Hi Members,
I have a big problem with thyroid hormone (medicine) absorption, however, I don’t take it close to vitamins. I stick to the same routine, regarding my medicine taking it morning with water. Now the hormone seems to not give any benefit, for my dosage is not a problem.
What’s your dosage and how do you know it’s not a problem? What are your FT3 levels (we’ll also need the laboratory reference range please to make sense of the result)?
The results show optimal levels like free t3 is upper 1/3, I take 50mcg tirosint and 5mcg of cytomel. I don’t understand the absorption problem, considering might be thyroid hormone resistance. I get off cytomel, then my t4 is 1.4. I never had a converse problem, until taking cytomel. Nowadays I don’t know what is happening!
Have you tried upping your dosage? What happens when you do? As MissGrace says, top third of range still might not be high enough for you. If there’s wriggle room to try a higher dose, then try a higher dose.
What about B12 levels, ferritin and and Vit D? Deficiencies in any of those can leave you feeling very unwell, especially when hypothyroid.
Please don’t take iodine. It’ll only make things worse.
I know my vitamin D is low.
I cannot see why taking T3/cytomel would alter your conversion, it would most likely lower both FT4 and TSH relative to the dose of T3 you take... but that has nothing to do with conversion.
Without detailed results (inc lab ranges) it becomes more difficult to advise.
You say FT3 is in upper 1/3 of range, that leaves you room to increase your dose if that is what is required.
The bottom line is ...how do you feel? What are your symptoms?
Finding your optimal dose is a long slow process and takes patience and determination, changing your dose too quickly will not be well tolerated. The body can take several weeks to adapt to dose change.
Have you kept a record of all medications/doses?.
You say, "My thyroid problem started with the introduction of Cytomel" which suggests you were symptom free before you started T3 which seems a bit odd. I expect you are bearing in mind that T3 is a very potent hormone and needs to be treated with respect.
If you had no problems, as you say, why did you add T3?
When was hypo diagnosed?
Do you have a copy of that diagnostic test result?
Were you then prescribed levo/T4 by your GP?
Did you start with T4 mono therapy then move to trials of T4/T3 combination?
If you think you are thyroid hormone resistant then this ebook may help.
The ebook is on Amazon for £3.56 or free if you have Amazon Prime. It is called "Impaired Sensitivity to Thyroid Hormone (Thyroid Hormone Resistance)" by Hugh A Hamilton
You may also find it helpful to check the work of the late Dr John Lowe...use your search engine.
I am Dio2/homozygous and also thyroid hormone resistant and understand how complicated it is to reach an optimal dose....after a year on T3-only I am very close. I titrated T4/T3 for over 6 months before that.
Look back to the start of your journey and working systematically check each step you have taken since then ....start with your diagnostic test result. I suspect the clue lies in that detail.
Not sure if this helps... but good luck.
Only thing I hear from my doctor is low iron and anemia.
Optimal levels are when you feel well and your symptoms are alleviated. So your levels aren’t optimum just because of where they are in the range. That’s how a GP might read it and that’s what causes so many problems. Are you sure that you don’t have a conversion problem with Levo, rather than an absorption one? 🤸🏿♀️🥛
If I was going by the labs, they don’t show any conversion issues. My thyroid problem started with the introduction of Cytomel. When I take my thyroid hormone/medicine is not absorpted, like the cells don’t respond. Iron anemia research shows thyroid wont function without significant iron levels.
Sorry to jump in here but my folate has reduced somewhat this year. I did private tests, bottom of range is 8.83 (I think) & my folate was 8.85 so just in range & that's after taking folate for a month (I regularly take Vit D, Magnesium & Zinc but not folate, decided to stop multivitamins a few years back as has high copper). Funnily enough, my TSH has gone from 0.75 to 1.77.
You need to get your iodine levels up. 2% Lugol’s iodine. Your thyroid needs iodine to function properly. I would also suggest vitamin C. There is a book by dr. Brownstien “iodine why you need it and why you can’t live without it.”
