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Tirosint, what are you doing to me?
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Tirosint, what are you doing to me?

I have been on Tirosint since November but I could not last longer than 10 days in a row on it.  Why? Because it gave me the following side effects:

- Intense sleepiness after taking it
- Hair falling out everywhere I go like it's supposed to be a sweater
- Anxiousness
- Heart beating rapidly
- Sweats and increased body odor
- Buzzing inside body like being really wired
- Teeth pain and dry mouth
- Anger issues
- Muscle pain
- No period

I was taking 50 mcg after being switched over from Synthroid 50 mcg. Not sure why my body reacts so weird to it but I couldn't even take it long enough  (6 weeks) to get a TSH, FT3, and FT4 test.   The sleeps and the hair loss was too much to deal with.

Anyone else have reviews with Tirosint?  I really was hoping that it would work for me but it was not the miracle treatment at all.

Thanks!

Can anybody else
Tags: Tirosint
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178 Comments Post a Comment
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219241_tn?1357815389
The thing is with some people just starting on Tirosent, they find the exact same dose as the previous synthetic too high. The body seems to absorb far more readily the gel capsule rather than the powdery filler and gum encapsulated little tablet, and you end up hyper! The synthetic tablet jsut doesn't absorb as well and you need more to obtain what you need, so going to Tirosent which is basically pure and easily digested means you are getting too much!

  Some of your symptoms do sound hyper, have you had blood tests recently? You might have to drop down the dose for a short while till you get used to taking something that actually in fact will work!

Many many people swear by Tirosent and I am sure your issue is just a matter of rearranging the dose.

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393685_tn?1325870933
Absolutely. Usually this T4 med should be half the dosage of what you were taking to start out.

Did you have labs doen while still on it? I'd be curious to see if you went hyper.
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Avatar_m_tn
I wish I knew that!  Since Tirosint is so new, docs probably aren't aware of Tirosint being so strong.  I couldn't even pass the 10 day mark since I was feeling like I was going 1000 miles an hour.  

I may just take the 50 mcg every other day but since I am trying to conceive, not having a period due to the med is a real issue at this moment.  I may go to Synthroid for now.
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Avatar_m_tn
Couldn't get far enough to even get near the lab mark.  This drug was making me go crazy! Sweating, heart palps, hair falling out, had to take naps, buzzing in my body, irritability (felt bad for my husband), and just not myself.  It was unbelievable how I felt.
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499534_tn?1328707778
It definately sounds like it made you go hyper. I am on Tirosint. This medicine is as hypoallergenic as it gets and is a lot more "pure" due to it not having all the fillers in it. It binds differently in your system, and is used more readily and quicker.
It would warrant seeing a Free T4 and a Total T4 to see the ratio of what is bound and what is free in your system.  I agree if you start out at a smaller amount and gradually increase it will work. You need to have labs done at the 6 week mark while starting this med.
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Avatar_m_tn
Hi Laura1967,
Thank you for the comment and experience.  Did you start out with the same dosage as your previous med?  Or did you start out a lower dosage?  Currently, have you increased or decreased since starting Tirosint?  I would love to give it another try but that would mean I would have to go to the doctor and ask for a 25 mcg and a 13 mcg prescription as the next lower dosage to the 50 mcg I was taking?
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Avatar_n_tn
I took only lasted 10 days on Tirosint. My issue was with muscle pain/cramps, so severe in my upper back that it was hard to breathe. I had them in my calves, neck, shoulders, upper back and then hands and fingers making it quite difficult to work daily, so I gave up. I am not sure why it did not agree with me, but the day after I stopped, it went away. I too wish it would have worked for me :(
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Avatar_m_tn
Did you lower to the next dosage or were you on the same mcg as your previous med?
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1139187_tn?1355710247
Look at some of my posts.   Went through everything you are speaking of.  Some of my posts have been locked but you can still read.  Made it 6 weeks and had to stop.
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649848_tn?1357751184
I totally agree with Laura, that Tirosint is about as hypoallergenic as you can get.  There are no common side effects; most side effects are the result of over or under medication.  

Being a gelcap, with no fillers, absorption is greater than with a pill. It's always best to start a new med on a lower dose and let your body adjust to it, before trying to get to the full therapeutic dosage.  

I actually *increased* my dosage when I went on Tirosint; went from 88 mcg levo to 100 mcg Tirosint and it's done awesomely for me.
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Avatar_n_tn
I actually changed from 100 of Synthroid to 100 of Tirosint along with no change in my cytomel. I could have been under or overdosed, but felt horrible and had a not so great endo, so I knew they might give me trouble. I may have given up too soon..but it was not fun at all. I also gained 5 lbs in 10 days on it....once I switched back to Synthroid, I have lost the weight and my muscles are fine now. I am not sure what happened, but I decided to switch back. Good luck with whatever you decide!
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499534_tn?1328707778
I switched over at the same dosage...and have increased since. I had room to work with though....my t4 level was only in the low normal range.  But....I am also on Cytomel (T3) as well.  I feel great on Tirosint.
My next question to you is what was your last Free T3 level?  
You can have too much T4 and too little T3 in your system which will cause hypo and hyper symptoms both! It happened to me....I was a train wreck until i added the T3.
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Avatar_m_tn
Thanks Barb for sharing your experience. It is great that it worked out for you.  What are your labs like on tirosint?
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Avatar_m_tn
Thanks rutkowski517.  I need all the luck I can get.
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Avatar_m_tn
Hi laura1967,
My ft3 is usually touching the low end of the range on any t4 medication only.  Last year I was on 50 mcg levoxyl and half grain of natuethroid and my tsh was around .3 with frees in the upper middle ranges.  I was going hyper and getting heart palls while not being able to sleep.  I am back on synthroid 50 mcg just to be safe and get back to my original dose and brand.
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Avatar_n_tn
I have been on Tirosint for a month, and also having problems, I only have a partial Thyroid and take 100mcg, it is killing my spine and abdomin (abdomen), plus insomnia,pain in my breast, the Dr. told me to miss one day as 75mcg is too low and 100mcg is too high, but it's not working, the day I take nothing all the pain almost goes away, so I know it's this meds, I want to try it but becoming very skeptical, I asked Dr. about cytomel and he said "you do not want to take it" but why. This is the worst thing to regulate and as the years go on the more problems there appears to be taking any of this meds, wish I never had my Thyroid removed, plus Dr's do not understand how awfull it is taking these meds, only the people taking them know. Any one out there taking something they are pleased with?
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Avatar_m_tn
It's possible that some of your reactions are due to starting with too high a dose.  It may have worked far better if you had started on no more than 50 mcg for 6-8 weeks and let your body become acclimated to the med.  If that worked, then you could increase by maybe 25 mcg every 6 weeks and gradually build up to the level you finally need.  Slow and sure is by far the best approach.

