Have some questions about begining t3 meds
Dorie
I am pretty new to this site so don't quite understand how things
work yet.Even still I am glad to be a part of this forum.My question
is I have taken synthroid only for the last 23 yrs.I can totally
relate to that never feeling the same after treatment for graves
disease post radioactive iodine on t4 meds only.Recently I went to see
a new endo (havent been in years) and he placed me on t3 50 mcg twice
daily in addition to my synthroid which he decreased from 200mcg to
150mcg.I am sorry to report this is not working in the begining I
seemed to notice alittle improvement for the better but now almost 4
wks into this I am feeling rather poorly.extremely tired sometimes
fall asleep sitting up,my feet and ankles are swelling and killing
me,Im constapated you name it.I phone my doc about the swelling a week
ago and he blew me off and told me to see my PA that it was not a
thyroid problem.I know I need more meds at this time but I am unaware
if I need more t3 or more synthroid.I am quite interested in using t3
after hearing mainly good things but I am really uneducated .I think I
need a new doc as well.can anyone explaine how the t3 conversion works
when adding cymotel to t4 thanks
Ray
wrote:
100 mcg daily of T3 is a very high dose. T3 is normally given in a
dose 1/4 to 1/8 of the T4. Do you have recent blood tests. It is
important to get T3 and T4 tests, both free and bound. Get the
numbers - don't just take the dorctors word that they are normal.
Rod
Let me start my saying welcome.
I have a feeling that is a typo! Dropping the thyroxine by 50mcg would
approximate to 12.5mcg (using the 4:1 ratio often quoted) - let's call
that 10mcg. Which is 5mcg twice a day!
But that could leave Dorie under-dosed. Even if 10mcg of T3 were an
exact equivalent to 50mcg of T4, the roller-coaster of T3 levels would
quite likely have her over-dosed for a few hours of the day and
under-dosed the rest of the time. And I am not convinced that 10mcg of
T3 *is* an exact equivalent of 50mcg of T4!
So I suggest that the reduction in T4 dose is too great for the T3 being
taken. I feel that a better approach would be for Dorie to take 150mcg
T4 every day - and have the flexibility to take a bit more (say 12.5 to
25mcg) as she needs. Of course, there's hardly a doctor who would go
along with that - far too much reliance on the patient.
I can't explain the T3 conversion with Cytomel any better than without
Cytomel! Although often talked about, I believe it to be considerably
more complicated than anyone allows. For example, the deiodinases which
actually do the conversion (known as D1, D2 and D3) seem to themselves
depend on the thyroid hormone levels in the system. There is much talk
over local conversion with at least liver, kidney, skeletal muscle,
brown and white fat, hair follicles and brain all doing at least some
conversion. And there is the question over how much of that T3 gets back
into the blood stream.
I take it that you know about taking thyroid hormones away from food and
other medications?
Are you taking anything else? Vitamins? Minerals? Medicines?
Let us know a bit more - and someone might be able to help more. Do keep
posting.
--
Rod
Hypothyroidism is a seriously debilitating condition with an insidious
onset.
Although common it frequently goes undiagnosed.
<www.thyromind.info> <www.thyroiduk.org> <www.altsupportthyroid.org>
Dorie
> On Mon, 3 Nov 2008 05:51:04 -0800 (PST), Dorie <roughcu...@yahoo.com>
>
> - Show quoted text -
Thanks for the info. Yes at the time of my visit I did have recent
blood tests with a TSH of 2.56 normal being 0.40 - 4.50 mIU/L and a
T3 of 141 with the normal being from 97 - 219 ng/dl T4 was at 1.4
normal 0.8-1.8 ng/dl So my T3 did suggest I was a bit low.as stated at
that time with those results I was on (synthyroid only) 200 mcg for
the past 5 yrs.I have been reading on some of the thyroid info sites
that the TSH ratios are now at 2 being considered a normal high so I
am going to assume that my TSH was also high.My T4 being in the upper
limits is understandable while taking synthroid I'm not sure I
understand the conversion of cymotel because I was under the
impression that this could even be raised based on symptoms as long as
the T4 is lowered.Also I am not having even one sign of being over
dosed on the cymotel as far as symptoms.As I mentioned in the begining
of the switch I started to feel alittle better I have a feeling that
this was due to the fact that the T4 was still in my system having the
half life that it has.Now at 4 weeks I am feeling very tired etc..
with the return of hypo symptoms.I have the impression from you that
it might be better for my doctor to raise the synthyroid back up to
mabe 175mcg instead of 200mcg Could you explain further ? As far as
meds go I do not currently take any vitimins etc However I have had
some other health issues having had 4 brain surgeries in the past 4
yrs for a rare but painfull condition called trigeminal neurlgia so I
do take pain meds but have been on them for some time without the
current symptoms.Unless I have misunderstood things I thought the
cymotel could and should be raised untill the patient is symptom free ?
