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Hypothyroid (using Generic pills)
I have had hypothyroid for 40 years. I am 56 years old. I took synthyroid 100mc for a long time . The past year it has fluctuated up and down every few months. I was taking 75 mc levothyroxine. My doctor said it is a generic brand and use levoxyl. Dr Oz had this consumer reporter on medications He said that levothyroxine can fluctuate it strength which makes sense since I am up and down every few months. I recently had bile reflux gastritis. My doctor switched me to levoxyl and my heart was racing so I got off the pill and had my thyroid recheked. He said it was normal a few weeks later. A month later I ended up with heart palpitations and ended up in emergency room. They took my thyroid and said it was high. They put me back on levothyroxine 75mc. I have been on it for 5 days. My palpitations are bothering me. I am wondering how long does it take for thyroid pills to make the palpitations go away. Are the palpitations caused by low thyroid. I would ask my doctor but the report is locked in his office and he is out of town I have tried to find a specialty doctor but the wait is 6 weeks. The good news is I lost 30 lbs. My diet has changed from the bile reflux gastritis and chamomile tea works great with a few other herbs. I heard that there is a test for thyrodd called free3 TSH and free4 TSH. That it is different from the plain TSH. Any other information would be helpful. Are there any other natural medications to take to help my thyroid function? Thanks loony 56
I took your advise and started taking the whole dose of 75 levothyroxine. I must say that a lot of that was my roller coaster of getting back on my thyroid pills and all the different strengths of thyroid pills.I am doing somewhat better. I want to thank you and gimel for helping during that thyroid crisis. I will get my blood tested again later this month. I will stay on the levothyroxine 75. I will make sure to get second opinion and not rely on my primary care doctor and stick with my endocrinologist and Med help. I have learned so much on this web sight. Thank you. I will post my blood test when I get those done
Dr. Lam has written a number of papers including Comprehensive Adrenal Fatigue Article, Adrenal Fatigue Versus Hypothyroidism, and Hypothyroidism.
I am under stress and could be adrenal fatigued along with hypothyroid all from this last 3 months of a roller coaster. I have had kidney stone in early March, Bile Reflux Gastritis late March. Been on and off thyroid pills because my doctor said all my stats were normal. Pure shock since I have not been off thyroid pills in years. Put on 3 different brands of Thyroid pills, some for a few days, 4 different doctors for all my medical problems along with reflux pills. I am confused period! If my latest thyroid test show that I need to be on the 75mc for thyroid I will take my levothyroxine 75mc. I have once before took half in the morning and half at night. Thank all of you for your ideas and knowledge. Loony56
No flak from me. The 37.5 dose was only a short term response to the Tirosint dose that seemed to cause a reaction, and was only to get her through the weekend, until a discussion with the doctor. The 75 mcg dose of levo did seem to result in a good level of Free T4; however, the Free T3 was below the midpoint of the range, which frequently is inadequate to relieve hypo symptoms.
That is because the range is too broad to be functional, due to the way ranges are established. The ranges are best utilized as guidelines within which to adjust levels as necessary to relieve symptoms. Many hypo patients find that symptom relief required Free T3 in the upper third of the range.
Also just curious as to why she should automatically assume that the adrenals are out-of-whack since she has been hypo? We hear from lots of hypo patients here, but haven't seen adrenals to be a constant companion of their hypothyroidism. Could you please provide a link to the info on adrenal fatigue symptoms that are pretty much the same as hypothyroidism?
That is because the range is too broad to be functional, due to the way ranges are established. The ranges are best utilized as guidelines within which to adjust levels as necessary to relieve symptoms. Many hypo patients find that symptom relief required Free T3 in the upper third of the range.
Also just curious as to why she should automatically assume that the adrenals are out-of-whack since she has been hypo? We hear from lots of hypo patients here, but haven't seen adrenals to be a constant companion of their hypothyroidism. Could you please provide a link to the info on adrenal fatigue symptoms that are pretty much the same as hypothyroidism?
Loony56 May 28, 2013
I’ll give you a little different opinion, which may generate some flak. I think that you are having problems because you have been on a roller-coaster of dosages.