Have you been tested for the biologically active thyroid hormones Free T3 and Free T4 (not the same as Total T3 and Total T4)?  If so, please post results and reference ranges.  If not, then you should make that a priority to get done every time you go in to the doctor for testing.

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649848_tn?1357751184
I agree with gimel, that you should have started at a lower dosage and worked up slowly.  

Since Tirosint contains nothing but the T4 medication, glycerin and water, it is virtually hypoallergenic.  Your symptoms are most likely from being, either, over or under medicated.  

You should ask your doctor if you can drop back to 50 mcg for a few weeks, and even though you may go a bit hypo, you will give your body a chance to get used to the med, then go up by no more than 25 mcg at a time.  

I feel better than ever since I've been on it (currently at 88 mcg and holding), and I'd sure like to see you give it another try.
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Avatar_f_tn
I'm so relieved to find this thread! I'm having similar issues with Tirosint. I thought I was losing my mind because I didn't have any of these problems on Synthroid and Tirosint has fewer ingredients! So I don't kno what I could possibly be reacting to.

I understand the theory of needing a lower dose because of the absorption efficiency but I went from 50mcg Synthroid (felt "ok" and lost 20lb in 6mos) to 30mg Armour (hypo symptoms returned, TSH tripled, gained 15lb in 6mos) to 50mcg Tirosint, which I've been on for 4 weeks and not only have my hypo symptoms remained if not worsened, but the depression/anxiety combo I've had the last 2 wks is devastating. I almost up and quit my job last week! Not at all like me. I've also gained 6-8lbs in the last 4 wks despite same exercise &diet I was doing while on Synthroid when I lost 20lbs.

How could I have done fine on Synthroid and be such a mess now?? I don't think I have any hyper symptoms. I thought my issues were due to adjustment of going off Armour (losing T3 input) but I've been off that for 7wks now, I should be feeling *some* improvement I would think, and certainly not worse! The depression and anxiety are killing me and I've been having stomach issues, not sure if that's related though.

I had blood drawn today so hopefully I'll know more in a few days, although my labs are almost always "normal" ugh. But I asked for Free T3 this time, she's never ordered that before...
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Avatar_m_tn
The FT3 test will help a lot to understand your current status.  

By the way, are you sure the lab is going to test for Free T3 and not Total T3?  I ask this because so many times they operate on auto pilot and just mark down their usual tests and you find out a week later that you got the wrong test.  If you aren't sure, it might be worth a call to the lab to make sure.  

A good thyroid doctor will treat you clinically by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  I think you might get some good insight about clinical treatment by reading this link to a letter written by a good thyroid doctor.  

http://hormonerestoration.com/files/ThyroidPMD.pdf
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Avatar_f_tn
Hi gimel:

Sounds like you know a lot about thyroid conditions. I have Hashimoto's for 25 years now and my doctor very recently gave me 112mcg Tirosint to try, changing from 125mcg Synthroid.  I'm also taking 5mcg of Cytomel, down from 10mcg, due to severe hair loss.  After reading these posts, I'm concerned about trying it now, although I like the fact that it's more pure, not synthetic.  Should I try a lower dose than the 112mcg?  Other than the hair loss this August, I'm doing okay with Synthroid, although I don't convert to T3 very well.  Thanks, Linda
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Avatar_m_tn
If you look through this listing of 26 typical hypo symptoms, how many would you say that you still have?

http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html

I don't understand the comment about Cytomel reduction, due to severe hair loss.  Hair loss is frequently associated with still being hypo due to inadequate/incorrect meds.  Have you ever been tested for the biologically active thyroid hormones, free T3 and Free T4?  If so, please post results, along with reference ranges shown on the lab report.  Also, please post any other thyroid related tests done for you.  
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649848_tn?1357751184
Neither do I understand the comment about the hair loss.  That's usually a symptom of being hypo.  

I'd also like to clarify - Tirosint is not "pure; it *IS* synthetic; it's difference from other synthetics is the lack of fillers that many people have reactions to.  Besides the T4 medication it contains, the only other ingredients are water and glycerin, which is what makes it hypoallergenic.  

