Erfa or Euthyral? Euthyrox was not a success

[Claproosch]

I am new here and would love to get some views from the community as I have been struggling with my meds in the past couple of months.

Here's the background:

May 2016: diagnosed with hypo, I had all the classical hypo symptoms (cold feet, hands nose, legs, constipation, aenemia, tired, brain fog, puffy eyes, post-nasal drip etc).

Had been at home from work since Jan 2015 diagnosed with a burn out. I just didn't seem to get better physically even though mentally I was back on track and keen to work.

Results (in brackets, the lab reference values):

TSH: 1,55 (0,3 – 4,5 mU/L)

FT3: 3,65 (3,23 – 6,47 pmol/L)

Ferritin: 38 (50 – 170 ug/L)

B12: 406 (300- 835 ng/L)

Vit D: 27,4 (30-60 ug/L)

Folate: don’t know if this was tested, can’t see it on the results (they are in French but isn’t it still called folate?)

My doctor in Brussels, a functional medicine specialist who first put me on meds, is hyper mega convinced that medicating with levothyroxine only has no purpose as he thinks most hypo issues are related to poor/no conversion of T4 to T3. He hasn’t even tested T4 because he thinks it is not important, it is T3 that counts.

He put me on Euthyral (Levothyroxine Sodium 0.1 mg; Liothyronine Sodium 0.02 mg)

and it did wonders for me. I felt amazing. That excitement eventually slowly died down, I started to become a bit more tired after 6 months or so, but I was still much better off and the best part: I had regular bowel movements and stopped having cold extremities. He also supplemented me heavily on zinc, selenium, Vit D, the whole works. Somehow however my ferritin and Vit D never seem to go up. As long as I can remember I have had them very low.

Blood results February 2017 – when on 1 tablet of Euthyral consisting of Levothyroxine Sodium 0.1 mg; Liothyronine Sodium 0.02 mg

TSH: 0,01 (0,3 – 4,5 mU/L)

FT3: 4,77 (3,23 – 6,47 pmol/L)

Ferritin: 33 (50 – 170 ug/L)

B12: 585 (300- 835 ng/L)

Vit D: 27,2 (30-60 ug/L)

Then, we moved to Spain and I ran out of Euthyral. Euthyral is not available on the market here. My doc in Brussels is not easy to get hold of, and I figured I needed to sort out my health in my new home in Spain, so I contacted a doctor in Valencia who specialises in thyroid problems, she does that online and via email. Never met her in person.

Also, I was experiencing some side effects, or was I? Heat intolerance, body /legs burning from within….but... it was also very hot in Madrid so difficult to tell. Still I felt I needed more Euthyral so prior to my penultimate test at the end of August, I increased my dosis from 1 to 1, 25 tablet of Euthyral. It gave me good energy levels but I was also perpetually hungry and had a quite active digestive system. I did not mind so much, as I have always struggled with constipation and bloating. Sleeping was not great, but again who sleeps well when it remains 38 degrees at night.

The new doc in Valencia had me tested on T4 and TSH. NO T3! I insisted she also test T3. 31 August 2017:

FT3: 2.54 pg/mL (reference 1.4 - 3.5 pg/mL)

FT4: 1.01 ng/dL (0.71 - 1.85 ng/dL)

TSH: < 0.03 μU/mL (0.4 - 3.7 μU/mL)

She put me on Euthyrox 112 mcg and told me to stop supplementing, apart from magnesium. She said taking Euthyral would be bad for my heart.

Within 6 weeks I felt gradually like I was going back to my burned out self, my brain and digestion slowed down. I could only get through the day on 6 coffee, and even that was wearing out quickly.

After 6 weeks Euthyrox 112 mcg (1 tablet a day) I did a test on 9 October:

FT3: 2.19 pg/mL (1.4 - 3.5 pg/mL)

FT4: 1.17 ng/dL (0.71 - 1.85 ng/dL)

TSH: 0.11μU/mL (0.4 - 3.7 μU/mL)

AC. ANTI-TIROGLOBULINA <5 UI/mL (reference < 5 UI/mL)

AC. ANTI-MICROSOMALES(TPO) <6 UI/mL (ref < 6 UI/mL)

Vit D: 24.50 ng/mL (ref: < 10 ng/mL Déficit, 10 - 30 ng/mL Déficit moderado,

30 - 96 ng/mL Valores recomendados, > 96 ng/mL Exceso)

At the next occasion I had, I went back to my doc in Brussels. He ridiculed the Spanish doctor about Euthyrox, and concluded I have no Hashimoto. To avoid side effects for Euthyral though, he gave me ErfaThyroid (NDT). I am now taking 1,5 pills in the morning but I don’t feel great. When I can, in the afternoon I take 0,5 on an empty stomach, but I am not always able to have enough time between meals and snacks and so I don’t bother if I don’t have an empty stomach.

I am longing back to my Euthyral even though in all fairness, the side effects were not great. But I now have ice cold feet and I cry / feel depressed / tired /foggy brain.

Should I increase the Erfa? Go back to Euthyral? Switching the meds is the hardest, I go through a few days of sickness/flu-like symptoms.

I worry also about posts about mixed Erfa quality....help! It's 18 degrees outside so no need for such cold feet (so cold they hurt).

Lastly, and I don't if it is related to the hypothyroidism, but I have intense pain around the lung / rib area in the early morning when I am still asleep - around 5 am it usually starts. It comes and goes in intensity, but when I have it, it's dreadful and I have to toss and turn and can not lie on my side. It is not a bone or muscle related problem, I have seen multiple therapists already and the pain is gone in 30-60 minutes as I move about after getting out of bed. I am flexible and work out moderately.

Thanks very much in advance!!