I have just purchased some Thyroid -S and would like to know how I go about getting the right dosage.
I’m currently taking 120mcg of Levothyroxine and 30mcg of Tiromel.
I cannot deal with the joint pain anymore!
My Iron, Vitamin D, b12, & ferritin levels are all okay.
I can see that Thyroid - S is a 60mg dose, and I have read that it is best to start on 30mg, would it be ideal to increase my dose over time according to how I’m feeling on it?
I also need to know if I am to stop taking levothyroxine while I am using Thyroid - S and if I need to do this carefully through stages?
Advice from someone who has gone through the same transition would be great 🙂
I thought I was going to feel better after introducing T3 but that has not been the case this far.
Thank you in advance ☺️
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HypoHater
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If you've been taking 120mcg of Levothyroxine and 30mcg of Tiromel for some time, changing to half a grain Thyroid S would be a massive reduction and a terrible shock to your system. If it were me, I'd do a straight, immediate swop to 3 grains Thyroid S, and stop the levo and T3 completely. You'd still be on a lower dose of T3, but increased T4, so not such a drastic change.
In that case, no. But, did you really start on 30 mcg T3, just like that? Wow! Surprised it didn't blow your head off! One usually starts on 5 mcg.
Anyway, I would suggest that you start Thyroid S on 1 grain. Stay on one grain for two weeks, then increase by 1/4 grain every two weeks until you get to two grains. Then, stay on two grains for six weeks and retest.
Yes, desperation is a poor adviser. SOME people feel better as soon as they start Tiromel. Not everyone. For some people, it takes time. The best advice I can give you is to never compare yourself to others because we're all different.
If you only started T3 two weeks ago, why not give it longer? I increased my T3 dose recently, only by 6.25mcg, retested after 8 weeks and saw the expected results, but I was still feeling improvement at 10 weeks.
You should start T3 at a low dose - 1/4 of a tablet, 5mcg or 6.25mcg depending on the size of the tablet, then increase gradually by 1/4 of a tablet at a time at least 2 weeks between increases until reaching 18.75mcg or 25mcg (or 15mcg or 20mcg) and then retest. Most people don't need more than 20mcg or 25mcg when taking it in addition to Levo so I think you may have jumped the gun by being on 30mcg after only 2 weeks.
Tiromel is a 25mcg tablet so I don't know how you're managing to get 30mcg.
My Iron, Vitamin D, b12, & ferritin levels are all okay.
What does "OK" mean? Are they optimal, ie
Ferritin - half way through range
B12 - top of range for Total B12, and for Active B12 70+ but 100+ is better
It was my mistake, I am taking 25mcg of Tiromel (not 30) I started on half a tablet and then a week later increased to a whole 25mcg.
In response to giving it time, my initial goal is to come off of synthetic medication as I don’t believe it is right for me and would like to try a more natural route.
As for my vitamin levels, I haven’t yet checked if they are in optimal range. My GP said that they were all good so I took this at face value while I concentrated on my thyroid levels. I have my results printed out so I will check their ranges.
This is all new to me, I’m still trying to understand everything but I struggle with understanding even the simplest things at times 😔
In response to giving it time, my initial goal is to come off of synthetic medication as I don’t believe it is right for me and would like to try a more natural route.
NDT might suit you….but it might not,
It’s manufactured, and not a natural product
Which brand of levothyroxine are you currently taking
Do you always get same brand?
Many people find different brands are not interchangeable
Before starting on T3 we need OPTIMAL vitamin levels
And then starting EXTREMELY Slowly
Important to get TSH, Ft4 and Ft3 tested before starting
Always test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
What were these results before you started adding T3
Often reducing levothyroxine by 25mcg 4-5 days before adding T3. But this reduction depends on where Ft4 is within range.