You should talk to your doctor if you think you need a lower dose; however, I actually started out higher with Tirosint, than I had been on my old levo.  I've since had to drop back down, and while I felt better at the higher levels, I was getting too close to hyper.
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Avatar_m_tn
I have hashimotos and was diagnosed in February..I was reluctant to go on meds as I don't even take Tylenol..but after my symptoms became terrible with the depression/anxiety combo and being constantly fatigued with no desire to do much of anything and my thyroid enlarged to the point that I constantly choke a little while eating I decided to take the plunge on tirosint because it was more pure and better regulated. Just a heads up the my endo is very holistic and told me that the generic Levo that they give instead of brand name synthroid is made in china, India and a variety

of countries and not regulated properly so the substance within your meds can vary dramatically depending on who made it..for the first week on the tiro I felt amazing and "normal" like I just awoke from a long standing bad dream and was like oh yeah this is what I used to feel like I remember now..however after that week I quickly went back to my version of hell I mean normalcy..I was only on 13mcg the smallest dose possible and after 6 weeks on it my tsh was 3.00 and my t4 was 1.0. They never tested my t3..they keep telling me I'm in the normal range so really don't want to do anything else and told me they would see me again in a year!!! but when I went in deb and they first diagnosed me my tsh was 2.47 and I felt terrible then so it's getting higher..

I do get really bad anxiety and night sweats and I feel as though my body is really sensitive to temp changes..does anyone else have this? My doc just upped me to 25mcg but I haven't started that dose yet..this is terrible..I just turned29 and don't want to keep feeling like crap! Help!

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Avatar_m_tn
I also go through bad mood swings and I feel like it amplifies my emotions..my body overall just seems overly sensitive to any hormonal change as with my period and those hormonal changes just add to the chaos and all my symptoms get amplified..

Sometimes I get really confused and feel like I'm in a fog and feel very disconnected to everything around me..it is quite scary and unnerving and I push through it but makes life difficult..I just don't feel like me but it's been so long since I felt good that I'm not even sure what that would feel like and it's so frustrating to go to numerous doctors and all them scoff at your symptoms and say oh your levels are normal..well I don't feel freaking normal and know that everyone doesn't wake up in the middle of the night panicked and sweating and can't ever sleep through the nite and has no energy at all..I work out all the time and eat organic and all natural..I dont drink or smoke and do all the right things health wise but to no avail..

I feel like I'm losing my mind with the constant roller coaster..like mentally and physically I'm drained...
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Avatar_m_tn
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.  Symptom relief should be all important, not test results.  Contrast the type of testing and treatment you have been getting to the clinical approach recommended in this link.  the link is to a letter written by a good thyroid doctor for patients that he consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.

http://hormonerestoration.com/files/ThyroidPMD.pdf

After reading the letter I'm sure you will have no doubts about need a new, good thyroid doctor.  If you will tell us where you are located, members may be able to recommend such a doctor in your area.

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Avatar_f_tn
(I had my thyroid radiated 15 years ago) I actually had the opposite effect. I was on Synthroid 100 per day 150 on M/F plus a compound of .12.I turned 50 in January, and I didn't have a period since February. I thought it was my menopause changing time. My hair was thinning, no sleep, my skin terribly dry.
However, this month since November 1st I've been on the Tirosint. 100 per day 113 MWF plus the compound of .13.
Low and behold my period returned. My hair is still thin, but not falling out, and I am sleeping better.
Curious find out my labs Dec 1.
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649848_tn?1357751184
I don't understand your dosing schedule. What is "100 per day 113 MWF"? Please explain more fully.  Hate to ask, but what's the "compound of .12" and "compound of .13"?  Are you taking an added compounded T3 med?
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Avatar_f_tn
I take 100mcg Tirosint everyday along with the compound (T3 pig thyroid) mixed by the pharmacy, and I take 100 mcg plus 13 Tirosint on Monday Wednesday and Friday.
It's a theory by numbers. I believe I am needing less as I go through hormonal changes, even though I do not have a thyroid any longer.
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649848_tn?1357751184
I'm sorry, I must be really dense, but I can come up with several different ways to interpret your dosage.  It looks to me like you are taking 100 mcg Tirosint daily (7 days/week), then on MWF, you take an additional 113 mcg, so on MWF, you actually get 213 mcg Tirosint? Somehow that doesn't make sense, so I'm assuming it's not right.

Or are you alternating 100 mcg with 113 mcg - meaning that one day you take 100, then the next you take 113 for an average of 106.5/day?

OR, are you taking 100 mcg Tirosint daily, then on MWF, you add the 13 mcg of T3 pig thyroid?  This one  makes more sense, but please verify.

The pig thyroid is strictly T3 med?  Strange, I didn't know they could separate the T4 from the T3 in pig thyroid - learn something new every day, huh?

In order to know if you are getting too much, we'd have to know what your actual thyroid hormone levels are.  That would be Free T3, Free T4 and TSH.  

Please verify your dosage, then it might be better to post your actual test results in a thread of your own vs latching onto an old one, like this.  You can post your thread, by clicking on the orange "post a question" button at the top of the thyroid home page.
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Avatar_m_tn
My new prescription of 125 mcg tirosint caused my full head of hair to completely fall out within a one month time period.  All three of my endos recommended the increased dosage due to high TSH level (9.3).  Why doctors will only test and dose according to a patient's TSH level and not provide for more comprehensive testing of TSH, T3, T4, Free T3 and Free T4 levels is beyond me!  It's obvious that its the interaction amongst ALL of these hormone levels that determines a thyroid patient's overall well being.    
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Avatar_f_tn
I'm 34 years old, I had the right side of my throyd removed 6 years ago, I started taking tirosint about a year ago, started off at 150 mcg I,m now at 175 I take 2 pills a day.  My hair and nails are so brittle and weak, but I can,t find anything else that keeps my levels normal.
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Avatar_m_tn
Even though you are taking a large dose of Tirosint, that does not guarantee that you will have adequate T3, unless your body is adequately converting the T4 to T3.  This frequently does not happen when taking T4 meds, so you really need to know your Free T3 level.  If your free T3 is in the lower half of the range, that is frequently associated with being hypothyroid and contributing to hypo symptoms, including brittle and weak nails.   If you look at this listing of 26 typical hypo symptoms, how many do you have?

