Feeling even more hypo after a month on Tirosint

[Sunshine_67]

I'm confused. After a month on Tirosint, my labs have gone up (I don't have them yet but my doc said they were higher, although my RT3 is probably also still high), but I'm feeling even more hypo and worse than ever. I thought this stuff was supposed to be absorbed better? I guess it is as far as my labs, but as far as how I feel it's not working at all. I even have new symptoms like blurry vision, severe pressure on top of my head like someone is pressing down on it, fatige and weakness is much worse and so is brain fog. Could I be allergic to levothyroxine?

[Brucergoldberg]

ok but for the record, IM DYIN!

i think my thyroid is getting worse, and the dose is too low.  I went ahead and set up the appointment for the end of next week which will be going closer over to the 5 week mark.  :(

[goolarra]

I'd give it another week.  My endo had me on a 4-week test schedule when he was adjusting my meds.  Four weeks, technically, isn't enough to completely stabilize the dose, but it's close enough.  Patience...

[Sunshine_67]

I finally switched from Tirosint to compounded armour. I have never felt well since I started taking Tirosint so I'm hoping switching to all natural will help. Right now my adrenals are all a mess though so I need to try and work on those.

[Brucergoldberg]

Im on day 21 of Tirosint .50.  I am still very hypo.  I am actually at the point where I feel better when i take the thryoid instead of before when it made me worse.  If i wake up and take it at 4 am, i sleep from 4 am to 7 am like a baby.

I am ready for more.  Im only on day 21 but want to get tested.  I feel like im slipping slowly backwards into hypo land again.   Is it too early to re-test?

bruce

[goolarra]

You're not hyper...you're body's just adjusting.  

Your FT3/RT3 ratio...2.9 / 14 * 10 = 2.07...does not indicate RT3 dominance.  The reference range on the ratio is approximately 1-2, preferably closer to the top of the range.  RT3 dominance would be indicated if FT3/RT3 ratio were less than 1 (or close to 1).  Your ratio looks just fine.

[Brucergoldberg]

on the same day that i had my reverse done i had t3 free done and it was 2.9  (2.3-4.2)

I feel like just the .25 of tirosint has thrown me hyper.  Thats the only way i can express it.   I know i need it, but why is such a tiny amount doing this?

[goolarra]

Bruce, I was thinking of this thread when I read your other one.

"I too had the RT3 test , but not on any thyroid.  Except the values for my RT3 test were quite different than Sunshines.  Mine was 14  by the ranges of 11-32.  Im confused on why her values were so different."

Yours could be expressed in different units.  I think yours is off by a factor of 10.  Your 14 would be equivalent to 140 on Sunshine's range.  What was your FT3 from that same draw that resulted in RT3 of 14?

As to question #2...no, that's not how it works.  When you take levo, your own thyroid doesn't just suddenly quit working and, in essence, "let the pill take over".  Your FT4 level is the result of the pill and your thyroid (if you have a functioning one) working together.  Your body does not distinguish the T4 in levo from the T4 that comes from your thyroid.  

Bruce, you are obviously very sensitive to changes.  Pick a dose and stick with it until it settles...4-6 weeks.  Changing dose is obviously your worst enemy.  Give yourself time to get used to it.  The same dose for 4 weeks, regardless of how you felt yesterday...you can't judge this on a day-to-day basis.  After 4 weeks, have bloodwork done, re-evaluate symptoms, adjust meds, repeat.  Consistency, consistency, consistency.

[Brucergoldberg]

I'm on day 3 but it sent me more hypo than ever.  I've made it 5 weeks on this and felt the same.   Should I of started higher?

[Sunshine_67]

With a TSH of 22, you definately need a higher dose. Are you also getting T3? Most people don't convert T4 well and need to also take a little T3, but with a TSH as high as yours, a dose of 25mcg is not high enough. That's probably why you're feeling so bad. Also, how long have you been on the tirosint? It takes at least 5-6 weeks for it to kick in.

[Brucergoldberg]

ive read this post with great interest as I too just started .25 tirosint once again and am having the same effects as the poster above.

I am trying to figure out if it is normal to go hypo after starting the meds.  My Tsh is 22, i posted my labs in another post.   I have been avoiding thyroid because I know exactly what it will do to me.  I went ahead and started thyroid yesterday.  Felt great yesterday.   Today, I felt as sunshine stated in her top post.

