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Thyroid  (Expert Forum)
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Hypo symtems back and T3
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida Sarasota - FL
Questions in the Thyroid forum are answered by Dr. Mark Lupo. Topics covered include goiter, graves disease, Hashimoto's thyroiditis, hyperthyroid, hypothyroid, thyroid cancers, thyroiditis, and thyroid stimulating hormone (TSH).
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MedHelp Member's Question

Hypo symtems back and T3

by Beachbrat1964, Dec 28, 2005 12:00AM
Hi,

I am going back to the endo, on Friday. I posted before about how he says he has "cured me".. I contacted another endo but they want me to have my current endo give me a refferal to them which i am sure will not go over well. I am kind of stuck, as my symptoms have returned cold all the time, aches, pains, dizziness, fatigue, constipation, brain fog ect. they do get some better with each increase, but after about 8 weeks the symptoms return. I was orginally diagnoised as hypo/hashi in June 2005 started on 50 synthorid then 75 now 100. I am currently on 100 synthorid, I am no doctor and do not claim to be,I have done mountains of reading because I want to feel better but how do I approach my current endo, regarding my symptoms are back I feel terrible. I do not know if I should ask about armour or have an increase in synthorid, I just want to feel better! my last dosage increase was in the first of Sep. The end of October  my tsh was still 2.5 i do not know my t4 antibodies were over 4000 and he never tests for t3 i am just looking to find what is a tactful way as a patient to ask for help.



thanks
Doctor's Answer

by Mark Lupo, M.D., Dec 30, 2005 12:00AM
I would treat (ie, increase synthroid) until the TSH is 0.5-1.0 (give or take) - if still symptoms then consider a trial of T4/T3 combo therapy (ie, add cytomel to synthroid or change to armour) -- doesn't always work but if you are otherwise healthy it is worth a try -- problem is that medical literature does not yet support this stance with the exception that several trials reported patients preferring combo treatment over T4 alone.
Member Comments (8)

by Chocobabe, Dec 30, 2005 12:00AM
To: beachbrat1964
You know, I never, ever had good luck with Endo's--I'm not including Dr. Mark here because I have never been his patient--but those I did see over the years kept ignoring my continued symptoms while on Levothyroxine (it's like Synthroid), and they kept telling me to go by my TSH. I kept listening.....and I kept getting sicker and sicker! And for me, it was ONLY when I switched to Armour did I FINALLY start to feel wonderful!! Maybe you can find a totally different doctor?? There is also a group on Yahoo--Natural Thyroid Hormone users--who have been so helpful to me. Maybe they could help you, too. By the way, when Dr. Mark mentioned that T4/T3 combos don't always work--I have noticed on the large group I belong to that the main reasons they don't work for a few is because the patients weren't allowed to take ENOUGH, or they had low Ferritin, or they had sluggish adrenals. All of those are correctible, I have noticed. Good luck!





by Beachbrat1964, Dec 30, 2005 12:00AM
I went to my endo today, to be honest was not expecting good results, he actually listend :)

He also said that he was increasing my synthroid to 125 from 100 and if after 10 weeks ( if i felt worse before to call) I was still not feeling good he would add T3, he wants me stabolized, and said he would go to 1.0 or a little lower but adding t3 now would not really benefit due to we had not exhausted all efforts with the t4 alone because i am not stablized as of yet, he said that he gets good results if needed adding cytomol but stablization is important to know what your doing. He was also not totally against armour but did admit its harder to regulate being hypo with hashi. So I will be starting 125 synthorid tomorrow, I hope and pray for me its the answer if not at least I know my doc is willing to add the t3. He said if this increase does not work he will add it on the next visit. I have been miserable for almost 10 yrs so I guess I cannot expect to be 100% in 6 months, so I will give it the 10 weeks and if i do not feel good I will call. Does this sound normal to you all?

Thank you all for your help!!!

by Chocobabe, Jan 01, 2006 12:00AM
To: beachbrat1964
Your scenario sounds so much like mine once was. I, too, was never feeling well, and they raised me to .125 as well once upon a time. I held fast with that raise and with believing in the TSH, and I wasted SO many years doing that, just like the 10 you've mentioned. And another experience to pass along to you--I have never found Armour hard to regulate and neither have the 1500 members on the group I belong to!! LOL. And though adding T3 is sure a better choice than being on straight T4 in my book, there are folks who went from a T4/T3 synthetic combo to Armour who report that they felt MUCH better. I can only report to you that switching from Levothyoxine to Armour was a HUGE difference, and by what I am observing, the same difference is being experience by thousands of other patients, and especially when their doctors understand how to let them take enough to rid symptoms. :o)



by ancientmariner, Jan 02, 2006 12:00AM
To: beachbrat1964
I second what chocobabe said - I was on Synthroid after RAI made me hypo, and still had all the symptoms that I developed after the RAI. I took Synthroid for almost 3 years and never felt well. When I started Armour, the results were immediate! I felt better right away. I did hit a point where increasing the Armour dose wasn't helping, so my doctor tested adrenal function, and I now take adrenal support, and 3-1/2 grains (210 mg) of Armour. I CLEANED 3 rooms on my house this weekend! I haven't done ANY cleaning for 3 years, I have just been too tired! (Good thing my husband doesn't mind cleaning! LOL!)

by nolapoo, Jan 03, 2006 12:00AM
It seems like everyone is on such a  high dosage of Armour 3 or more grains. I have half of my thyroid. Maybe I'll ask for 1 grain to start and then go up. What do you think? I was up to 175 mcg of levoxyl  and it didn't work. Now I'm starting all over with 50mcg of levoxyl. If 175 didn't work....then I know 50 won't. My doc is not really happy about giving me Armour so I want to get as much as I can....maybe get 3 grains and cut it in half until I get used to it and go up to 3 grains if needed and if not just stay with 11/2 grains.

by ancientmariner, Jan 04, 2006 12:00AM
To: nolapoo
From what I've read, years ago, when desiccated thyroid was the ONLY treatment for hypothyroidism, dosages were adjusted by symptoms, and an average dose was between 3 and 5 grains, which I've also heard is the amount a "normal" human thyroid puts out.

by Beachbrat1964, Jan 05, 2006 12:00AM
Hi again,

I was wondering if 125 is a medium dose?

I went from 100 to 125 feeling better in the aches and pain catarogy but now rather anxious, heart palps fog head.

I do have a cold/flu as well and took a over the counter theraflu and that had a huge adverse reaction. ( last Sunday)

I just learned today that is a no no its not tolerated well.

So I do attribute some of my feeling sicky to that and the bug  but the anxiety not sure about.

I had heart palps when first put on 50 synthroid but the beta blocker helped that that i take, maybe its just an adjustment period.

I hate this! I was so tickled to get the increase and to have the pains starting to subside, but now this geesh which is worse. any advise or feedback would be greatly appreciated.
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