http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html

Also, please post your thyroid test results and reference ranges shown on the lab report.
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Avatar_f_tn
I also had most of my thyroid removed.  I started on the Tirosint and for a little bit felt so much better.  We increased the dose according to labs and that is where I started having issues.  I couldn't sleep, back pain that I couldn't get rid of.  Started seeing a chiropractor trying to figure out what the heck I did.  Shortness of breath that came on gradual plus muscle weakness.  If I walked over to the other side of the room I felt as if I ran a mile.  My leg muscles would just scream. I couldn't even open a jar of jelly that was already opened.  After one night of sitting up all night wondering if I should go to the ER as the SOB got so bad I thought I was going into respiratory distress, I said enough.  I stopped the medication.   The next day I was totally exhausted and still SOB but I could tell it was getting better. The next day it was even better.  It took a bit but it got better.  Called my Endo the next day and she can't figure out why I was having any issues.  My nails were brittle to and my hair dry and falling out.  She switched me over to Synthroid and it seems to be much better.   They are not sure why some of us are having problems with the med.  Although when you pick up your script there is a list of thing to watch for, then when you call with the side effects they can't figure that out.  Why are they on the package inserts then?
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1139187_tn?1355710247
Regarding the insert of tirosint, if you never knew anything about thyroid disease and was given the package insert from tirosint, you would probably know more about the disease than 99% of most of the endocrinologists out there that treat it.  Its a very comprehensive insert.
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535882_tn?1396580285
word up , sounds hyper.
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1139187_tn?1355710247
or too much too quick
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535882_tn?1396580285
truth
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649848_tn?1357751184
Can you post current labs, with reference ranges and tell us what dosage of Tirosint you started at?  I agree that it sounds like you started at too high a dosage.  

It's almost always best to start at a very low dosage and let your body become accustomed to having the hormones, then test every 5-6 weeks and increase slowly as needed, based on symptoms and labs.  
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Avatar_m_tn
I'm currently taking 125 1 per day. I started on 112 and with my TSH too high was increased. My endo insisted that I stop taking synthroid because of 'povidone'  (never really had a sinus issue) I cannot take levoxyl I cannot swallow it. I also take a supplement for T3
Once I started with the 125 my hair loss has increased and I'm having cold feet and hands, restless nights, and recently a hoarse throat.
I want my synthroid back.
I don't think this drug is for me.
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649848_tn?1357751184
Can you post your current labs, with reference ranges?  Your symptoms actually sound hypo.  Do you know if you have Hashimoto's?  

How long were you on the 112 mcg? And how long have you been on the 125 mcg?  It's not unusual to have symptoms become more severe following an increase in med, or maybe your doctor just didn't give the 112 enough time do its thing.

With Tirosint being absorbed so much better than pill type meds, people often find they can get by with lower doses.  
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Avatar_m_tn
They are hypo, I do not have a thyroid any longer. I had Graves and had it radiated. I do not have hashimoto.

I've been on 125 Since January 1 - I do not have the current since modified
as of November, I will be going in a week or so for bloodwork.
Free T4   1.74
TSH        0.13
Vit D       39
as of September
Prior to taking the 112  -
Free T4  1.2
TSH       0.620
Vit D      38

I've been taking Tirosint since December. 112, and now 125. I have never lost this much hair in the 17 years. The symtoms (symptoms) are hypo. The weight gain has begun as well. I thought it was going to be a great fix, but I think it is turning out to be to much of an adjustment factor.
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Avatar_m_tn
I know your pain suzie. I have had so many probs since mine was removed. I don't think I've ever had the right mix of meds. I seem to flux so often that I don't ever feel just right.
I really think the more they mess with my meds, the worse I get. My first endo had such a bad attitude that my last visit with him, when he asked how I was feeling and I told him, "I'm still so very tired around 4:00 in the day" he told me I need to go on anti depressants. I was so upset with his curtness that I left him for another doctor. This one likes to play with the numbers and the meds.
At first I thought he was really listening, but now I think it's just his opinion of the drug companies are just getting in the way. Believe me I've taken just about all of them in 17 years time.

I thought Tirosint was going to be well suited for me since I seem to not retain many meds, because it was a gel cap and not many fillers, but I think it might have been a mistake to leave the synthroid and not increase it instead.
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649848_tn?1357751184
What are the reference ranges for the FT4?  Ranges vary from lab to lab, so must come from you own report.  If it's like what we normally see, it should be something like 0.8-1.8.

Your FT4 from Nov actually indicates hyper, not hypo; however, since there is no FT3 level to go with it, it's impossible to say.  Can you get your doctor to order it with the next set of labs?  FT3 is the hormone that the individual cells actually use, so if its levels aren't adequate, you're not going to feel well.

I'm suspecting that you don't convert the FT4 to FT3 well........ and may need a lower dose of FT4 med with an addition of FT3 med.

