kept increasing till all my symptoms went. I'm on 2 grains now and apart fron arthritis inboth knees u feel better than I ever did on levo.

[phirestar in reply to Glynisrose]

I don't seem to feel any different no matter dose of med. need to do labs to see where tsh is. Part of the $ swap is copay for labs has gone from 25$ to 40$. General pattern for testing has been 6-8 weeks followed by a 3 month test since starting meds. Jan-march last year got really sick in synthroid w bad reactions to cat scan dye. I did an outside test and that was the lowest ft3/ft4 has been. 3.1/.82 respectively w tsh at 13.9 on 37.5 mcg synthroid. Ihave some 13, 25 and 50mcg tirosint caps so I could reduce dose or skip days. August 2016, doc took me off mylan bc I got so sick for 3 weeks. Tsh went from 3 to 21 but all the sick/weird stuff stopped and it was the best I'd felt in 8+ months. I've attempted to establish some benchmarks over the last year so I might know what to look for. I have no idea why my tsh jumps around so much while my ft3&4 remain more consistent. Thx

[Learner1]

Have you investigated the supposedly inert ingredients in the various T4 options? The advantage of Tirosint US that it's allergen free.

But, if you Google NIH Pillbox, you can look up all the variations of T4 on the US market and perhaps find one you're not allergic to, by clicking on the ingredient lists under each entry. (For me, it's hard to find options without corn or milk...)

I got my insurance to pay for compounded T4 made with a cellulose filler - you might price it out and see if it's cheaper.

As for inflammation, your antibodies are high. You might consider a gluten free diet if you're not already on one, and look into other food allergies, too.

[phirestar in reply to Learner1]

Googled each excipient in mylan levo and synthroid bc what I was doing made no sense. Also googled side effects/reactions to each. I still have difficulty with the fact that I was kept on these for just over a year as sick as I kept getting. For me, there may be a difference between being on a maintenance med (thyroid) vs a 2 week antibiotic.. Mylan and synthroid share some excipients and interestingly enough, the ones they don't impacted me in different parts of my body. I'm looking for options that I might be able to get through a different Medicare plan since most only have mylan levo and synthroid and the exiting tiers put anything else in the highest co-pay level. Therefore, the retail cost becomes significant vs what I would pay. I might need to stay away from a cellulose mix unless I know where it's sourced. I've stayed in current plan in order to get tirosint to see if I stabilized on it and went to optimal dose(based on tsh) at the end of last year. Tsh went from 7.56 to 2.34 (above) by going from 50 to 75 mcg tirosint. I found a FMD last year that agreed to give me a script for compounded t4 if plan wouldn't rx tirosint. Plan docs are not likely to rx compounded meds but the cost when I checked was reasonable though I've heard it's now more expensive. So now I'm looking into different plans to make a switch in October (and attempting to stockpile some tirosint while waiting for whatever approvals might be required) . -wp thyroid cost is something that I could afford where tirosint is likely to be several hundred dollars and not on any other plan formulary. Based on doc comments, they think the increases in inflammatory markers are due to thyroid antibody increases.

[Learner1]

I've had several things compounded and have had good experiences querying the compound pharmacies on sourcing... corn seems to be very sneaky. The compounding pharmacies seem to be pretty sensitive to dealing with people with allergies. We're a good market.

I find taking T3 much less of a hassle to get. The Perrigo one is pretty safe, and it's cheap and widely available. Is new on T3 only and done fine, though now I take both. All the natural thyroid products contain allergens...