I am trying to figure out how long the adjustment period should be on this.  WIth me having such a high tsh, the Dr. thinks i need probably 50 or 100 mcg.

I wanted to join in this post for two reasons (related to this post)

1.  I too had the RT3 test , but not on any thyroid.  Except the values for my RT3 test were quite different than Sunshines.  Mine was 14  by the ranges of 11-32.  Im confused on why her values were so different.

2.  Is it possible that the small amount of thyroid that we are taking is just so small of a dose, that the thyroid is becomming dependent on the "Pill"  and not its own production, but the Pill is not big enough so its sending us hypo?

I felt pretty crappy with tsh of 22, but i feel MUCH worse on the meds.

I agree with this statement "I'm not getting headaches, it's just pressure on top of my head like if someone was pressing their hands down on your head. It's not a pain and it never goes away with advil, so it's not a headache. The fatigue is more hypo"

In addition, my ears ring worse, im so beat down i can hardly think, im hot, and sweaty and confused.  

[Sunshine_67]

Again, my stressor is my hormone imbalance. I've had my RT3 go from 350 to 230 and back up to 406, all while taking T4. So in MY case, I do not need T3 only, I just need to address the stressor, which I still have. I trust my doctot 100%. She has saved my life after going thru 3 years seeing 8 different moron doctors who knew nothing about thyroid or hormones. If she doesn't believe in using T3 only, then there's a very good reason and I trust her judgment.

I did not mean for this thread to become an arguement. I simply was stating an surprise reaction to a new medicine.

[Barb135]

"That's a generalization and not true for everyone."

Nothing we post holds true for everyone, because we are different individuals and we each react to stressors, medications, disease or anything else, in our own way.  

[goolarra]

I'm not saying that recurrence is impossible, just that having RT3 dominance once does not increase your probability of getting it again.  All I'm saying is that if X% of the general population gets RT3 dominance, your risk of getting it stays at X% after treatment; it doesn't increase.

"...the condition is easily diagnosed and treatment is curative. After proper treatment the patient is back to normal and there is no further need for treatment. "

I'm not trying to convince you of anything...just think this is an interesting discussion and trying to throw out some ideas.

RT3 dominance is a response to stress (which can include environmental toxins, vitamin imbalances, other hormonal imbalances, illness, surgery, etc.).  If your RT3 dominance was caused by hormone imbalance, and that imbalance still exists, then it has to be addressed.  However, high RT3 in times of stress is not "abnormal".  What is abnormal is the body not releasing the RT3 after the stress is over.  It's possible that the stressor long since disappeared, but the cells are still blocked, as could be the case with someone who developed RT3 dominance from the stress of an injury, illness or surgery, for example.

[Sunshine_67]

That's a generalization and not true for everyone. I've read many posts of people who lowered their RT3 with T3 only and as soon as they added T4 back, their RT3 went up again because the cause of the high RT3 was never addressed. If my high RT3 is protecting my body from something, then that something needs to be found, addressed and treated or the high RT3 will just keep coming back. In my case, the cause is hormone imbalance caused by a damaged pituitary gland. So until my hormone levels are back to normal, my thyroid meds will never work on me.

[goolarra]

Apparently, once the FT3/RT3 balance is restored, you are no more likely to have RT3 dominance again than someone who never had it.  The objective of treatment is not to reduce RT3 to zero (FT3 and RT3 are both converted from FT4 all the time), but to release the RT3 that has docked in cells and free up the T3 receptor sites for T3 to get in.

The theory is that more RT3 is created in times of stress and that even one very stressful event can cause RT3 dominance.  RT3 is our body's way of protecting organs from overload.

[Sunshine_67]

That article is interesting, but again, what happens if my RT3 got down to zero, I went back on T4, and if the original cause of the high RT3 wasn't fixed yet, the RT3 will just go back up?  There's a reason my body isn't using the T4 correctly, and until that reason is found and fixed, treating just one symptom will only be temporary.