Your labs you posted on 75 T4 are really quite good. Your FT4 is 1.28 versus normal women median 1.1, and your FT3 is 3.1 versus normal median 2.9. So this says to me that you ought to be taking 75 T4. That 40 yr endocrinologist knows what he is talking about.
If you take less than 75, then you are just making yourself hypothyroid, making matters worse – which caused the palpitations to start in the first place. The period when the doc told you to stop completely was utter nonsense and really screwed-up your system.
No matter what dose you take now or what type or what brand - you are going to have palpitations that just seem to happen randomly without rhyme or reason. So it is not a case of the “medicine not agreeing with you” – it does not cause the palps – it was going to happen anyway. This is going to keep happening until you get on the 75 and stay there for quite a while. So you need to pick you one – you were on 75 levo before the labs – and stay there and realize it takes 4-5 weeks for you thyroid levels to stabilize. You also have to realize that the rest of your body (for instance adrenal glands) is out-of-whack because you have been on this thyroid roller-coaster. (Look up the symptoms for adrenal fatigue – they are pretty much the same as for hypothyroid). So you have to be careful and make sure everything else is working right before blaming things on the thyroid and adjusting the thyroid meds when you don’t feel right.
I know palps are no fun – I’m just getting clear of them…
Good luck.
P.S. the business about 25 or 50 being the stating dose is for people who are just starting from scratch and do not know what dose the need. So they start small and work up. In your case you already know from labs that you need a higher dose.
I’ll give you a little different opinion, which may generate some flak. I think that you are having problems because you have been on a roller-coaster of dosages.
Your labs you posted on 75 T4 are really quite good. Your FT4 is 1.28 versus normal women median 1.1, and your FT3 is 3.1 versus normal median 2.9. So this says to me that you ought to be taking 75 T4. That 40 yr endocrinologist knows what he is talking about.
If you take less than 75, then you are just making yourself hypothyroid, making matters worse – which caused the palpitations to start in the first place. The period when the doc told you to stop completely was utter nonsense and really screwed-up your system.
No matter what dose you take now or what type or what brand - you are going to have palpitations that just seem to happen randomly without rhyme or reason. So it is not a case of the “medicine not agreeing with you” – it does not cause the palps – it was going to happen anyway. This is going to keep happening until you get on the 75 and stay there for quite a while. So you need to pick you one – you were on 75 levo before the labs – and stay there and realize it takes 4-5 weeks for you thyroid levels to stabilize. You also have to realize that the rest of your body (for instance adrenal glands) is out-of-whack because you have been on this thyroid roller-coaster. (Look up the symptoms for adrenal fatigue – they are pretty much the same as for hypothyroid). So you have to be careful and make sure everything else is working right before blaming things on the thyroid and adjusting the thyroid meds when you don’t feel right.
I know palps are no fun – I’m just getting clear of them…
Good luck.
P.S. the business about 25 or 50 being the stating dose is for people who are just starting from scratch and do not know what dose the need. So they start small and work up. In your case you already know from labs that you need a higher dose.
My doctor called me this morning. He said "I heard the medicine did not agree with you" He told me to stay off entirely until I felt better. I told him I cut a levothyroxine in half and felt better and at least my heart beat is not beating out of my chest. He told me to stay off the tirosint. He never offered me a lower dose. He finally said to keep the levothyroxine and keep taking the half which is 37.5mc and to get my blood tested in a month. I prefer to take the levothyroxine even though it is generic with least side effects for me. He said Generic pills vary up to 20 percent and brand up to 5 percent. I know now that the recommended starting dose for T4 should be below 50mc.Thank you. Loony56
Thank you. You have been a huge help. I will take half of my 75mg. Once again thank you! I will keep you posted. loony56
Mixing brands should not be a problem. In view of your situation, reducing your med by half of the 75 should be a step in the right direction, until you are able to talk with your doctor Tuesday.
