new combo t3/t4

[MiaMam]

After how long can you feel the effects of a new thyroid medicine? I’ve been put onto a new combo by my endo - novothyral 1/4 tablet which is 25 t4 and 5 t3 plus added 25 t4, total 50t4 and 5t3. This is after trying out thyroid-s for the last year up to 2 grains.

[pennyannie]

Hello again :

2 grains of Thyroid S would have given you - 18 mcg T3 + 76 mcg T4 -

and so now you are taking - 5 mcg T3 + 50mcg so a big drop in medication :

Were you ever on dose of anything - T4 or T3 or T3/T4 combo or NDT that came to close to relieving symptoms of hypothyroidism.

From memory think you have Hashimoto's - so are liable to erratic own thyroid hormone production as this AI disease progressively damages and disables your thyroid.

Did you find your old posts as I think I explained further about Hashimoto's in a previous reply.

You are looking at around 6-8 weeks to see the effects of this new dose in a blood test - though you may well experience new symptoms within around a week.

[MiaMam in reply to pennyannie]

I was on 100 mcg t4 for 11 years but never resolved my issues. I started getting stiffness and pain in my neck and my left side and so started experimenting on my own last year. I’m on this new dose for the last week but feel awful. My endo prescribed it. I can’t sleep plus my stomach problems are back as well as my back pain. The problem is it seems t3 and the constant buzzing in my ears. I texted cortisol, it was high in morning the at midday and then normal afternoon and evening. So I’ve been taking holi basil last month and will continue. My vit d was low so I’m now supplementing 5000 a day with K and 2000 vit c and magnesium. My ferritin was low but my iron was good so I don’t dare supplement it to not cause more issues. Im not sure if I should though. I really want to figure this out and try and be able to go back to the ndt and upping my dose until optimal but can’t figure it out and am getting frustrated (not the best thing). I can’t tolerate coffee anymore , it sends me in a frenzy yet I need it for my stomach.

[pennyannie in reply to MiaMam]

Ferritin needs to be at least over 70 for any thyroid hormone to work - this is what I read in several places when researching about why my ferritin was at 22 - and told I was fine and have an anti depressant.

In fact no thyroid hormones work well until the core strength vitamins and minerals of ferritin, folate, B12 and vitamin D are up and maintained at optimal - I no aim for a ferritin at around 100 - folate around 20 - active B12 75 ++ ( serum B12 500 ++ ) and vitamin D around 100.

It reads as though you have some stomach issues - needing coffee for your stomach ?

Did you read up on Dr Izabella Wentz's research as with Hashimoto's it is essential to heal the gut first as optimal absorption of the thyroid hormones takes place in the gut.

[MiaMam in reply to pennyannie]

My ferritin is well below that in the 20’s range so that could be the issue. How do you get it up? Iron supplements ? Stomach issues are a chicken and an egg story , I’ve been ‘curing’ it for years but it’s when I get the right thyroid supplements, I have no stomach issues. Otherwise worked with many dr’s but no one ever properly checks minerals and vitamins. My vit d is below 60 as well and they all say it’s fine. Do you supplement all the time? I’m going to pull out all my last lab results and check properly and get onto supplementation I think. I’ve tried everything else.

[pennyannie in reply to MiaMam]

Yes - I'm much improved and in my 5th year of taking Thyroid S -

I am with Graves and post RAI thyroid ablation 2005 so likely now with no thyroid function of my own - but I still need to supplement all of these vitamins and minerals in order to stay well.

My levels were all within the NHS ranges so considered ok and good to go - but none of them optimal - so I supplement myself - and run my own blood tests, monitor myself and out of the NHS system - which I 'm not recommending - it doesn't suit everyone and you maybe more fortunate than me and find help and understanding.

[MiaMam in reply to pennyannie]

I doubt it. I live between india, Dubai and Serbia and finding anyone that understands this is a nightmare. I go to several naturopathic dr’s , Ayurveda, regular and just keep getting worst. Thyroid s made me feel great for about a month so I’m stubborn to figure it out. Thanks so much for your inputs! I will feel free to ask you questions on my vit levels

[pennyannie in reply to MiaMam]

I think you jumped to too high a dose on Thyroid S if my memory serves me right - yes no problem - if not me - there's always someone who will help you - no worries.

What work take you to all these places - or is that a silly question ?

[MiaMam in reply to pennyannie]

Not silly at all. I had a distribution business in india for over 30 years - retail and wholesale , guess watches , Swarovski etc, that’s where I fried my thyroid .. if you want to see what stress is- run a business in india 😊. It was great though and a lovely period of my life, but now need to recover. Dubai is close by and Serbia is home so I want my child to learn the language.

[MiaMam in reply to MiaMam]

Another question - can being under-dosed on thyroid meds make your morning cortisol high and make you hyper ?

[pennyannie in reply to MiaMam]

Well that's very interesting - I've had some experience manufacturing in the Far East but even working with a multi national company it was a roller coaster with some unimaginable disasters.

[Jaydee1507 Administrator in reply to MiaMam]

It sounds like your vitamin levels have a way to goo before they are optimal. We need optimal vitamin levels for our thyroid hormone to work well.

Perhaps start a new post with all of your vitamin levels including lab ranges for each test.

If your ferritin is that low you should get an iron panel blood test done.

Vitamin D should be around 100 - 150. Buy one that includes vit K2 to help it go to your bones. Some are available in oil or you can take it with an oily meal for better absorption. Many members like the ‘Better You’ range of mouth sprays that contain both bit D & K2. Use this calculator to work out how much to take to get your level to 100-150. wildatlantichealth.com/vita...

[MiaMam in reply to Jaydee1507]

Thank you. Sound advice. Will do so.

[SlowDragon Administrator in reply to MiaMam]

My vit d is below 60 as well

What’s the unit of measurement for vitamin D

In U.K. we use nmol

Aiming for around 100nmol or 40ng/mL

most of world measures in ng/mL

[DippyDame]

How do you feel?

2 grains NDT = 76mcg T4 + 18mcg T3

Your new dose = 50mcg T4 + 5mcg T3

You may feel the result of this reduction in a few days!

However, without full thyroid test results it is well nigh impossible to know how much hormone replacement you need.

Test after 6/8 weeks on a steady dose, at 9am and at least an hour after food and drinks, 24 hours after last T4 dose and 12 hours after last T3 dose

At very least, test TSH, FT4 and FT3... ideally include vit D, vit B12, folate, ferritin and thyroid antibodies Tg and TPO.

[MiaMam in reply to DippyDame]

I feel horrible. That’s why I asked. I’m dreading the next 6-8 weeks and feeling hypo. I’m going to pull my last test results and come back to you please 🙏.

[DippyDame]

Yes, I thought you must be feeling miserable, hopefully we can get you out of this horrible situation.

Post those results and we'll be more able to see what is going on.

Meantime, try and hold on to the thought that with the correct medication you will feel well.

It will take time so stay strong.

Here, we're all in this thyroid mess together and we understand..so just ask when you need help

Those results should help!