It's often typical when changing to a medication and/or dosage that symptoms will worsen for a while.  Your doctor should not have increased your dosage so quickly; he should have given your levels time to stabilize.
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Avatar_n_tn
Contrary to what most are saying on here about reducing your dosage of tirosint, I also believe that you may need to increase the dosage compared to the usual synthetic. At least at this time I am of the belief that because it is a liquid, your body does not absorb as much as a pill that does a slow dissolve. When I do not have enough medication in my system my blood pressure goes up, especially the bottom number. When I switched to Tirosint at the same dosage, 100, that is what happened and in a few days i was at the hospital with Bp of 186/106 and climbing. I am back on my usual dosage of synthroid for now, but I am allergic to synthroid, with watering eyes, back pain, bloating so I plan to give tirosint another try later at a higher dosage.
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649848_tn?1357751184
Not all pills are completely dissolved, therefore, Tirosint being a gelcap will dissolve and be absorbed better than a pill.  Your body actually absorbs liquid better; that's why vitamins/minerals are sometimes recommended in liquid form.

Everyone is very different and what works for one, may not work for someone else.  Many people find that starting Tirosint at the same dosage of their previous med, is too much.

It sounds like you simply needed a higher dosage than the 100 mcg.  If you have current labs to post, members might be able to make some suggestions for you.
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Avatar_n_tn
I can not post labs because I only made it a week with the Tirosint. It seems the problems a lot of people are describing on here are hypo symptoms. If thats the case they obviously need a higher level of medication and if thats true then Tirosint for some reason is undermedicating them.


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649848_tn?1357751184
Yes, many of the symptoms being described here are hypo.  It isn't the fault of the Tirosint under medicating anyone; in many cases, doctors are starting patients on too high doses, rather than starting low and working up gradually, or the doctor isn't allowing sufficient increases to alleviate symptoms.  Many people are too quick to blame the medication and stop it before they have a chance to get used to it.

Additionally, it's not uncommon for a patient to have worsening symptoms for a while after changing their medication/dosage.  Adjusting thyroid medications takes a lot of time and patience and many people don't have that.  It takes at least 6 weeks for a T4 thyroid medication to reach full potential, but many people take one pill and think they should feel better immediately, then stop the medication if they don't.

Starting at a lower dose, may send one hypo for a bit, but it allows the patient acclimate slowly to the medication.
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Avatar_n_tn
would you please share why you stopped taking Armour? I started Tirosint 25mcg, on 4-7-2012 by 4-10-2012 I stopped taking it! My body hurt so bad and I was having trouble thinking. I was on vacation with my 2 small grand daughters and needed to be cognitively alert. This is my first experience taking a thyroid medication in over 5 years. 5 years ago I was put on one (don't remember the name) but it made me so dizzy I just stopped, assuming it couldn't be good for me. I am a  all "natural"  person, I eat organic and don't take other medications, except Ambien because sleeping became a "dream" for me. I was hoping Armour would be better because it is natural and contains T3 as well as T4.
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649848_tn?1357751184
What are your current thyroid levels?  Please post results, with reference ranges, which vary lab to lab, so must come from your own report..

25 mcg might have been to high a dose to start on.  On the other hand, we often have members report that when starting a med, symptoms worsen for a period of time......  it takes at least 4-6 weeks for a T4 med to reach full potential in your body.  3 days on the med would not be sufficient to cause such a reaction.  

Tirosint consists only of the T4 med, water and glycerin....

While Armour is considered to be "natural", it comes for pigs and contains about 4 times more T3 than the human body naturally produces. The T4 in synthetic meds is identical to what your body would produce.  I know that some people do well, only on Armour or other NDT meds, but what's "natural" about taking more hormones than your body would normally produce, if it could, unless you really need them?

Maybe if you could post your current thyroid blood test results, members could help assess the testing/treatment and offer further suggestions.  

You should be getting tested for a minimum of TSH, Free T3 and Free T4.  When you post results, pleas post reference ranges, which vary lab to lab, so must come from your own lab report.
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It states in the package insert that if you are experiencing hairloss, sleepiness, anxiousness, overeating, joint pain, muscle cramps. etc. that you are experiencing hyperthyroidism due to too high of a dosage. My doctor said everyone should start at the lowest dosage and work themselves back up because this medicine absorbs in the small intestines and not the stomach the whole dosage is absorbed while with Synthroid it is absorbed in the stomach and any little thing makes it difficult to absorb fully. My doctor said she has had many people that are much happier with this drug and had better results too. She started me on the lowest dose of 13mcg. I used to be on 50mcg of Synthroid. If you are experiencing severe side effects it is most likely due to a too high of a dosage and you should drop down to a lower level since this drug absorbs so well and reliably.
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This is from the Tirosint package insert-if you are experiencing these symptoms your dose is too high and needs to be adjusted. When it talks of Arthralgia that means body pains-you can also find the package insert here:http://www.tirosintgelcaps.com/Tirosint%20Promo%20PI.pdf

ADVERSE REACTIONS
Common adverse reactions with levothyroxine therapy are primarily those of hyperthyroidism due to
therapeutic overdosage [See Overdosage (10)]. They include the following:
• General: fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating
• Central nervous system: headache, hyperactivity, nervousness, anxiety, irritability, emotional lability,
insomnia
• Musculoskeletal: tremors, muscle weakness
• Cardiovascular: palpitations, tachycardia, arrhythmias, increased pulse and blood pressure, heart
failure, angina, myocardial infarction, cardiac arrest
• Respiratory: dyspnea
• Gastrointestinal (GI): diarrhea, vomiting, abdominal cramps, elevations in liver function tests
• Dermatologic: hair loss, flushing
• Endocrine: decreased bone mineral density
• Reproductive: menstrual irregularities, impaired fertility
Adverse Reactions in Children
Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in children receiving
levothyroxine therapy. Overtreatment may result in craniosynostosis in infants and premature closure of
the epiphyses in children with resultant compromised adult height. Seizures have been reported rarely
with the institution of levothyroxine therapy.
Hypersensitivity Reactions
Hypersensitivity reactions to inactive ingredients (in this product or other levothyroxine products) have
occurred in patients treated with thyroid hormone products. These include urticaria, pruritus, skin rash,
flushing, angioedema, various GI symptoms (abdominal pain, nausea, vomiting and diarrhea), fever,
arthralgia, serum sickness and wheezing. Hypersensitivity to levothyroxine itself is not known to occur.
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The problem is that those symptoms can "cross over" and indicate either hyper or hypo -- I had every one of those while I was extremely hypo.

