Thyroid Medication Options

Parent Cafe
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<p>Interesting you should mention the T3, Hugcheck. I posted a similar message on a thyroid board and someone immediately said that based upon my symptoms and lab work (High Free T4 and normal TSH) I probably needed T3. Again, finding someone who will work with me on this might be a challenge. </p>

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<p>So I’ve heard. I sure hope that’s not the case. I’m right at 90 days. I feel like my estrogen is under control and honestly, I can’t mentally deal with any more fluctuations in hormones, female, thyroid or otherwise. I’m emotionally exhausted from all these ups and downs. Just when I feel like I’ve had a few great days, it seems like it comes crashing down on me (with anxiety and panic attacks) and then a few days later I feel great again. It’s been extremely difficult to figure out if it’s stress-related to the surgery, thyroid or my female hormones. It’s probably a combination of all 3.</p>

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<p>MomLive one of the hardest things for my husband (and for me to watch) was that he was so sick / depressed / tired from the thyroid disease itself that he had a hard time mustering the energy to advocate for his needs. It took him over a year on just T4 to get stable enough to understand what I was telling him (from the beginning based on my internet research) about adding in T3 or getting the doc to prescribe Armour. (Armour is the pig source thyroid hormone that has T4 and T3 (and probably other thyroid stuff) that all hypos used to take before synthroid was developed and which many patients report on the internet that they felt better on until T3 was added to the T4 of the newer synthetics.)</p>

<p>Logically, the doc’s say your body metabolizes T4 to T3 so you should be fine getting the T4. However, that metabolic pathway can be messed up and the logic of how all this hormone stuff works is about as nontrivial as it comes with all the feedback loops and interactions and cellular vs. extracellular vs. in the blood vs. in the endocrine organ etc. etc. etc. So. I have to think that if you can find an Endocrinologist who is up to date and practicing on thyroid patients (as opposed to primarily diabetic patients) you will find they are well versed in adding T3 - cytomel. It’s not unusual now and getting more common every day to add that into the mix.</p>

<p>And as for getting a referral or second opinion or whatever you want to call it, if you have had hysterctomy AND have underlying thyroid (or am I mixed up?) then it’d be remiss, IMHO, NOT to have a specialist (endocrinologist) on the case.</p>

<p>T3 T3 T3! xo xo xo</p>

<p>Teri I hope you are better fast!</p>

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<p>Cytomel also has T3 in it (and a little T4).
It is my personal miracle.- I would be on the floor without it.
MD kept increasing my T4 dose for months and nothing happened to the way I was feeling. Day after (yes that was all the time it took) on Cytomel and I was a new person. </p>

<p>Some people just do not convert much T4 into T3.</p>

<p>As for fluctuations, that is a tough one. It is a sign that your thyroid gland is inflamed and I feel for you.
My endo believes in putting the thyroid completely to sleep (which may not be possible in your case) by gradually increasing to high levels of T4 supplementation- to reach a point of hyperthyroid for a bit of time. After a week or two of feeling hyper (because you are getting hormones from both the gland and the med), the gland will shut down (as the ovaries do on BCP- all the endocrine glands are meant to respond this way). Then the hyper feeling goes away, and the meds are providing all your hormone and you can control the dose.</p>

<p>Of course, there are some whose glands do not respond as expected. I think he prefers to remove the gland than do the iodine therapy- in these cases. </p>

<p>Have you had your thyroid scanned for any physical abnormalities that could explain the swinging back and forth?</p>

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<p>Hi All, I just wanted to re-iterate what I’ve learned about my own hypo-thyroid life. I’ve been on Synthroid since my 18-year-old was 6 months old. The most important thing I’ve learned is to be diligent about taking your thyroid meds the same way every day:</p>