If Ft4 at top, or over range….reducing by 25mcg
If Ft4 mid range, probably no reduction
If Ft4 at bottom of range …..don’t add T3, get 25mcg dose increase in levothyroxine and retest again in 6-8 weeks
Only starting with 1/4 tablet (possibly split into 2 x 1/8th)
Wait at least a week
Do you know if your hypothyroidism is autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies?
Have you had TPO and TG thyroid antibodies tested
About 90% of primary hypothyroidism is autoimmune thyroid disease aka Hashimoto’s
If you have Hashimoto’s you need coeliac blood test done BEFORE considering trial on strictly gluten free diet
Approx 85% of Hashimoto’s patients find strictly gluten free diet helps or is absolutely essential, and needs trying before adding T3
Well, yes. But now the OP has the Thyroid S, she might as well try it. With all this hype about it being 'natural', people obviously want to try it, thinking it just has to be better than 'synthetic'. I was the same. I moved heaven and earth to get hold of it in a country where it's illegal! Only to find that it really, really didn't suit me - in fact, it made me very ill. I'm much better off on synthetic T3. As I always say, toadstools are 'natural', but I prefer mushrooms in my omlette.
Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
I have been taking 4,000 IU of Vit D3 for as long as I can remember.
You should never just continue with a dose of D3 without testing. Vit D is fat soluble and any excess is stored, without checking your level this can lead to toxicity.
First you test to determine your current level and see whether you need to supplement, you compare that result with the level recommended by the Vit D Society and Grassroots Heath, which is 100-150nmol/L, with a recent blog post on Grassroots Health recommending at least 125nmol/L.
You then take the right amount of D3 to bring you up to the recommended level, so then retest after 3 months to check your level and once you've achieved the recommended level you reduce to a maintenance dose to keep it there, that may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. You will have to buy these yourself.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.
For Vit K2-MK7 I like Vitabay or Vegavero brands which contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.
Magnesium helps D3 to work. We need magnesium so that the body utilises D3, it's required to convert Vit D into it's active form, and large doses of D3 can induce depletion of magnesium. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.
B12 and folate are OK given the ranges you've quoted.
Ferritin - 44 ug/L (15-445)
This is too low. That appears to be a male range, female ranges are generally 13-150 or 15-300.
Ferritin is recommended to be half way through range, with some experts saying that the optimal level for thyroid function is 90-110ug/L.
Thyroid-S, or any NDT, is not as natural as people think. Yes, it's made from desiccated pig's thyroid but all tablets need synthetic excipients, those listed for Thyroid S are:
Thyroid extract USP
Lactose (a milk sugar and is a filler)
PVP K90 (Polyvinylpyrolidone; water soluble coating/binder; no known hazard)
Aerosil (silicic acid powder; help disperse the ingredients)
Sodium starch glycolate (helps dissolute/disintegrate the pill)
Magnesium stearate (filling agent)
Eudragit (a common sustain-released coating)
Methocel (a water soluble cellulose — helps bind pill)
Talcum (a filler)
Ponceau 4r lake (red additive-aluminum)
Tartrazine lake (yellow additive-aluminum)
Brilliant blue FCF lake (blue additive-aluminum)
Sunset yellow FCF (yellow additive)
Titanium dioxide (white)
PEG 6000 (water soluble polymer; binder)
Dimethicone solution
There are far fewer excipients in Levo.
TSH: 11.3 (0.27-4.2)
Ft4: 12 (12-22)
Ft3: 3 (3.1-6.8)
These are very hypothyroid results. Were you actually taking Levo at the time? If so you were grossly undermedicated. You need to build up your Levo dose until your TSH is 1 or below and your FT4 is as high as possible, then look at the FT3 and that will tell you whether you need some T3, whether in the form of added T3 to Levo or NDT.
You have to remember that NDT has a fixed ratio of T4 to T3 and that is approximately 4:1. This ratio is fine for some people but not for everyone. I am currently optimally medicated with a ratio of 6:1 which can only be achieved with Levo plus T3.
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