There's iodine in thyroid meds. 😊
I’m aware it was has iodine sodium iodized to t3. I heard on a website talking trash about lugol’s iodine. If iodine can help, I will try it out.
Otherwise I think my iodine is covered with salt.
I will research the iodine because I heard it actually makes people hyperthyroid.
I was advised to avoid iodine on another site.
No, the thyroid doesn't need iodine to function properly. Iodine is one of the ingredients of thyroid hormone. If your thyroid is not working properly, and cannot make enough thyroid hormone, it doesn't need more iodine, it needs less. Excess iodine can cause all sorts of problems, and is actually anti-thyroid. It used to be used to reduce thyroid hormone production in people with Grave's. It is not recommended for hypos.
healthunlocked.com/thyroidu...
It's interesting that iodine is being pushed for thyroid patients knowingly that there is iodine in our thyroid meds already . Why ???? Can it be the Iodine companies ?
No. It's just ignorance about how the thyroid really works. 
You know greygoose I'm always suspicious when something is being pushed in general . They produce all kinds of studies to back it up . It's always an interest groups that are financing it . So some will buy into it . We have to be very mindful not to fall for their ploy .
I very much doubt there's much profit in iodine. It's a natural substance, you can't patent it. So, I rather doubt that's the reason. And, to my knowledge, no-one has ever produced a study to say we should all be taking iodine. It's just that the two go together - thyroid = iodine. Usually, the people that push iodine don't really understand how the thyroid uses it. They just know that iodine deficiency can cause hypothyroidism. And they think it's like putting petrol in a car to make it go further. That's my experience, anyway.
You are probably Right . You mean they think the more is better kind of thing ?
Something like that, yes.
greygoose you know it's hard to win a debate with you when Your *Spot On* .
It's True . Your very sensible and very well informed . You really *Get It* .
eat4longevity
You need to get your iodine levels up
You can't possibly know that unless iodine has been tested and found to be deficient. Very unsound advice. Nobody should supplement with iodine unless testing has shown a deficiency, then supplementing should be under the guidance of an experienced practioner.
Great Advice as Always SeasideSusie . Infect adding more Iodine to our thyroid meds can give us hypo symptoms .
In your shoes I would definately tackle the iron deficiency as that WILL be affecting you causing fatigue etc.
Secondly whatever you do make one change at a time. That way you will find out what does help. To some degree treatment of hypothyroidism is trial and error.
Blood test results are a guide they are not. gospel!! I need my thyroid levels to be further up in the range than in the top third to feel well.
Lastly if you still feel unwell once you have optmised your thyroid levels and addressed your iron levels it maybe that you need to consider a different form of thyroid meds such as a ndt. Not everyone suits the synthetic meds. I didn't though my blood work looked good on them.
You have low vitamin d and I know vitamin d shares the same receptor site with thyroid receptor sites.
Which thyroid hormone are you taking? It can make a lot of difference. Levothyroxine (Synthyroid) does not work well for as lot of people, yet it is the one doctors seem to prescribe first. For me, Levo is like taking nothing. If that's what you're taking, and it isn't working for you, Natural Dessicated Thyroid (Armour) or T3 (Cytomel) may work better for you. ... I would say: "Discuss it with your doctor" but so many doctors just don't understand that Levo is not the best choice for a lot of people.
Great advice from Waveylines. Just be systematic and work through each thing slowly.
In your case, try pushing freeT3 all the way to the top by increasing slowly (blood test every 6 weeks and adjust).
If you have vitamin deficiencies, work on those. Iron deficiency is one of the difficult ones to work on because the tablets can make you feel sick. You may need to try two or three ways of supplementing before you find one that works for you. Then in 6 months or so get retested to confirm that what you're doing is raising levels.
If you get to the point where there is nothing more to try with T4+T3, change over to T3-only or NDT and try those. Stay for at least 6 months on the T4+T3 first, it takes a while to get these things to work.