We do recommend that people start with a lower dose than the pill form they are on, but dropping all the way back to the lowest dose, seems like overkill, since it risks sending the patient all the way back to hypo and having to start all over.

I've been on Tirosint since it came out in 2009, actually started at a higher dose than the levo I'd been on, later had to back down and am currently on the same dose, 88 mcg, that I was on of levo.

I've done better on Tirosint than I did on any other thyroid med, but we're all different and some just don't do well on it.  

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I guess we were typing at the same time...... librarygirl has not been on the forum in well over a year - since shortly after this thread was started, so it's unlikely she will respond here.

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Hi. Thanks for keeping this Tirosint discussion alive, as it is helpful
for me (and others) to read about all the patients' experiences
with it.  I've been on Tirosint since 2010, and it has been helpful
in ways that no other drug has been for me since Synthroid was
reformulated, 'way back in 1982-83.  HOWEVER, Tirosint has
also been very strong and tricky for me to work with, and I still
struggle with adjusting it.  Finally found a more flexible and
knowledgeable doctor to work with me on this....

Like some have found, many patients would probably need to
start with a lower dose than they may ultimately need, and
just go at a slower and more gradual pace when increasing.
This is what I've had to do, and my current doctor is helping
me with.  The doctors I was going to before just kept making
me feel bad about not being able to tolerate the full dose
as fast as they wanted.  I just couldn't do it without getting
hyper-type symptoms, even though my labs didn't really
show hyperthyroidism.   Current doc says my body just needs
a lot of time to get used to this stuff, and that we must go
very slowly and gradually....chopped my dose down a lot,
and said we will just be patient and give it a lot of time.

My case is more complicated than many others, as I've often
stayed undermedicated due to bad side-effects from all these
thyroid meds except Old Synthroid (which I could take the
full dose of for over six years).  So, others may not have their
body fight this Tirosint as much as mine does....doc says my cells
are used to being undermedicated, so they kind of rebel against
any increase in medicine......and it will take them a while to adapt
to these increases.  But because Tirosint has helped me in other
ways that the others don't, I will keep trying to work with it.
Positive things about Tirosint for me is that it doesn't make my
head and upper body shake, it has helped me heal up a long-time
leg infection, and it has reduced some swelling in my legs, but
there is still more to go.  

New doc has also given me some low-dose beta blockers
(Propanolol) sp?  at 10 mg, to be taken 1 to 4 times a day if
needed, to fight off any hyper-type symptoms that I still can get
as some of the higher amounts of Tirosint dump out of my system,
and I continue working with these lower amounts.  I'm only supposed
to take them as needed.......doc thinks this whole thing could take
one or two years (or even more!) for my dopey body to adjust
completely to the correct amount of Tirosint without need of
beta blockers and/ or without getting side-effects from the
Tirosint anymore, but thinks it can be done.  I hope so!  
Thanks to all who've contributed to this thread.   S. D. in Calif.
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Hi Everyone,

It's been a while being on this thyroid med roller coaster.  There was a time early last year that I decided to stick to Tirosint for at least 6 weeks just to get my labs and I couldn't stop thinking every single day during the latter weeks how many more days I would need to stay on Tirosint.  It was starting to hurt my joints, muscles, hair, and started feeling hyper.  

I have been on Synthroid the majority of the time and I think it has stopped working for me as my TSH is going up (yes, my pituitary is screaming for more hormones) but my FT3 and FT4 still seem the same.  As I increased Synthroid, I noticed my Frees are declining.  Levoxyl will be my next logical medication as my labs were great on it before (much better than with Synthroid).  Some posters on this thread have mentioned increasing the dose of Tirosint but to me I think Tirosint may be too strong for most people.  There is no way that I could up Tirosint to 62.5 (alternate between 50 and 75) as I couldn't go on Synthroid 62.5 with all the hyper symptoms I was getting (diarrhea, oilier skin, puffiness around shins) as Tirosint is supposed to be more absorbed than Synthroid.

Here are my labs for most of the past 2 years:

April 2010 (no thyroid meds)
TSH 7.14
FT4: 1.2 (0.8-1.8)
FT3: 257 (230-420)

(50 mcg Synthroid)
TSH: 1.65
FT4: 1.3 (0.8-1.8)
FT3: 2.4 (2.3-4.2)

(Levoxyl 50 mcg)
TSH: 1.06
FT4: 1.5 (0.8-1.8)
FT3: 275 (230-420)

(50 mcg Tirosint)
TSH: 0.73
FT4: 1.5 (0.8-1.8)
FT3: 2.5 (2.3-4.2)

For this lab: I took 50 mcg/day Synthroid and I increased my Synthroid to extra 37.5 mcg on Sunday
(50 mcg Synthroid w/ extra 3/4 pill each week)
TSH: 2.79
FT4: 1.6 (0.8-1.8)
FT3: 2.6 (2.3-4.2)

For this I increased to 62.5/mcg Synthroid per day:
TSH: 2.47 (0.450-4.500)
Free T4: 1.56 (0.82-1.77)
Free T3: 2.5 (2.0-4.4)

I am now back to 50 mcg Synthroid per day with an extra 3/4 on Sundays.  I felt the best but still feel tired.  No way could I go to 62.5 as I started getting diarrhea and too much energy.  Can't function like this.  Tried 75 mcg Synthroid and couldn't get past 2 weeks, my mind felt wired but tired and I was getting major anxiety attacks.