<ul>
<li><p>Same time every day (for me, early morning is best, right before I pour my first coffee)</p></li>
<li><p>Don’t eat any food within 30 minutes of taking your thyroid meds</p></li>
<li><p>Don’t take thyroid meds with vitamins (take vitamins at opposite time of day, like evening)</p></li>
<li><p>Try your hardest to make time to do any kind of exercise for 30 minutes/day. Walking is great for this. Exercise encourages so many functions in your body to behave better.</p></li>
<li><p>Try hard to avoid processed white flour snacks and meals as well as sugar. A health professional told me this years ago because doing so helps reduce general inflammation throughout your body. (I cheat on this one, but I’ll keep trying to adhere.)</p></li>
<li><p>If you miss a few doses for whatever reason, get back on track ASAP, and don’t have blood tests done w/i two weeks of missing some doses. This could put you on a roller coaster of med changes that are very confusing for you and your doctor.</p></li>
<li><p>If you feel you are in between 2 dosages, it is okay to take one dosage (112mcg) day and another dosage (125mcg) the 2nd day, but make sure you doctor knows this so he can prescribe accordingly. My grandfather had to do this for 30 years and he lived to 99!</p></li>
<li><p>You know your body best … don’t be embarrassed to advocate for yourself.</p></li>
</ul>

<p>I’m currently taking 125mcg each day, and have gained 10 lbs over the last 2 years, and recently received results that my TSH was 4.1, but I won’t re-adjust my dosage until I get back into a regular exercise routine again. I know my body self-regulates better when I am exercising, and this winter I was a bad slug. Even walking 30-min once a day does a ton to self regulate my body, especially as I approach the big 5-0 in 1.5 years. I’ll check back in a month or so to see if my daily brisk walks helped me.</p>

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<p>Here’s a link to very interesting 90 minute podcast on thyroid issues. Really good stuff for anyone who wants to better understand what’s going on. It’s a worthwhile listen.</p>

<p>[Ask</a> the Experts podcast - Thyroid 101](<a href=“http://livinlavidalowcarb.com/blog/ask-the-low-carb-experts-episode-10-all-things-thyroid-thyroid-101-chris-kresser/13707]Ask”>Home - Tasty & Healthy Recipes)</p>

<p>For example, very low carb diets or very low calorie diets can knock down thyroid production.</p>

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<p>I mentioned in earlier posts that I am having some back/hip pain after taking Synthroid for a few weeks (have stopped for now). I have been doing more research, and am wondering if the Synthroid has triggered some kind of osteoarthritis. It looks like there is a connection between osteoarthritis and hyPERthyroidism, and I know that too much Synthroid for hyPOthyroidism essentially can bring about the hyPER symptoms. Still having deep aches in my hips and back while sleeping and for the first couple hours of the morning. Better than when I was on the Synthroid, but it has not gone away.</p>

<p>Could the Synthroid have triggered osteoarthritis in some way? :frowning: Does anyone else have any experience with this?</p>

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<p>MomLive,
Please check your intake of goitrogenic foods:
–all the cruciferous veggies (broccoli, cabbage, caulifower, brussels sprouts- you know which ones have that smell!)
–soy (soy sauce, tofu, tempeh, veggie burgers and other fake protein foods, some protein shakes, health bars)
These tend to cause inflammation of the thyroid gland or “goiter”, which dysregulates the thyroid hormone production. </p>

<p>Soy is problematic for other reasons:
–it is not a complete or well-tolerated protein; eggs are the perfect protein
–it is cheap to grow, especially since the majority of the crops are GMO (Genetically Modified) for hardiness (so include pesticidal aspects) and high growth (include fertilizing aspects). It is not clear yet what the long term effects of eating these “synthetic” crops are on our bodies, but why take the chance if you are having health issues? </p>

<p>There may be a pattern in your lifestyle that is correlated to the hyper and hypo periods:
–hypo: more high glycemic foods, feeling more stress, less exercise, goitrogenic foods, at a heavier weight
–hyper: less glycemic diet, feeling calmer, more exercise, goitrogenic foods, at a lower weight</p>

<p>The other really big wild card is IODINE consumption. All the integratives and alternatives say more Iodine is needed for thyroid function. However, there are studies that negate this, and some feel that it causes a temporary boost on thyroid pathways, but that LT it actually creating thyroid fatigue. This is a topic with a lot of differing opinions.
Iodine is found in:
–ocean fish
–various supplements
–iodized salt
–spinach IIRC
I am not sure if it is in Sea Salt (better than bleached sodium chloride)…</p>