[Sunshine_67]

My doctor already knows one of the problems. My hormones are way too low. She said she can only increase the hormones a little at a time though because if you end up with too much hormones, your body can't get rid of them and you could get cancer. I just took an adrenal saliva test a week ago so that will show where my cortisol is. My body is stressed right now from too little hormones and probably cortisol imbalance. She said lowering the T4 will also probably help. Since the Tirosint absorbs better, taking a high amount before was probably too much. I'm doing labs in another two weeks so I'll see if lowering the T4 helped any. Since this doctor does not agree with T3 only, showing her articles won't make a difference. She's very opened minded, but when it comes to that, she won't change. She's a very good doctor though. After seeing 8 doctors in 3 years who only made me worse, she's the best I've found. The only one out of 8 doctors who would even test my hormones and treated me by symptoms as well as labs.

[gimel]

I agree with trying to identify and resolve any conditions that may be causing the excessive RT3.  This link is a long list of those possible causes.  What is your doctor doing to try and identify possible causes?

http://www.thyroid-rt3.com/whatare1.htm

I think you will find the link below to be interesting as well.  It seems to tie in with the example of the lady you mentioned that went hyper.  The link details the recommended treatment and it mentions the need to carefully monitor symptoms and pulse/temperature, as a way of identifying changes quickly.  Here is a quote from the link.  "If the  T3  you are taking does clear most hypo symptoms and you had high in range or over range RT3 levels then be prepared to drop the amount of T3 you are taking when resistance clears. This can be dramatic and you can end up needing half what you needed the day before when the resistance clears. This is one of the reasons that you need to go by symptoms and pulse/temperature, things happen too fast to base it all on lab numbers.  You can of course keep the dose lower and put up with feeling hypo for longer, when it clears you simply end up feeling less hypo."

http://www.thyroid-rt3.com/howisit1.htm

[Sunshine_67]

My doc also gave a patient more T3 to try and lower her RT3 and the woman went so hyper she ended up in the ER. My doc is letting me take a little more T3 and lowering my T4 to 88mcg so maybe that will help. I was actually feeling a lot worse (more hypo) on a higher dose so it obviously was stressing out my body.

[Sunshine_67]

I don't believe in it because it's just a bandaid. I've read many articles of people who took T3 only, got their RT3 down, but because they never found out and treated the actual cause of the high RT3, it just came right back when they added T4 again. My hormones and damaged pituitary gland are what's causing all my problems, so taking T3 won't solve my problems. My body is stressed because my female hormone levels are practically at zero and my adrenals are stressed as well. Without finding the actual cause and treating that, putting a temporary bandaid on the situation won't help me.

[Barb135]

Not converting thyroid med properly is an issue that a lot of us deal with, and the answer is simply adding a T3 med to our T4 med.

The issue of RT3 is much more complicated.  Both your levels of FT4 and FT3 are right at the top of their ranges, when it's usually recommended that FT4 be about mid range and FT3 in the upper 1/3. Your conversion seems to be just fine; it's the ability to use the FT3 that seems to be impaired.  

You have plenty of both FT3 and FT4; however, RT3 blocks FT3 from entering the cells, so yours is simply "floating" around in your blood, not being used.

Many doctors do not believe in T3 only, treatment, but I'm curious as to why you don't believe in it, if it could help you feel better.

[gimel]

I'm not sure your doctor's explanation squares with other things I've read.  This is a good link on the subject.  If you go through the many additional links on the page you can find lots of pertinent info about causes and treatment..


http://www.ei-resource.org/myblog/reverse-t3-and-thyroid-resistance-.html

[Sunshine_67]

My doc says the high RT3 is from being on too high a dose of thyroid meds and it's causing stress in my body. That along with my female hormones being almost zero from a damaged pituitary gland. No, I didn't take T3 before my labs. My doc doesn't believe in T3 only and neither do I. There's something causing my body to not convert thyroid meds correctly and I need to find out what's causing it. It's no doubt that my body doesn't produce hardly any hormones on its own so my doc says I'll need high doses of hormone replacement. I've read if you have low hormones, your thyroid meds won't convert well.

My labs definately show that I'm hypo because of the high RT3. All my symptoms are hypo.

[gimel]

I agree with the issue that goolarra mentioned, reverse T3.   If I remember correctly one of her old posts on RT3, from some time ago, your FT3/RT3 ratio would calculate as 1.0.  The recommended range was 1 - 2, and the higher the better.  If I remember the recommended treatment protocol correctly it involves trying to flush out the excess RT3 by dosing with T3 meds only, to prevent the continuing conversion of T4 to RT3.  Does your doctor have any experience with this?