medication how much

[bossbird]

my endo is struggling to control my Hashimotos, my last blood results were -

FT4 9.4 (11-23)

TSH 0.02 (0.3-5.5)

FT3 5.3 (4.1-7.9)

so meds were increased to

200mcg T4

20mcg T3

2 grains Armour

I've now been on the above for 3 weeks, feeling better but still have some way to go

question how much medication can a person take before it becomes harmful?

Ive recently had an MRI scan just in case its the Pituitary gland results in about 10 days

[greygoose]

I would say, a lot more than that! Your Frees are still very low. The idea is that you take the amount you need to get rid of your symptoms. Some people need more than others. I myself am taking 150 mcg T3 and 3.75 grains NDT. And I'm considering an increase soon.

You are very lucky to have an endo that allows you to take such a large dose and have your TSH suppressed without having a heart attack himself! lol Did you ask him your question?

But it's a strange mixture. How did you arrive at that? Why not cut out the T4 and take more Armour? (Just curious.)

The point is, how do you feel? If you feel well then that's fine. If you still have symptoms then you need more.

Hope that helps, Grey

[bossbird in reply to greygoose]

thanks Grey - my endo cant supply Armour at the moment so as I have only a limited supply from a previous dr so this one added T4 I would prefer Armour - if there is T3 in Armour why do you take so much in addition was it on your blood results?

[greygoose in reply to bossbird]

I dose by symptoms. I've tried all sorts of combinations to find the one that suits me best. I don't feel right on T3 only, I have the impression that something is missing. On the other hand, I don't convert well, so need the T3. The important thing for me is listening to my body, and that's what my body has told me so far. But I quite believe that one's needs change - another reason a fixed daily dose of T4 didn't suit me - so my dose might change in the future, too.

I think the reason that a lot of people don't get well is the rigidity of their treatment. The thyroid doesn't put out a fixed daily amount of hormone, and conversion isn't done on a rigide daily regime, it adjusts to one's needs, so why would doctor's think that a fixed dose would be all one needs. My doctor told me I could take more or less according to how I feel. I do generally stick to the same amount, but increase the T3 slightly if I'm feeling ill or if I've had a heavy day. I do it by feeling. Most doctors consider that everyone is as stupid as they are and not capable of handling a flexible dose, and perhaps some people aren't, but I consider that I am, so that's what I do.

Hugs, Grey

[bossbird in reply to greygoose]

ok my endo is very good and understanding and will allow me to self medicate but I'm not sure with my blood results if i should up T3 T4 or the Armour i used to know what to do but now I'm confused

i recently went up by a stone which isn't moving and i feel weird x

[greygoose in reply to bossbird]

Hmmm... difficult. I can't understand why your FT4 is so low when you are taking so much. That could point to good conversion but your FT3 is so low... Have you tried T3 only?

[bossbird in reply to greygoose]

perhaps i should have mentioned that last Oct i changed Endo because i wanted to try Armour and my usual endo isn't allowed to supply - the new Endo knew I was on 250 T4 and 20mgc of T3 3 time a day but only allowed me 2 grains of Armour then 4 months later became very ill seems I had adrenal fatigue so went back to first endo who's helping me get back on track now i don't know what 2 grains = in T3 & T4 to see if I'm on more or less than in the first instance?

[greygoose in reply to bossbird]

One grain is 60 mcg T4 and 9 mcg T3. So, yeah, you're on more T4 than before by 70 mcg and 18 mcg more T3.

So where is all that T4 going? Even if you have adrenal fatigue, it should show up in your blood tests...

So what are you doing for your adrenal fatigue? How long have you been doing it? What does your endo say about all this? Apart from telling you you have adrenal fatigue, that is.

[helvella Administrator]

Can I clarify? that is 200mcg levothyroxine AND 20mcg Liothyronine AND 2 grains of Armour every day?

That is a high dose. But the odd person does need a high dose.

The obvious questions are whether you are absorbing the thyroid hormone or if something is acting as a sink for thyroid hormone. Occasionally something produces lots of the hormone that converts thyroid hormone and dose so to the extent that you cannot keep reasonable blood levels without such high doses.

"consumptive hypothyroidism" is the term... But it is very, very rare.

Rod

[bossbird in reply to helvella]

thanks Rod ill check it out

[helvella Administrator in reply to bossbird]

I mis-typed, I meant:

produces lots of the enzyme that converts thyroid hormone

Apologies

[shaws Administrator]

Before the TSH was invented, people were medicated between 200mcg and 400mcg of Natural dessicated thyroid. You would soon know if you were taking too much by pulse/temp and you just reduce your dose slightly.

[bossbird in reply to shaws]

Hi whats that in grains?

[shaws Administrator in reply to bossbird]

Depending on which NDT, 1 grain is around 60 to 65mg.

thyroiduk.org.uk/tuk/treatm...

Dr Lowe has said that people who have Thyroid Hormone Resistance need supraphysiologic doses.

web.archive.org/web/2010122...