My question to you is it allright to take half a dose of generic levothyroxine. I only took the tirosint for 2 days which made me hipper. I could feel my heart beating even when I was sitting and then when I would get up and move it would beat quite faster not a good feeling. This is the sign that the Tirosent is still to high. I will call tuesday to the doctor and ask for lowering my meds. I am super sensitive about medications.Thanks loony56
I have 75 Tirosint, and 88 Tirosint ,and I have levothyroxine 75, I have synthroids 100. I could take a half of levothyroxine which would be half of 75. Not sure if mixing brands is good. Not sure of taking none is good either. Of course the offices are closed on Monday. Do you think I should take my levothyroxine and cut it in half for a few days until I can call on Tuesday. I really do not want to take the tirosent dose if its causing me to be hiper. Everytime I go up the stair my heart goes really fast.Not sure what to do.Thanks. I am so glad you are there! loony56
It was mentioned above that the recommended starting dosage of T4 med is usually 25 - 50 mcg daily. Then patients that are really sensitive to meds increase by 12.5 -25 mcg, and sometimes even less when getting close to optimal dosage. If you were taking T4 in tablet form you could split them and try less. Obviously it is a bit more difficult with Tirosint. The best thing there would be to get a script for a smaller dose. Can you hang in until the doctor is available on Tuesday?
I started taking the Tirosint 75. I remember you saying you were concerned about me starting off on the 75. I did wake up a little nervous feeling. Maybe to high to start. I called the online doctor since this was saturday. This doctor told me that he would never have treated me since my thyroid TSH isn't really that high.I have been told to be on medicine by 3 doctors. I think he thinks I am crazy because I am so sensitive to starting medications. I have been on thyroid pills for most of my life. He told me to stop and call monday. Now I am really confused. This doctor was really short with me and really does not know me. My heart palpitations are better just feeling nervous. If I stop I am back to square one. I think I will talk to my doctor and just let them know that I am sensitive to all medicines, all of my life. I have read med forums about many people are sensitive and thats why you suggested my starting dose was a little high. I do believe the best is to start low and gradually work up. Am I correct? Another question is a starting dose for anybody changing pills, going on a higher dose or just starting on thyroid. Thank you loony56
I had Bile Reflux Gastritis which gave me Reflux. I know am off all reflux pills and drink Herbal Teas. I stay away from dairy, gluten, processed foods, and meat. I eat fish, vegetable and fruit. I noticed that dairy,gluten and meat have to many chemicals and hard to digest. My reflux is better. Thanks loony56
He is going to have me take the 75 for a month. No 88. He said that since I was taken some thyroid on and off for the last month I should be ok. If I have problems I can call him. I think I will be ok with that. I had problems with Synthroid 100mc. I was ok on the 75 levothyroxine but I kept fluctuating for the last couple years. Thats why the other doctor put me on the Synthroid which happen to be to big of a dose. Thanks loony56
Yes, some of our members take Tirosint. It is a gel cap. It contains no filler/binder, so it is supposed to be hypo allergenic. I am still concerned about your starting dosage. Did you mention that the recommended starting dosage of T4 meds is typically 50 mcg or less?
I went to a specialist today who has had 40 plus years experience in endocrinology. He put me on Tirosint 75mcg and 88mcg.He said I have a low tolerance for adjusting on one strength and to do one 75mcg and then the next night on 88mcg. He said that night time is ok which I like doing better at night since I go to bed late and not mixing it with other pills and not have to worry about it being on an empty stomach for morning. He did say the 1mg of synthroid was a bit to much. I will give this a try. He thinks all the fillers are not agreeing with me. He said levothyroxin could be off 20% and brands could be off as much as 5%. I will start this tonight. Will see. Have you heard of Tirosint? Thanks loony56
That is far too much for a starting dose. Your doctor should know better. The typical starting dose for T4 med is 25 - 50 mcg. Following is a quote from the link below it.
"treatment is usually initiated by starting patients on a small dose of L-thyroxine (T4). The medication thyroxine is identical to the T4 or thyroxine normally produced by our own thyroid, hence side effects range from minimal to none, as long as the correct dose of thyroxine is eventually prescribed. The starting dose of thyroxine usually ranges from 0.025 to 0.05 mg a day, and may be higher in younger otherwise healthy individuals. In older patients, or patients with co-existing or suspected heart disease, it is especially important to start with a low dose of thyroid hormone, so as not to aggravate concurrent or unsuspected conditions such as angina or other forms of heart disease."
