Thyroid med change

Hi,

Due to low T3 my doc added 1/4 grain of nature throid to my .75 mcg synthroid. Day 3 and I can't sleep, feel depressed and have bouts of anxiety. I wasn't having any of these symptoms before. Does anybody have any insight?

Thank You,

Sandy

[shaws Administrator]

Why didn't doctor just add in some T3 to your T4. Would seem simpler. I'd just drop back to your previous dose and if you are symptomatic ask him to add some T3 to T4 as several researchers have found people benefit with T3 added to T4. NDT might not have added sufficient T3 as it contains T4, T3, T2, T1 and calcitonin. 1/4 tablet of NDT is approx 25mcg of levo.

[jamesal0]

Don't mix NDT and Levo it'll give you alsorts of weirdnesses. Having said that it's pretty normal have sleep issues as a Hypothyroid. I fixed my steep issues with a Testosterone sup, but you need to find out where your hormones/vits are first. Get testosterone, oestrogen, progesterone B12, Iron, D tested and supplement if not in upper percentiles.

Re NDT if you're going to muck around with it, go all the way - just change to NDT, once you sort out the dosing you'll love the stuff.

[LAHs]

Don't be too critical of your doc, at least s/he is dipping his/her toe into the pool of enlightenment. At least s/he realizes that T3 is important!

Get your basic blood test numbers now that your are on the new dosage and post them. It could be that you are now getting too much T3, that can make some people sleepless and anxious - and lively and energetic. I think you are probably on the right track but you might have overshot the target a little. But post your new results, that will tell you what the problem is.

[Eddie83]

As I recall, 1/4 grain is equivalent to 9mcg T3 plus 38mcg T4. Since you are on 75mcg T4, the doc just boosted your T4 dose to 113mcg while adding 9mcg T3 at the same time. Now if the doc had suggested this to me, I would have gone into "WTF??" mode. If the doc had any sense, he/she would have reduced your synthroid first, to allow your blood T4 level to fall, then added the NDT say, several weeks later. But, when it comes down to it, it would have been a lot simpler if the doc had just added some T3 to your T4, say 2.5 or 5mcg to start. BTW, I am on 75mcg T4 plus 7.5mcg T3, and I already know that boosting my T3 to 10mcg or 12.5mcg can send me into hyper. If there's anything worse than hypothyroidism, it's hyperthyroidism! And anxiety is a common manifestation of hyperthyroid.

[Hidden in reply to Eddie83]

Geez, ok I see.

[Hidden]

I don't get it. How does 75+9=114?

[Eddie83 in reply to Hidden]

T4=75mcg from synthroid. T4=38mcg + T3=9mcg from NDT. That adds up to T4=75+38=113mcg plus T3=9mcg. Another issue is that T3 is 3-4 times more powerful than T4 ("T3 power factor"), so taking T3=9mcg is like taking between 27 and 36mcg T4. This gives you a maximum T4-only equivalent of 149mcg.

[helvella Administrator Thyroid UK in reply to Eddie83]

Figures you are using are not right for a quarter grain.

[Eddie83 in reply to helvella]

You are right. That's what I get for not looking this info up every time. T4=38 + T3=9 is what is in each grain of Armour (from the full prescribing info). So 1/4 grain is T4=9.5 + T3=2.25.

[helvella Administrator Thyroid UK in reply to Eddie83]

It is easily done - sorry for the very brief response earlier, I was not in a position to provide a full explanation but you obviously understand!

[TSH110]

I take thyroidS but decided to try nature throid just to see how it compared - it sent me a bit crazy and seemed a lot less smooth and sophisticated than thyroid S plus it tasted horrible whereas I take TS sublingually as it tastes quite lovely despite coming from a pig (I don't eat meat). May be it is that particular NDT that does not suit and another might be better. ThyroidWP is by them and has far fewer fillers than naturethroid. ThyroidS also has fillers their Thyiod has fewer fillers but no sophisticated controlled delivery. I can't see why some with Levo would be bad persay. I understood that ideally one can add T3 to NDT to get the best T4/T3 ratio.

Also I started on 1/4 grain but reduced Levo by 25mcg and got near immediate and huge improvements. Maybe it is too much just adding it to the Levo dose. I worked up very slowly and split the daily dose of NDT until I completely switched over to NDT. I am sure I have read some people here take Levo and NDT and feel good on it.

Hope that might help give some possibles in why you got the jitters with it. I became very bad tempered and anxious on naturethroid like I had gone a bit hyper.

[Hidden in reply to TSH110]

So you were taking Levi and thyroid at the same time?

[TSH110]

Hidden Yes but only as I swapped from Levo to NDT slowly replacing Levo with NDT following the thyroid patient advocacy gidelines. Stop the Thyroid Madness have a guide too I don't think they are identical. In theory you can just switch in one but I had a lot of heart pains and T3 is powerful and it is best to go carefully if you have angina. Ironically the heart pains improved greatly on NDT.

[Hidden in reply to TSH110]

Well, this is what my doc was trying to do with me but I had bad reaction. What dose of DNT are you on now?

[TSH110]

I used to take 120/125 mcg Levo 3/4 days a week.

I substituted 1/4 grain NDT for 25mcg Levo slowly swapping. Initially I only needed 1.25 grains but now I need 2.25 grains a day but this dose has remained stable for some time. They say approx 60mcg Levo = 1 grain so my later dose is closer to this than the initial one. Hope that helps. I'll seek out the link to TPA guidance which I found very helpful:

tpauk.com/main/article/how-...

[Eddie83]

Now that I've corrected my error ... the doc added just T4=9 + T3=2 to your 75mcg Synthroid. But since it makes you feel anxious, that must mean that 75mcg is near your upper T4 tolerance limit. Do you know what your FT4 is? Just FYI: I am one of those people who has to dose T4 so as to keep my FT4 low in range, and my doc has several patients like me. The bottom-line being, how you feel is more important than the numbers! Seems to me the best course would be to drop Synthroid to 62.5mcg, wait a week or two, then add the NDT back in. If you end up adding even more NDT, or T3, be sure to subtract that much T4, and T3*3, from your Synthroid dose.

[Hidden in reply to Eddie83]

I never had insomnia with t4 meds. Ft4 middle range.

[Eddie83 in reply to Hidden]

I am on T4=75mcg daily. If I hike my dose to 88mcg, I start feeling anxious and out of sorts within days. Everyone has a threshold where hyper symptoms start, and apparently yours is 75mcg. Also, the threshold of hyper varies with how active you are; on sedentary days, you don't need as much.