<p>Menopause and weight gain and white fat gain can also change the action or the needs of the endocrine system. </p>

<p>Good luck, you seem to have identified a cycle, and are likely to learn more about how your body works and what it responds well to with vigilance and research. The endocrine and sex hormone and metabolic and immune systems are exquisitely inter-connected so it is very hard to get to the bottom of this. Take care.</p>

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<p>Also, for a mood-lift until things get sorted out, up your Omega 3’s a LOT (cuts inflammation, helps with low moods), and take the newer mega dose recommended of Vitamin D (actually a hormone, too).</p>

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<p>Thanks for all the information. Once again you guys have been incredibly helpful. After much thought, I’ve decided I’m going to lay it all on the line with my family doctor tomorrow and see how he responds. Worst case scenario, he proves he is no longer the right doctor for me. I’ll let you know how it goes after my appointment. I really need someone to help me sort this out. If it was just one variable, it would be easier but throw in abrupt (surgical) menopause, hormone replacement therapy and possibly temporary adrenal issues from a major surgery (my gyn surgeon mentioned this) and who knows?</p>

<p>Food and supplements…the irony is I’m eating better than I ever have. Am doing a no preservative, extremely healthy and balanced home delivery food plan. All carbs are coming from veggies and a few fruits. I cut out all alcohol and coffee right after the surgery as well. Have lost 10 pounds. I just started exercising again very slowly about 2 weeks ago. I do take Omega 3 (3 pills a day), Vit. D, Bs, magnesium and a few other things. I have been thinking about temporarily upping the Vit D - I may do that.</p>

<p>I read up on the iodine thing a few months ago because my sister takes it and decided not to go that route at the moment. With my life-long history of thyroid issues I’m concerned that I could really throw things out of whack. Lord knows I don’t need one more thing to get me even more off balance.</p>

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<p>Why is this? I am not taking thyroid medication yet but I do take thyroid supplements, which I take at the same time as all my other supplements. I’m currently taking a multivitamin (which I hope to get off once I finish adjusting my diet to get all my nutrients naturally), an iron supplement, and a calcium supplement in addition to my thyroid stuff and I take everything with breakfast (except my second multivitamin dose is with dinner.) Is there a problem with this?</p>

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<p>My uderstanding is that Calcium (in food, too) inhibits use of thyroid somehow. There may also be other compounds. And there may be some competition in the gut absorption.
I am also curious to know more about this. </p>

<p>Teriwitt had a huge issue when she changed her approach on this.
The point is that you need to do the same exact thing every day, as that is how you get the same dose internally every day.
Since my breakfast (thus calcium consumption, for instance) varies a lot from day to day, I alway take my thyroid meds I hr before any food or supplements.</p>

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<p>I don’t know why you can’t take Synthroid w/ a multi-vitamin either, but when I did take my Synthroid and multi-vitamin at the same time, my TSH tests were whacky (as if I was even more hypo-thyroid). Once I adjusted it back, I was able to reduce my thyroid meds down a notch and my TSH level also dropped, so it did appear to impact the absorption of the Synthroid.</p>

<p>I seem to be able to take my vitamin D gel pills with my Synthroid (2000 IU/day … I live North and work indoors a lot) and that doesn’t mess up my TSH levels. If I do take any other vitamins, I take them 12 hours away.</p>

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<p>Hmm… that’s interesting… My multivitamin pills are two doses of three pills so I HAVE to do one in the morning and one in the evening, six pills at once would be too much. But maybe I could take the thyroid pills in the middle a while before lunch? I do believe the bottle did suggest to take them 30 minutes before eating unless upset stomach occurs, which I didn’t bother to test because supplements generally do bother my stomach.</p>

<p>I’m allergic to milk and am having a really hard time getting adequate calcium from my food, so the calcium supplements are a must. But I could do those at breakfast and the thyroid supps a few hours later. Or is that not enough time in between? This is confusing. </p>