Will try Levoxyl to see how I do.
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Are you sensitive to the fillers/binders in thyroid medications?  "Side effects" of thyroid medication are those going hyper, but many people have reaction to the fillers/binders in pills.  That's the main reason some have such good luck with Tirosint.  

It often takes people a long time to get up to their full dose of a thyroid medication because it takes time for the body to adjust to having the hormones.  

Additionally, you have to keep in mind that being hypo means we've actually been ill.  It takes time to recover from most illnesses; therefore, we shouldn't expect to recover from hypothyroidism real quickly, either.

Many of us have to be put on beta blocker to counter the effects of thyroid medication.  Some are able to get off it, eventually; others of us have to stay on it for life.

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All of your labs show FT3 near the bottom of its range, while your FT4 is well over mid range, on most of them.  This indicates that you aren't, properly, converting the T4 to T3 and you could stand to back off the T4 med and add a bit of T3, such as cytomel, generic T3, or desiccated hormone containing both T4 and T3.  

You might mention this to your doctor, and think about starting on a very low dose - not more than 5 mcg/day, but probably 2.5 to see how you tolerate it. Once you bring your FT3 level up, your tiredness should go away.
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I agree with Barb.  A source of T3 may be very good thing to try.

The sentence that really caught my attention was when you said: "As I increased Synthroid, I noticed my Frees are declining."

That to me suggests two things.  One is that you are not converting well and two you may have an issue with reverse T3 (RT3).  Both situations are usually helped by less T4 and more T3.

The next time you get tested you may want to ask the Dr to test your Reverse T3 levels.

Since this is also seemingly a very long term situation, you may also look into adrenal fatigue.  if your adrenals are messed up it can also affect the reverse T3 situation I believe.
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Too bad Cytomel or Armour never works well with me.  I tried to add these to my T4 and also tried Armour alone and would get heart palps, swollen face/joints/shins, and constant tiredness.  It could have something to do with my adrenals, in which I am constantly stressed out and don't sleep very well.  At this point, I don't know what else to do but keep taking T4 and eating a couple of Brazil nuts each day to help with my conversion while keeping stress levels low.
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Having low T3 makes your body not work well....

I would really think about adding just a 2.5mcg of T3 to see how you feel in a week....just my 2cents
Mia
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Looks like the biggest problem with synthroid was an absorption issue.  Look how high your FT4 came on Tirosint.......

Sometimes it take different combinations of med(s) to work.  Have you tried T3 med since you've been on Tirosint?  It might work completely different than it did when you were on synthroid.  

I would start VERY low, by splitting pills and proceed with caution, as you tolerate the med.

In addition, some of us have to start on beta blockers to deal with the palps.  Some can go off it, later, some of us have to stay on it.  I was able to cut my dose in 1/2.  Swollen face/joints and tiredness, were most likely caused by still being hypo on the synthroid.

Be careful with the Brazil nuts; they have a very large amount of selenium, which can be toxic if levels get too high.

Are you getting support for your adrenals?
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This post has helped me understand why I am not sleeping, depressed and in just a bad mood. I was on Synthroid and my levels were great. The problem is I have Celiac. Did you know there is a link between Gluten and thyroid problems. So I changed to Tirosent. Cutting out the gluten has been very positive, no more red itchy eyelids and other rashes all over my body. I am going to call endo and try a lower dose after reading these post. I am currently on 125mcg, the same as Synthroid.
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For me personally, Tirosint has been anything but the miracle drug I had hoped.  I originally took Levoxyl and had no problems.  I then switched doctors, and he switched my meds believing that Tirosint was the latest and greatest.  I am not a moody person at all normally, but on Thirosint I have EXTREME mood swings.  I can cry at a drop of a hat, or get angry in seconds.  Again, that's rare for me under normal circumstances.  I also have horrible acne now.  Even as a teenager I never had acne like this.  It's to the point where it's embarrassing.  I'm not mentioning the hair loss, since that subsided.  I have horrible muscle/ lower back pain.  Again, I have never had back pain previously until Tirosint. I cannot wait to get off this thing......and yes, I have been on it for four months, so I was on it long enough, and my ranges were in the "normal" range.  I have never felt this bad in my whole life.
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Just being in the "normal ranges", often isn't enough; you have to get them to what's optimal for YOU.  