Dorie
> On Mon, 03 Nov 2008 06:53:33 -0800, Ray <R...@ray.com> wrote:
>
> ... On Mon, 3 Nov 2008 05:51:04 -0800 (PST), Dorie <roughcu...@yahoo.com> ... wrote:
>
> ...
> ... >Hello to All
> ... > I am pretty new to this site so don't quite understand how things
> ... >work yet.Even still I am glad to be a part of this forum.My question
> ... >is I have taken synthroid only for the last 23 yrs.I can totally
> ... >relate to that never feeling the same after treatment for graves
> ... >disease post radioactive iodine on t4 meds only.Recently I went to see
> ... >a new endo (havent been in years) and he placed me on t3 50 mcg twice
> ... >daily in addition to my synthroid which he decreased from 200mcg to
> ... >150mcg.I am sorry to report this is not working in the begining I
> ... >seemed to notice alittle improvement for the better but now almost 4
> ... >wks into this I am feeling rather poorly.extremely tired sometimes
> ... >fall asleep sitting up,my feet and ankles are swelling and killing
> ... >me,Im constapated you name it.I phone my doc about the swelling a week
> ... >ago and he blew me off and told me to see my PA that it was not a
> ... >thyroid problem.I know I need more meds at this time but I am unaware
> ... >if I need more t3 or more synthroid.I am quite interested in using t3
> ... >after hearing mainly good things but I am really uneducated .I think I
> ... >need a new doc as well.can anyone explaine how the t3 conversion works
> ... >when adding cymotel to t4 thanks
> ...
> ... 100 mcg daily of T3 is a very high dose.
>
> Not for me, it isn't. I have taken 100 mcg T3 for the past 10 years and couldn't
> feel better.
>
> I have tried taking 75 mcg - after a few weeks I feel my memory going down the
> drain and the fog coming back. We are all different...
>
> =====
> It sounds much better in French, but then, everything does.
Hi there you mentioned you have been taken 100mcg T3 for the past 10
yrs. is that in addition to your synthyroid ?
Dorie
> On Tue, 4 Nov 2008 07:51:46 -0800 (PST), Dorie <roughcu...@yahoo.com> wrote:
>
> ... On Nov 4, 7:24 am, Magda <pikroda...@noos.fr.hello.spammers...> wrote:> ... > ...
> ... > ... >Hello to All
> ... > ... >work yet.Even still I am glad to be a part of this forum.My question
> ... > ... >is I have taken synthroid only for the last 23 yrs.I can totally
> ... > ... >relate to that never feeling the same after treatment for graves
> ... > ... >disease post radioactive iodine on t4 meds only.Recently I went to see
> ... > ... >a new endo (havent been in years) and he placed me on t3 50 mcg twice
> ... > ... >daily in addition to my synthroid which he decreased from 200mcg to
> ... > ... >150mcg.I am sorry to report this is not working in the begining I
> ... > ... >seemed to notice alittle improvement for the better but now almost 4
> ... > ... >wks into this I am feeling rather poorly.extremely tired sometimes
> ... > ... >fall asleep sitting up,my feet and ankles are swelling and killing
> ... > ... >me,Im constapated you name it.I phone my doc about the swelling a week
> ... > ... >ago and he blew me off and told me to see my PA that it was not a
> ... > ... >thyroid problem.I know I need more meds at this time but I am unaware
> ... > ... >if I need more t3 or more synthroid.I am quite interested in using t3
> ... > ... >after hearing mainly good things but I am really uneducated .I think I
> ... > ... >need a new doc as well.can anyone explaine how the t3 conversion works
> ... > ... >when adding cymotel to t4 thanks
> ... > ...
> ... > ... 100 mcg daily of T3 is a very high dose.
> ... > Not for me, it isn't. I have taken 100 mcg T3 for the past 10 years and couldn't
> ... > feel better.
> ... >
> ... > I have tried taking 75 mcg - after a few weeks I feel my memory going down the
> ... > drain and the fog coming back. We are all different...
> ... >
> ... > =====
> ... > It sounds much better in French, but then, everything does.
> ...
> ... Hi there you mentioned you have been taken 100mcg T3 for the past 10
> ... yrs. is that in addition to your synthyroid ?
>
> Synthroid has as much effect on my thyroid as a glass of fresh water. Alas, I
> can't count on T4 to keep me alive and functioning.