I have thyroid hormone resistance. I've had a thyroidectomy and didn't feel much better on synthetics than nothing at all, and have been in bed most of the time. NDT felt much better, over the past 2.5 years I've been slowly raising to very high levels. Currently have a freeT3 of about 11 ( 3.4-6.8), am finally feeling a bit more normal on a combination of NDT and T3. You've got to slowly try each thing out.
I too had TT many years ago . I was on T4 Only for many years . At first it worked well for me . With time I developed all sorts of symptoms not realizing that I was missing very important components that my own thyroids have once made and no longer do . Adding synthetic T3 with my T4 did not feel well for me . Adding NDT to my T4 was a game changer for me . It made a huge difference . It's very interesting that as many of us that had TT we each individually find our *Optimal* with different thyroid meds . It just shows it's Not one size fits all . It ought to be Respected too .
I definitely felt a huge improvement when I first tried NDT. Even though I changed over to a tiny dose and had a TSH over 100, I still felt more like me in some way.
I've raised slowly on NDT, and then when I stopped getting improvement and feared I might be overmedicated started swapping in some T3 and have had improvment again.
Who knows where I will end up! 😈
Your right . Our metabolism keeps changing hormones fluctuate, stress, weight changes and even our meds can change (fillers) without our knowing it . I think that thinking that once we are well dosed and feel optimal it's not going to be edged in stone . Very Unfortunate . But yet reality . In reality healthy thyroids that are intact go through adjustments that we are not aware of . Here we are manually having to adjust our thyroid meds accordingly .
Does monotherapy t3 work effectively to treat hypothyroidism?
Yes, T3 monotherapy can work just as well as Levothyroxine or NDT monotherapy. They are all thyroid hormone.
Many people will find they have a strong preference for one over the other, some people feel they need some T4 to feel well, but other find any T4 makes them feel worse.
Yes It comes to the body chemistry. I tried cytomel only in the past, it seemed to work good.
I can’t waiting on the iron supplements, I took early to decrease. I had recently picked up vitamin d and it gave me energy right away. I hope the cytomel doesn’t cause any cognitive problems.
Hi MorganLeesoso, I have replied to your query on another post but here you say thyroid problem started on introduction of Cytomel T3...do you mean you started to feel more symptomatic/ill, or your blood results now look ‘wrong’? As soon as T3 is added to levothyroxin then FT4 and TSH can start to go down, even on a small dose, below ‘range’ but that is normal. How is your dr. treating Anaemia. Do you know if your other folate, b12 and vit D levels are optimal too?
Well when I had added cytomel it seemed everything was great. My energy levels and my mood improved significantly on cytomel. I would say in about a few on cytomel that health issues came up. I had chronic iron, less energy, brain fog, and depression. My thyroid level results should hyperthyroidism, but a lot thyroid patients have no issues with suppressed tsh. The anemia is due to low iron.
i am curious...is your doctor looking at the TSH being low AND freaking saying you are hyper ...because it will naturally go way down with any t3 meds so you have to ignore the tsh, also.....when did you take your thyroid meds before test...the day before i hope and not the same day...because that can give you misleading results and cause you to be undertreated...this is true for any t3 meds for test
A suppressed TSH doesn't make you hyperthyroid. The TSH becomes suppressed when you are hyperthyroid, but that is because the Frees are high.
You cannot become hyperthyroid, because you are hypothyroid. You cannot swing from one to the other. You could be over-medicated, but that's not the same thing. And if your FT3 is only in the upper third, then you probably aren't over-medicated.
If your TSH is suppressed, it is because you are taking T3, not because you are hyper or over-medicated.
Do you have symptoms of over-medication? If so, which ones? It's sometimes difficult to tell with symptoms, because so many can be hypo and hyper symptoms. And, if you think the hormone isn't getting into the cells, then they cannot be hyper/over-medicated symptoms. The hormone in your blood doesn't do anything. It has to get into your cells in order to cause over-medicated symptoms.