http://www.mythyroid.com/hypothyroidism.html
"treatment is usually initiated by starting patients on a small dose of L-thyroxine (T4). The medication thyroxine is identical to the T4 or thyroxine normally produced by our own thyroid, hence side effects range from minimal to none, as long as the correct dose of thyroxine is eventually prescribed. The starting dose of thyroxine usually ranges from 0.025 to 0.05 mg a day, and may be higher in younger otherwise healthy individuals. In older patients, or patients with co-existing or suspected heart disease, it is especially important to start with a low dose of thyroid hormone, so as not to aggravate concurrent or unsuspected conditions such as angina or other forms of heart disease."
http://www.mythyroid.com/hypothyroidism.html
I started taking my synthroid 100 mcg on tuesday. I felt fine for a couple days. Yesterday I had this headache. It felt like a sinus headache. I called the doctor and they said the synthroid would not give me one and thats not from the thyroid pill. I came home and used a netti pot. I am not so sure that is a sinus headache. Today was a bad day for me. I was not able to do anything. I could not take my mother to the doctor. I felt like I was real light headed, lethargic, not able to walk. Real dizzy. I think the pills are to strong. Some people say that when you start synthroid you should start on a light dose. I am not even sure if I want to continue synthroid. I might go back to my levothyroxine. I have never had so much trouble with my thyroid. I am not taking pills tomorrow. I will call the doctor monday. I heard that taking thyroid pills is better at night. Any ideas what could be going on. Thanks loony56
I think I have high Ferritin levels from the Hemp and powdered vitamins I put in smoothies since I could not eat for 8 weeks due to Gastritis. I was really weak from not eating. That is doing better. I will not do any more vitamins that have iron. I think Alive makes a good vitamin that has no iron. I am looking for foods that will behave with my stomach that is low fat and no or low iron for my gallbladder and low iron. I cannot do acidic. I will ask my doctor about the Ferritin and a full iron test panel. That is really a good idea. I will start my 100mc of thyroid tomorrow. I will continue to take my vitamin D3. I really appreciate you! Thank God for all the good you do! Any ideas for low iron foods. I guess I will be doing research. Thank you loony56
In case you haven't seen and read this info that I post so often, I want to make sure you have read it.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation. The letter is then sent to the participating doctor of the patient to help guide treatment. In the letter, please note the statement, "the ultimate criterion for dose adjustment must always be the clinical response of the patient."
http://hormonerestoration.com/files/ThyroidPMD.pdf
So that is why you see so much on the Forum about testing Free T3 and Tree T4, and adjusting those levels enough to relieve hypo symptoms. When already taking thyroid meds, TSH is basically useless for dosing a hypo patient. Scientific studies have shown that Free T3 correlates best with hypo symptoms while Free T4 and TSH do not correlate at all.
Both your Free T3 and Free T4 are below the middle of their ranges, which frequently relates to having hypo symptoms, because the ranges are far too broad to be functional for many people. So if you continue to have hypo symptoms, there is plenty of room to adjust your meds and increase your Free T3 and Free T4 levels. So far you seem to be converting the T4 med adequately, as shown by your test results, so increasing your T4 med should be adequate for now.
Your B12 appears to be adequate. Your Vitamin D level is a bit below the level of 60-70 that seems to be optimal for many people. Your ferritin is obviously high. My question is why. It seems to be higher than I could account for by your diet, even though I admit I'm not familiar with the effects of having no gall bladder. I think you ask the doctor to explore further to make sure there is no other potential cause, by getting a full iron test panel, including serum iron, TIBC, UIBC, and % saturation, along with the ferritin..
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation. The letter is then sent to the participating doctor of the patient to help guide treatment. In the letter, please note the statement, "the ultimate criterion for dose adjustment must always be the clinical response of the patient."
http://hormonerestoration.com/files/ThyroidPMD.pdf
So that is why you see so much on the Forum about testing Free T3 and Tree T4, and adjusting those levels enough to relieve hypo symptoms. When already taking thyroid meds, TSH is basically useless for dosing a hypo patient. Scientific studies have shown that Free T3 correlates best with hypo symptoms while Free T4 and TSH do not correlate at all.
Both your Free T3 and Free T4 are below the middle of their ranges, which frequently relates to having hypo symptoms, because the ranges are far too broad to be functional for many people. So if you continue to have hypo symptoms, there is plenty of room to adjust your meds and increase your Free T3 and Free T4 levels. So far you seem to be converting the T4 med adequately, as shown by your test results, so increasing your T4 med should be adequate for now.