>
> =====
> It sounds much better in French, but then, everything does.
So I take it you are on T3 alone and feel great .Good for you.I was
thinking about trying Armour which is supposed to work better for
those without any thyroid left.I fit into this catagory.Have you ever
trid Armour ?
Dorie
Rod
Dorie,
I am one of those who do not have much faith in the TSH test for
adjusting doses (whether T4 or T3). The changes in ranges seem to be
sensible but, in my opinion, are mainly important for screening and as
part of initial diagnosis.
My point was that I did not believe dropping your T4 dose to 150mcg was
justified. If any reduction was required (and the doctor may well have
felt that a reduction was required even without any evidence), it should
have been a smaller reduction. If you were already a bit low, then the
reduction should have been even less. But I was trying to make a broad
suggestion. Maybe there should not have been any reduction if you were
already underdosed? And what you have said seems to back that up. I
think you are slowly getting more and more hypothyroid.
I am well aware of trigeminal neuralgia - having been investigated for
odd (and sometimes severe) facial pains. Luckily mine subsided to a
large extent. In fact they improved considerably when I started taking
1000mcg vitamin B12 daily. B12 problems are fairly common in hypoT and
you might consider asking for a B12 test.
The pain meds you are on (and you have not said which ones) might
interact with thyroid hormones resulting in greater dose requirements
than normal. If the doctor hasn't thought this through, he might be
worrying about a large dose which isn't actually a problem at all.
Dorie
>
> - Show quoted text -
Rod
I have to agree with you.I do feel this doctor was a bit excessive
with the T4 reduction in veiw of the fact that I was already hypo with
active symptoms when I saw him for consultation.If the symptoms
weren't enough my blood work indicated the same.I also agree that the
blood tests are worthless when considering treatment.Unfortunately I
believe this new doctor I am seeing treats labs instead of patients
because when I phoned his office to let them know how poorly I was
feeling to get him to increase the meds. the nurse said he wouldn't do
anything for me without bloodwork.Lucky me .This doctor did seem
updated with the T3 treatments so I assumed he would be more open
minded.I have an appt to see him 1 1/2 wks early and will get labs
done tomorrow.In the mean time I have discovered doctors on a thyroid
site who are more open minded in this area.I will do alittle homework
and make an appt. to see one of these Dr's of no luck with this
one.Will be sure and let you know what happened Thanks for your help
and advice
Dorie
Dorie
>
> - Show quoted text -
Rod
Boy do I now feel stupid.On my first post I listed the Doctor
putting me on 50mcg of T3 this was totally inaccurate.The starting
dose was 5mcg of T3 twice daily.I guess I have been more out of it
than I thought.However the info. I gave on the reduction of T4 was
150mcg from 200mcg daily.I guess this would shed a whole new light on
things as far as my Question weather or not the T3 could be
increased.Do you have any different feedback with this new info ?
Thanks
Rod
Dorie,
Have no fear!
Did you see my first post? It started:
"I have a feeling that is a typo! Dropping the thyroxine by 50mcg would
approximate to 12.5mcg (using the 4:1 ratio often quoted) - let's call
that 10mcg. Which is 5mcg twice a day!"
I guessed you had made a slip of the fingers.
Thyroid problems affect the brain! (True and also meant light-heartedly.)
After that, I simply assumed 5mcg twice a day. Yes - a perfectly
reasonable alternative to readjusting the T4 back up (whether to 175 or
200) would, in my opinion, be to increase T3/Cytomel. Some people take
their Cytomel once a day - others prefer spreading it more evenly. So,
if you were to go up to four 5mcg tablets a day you might wish to take
them all separately.
Dorie
Thanks again.I will see the doctor on Monday.Your suggestions have
given me some insight on what I will ask him for.As I stated in my
first post I really know nothing about T3 or how it works (as far as
dosing) Have just heard mainly good things about it's ability to
adress the symptoms of hypoT better than the standard T4 theraphy.If
this is so I would like to give it a try.
Ray
wrote:
> Boy do I now feel stupid.On my first post I listed the Doctor
>putting me on 50mcg of T3 this was totally inaccurate.The starting
>dose was 5mcg of T3 twice daily.I guess I have been more out of it
>than I thought.However the info. I gave on the reduction of T4 was
>150mcg from 200mcg daily.I guess this would shed a whole new light on
>things as far as my Question weather or not the T3 could be
>increased.Do you have any different feedback with this new info ?
>Thanks
You might want to consider natural desiccated thyroid (Armour or
Nature-Throid). It contains both T3 and T4 and is cheaper than the
synthetic T3.
