Can’t tolerate NP, Armour or Eltroxin- what next?

[Compostella1]

Hi all -

I have trialled eltroxin , armour and np thyroid and on the lowest dose of each I end up with palpitations.

I am gluten free since March which I am not sure is making any difference but I’ll stick to it.

I have attached most recent bloods- I know I need to up ferritin- am taking iron supplement as of this month and Vitamin D. I am seeing a nutritionist to perhaps trial no dairy, soy etc in an effort to tolerate meds.

My question is - does anyone have suggestions of what to do in the interim? I had to stop meds 3 days ago and have zero energy since, headache and major buzzing feeling. Sleep not great and in generally pretty ‘off’.

I was thinking of trying armour at lowest dose day on day off jst to have something going in.. this is probably the drug I tolerated best but every ally did get palpitations on it.

I am doing the adrenal test next week.

I have been given option of eltroxin and t3 but am very apprehensive as had such a bad time on eltroxin. Very bad anxiety and physically unwell.

Any help /thoughts wld be grt!

[Compostella1]

Apologies first bloods from mid April- these start of June

June bloods

[Lalatoot]

You cannot alternate days with Armour. The body needs a steady daily dose of T3. You can alternate days with Eltroxin as it is T4 only.

[Compostella1 in reply to Lalatoot]

Aha - thanks for that

[carolwxyz]

When I started on thyroid hormone many years ago I was very hypothyroid clinically with normal blood levels. I think it was T3 I was started on and I had to start on a much lower dose than given.

[Compostella1 in reply to carolwxyz]

I’ve started on lowest dose on everything- 25mcg eltroxin, 1/4 grain armour etc so I can’t go any lower on dose unfortunately

[shaws Administrator in reply to Compostella1]

Always take thyroid hormone with one full glass of water - as we do not want it to stick in our throat.

[humanbean]

Palpitations can be caused by low ferritin (iron stores) and serum iron. An iron panel test would be helpful. Something like this :

medichecks.com/iron-tests/i...

You might be anaemic, but you would need a Full Blood Count including a haemoglobin level to diagnose that.

am taking iron supplement as of this month

What form of iron supplement are you taking, what dose is it, and how many times a day do you take it.

Iron supplements must always be taken 4+ hours away from thyroid hormone replacement of any kind.

[Compostella1 in reply to humanbean]

I take iron biglycinate 40 mg . Yes I do take away from thyroid meds

I was anaemic when first diagnosed last year but had iron infusion and oral iron and resolved. Hv started this iron to get ferritin up.

[humanbean in reply to Compostella1]

Just to give you something to compare with...

I take iron biglycinate 40 mg

When I was desperately short of iron I was taking one tablet, three times a day of ferrous fumarate 210mg . Each tablet contained 69mg of iron. And since I was taking three per day I was taking a total of 207mg of iron per day.

I'm not suggesting that you must have lots and lots of iron. But if your level of ferritin is not rising with your current dose then you can increase quite a bit if you can tolerate it.

If you live in the UK the British National Formulary gives you information on the iron supplements that doctors prescribe here. They can be bought without prescription in pharmacies with pharmacist approval.

bnf.nice.org.uk/treatment-s...

It mentions four supplements in blue on that link - click on them for more info on each one including dose for different people and for different reasons.

[SlowDragon Administrator]

Palpitations can be due to being on too small a dose

[Compostella1]

Yes- however when I have increased the dosage the palpitations get worse. So unsure how I can get past that.

[radd in reply to Compostella1]

Compostella1,

NDT can be the most tricky to medicate with low iron levels & Hashi.

This is because the T3 within NDT doesn’t tolerate low iron well so you can’t raise NDT quickly enough to prevent thyroid activity. Too much thyroid activity can instigate a Hashi attack when thyroid antibodies are raised as yours are.

Also it may be that the amount of thyroid hormone you need to quell thyroid activity exceeds the amount you actually need for best function (ie it will make you over medicated.)

If I was you I would switch back to Levo because with added T3 it becomes a completely different scenario to your medicating T4 mon-therapy previously. This also give you the option to titivate each hormone independantly which NDT prevents.