I think it's far more likely that you are under-medicated. But, without seeing your exact results and the ranges, it's impossible to tell.
Exactly what I said about the suppressed tsh! On the undermedicated part I would say not really, If I take a dose lower or higher of my present dose, it makes me sick. I will have to post my free t3 later!
Better if you posted TSH, FT4, FT3 and antibodies.
Have you got TSH, FT4 and FT3 results from same blood draw to share, lush thyroid antibodies and vitamins/ minerals too if possible? Then we might work out what is overmedicated or not; sometimes hypo and hyper symptoms can be similar, while drs. panic with TSH below range even if FT3. Is fine ( but probably not tested). I found adding T3 in a tiny 1/8 th of 25 mcg pill felt like ‘rocket fuel’, but got palpitations till I got up to the full 25 mcg T3 pill with levothyroxin.
I ask my gp to ordee a full thyroid panel and a vitamin/minerals labs. Most doctors never bother to order labs for vitamins.
I do have vitamin d deficiency.
So low iron/ferritin with Anaemia and deficient (ie below out of range, or just low on range?) vit D...you really do need these sorted before you go down route of fine tuning your T3 dose. If Anaemic and deficient in vit D then your dr. should be treating these as a priority, rather than be giving you T3. Although various members have asked for your blood test results, I notice you haven’t given them. I would suggest you might need everything doing TSH, FT4, FT3, and thyroid antibodies (TPO and TgAb) if you don’t already know if you are Hashimoto’s (autoimmune thyroiditis), and the 4 vits/mins ferritin, b12, folate and vit D to give you a baseline and idea how to improve your thyroid health, perhaps even without taking the T3 for 6 weeks.
Yes I’m going to do labs, as soon as possible.
I had just took vitamin d and I noticed a big difference.
I just wondered if your weight has altered at all on Tirosint(?). If by any chance you lose weight like me on it, could you have less fluid on board to circulate medications in general into the right cellular compartments? Sometimes (in my case at least) I think the Tirosint is just plain absorbing too well for it’s own good & dehydrates somehow a measure in it’s process.
I am just suggesting (as a very novice fellow Tirosint user mind you) if you have lost any weight you may need to increase your fluid intake to get medications to work efficiently.
Yes I would lost about 20ibs on tirosint, it seems to speed metabolism. Tirosint was wonderful for almost 6 months; however, tirosint became less effective overtime. I can say tirosint having no fillers, it made a big difference. Regular levothyoxine fillers caused bad side effects.
If it raised your FT3 level then it would have had an effect on your metabolism. That's what it's supposed to do. But, if it became 'less effective', you probably weren't taking enough. Why didn't you try increasing it?
My free t3 levels were above the free t3 range, in fact they to high. It just at a cellular level it didn’t work.
The only logical answer the tirosint doesn’t work with my body chemistry,
No, that's not the logical answer, I'm afraid. I don't think it has anything to do with your body chemistry. It was fine for you to begin with, wasn't it? But, your FT3 went over-range? Above you said that it was in the top third of the range. It really, really would help to understand if you posted your results and ranges so that we can see what we're talking about.
Do you have Hashi's?
Also, if your FT3 is too high, that could be what's causing your symptoms. Too high can be as bad as too low.
I have had a similar experience too. Tirosint was like a wonderful antidepressant, I felt like a million at first but that effect was not as great over time. I had not thought of it as speeding up metabolism, thank you for sharing that insight. I guess this was because I went gluten free at the same time I started Tirosint. I did switch back briefly completely to Synthroid & gained weight back immediately so I don’t attribute weight loss to gluten free meals. Maybe we need to eat as if we are on a crew team!
Diabetics develop “insulin resistance”, I wonder if we develop a different form of resistance(?).
You make a interesting thought about resistance, probably going to research tirosint more.
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