Dorie
Hi there thought I would tell you about my dr's appt. today as
promised.What a joke.First of all I know you don't have much reguard
for the TSH test but just for the sake of proving a valid point here I
will make reference to it.I did go get the labs as this doctors office
requested before my visit.They explained over the phone that the Dr
would do nothing for me without recent tests.My TSH that was 2.58 4
weeks ago is now 4.46 with the normal lab values being 0.40-4.50 this
is obviously caused by the reduction of T4 fro 200 mcg down to 150mcg
with the addition of T3 5mcg twice daily.Anyways all this being said
this doctor tells me he does not think my symptoms are being caused by
my thyroid .He is a DR who unfortunatly treats labs instead of
patients and even though my TSH has doubled since he started this
treatment his ego got the best of him.How ANNOYING He however did
suggest I go back up on the T4 taking only 25mcg extra three times a
week and remaining on the T3 50mcg twice daily.To me this makes no
sense at all .The T4 of this small amount is not going to be enough
even with the addition of T3.Does this make sense to you also ?
Needless to say I will get a seccond opnion this Wed from a more open
minded doctor.Will keep you posted.Do you have any thoughts ? Thanks
Rod
<snip>
>
> Hi there thought I would tell you about my dr's appt. today as
> promised.What a joke.First of all I know you don't have much reguard
> for the TSH test but just for the sake of proving a valid point here I
> will make reference to it.I did go get the labs as this doctors office
> requested before my visit.They explained over the phone that the Dr
> would do nothing for me without recent tests.My TSH that was 2.58 4
> weeks ago is now 4.46 with the normal lab values being 0.40-4.50 this
> is obviously caused by the reduction of T4 fro 200 mcg down to 150mcg
> with the addition of T3 5mcg twice daily.Anyways all this being said
> this doctor tells me he does not think my symptoms are being caused by
> my thyroid .He is a DR who unfortunatly treats labs instead of
> patients and even though my TSH has doubled since he started this
> treatment his ego got the best of him.How ANNOYING He however did
> suggest I go back up on the T4 taking only 25mcg extra three times a
> week and remaining on the T3 50mcg twice daily.To me this makes no
> sense at all .The T4 of this small amount is not going to be enough
> even with the addition of T3.Does this make sense to you also ?
> Needless to say I will get a seccond opnion this Wed from a more open
> minded doctor.Will keep you posted.Do you have any thoughts ? Thanks
I rather agree with you - it doesn't sound like it will be enough.
However, at least you can do that with his blessing! And it should be a
step in the right direction.
I think the direction the TSH test shows is often sensible. Going up so
markedly is indeed a fairly clear sign.
Dorie
>
> - Show quoted text -
I feel alittle better just knowing you agree with me because the Dr
really had me seccond guessing myself.I have to be really honest here
though.I really don't know if I can live with only raising the T4 only
25mcg only 3 days a week.Clearly because I don't feel this will be
enough and I realize even with the proper dosage it will take weeks
before I begin to feel better.Holidays are just around the corner and
I might be being a bit inpatient but I am really feeling badly.I am
honestly thinking about moving my dosage back up to 200 mcg of the T4
with the logic that even before the addition of T3 my TSH levels were
at 2.56 which is what provoked this Dr. to add the T3 to begin with
and truely at the beginning of this addition I was starting to feel
better.I am not really one to look at the blood levels either but in
this case there is clearly something wrong.The only concern I have is
that I have read that when you start T3 along with T4 the T4 should
be lowered by about 36mcg's or so and I dont want to wind up Hyper but
I'm also thinking that my TSH was 2.56 on just the synthroid so the
adding of T3 probably wouldn't produce hyper symptoms because there is
clearly room to work with.What are your thoughts?
Rod
Dorie,
My thoughts, for what they are worth, are:
I thought you'd end up here. :-)
Have you got sufficient tablets for what you propose?
Remember, even if you do increase your dose, you can always reduce it
again if you feel it is too much.
It is the TSH that takes ages to stabilise (I get the impression it
starts to change quite quickly but that can continue for quite a while).
I have seen T4 take effect within minutes. Full recovery takes a long
time but some changes can occur *very* quickly.
Although holiday is important to you, try not to let yourself pushed
into anything because of it. These issues will still be there in one
form or another long after this holiday.
Your comment about reducing the T4 due to the T3 would only apply if the
T4 level was spot on to begin with. But you keep saying you felt
underdosed before starting the T3. (It also appears that sometimes
taking a spot of T3 can increase the ability of the body to make use of
the T4 that is available.)