<p>I was recommended by my GP to see an endocrinologist because I developed a goiter and have had major hypo symptoms, and it runs in my family, but I need to wait a couple months before I can ask for more time off to make it happen, since I’m off work now for the wisdom teeth. So I’ve just been taking some supplements in the interim to see if it alleviates any of my symptoms. My mom has a hypoactive thyroid and thought these pills helped more than her meds.</p>

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<p>[Gastrointestinal</a> Issues and Thyroid Medication Dosage](<a href=“http://thyroid.about.com/b/2012/03/05/gastrointestinal-issues-and-thyroid-medication-dosage.htm]Gastrointestinal”>Thyroid Disease Treatments) Interesting article on stomach issues as they affect thyroid med’s uptake. Mary Shomon’s FB page has 10 tons of info.</p>

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<p>Yea! My family doctor has temporarily redeemed himself. I told him the whole story and he said that it did sound like I was probably overdosed at 125mg Levoxyl and that is probably what is causing the panic attacks. He also agree that it’s possible I need to be on a dose between 112 and 125mg and he is willing to work with me on that (I didn’t get into the whole T3 thing - I decided to take it one step at a time). He does have patients who alternate their daily doses, etc. He’s going to retest me while I’m on the 112mg right now and have me return in 4 weeks and then see where we go from there. He did say this will be a slow process to get it right but I’m okay with that. The important thing is I finally have his attention and he is willing to work on this with me. I feel like the door is open to get a referral to an endo if we can’t this worked out to my satisfaction. </p>

<p>I told him in no uncertain terms that the 100 mcg dose he had me on was no longer working for me and I wasn’t willing to go back to feeling that way. He agreed that I seemed to be doing better at a higher dose. Except for the panic attacks, I have been feeling better than I have in years. So we’ll see where we go from here…</p>

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<p>Excellent news, MomLive. Hope this very simple solution is what it takes for you!!!</p>

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<p>Momlive … I’m happy your discussion went well. You’re on the right track to feeling more normal more consistently … keep up the good work.</p>

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<p>I think I mentioned this earlier. What works for me is to take the levothyroxine whenever I get up during the night to go to the bathroom. The time varies, but it is always several hours after I’ve eaten and at least an hour before my morning coffee – empty stomach. The proper dose is going to depend on when you take it as absorption will be best on an empty stomach. A dose that is adequate then might not be enough if you are taking it before or after eating/drinking or vice versa. So, if you change when you take it, you have to be on the lookout for warning signs of an incorrect dosage.</p>

<p>As I understand it, Levothyroxine is best absorbed in the small intestine, thus you want it to pass through the stomach quickly and undigested. If you eat or drink, you stimulate stomach digestive acids that break down the pill in the stomach before it can pass through to the intestine. Empty stomach, tiny pill, with just water, passes right through. The stomach doesn’t know you’ve eaten anything.</p>

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<p>HELP! They’re no longer making Levothroid, according to the CVS tech who called this AM to tell DH they couldn’t fill his scrip nor find any more of the medicine anywhere nearby. Oh and they knew this production change was coming months ago (but didn’t bother to inform DH). Jeebus xmas thanks a bunch and now we get to do the medicine brand dance all over again. I am SO not looking forward to the slow process of finding the brand that will work well for him. Here is how the convo will go: Me: DH you are not thinking clearly and I think you need a different med formulation. Him: leave me alone I’m fine. Me: (the next week) I think maybe your meds should be adjusted? Him: leave me alone. Me (the next month) Med’s? Him: would you plz stop bugging me. Me: (months later) silence. Him: I think maybe I need med’s changed…</p>

<p>/sigh</p>

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<p>Ok so the Pharmacist gave me the number and website for ForestPharm.com who make levothyroid and just to save you folks time if you want info re/ this the number to call is 866 927 3260. This is an info line devoted to levothyroid.</p>

<p>Edit: phone call revealed:</p>

<p>Lloyd in Iowa is the manufactuerer and Forest is the distributor.</p>

<p>FDA audit of mfctr quality systems resulted in shut down.</p>

<p>No timetable on the product.</p>

<p>Forest mfctrs and dstrbts Armor. All strengths of that product are readily available.</p>