Your B12 appears to be adequate. Your Vitamin D level is a bit below the level of 60-70 that seems to be optimal for many people. Your ferritin is obviously high. My question is why. It seems to be higher than I could account for by your diet, even though I admit I'm not familiar with the effects of having no gall bladder. I think you ask the doctor to explore further to make sure there is no other potential cause, by getting a full iron test panel, including serum iron, TIBC, UIBC, and % saturation, along with the ferritin..
Lab results for my HYPO THYROID and Ferritin levels. These are my latest labs. Look at my Ferritin. You were right to get that checked I owe you! Vitamin D3 is ok, Vitamin B 12 is ok.
Vitmamin B 12 803 pg/ml 211-946
Folate Folic Acid serum 15.3 ng/ml 3.0
Thyroxine T4 Free, Direct, S 128 ng/dl 0.82-1.77
TSH 5.780 HIGH uIU/ml 0.450-4.500
Thyroid Peroxidase (TPO) Ab <6 IU/ml 0-34
Triiodothyronine, free, serum 3.1 pg/ml 2.0 - 4.4
Vitamin D 25 Hydroxy 42.2 ng/ml 30 -100.0
Ferriten Serum 307 High ng/ml 13 - 150
My Ferriten is high. Men should be 30- 400 Women should be 15 - 150 I am now looking for foods low in Iron. This is not easy. I have no gallbladder which I cannot digest fats,Hypo thyroid ( avoid Crucaferous) spelling, and I have Bile Reflux (no acidic) I can eat fish, bananas, potatoes, oatmeal I tell ya food is no fun! Every time I think a food is ok its not. I found a multi vitamin with no added iron. My doctor did order me Synthroid 100. mc for the HYPO. I was using levothyroxine but i was fluctuation way to much with thyroid issues. I really do believe that it was generic. Any suggestions. I really want my life back. Thanks loony56
Vitmamin B 12 803 pg/ml 211-946
Folate Folic Acid serum 15.3 ng/ml 3.0
Thyroxine T4 Free, Direct, S 128 ng/dl 0.82-1.77
TSH 5.780 HIGH uIU/ml 0.450-4.500
Thyroid Peroxidase (TPO) Ab <6 IU/ml 0-34
Triiodothyronine, free, serum 3.1 pg/ml 2.0 - 4.4
Vitamin D 25 Hydroxy 42.2 ng/ml 30 -100.0
Ferriten Serum 307 High ng/ml 13 - 150
My Ferriten is high. Men should be 30- 400 Women should be 15 - 150 I am now looking for foods low in Iron. This is not easy. I have no gallbladder which I cannot digest fats,Hypo thyroid ( avoid Crucaferous) spelling, and I have Bile Reflux (no acidic) I can eat fish, bananas, potatoes, oatmeal I tell ya food is no fun! Every time I think a food is ok its not. I found a multi vitamin with no added iron. My doctor did order me Synthroid 100. mc for the HYPO. I was using levothyroxine but i was fluctuation way to much with thyroid issues. I really do believe that it was generic. Any suggestions. I really want my life back. Thanks loony56
Just because thyroid test results are in the so-called "normal" range does not mean they are adequate. The ranges are far too broad to be functional for many people. Please post all those results and their reference ranges so that members can further assess.
Thank you for the information on getting my TSH, FREE T4 and FREE T3, Vitamin D 3, Vitamin B12 and my ferritin levels checked. All my blood tests were normal except my TSH levels were 5.78 should be 0.450-4.500. The doctor is putting me back on Synthroid 100mc. My Ferritin cam back high. 307 should be 13ng-150ng. Now I know why I have been tired and dizzy with heart palpitations. I am increasing my thyroid and stop vitamins that contain iron or very low iron. I do need to find out which foods to eat for low iron. I think its called Hemochromatosis. I think if I get on higher thyroid pill and stop eating high iron foods and vitamins I can get better. Do you know anything about high ferritin levels and is mine real high or can it be modified by eating low iron foods and vitamins. I have a hard time eating at all because my thyroid issues and Bile reflux gastritis. I finally know what is going on. All my other blood tests were normal. Loony56
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