You are taking full responsibility for your dose by doing this. Think
about that. Also, try to think what you will tell your doctor when you
next see him. What if you go and you feel fine and your TSH is spot on -
he will be thinking he was right! Until you tell him. Or if you need
more tablets to keep going - where will you get them from if he refuses?
Or if you feel worse?
Make sure that at least someone near you knows what you are doing.
(Not once have I written "Do it"; nor "Do not do it". You have to make
your decision in your circumstances.)
All the best
Dorie
Rod
You do make some valid points.I do not think I will return to this
Dr. his inability to get past his own ego is an early indication that
he would not be suited to treat thyroid patients,myself included.The
fact that he is indeed a doctor who treats labs before his patients is
another.What really had me baffled was even with labs to back up my
symptoms at present he still remained closed minded.I had put my faith
in him that he would make things better, not worse.I believe even you
stated that his decision to lower the T4 so much at the start of T3
was a bit unjustified .I say especially with a TSH of 2.5 and
systematic.That being said when I returned and he stated that my
symptoms were not thyroid related with now a TSH of 4.46 is down right
ignorant.It has had me a bit fustrated because instead of moving
foward I feel I took two steps backwards as a dirrect result of this
Dr's advice.In the begining I was quite excited because he knew about
T3 but he is still very old fashioned and treats labs instead of
patiets and does a losy job at that LOL!!I haven't shared a whole lot
with you as far as my recent brain sugeries.My first microvascular
decompression for trigeminal neurlgia was done locally.At the time I
believed I had done my homework picking a surgeon,I even interviewed
him (asked numerous questions) to make a long story short he lied and
I wound up with anesthia delorosa because he paded my entire nerve
and damaged it.this resulted in 3 more surgeries at UCSD to try and
fix the problem.This is why I also must remain on narcotics
(oxycontin,percocet) Anyways my faith in doctors has been shattered as
a result.At the sake of sounding like I feel sorry for myself it has
indeed been a long journey back.I believe the fact that I do take pain
meds is what led this Dr to decide my current symptoms are not thyroid
related but let me assure you I am quite adjusted on these meds for
some time now and my current symptoms are not typical even on my pain
meds.However still I am not a doctor and probably should not try and
treat myself.I have decide to take 25mcg 7 days a week instead of
three and consult with one of the thyroid friendly docs listed on one
of the thyroid sites for this area.If nothing else this doctor does
prescribe armour so she will probably be more open minded as you know
not many doctors will not even prescribe this.I don't believe going up
on the T4 7 days a week instead of 3 will get me in to too much
trouble at this point.I do wish I had friends in this area who could
suggest a good thyroid doc but I dont have friends with this problem
so I am stuck having to depend on the internet for such info. so
really know nothing about this new doc will have to use my own
judgement.I'm glad I have been able to write back and forth with you
it has been suportive and I thankyou.Will keep posting :]
Rhonda Lea Kirk Fries
<snipped>
Just keep in mind that 1 ug of T3 is, at a minimum, equivalent to 4 ug
of T4. (By some estimates, 1 ug of T3 is equivalent to 5 or more ug of
T4.)
Based on that, taking an additional 75 ug/week gives you the functional
equivalent of what you were taking in the first place, plus an
additional 5 ug.
In other words, when the doctor put you on 10 ug of T3 + 150 ug of T4,
he was effectively shorting you the equivalent of 10 ug of T4 daily.
When you add in the additional T4, you're back where you started, except
that your T3 levels will be higher.
This may not be the right dose for you at all, but it sounds like this
guy is willing to work with it. Having spent years doing battle with
doctors, I can assure you that a little attitude is nothing when faced
with a medical professional who simply has no clue and who will not
prescribe outside very strict standards.
I recently found a brand new internal medicine textbook...well...go here
and read down the page to the recommended treatment for hypothyroidism.
Keep in mind that this is a book published in 2008.
or
http://preview.tinyurl.com/564gg4
I have gone through a lot of doctors. If you have one who is at least
willing to experiment a little, it might be worth giving him some time
to do so.
--
Rhonda Lea Kirk Fries
"You know you can indict a ham sandwich if you want to."
William J. Martini, Judge, United States District Court
Dorie
wrote:
> Dorie wrote:
>
> <snipped>
>
> Just keep in mind that 1 ug of T3 is, at a minimum, equivalent to 4 ug
> of T4. (By some estimates, 1 ug of T3 is equivalent to 5 or more ug of
> T4.)
>
> Based on that, taking an additional 75 ug/week gives you the functional
> equivalent of what you were taking in the first place, plus an
> additional 5 ug.
