Results with symptoms

[Rosebud1955]

Hello everyone: I have new results and would appreciate some advice/suggestions. I was taking 75mg Erfa thyroid + 25 mcg Synthroid @ 7am when these labs were done. Took 45mg + 25 Synthroid the morning before labs, then 45mg Erfa @ 9pm. No meds the morning of.(fasting). These are my results: tsh : 0.01 (0.32-4.20). FT4 : 12 (9-19). Ft3 : 4.6 (2.6-5.8) B12 : 1044 (138-652). Ferritin : 194 (15-272). Vitamin D : 114.1 (75-250) Folate not tested, supplementing with good B - vitamin ( 400 folate included). I was supplementing with sublingual B12 but has since stopped. I take 1000iu vitamin D3+K2 (sublingual) After pointing out my symptoms to the Endo, he suggested that I increase my Erfa to 90 mg. He suggested that I take Erfa 60 + 25 Synthroid in the morning and Erfa 30 in the evening. I started this two weeks ago, I’m now feeling worse than I did when I was taking all the meds at once in the morning. Massive hair loss, dry skin, more severe post nasal drip which gets worse the same time every day ( 10-12 hours after my morning dose), also having headaches at the same time, excessive over heating in my back and pain in the back of my neck. ZERO motivation. This is very out of character for me. I’m thinking that maybe my T4 is too low for me, and that I may be running out of T3 in the evening time. Should I have left the Erfa dose @ 75 and increase my Synthroid? Is there any real harm in taking my full dose together (7am) My Endo thinks the body cannot handle more than 60 mg Erfa at one time. It has been very stressful for me having to divide the dose. I take several supplements (Chronic Lyme Disease). I was doing better when I took them as a single dose. I’m thyroidless due to thyroid cancer.

Thanks for any suggestion/advice

[pennyannie]

Hey there again :

I can't see too well all these results but just quickly, if you felt better taking the NDT all at once in the morning - do that :

B12 looks very high and over range and no folate result - did you stop supplementing for around a week before the blood draw ?

With NDT you can have a low T4 as long as your T3 is high enough for you to feel as well as you can, that is all that matters.

There is a unique ratio in NDT of T3/T4 and by adding T4 to your dose you are eroding that unique ratio so maybe not a good idea ?

I take 1 + 1/2 grains all together at around 3.00 am in the morning at a toilet break and go back to seep for a couple more hours, no problem.

I wonder if your adrenals are compromised - as they tend to pick up the slack when the thyroid is under stress or not optimally medicated for - I also take an adrenal glandular ?

Still thinking --

[Rosebud1955 in reply to pennyannie]

Hi Penny, Thanks for your input! The only reason why I take the extra T4 is because Endo thinks I need a little more T4 and does not feel I need any more T3. I’m tempted to just take the 1+1/2 and see what happens. That would give me only 35+17 T4 and 12 T3. That might just be enough for me considering my age (67) my energy level doesn’t seem to be a problem,mi walk 5 kilos every day with no problem. The problem is the hair loss, dry skin and lack of motivation. I wish I could take mine overnight, that sounds like a good idea. It was suggested that I try ashwagandha, I might give it a try. Do you feel well on your 1+1/2? I take Erfa which is a little less T3&T4 than armour. I appreciate all the help I have received from you lovely people. I’m in a far better place now than where I was before I joined.🙏🏻 Thanks to everyone who gave me valuable advice!

[pennyannie in reply to Rosebud1955]

So I am 75 and a little further down the road than you :

I wish I was able to walk as far as your good self - my excuse will be cliff tops and those valleys in between which I find a challenge too far !!

Finding motivation is a hard one - especially if living alone.

How are your ferritin, folate, B12 and vitamin D levels as these need to be maintained at optimal levels for any thyroid hormone replacements to work well.

My hair and skin are on the dry side but not to a degree that concerns me too much though use topical OTC products.

All you can do is try - that's all any of us can do and just sharing information on this safe forum is sometimes reward enough and gives back some level of relevance.

I'm much improved on NDT and keep thinking if I could just up my dose I'd find more energy but I've tried various options and I end up back at this relatively low dose.

So, I'm still open to experimenting and researching for myself, nothing is a " done deal " .

[Rosebud1955 in reply to pennyannie]

My ferritin and B12 are good (results in my original post) Endo reluctant to check folate, I supplement a good B- vitamin with 400 folate so I didn’t fight for testing. Thanks!

[greygoose]

Given that some people take 250/300 mcg levo all in one go, and others take around 100 mcg T3 all in one go, I would say that your endo is wrong in saying that the body cannot handle more than 38 mcg T4 + 9 mcg T3 all in one go. I wouldn't at all doubt that some people can't, but we're all different, and therefor some people definitely can. Try it and see.

[Rosebud1955 in reply to greygoose]

Thanks for your suggestion GG, this thyroid journey can be scary. I had bad debilitating symptoms in my early journey and I think it traumatized me. I am now scared especially after increases. I tried it all in one go this morning and is now crippled with headache all day. I want to wait and see if will settle down but is very scared, can’t deal with the side effects. I think my body is extremely sensitive to these hormones. I will go back to splitting and give it some 58me to settle in. I appreciate your advice!

[greygoose in reply to Rosebud1955]

You're welcome.

[Imaaan]

Hey Rose

Your vit d is only at 22% and your iron is at 69% . A slight increase on your ferratin may help you tolerate the meds better. My optimal is around 75%. As for the vit d levels, you need to up it. If I was in your shoes I'd take 10,000IU. For a while I just got a prescription from my doc and would take it 5 days a week. After I reached the low end of the range my doctor reduced the amount so I purchased 5,000iu from Amazon and took 2 a day to further raise my levels.

I think the symptoms you're experiencing may be due to the increase rather than splitting your dose. You could ride it out or try taking it at one go as others suggested. Personally, if I was experiencing symptoms with a split I'd rather not take it in one go because it would overwhelm my system. With every dose increase, I dealt with symptoms and it would settle down around the 3rd week.

I split my doses to three times or else I cant tolerate it. I was on Erfa and synthroid for about 11 months.

Also, it could be a cortisol issue. Taking ashwagandha at a 300 dose helped me. I used a Canadian brand that provided a low dose of 150 in each pill.

[Rosebud1955 in reply to Imaaan]

Thanks for your input! Because I take so many other supplements I’m unable to split my dose any further, it’s even difficult for me when I split in two doses. I will definitely take your advice in upping my vitamin D. I had reached the 200 mark but slacked off over the summer months. I was also not consistent in taking it daily, so I will increase to 200 and try to be more consistent. Now that the winter months are approaching I know my level will drop. I think I will continue splitting my hormone doses and wait for things to settle. It’s truly can be an up hill battle!

[Imaaan in reply to Rosebud1955]

Hope all goes well and you see improvements sooner rather than later. Another option is to split the t4 in half and take only half along with your morning dose for about a week to get use to the erfa increase and reintroduce the full amount the following week. So 60 Erfa and 12.5 T4. I tweaked my t4 around as we increased my Erfa dosage and it helped with tolerating it.

[Rosebud1955]

Thank you so much, I think I will try tweaking the T4, sounds like a good idea. I’m willing to try anything to get to a better place!