>
> In other words, when the doctor put you on 10 ug of T3 + 150 ug of T4,
> he was effectively shorting you the equivalent of 10 ug of T4 daily.
> When you add in the additional T4, you're back where you started, except
> that your T3 levels will be higher.
>
> This may not be the right dose for you at all, but it sounds like this
> guy is willing to work with it. Having spent years doing battle with
> doctors, I can assure you that a little attitude is nothing when faced
> with a medical professional who simply has no clue and who will not
> prescribe outside very strict standards.
>
> I recently found a brand new internal medicine textbook...well...go here
> and read down the page to the recommended treatment for hypothyroidism.
> Keep in mind that this is a book published in 2008.
>
>
> or
>
> http://preview.tinyurl.com/564gg4
>
> I have gone through a lot of doctors. If you have one who is at least
> willing to experiment a little, it might be worth giving him some time
> to do so.
>
> --
> Rhonda Lea Kirk Fries
>
> "You know you can indict a ham sandwich if you want to."
> William J. Martini, Judge, United States District Court
Rhonda
thanks for the feedback.however this dr was not willing to work with
me so I will be getting a seccond opinion next wk.I did in fact get an
attitude on my last visit while trying to educate him.He became very
defensive to say the least.I find it is much easier to move on to
another Dr when you find one who is not willing to listen or work with
you
Dorie
>
> <snipped>
>
> Just keep in mind that 1 ug of T3 is, at a minimum, equivalent to 4 ug
> of T4. (By some estimates, 1 ug of T3 is equivalent to 5 or more ug of
> T4.)
>
> Based on that, taking an additional 75 ug/week gives you the functional
> equivalent of what you were taking in the first place, plus an
> additional 5 ug.
>
> In other words, when the doctor put you on 10 ug of T3 + 150 ug of T4,
> he was effectively shorting you the equivalent of 10 ug of T4 daily.
> When you add in the additional T4, you're back where you started, except
> that your T3 levels will be higher.
>
> This may not be the right dose for you at all, but it sounds like this
> guy is willing to work with it. Having spent years doing battle with
> doctors, I can assure you that a little attitude is nothing when faced
> with a medical professional who simply has no clue and who will not
> prescribe outside very strict standards.
>
> I recently found a brand new internal medicine textbook...well...go here
> and read down the page to the recommended treatment for hypothyroidism.
> Keep in mind that this is a book published in 2008.
>
>
> or
>
> http://preview.tinyurl.com/564gg4
>
> I have gone through a lot of doctors. If you have one who is at least
> willing to experiment a little, it might be worth giving him some time
> to do so.
>
> --
> Rhonda Lea Kirk Fries
>
> "You know you can indict a ham sandwich if you want to."
> William J. Martini, Judge, United States District Court
Rhonda
I did have one question because I don't understand the way the
conversion works from T3 to T4
Question is if I take 25mcg of T3 7 days a week instead of three where
would that put me in terms of T4 ?
You had said 25mcg of T3 3 days a week would be the same as 200 mcg of
T4 right?
Thanks for your help
Rhonda Lea Kirk Fries
It's an approximation. The idea is that the equivalence between the T3
drug and the T4 drug is 4:1. This is taken from the charts prepared by
pharmaceutical companies to guide doctors when they switch a patient
from one type of thyroid drug to another. Other sources cite ratios as
high as 7:1.
T4 is converted to T3 in and by the body. This is why some doctors are
insistent on prescribing only a T4 drug, under the theory that the body
will use T4 to make the T3 it needs. Of course, for some of us, this
doesn't work out too well, but for many, it's fine.
> Question is if I take 25mcg of T3 7 days a week instead of three where
> would that put me in terms of T4 ?
He's giving you an extra 25 mcg T*4*, not T*3*, right? 25 mcg of T3 is a
lot of T3 (i.e., the approximate equivalent of 100 mcg T4). I guess the
equation can be worked backwards as well, purely as a mathematical
exercise, but in practical terms, T4 is only equivalent to T3 when it is
converted to T3 in the body. Some people could take T4 all day long and
get no result if they have difficulty converting it.
> You had said 25mcg of T3 3 days a week would be the same as 200 mcg of
> T4 right?
25 mcg T3 drug = 100 mcg T4 drug so that would be approximately the same
as 300 mcg of the T4 drug.
But I'm afraid you're misunderstanding the way each works. T3 goes to
work immediately and has a half-life of...well, I'd like to know the
answer to that myself. Some sources say 2.5 days, some say a day and
some say 4 hours. Nonetheless, it doesn't work for very long. T4 has a
much longer half-life than T3, which means it remains in the body,
available for conversion, for a relatively long time. The point is that
if you take 25 mcg of a T3 drug three times a week, you're going to be
all over the place, and you're not going to feel very good at all. On
the other hand, studies have shown that it is possible for some to take
a full week's dose of T4 and suffer no adverse effects.
Have you read any of the information on the ast website? You might want
to do that to get a better understanding of what I'm not explaining all
that well in this post.
> Thanks for your help
Good luck. Remember that the better educated you are, the better you
will be at guiding the doctor you ultimately choose. There are a lot of
books out there on hypothyroidism (as well as a lot of sites on the web)
and many of them are factually incorrect. (For instance, there's one
allegedly patient-oriented doctor who makes the claim that T3 doesn't
cross the blood-brain barrier--it's total nonsense, but he's considered
a "good" doc.)
Dorie
>
> - Show quoted text -
now I realize how truely out there I am at present because I got
everything backwards when asking you the last question.So for the sake
of not looking too stupid my question was supposed to be
If I take an extra 25 mcg of T4 7 days a week instead of 3 along with
my regular dose of T4 which is 150 mcg for a total of 175mcg's daily
of the T4 along with the 5 mcg's T3 twice a day where would that put
me ? Thanks
The reason I ask is because I felt underdosed on 200mcg T4 that I was
orginally on before my doctor reduced it to add T3 I'm wondering if
after a few wks this might work better ?ps Sorry about the mistake I
seem to be doing that alot lately :]
Rhonda Lea Kirk Fries
> now I realize how truely out there I am at present
Most, if not all, of us have been there.
> because I got
> everything backwards when asking you the last question.So for the sake
> of not looking too stupid my question was supposed to be
> If I take an extra 25 mcg of T4 7 days a week instead of 3 along with
> my regular dose of T4 which is 150 mcg for a total of 175mcg's daily
> of the T4 along with the 5 mcg's T3 twice a day where would that put
> me ? Thanks
If you're taking 175 mcg T4 + 10 mcg T3, your approximate daily dose is
equivalent to 215 mcg T4.
If you take it as he prescribed it, i.e., an extra 75 micrograms of T4 a
week, it puts you right back to the equivalent of 200 mcg.
The only way you'll know what works is to have regular labs that allow
you to compare your Free T3, Free T4 and TSH. Well, that's my opinion.
Relying on TSH alone is stupid, but a lot of doctors do it. The problem
is that if your TSH is "normal" but your FT3 is still stuck in the low
normal range, you're going nowhere. This is why talking about all these
equivalences doesn't do much but provide a general guide for starting
out. And everyone has a theory. Based on what you reported, I think your
doctor followed the ideas of Dr. Kenneth Blanchard (you can google for
/What Your Doctor May Not Tell You About Hypothyroidism/) when he
decided how to switch your dosage.
> The reason I ask is because I felt underdosed on 200mcg T4 that I was
> orginally on before my doctor reduced it to add T3 I'm wondering if
> after a few wks this might work better ?
Do you have any lab results that include numbers other than your TSH? If
your Free T3 was at the lower end of normal, what you're doing may well
be enough to get you going.
As for the bit about "a few weeks"...well...you may feel better in the
sense of being less foggy and confused, but if you're like most people
(and depending on how long you've been "underdosed"), it will take more
time than that for your body to recover.
I was nearly a year on either too high or too low a dose of T4--without
any T3 at all--and it was a mess. (At the high dose, I had a low FT3 and
TSH, a high T4, but I was having hyper symptoms. At the lower dose, I
had low FT3, normal T4, and a high-normal TSH, but I was having bad hypo
symptoms. You would think that one of those doctors--especially the
"thyroid expert" who is still listed on the "Top Docs" list--would've
figured out that T4 alone wasn't working for me.) I'm now on day 15 of
Armour, and I'm much more coherent, but I can't get moving. And if I do
get moving and stay moving, I pay for it later on.
But everyone is different. I don't think I could handle a nothing-but-T3
regimen, but Magda (who replied to you, which is why I'm using her as an
example) does best on it. <shrug> You'll find a lot of individual
variations, so don't make the mistake of thinking that what someone else
is taking will solve the problem for you.
> ps Sorry about the mistake I
> seem to be doing that alot lately :]
Here's a list of symptoms. Reading it always made me feel better when I
was worried about walking around in a brain dead thryoid fog:
http://www.thyroiduk.org.uk/tuk/pages/conditions/thyroid/hyposymptoms.html
Knowing that the way I was acting and feeling was normal for someone
with hypothyroidism cheered me up quite a lot.
Dorie
wrote:
>
> Knowing that the way I was acting and feeling was normal for someone
> with hypothyroidism cheered me up quite a lot.
>
> --
> Rhonda Lea Kirk Fries
>
> "You know you can indict a ham sandwich if you want to."
> William J. Martini, Judge, United States District Court
presently my labs are as follows TSH 4.46
T3 total 159
free T4 1.0
This is on the dose of 150 mcg T4 once daily T3 5mcg twice a day
I had been on this dose only 4 weeks when I had labs drawn early
because I was feeling poorly.
I had been switched to the dose stated from 200mcg T4 once a day wiht
out the use of T3
clearly those labs are not acceptable
Prior to those labs and on 200 mcg T4 only for the last 5 or more
years my labs were
TSH 2.58
T3 total 141
free T4 1.4
I didn't feel well with these labs either
I guess I'm confused as to what needs to be different to feel better
as this thyroid stuff is all kind of new to me
I always took the doctors word for "your normal" in the past because
there was nothing I could do about it any way.Usually when your labs
are in normal range you are hard pressed to find a doctor to tell you
your symptoms are thyroid related much the less change your meds!!
Even now this new doc is trying to tell me it's not your thyroid,which
is why I'm getting a seccond opnion.
I went to him hoping to feel better but as you can see from the most
recent labs up top I took a few steps backwards
He did tell me upon doing a altrasound in his office on my first visit
that I had no thyroid left as a result of radio active iodine some 20
yrs ago for graves disease.He stated because I had no thyroid left I
would be easy to treat with meds.I find that funny now with the
current meds he has prescribed.I hope I get lucky enough to find a doc
who can fix this.I will try to study throid alittle further before my
next appt.
Thanks for the recent info :}
Rhonda Lea Kirk Fries
<snipped>
> presently my labs are as follows TSH 4.46
> T3 total 159
> free T4 1.0
>
> This is on the dose of 150 mcg T4 once daily T3 5mcg twice a day
> I had been on this dose only 4 weeks when I had labs drawn early
> because I was feeling poorly.
> I had been switched to the dose stated from 200mcg T4 once a day wiht
> out the use of T3
> clearly those labs are not acceptable
> Prior to those labs and on 200 mcg T4 only for the last 5 or more
> years my labs were
>
> TSH 2.58
> T3 total 141
> free T4 1.4
>
> I didn't feel well with these labs either
Normally, it's important to post the lab's reference range along with
ones results, because the results aren't meaningful without them. In
this case, it's obvious that something isn't right. I'm not sure how
helpful the TT3 result is either. You really need a free T3 test.
> I guess I'm confused as to what needs to be different to feel better
> as this thyroid stuff is all kind of new to me
> I always took the doctors word for "your normal"
Yeah, there are a lot of hypos out there who have heard those exact
words.
> in the past because
> there was nothing I could do about it any way.Usually when your labs
> are in normal range you are hard pressed to find a doctor to tell you
> your symptoms are thyroid related much the less change your meds!!
Years ago, I had a friend who gained a bazillion pounds after treatment
for thryoid cancer. Her doctor's response? "Get the fork out of your
mouth." She had been such a beautiful young woman, and within months she
was layered by fat--all because some bozo with a medical degree wasn't
smart enough to look at her rather than her labs.
> Even now this new doc is trying to tell me it's not your thyroid,which
> is why I'm getting a seccond opnion.
> I went to him hoping to feel better but as you can see from the most
> recent labs up top I took a few steps backwards
> He did tell me upon doing a altrasound in his office on my first visit
> that I had no thyroid left as a result of radio active iodine some 20
> yrs ago for graves disease.He stated because I had no thyroid left I
> would be easy to treat with meds.I find that funny now with the
> current meds he has prescribed.I hope I get lucky enough to find a doc
> who can fix this.I will try to study throid alittle further before my
> next appt.
Have you looked at Mary's Top Doc's list? I don't entirely trust it,
because some good doctors are missing and some bad ones remain, but it
might be a starting point.
The Armour Thyroid site has a physician locator, and although I'm not
convinced that Armour is a silver bullet, it would seem to me that a
doctor who is open to the idea of Armour might be more inclined to look
at the patient rather than the labs:
http://www.armourthyroid.com/con_phLocator.aspx
> Thanks for the recent info :}
Here's a little more:
http://www.armourthyroid.com/con_faqs.aspx#q4
It's a chart that shows the conversion between the various drugs. I
wouldn't take it as more than a starting point, because the last time I
tried Armour, the doctor put me on 120 mg--which should've been a bit of
an overdose according to the chart--and I ended up with a TSH of 64.