If you will post your actual results, members can assess them and possibly offer some suggestions.
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Just wondering if you have found any relief? I think I am very similar to you--very sensitive to hormones and PMS and all that seems to be out of whack as well...can't find a dr. who can work on both  thyroid and PMS-type hormonal stuff.
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I have read the letter from the Thyroid doctor at hormone restoration.  I would love to know a good endo or thyroid doctor who prescribes for symptoms and really knows what they are doing.  Some try to be understanding but are lost if what they prescribe doesn't work.  Had Graves since 2000 and been radiated.
Have been on them all and considering Tirosint but don't hear to many good results and don't want to go through more misery without someone real experienced.  I live in a small Alabama town.  zip is 36507 .  Need someone close enough to go regularly.   Thanks,
lowerlac
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My background: was probably hypothyroid for 8 to 10 years before anyone would medicate me.  I was started on Synthroid (at 33 years old), which made a good night's sleep impossible, so I switched to Armour.  LOVED it.  Not perfect, but tons better.  I bought a book from my library last year for 25 cents by a Dr. Kenneth Blanchard (HIGHLY recommend his books, found on Amazon), and then both my mother and I (she is hypo 30+ years) went to see him in March 2012.  I have been on Tirosint since that time and it is a MIRACLE for me.  My TSH is lower than it has been in 8 years and with no side effects.  (It was 9.5 in Aug 2011 at the highest, which was when I was weaning off Synthroid and beginning Armour.)  I will never go back to the other medications.  My response to the people who had negative reactions when trying Tirosint for just a short time (less than 5 months, to be sure), is to wait it out.  It takes months for Sythroid to clear your system and I would be willing to bet good money that those symptoms attributed to Tirosint are actually "detox" from coming off Synthroid and its fillers/dyes which can be very allergenic.  After that, you need to wait til Tirosint builds up.  But then, some people do very well on Synthroid while I did not...so it stands to reason some will not do well on Tirostint (tho personally I don't see how...).  Having said all that, Dr. Blanchard prescribes T3 (not cytomel) for me and my mother...and that helps *tremendously* with the depression, hair loss, skin issues, memory problems, etc.  Most doctors will not prescribe compounded T3, which I think is very, very shortsighted on their part, and I personally will NEVER see a Dr. who does not prescribe it (as I refused to see a specialist who insisted on putting me back on Synthroid and then using Ambien for my sleep issues, all when I am trying to get pregnant).  I hope you and everyone else here finds the relief they need. :(  I know I have.
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Glad to read someone in 2013. 2 weeks now on Tirosint and having problems.. Chest pains,sore muscles,itching and arthritis in my hands, burning eyes and believe it or not, I'm 78 and it gave me the old menstrual cramping that I do not want to get!  Have been on Synthroid before and couldn't cut it so went on Armour and it did just fine but my TSH levels would go up and down. My dr. wants to wean me off of Armour and put me on Tirosint . So far, I don't think it is such a good thing. Wonder if you are suppose to p ut up with all of these symptoms....will it stop eventually?  Help!
Arlene
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If Armour Thyroid worked for you, I suggest that you should stay on it.  The fluctuating TSH means nothing.  When taking thyroid meds, TSH is frequently suppressed, causing doctors to erroneously want to reduce meds.  Scientific studies have shown that when taking thyroid meds, TSH is almost useless as a diagnostic.  If you want something to show your doctor to persuade him to continue with Armour, here is a link and some excerpts from the study, published in the British Medical Journal.  This is only one of many such studies with the same conclusion about TSH.  

http://www.bmj.com/content/293/6550/808
"To establish their role in monitoring patients receiving thyroxine replacement biochemical tests of thyroid function were performed in 148 hypothyroid patients studied prospectively. Measurements of serum concentrations of total thyroxine, analogue free thyroxine, total triiodothyronine, analogue free triiodothyronine, and thyroid stimulating hormone, made with a sensitive immunoradiometric assay, did not, except in patients with gross abnormalities, distinguish euthyroid patients from those who were receiving inadequate or excessive replacement. These measurements are therefore of little, if any, value in monitoring patients receiving thyroxine replacement."

Further from the full text in the PDF.

"At present there is no variable that can readily be measured
satisfactorily to assess the end organ response to thyroid hormone
action in patients receiving thyroxine replacement. The serum
concentration of thyroid stimulating hormone is unsatisfactory as
the thyrotrophs in the anterior pituitary are more sensitive to
changes in the concentration of thyroxine in the circulation than
other tissues, which rely more on triiodothyronine.
Our data indicate that the reference ranges for serum total                                
thyroxine, analogue free thyroxine, and thyroid stimulating                        
hormone in patients receiving thyroxine replacement are different
from conventional reference ranges. It is clear from table IV,
however, that serum thyroid hormone and thyroid stimulating
hormone concentrations cannot be used with any degree of con-
fidence to classify patients as receiving satisfactory, insufficient, or
excessive amounts of thyroxine replacement. There is little dif-
ference between the ability of concentrations of total and analogue
free thyroxine to detect over-replacement; the poor diagnostic
sensitivity and high false positive rate associated with such measure-
ments render them virtually useless in clinical practice. Concentra-
tions of total triiodothyronine, analogue free triiodothyronine, and
thyroid stimulating hormone are also incapable of satisfactorily
indicating over-replacement. The tests perform equally badly in
detecting under-replacement.
A question that remains to be answered convincingly is whether it
is clinically necessary to measure thyroid hormone concentrations in
patients receiving thyroxine replacement. The standard replace-
ment dose in Europe and America was 200-400 [mcg a day until 1973,
when it was halved to 100-200 [mcg a day on the basis of biochemical
measurements of thyroid hormone concentrations.  We are not
aware of any study that has shown that this reduction in the standard
dose has had any clinically beneficial effects. Different groups have
shown changes in sodium metabolism, hepatic enzyme activity in
serum, and systolic ejection time intervals' in patients receiving
high doses of thyroxine, but such measurements have not been
shown to be of any relevance to patient care.
We consider that biochemical tests of thyroid function are of
little, if any, value clinically in patients receiving thyroxine
replacement. Most patients are rendered euthyroid by a daily dose
of 100 or 150 ,mcg of thyroxine. Further adjustments to the dose
should be made according to the patient's clinical response."

This conclusion coincides with my definition of a good thyroid doctor as being one that 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.  Symptom relief should be all important, not just test results, and especially not TSH results.  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

When you see the doctor about all this, I also suggest that you should be tested for Free T3 and Free T4 (not the same as Total T3 and T4).  Also, since hypo patients are frequently too low in the range for Vitamin D, B12, and ferritin, those should be tested as well.
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WOW!  I wish I understood everything that you posted. Are you a physician?

I have had to have a compound pharmacy make my Armour because they use one filler which is not harmful.  Synthroid had 7 fillers in it and one of them was talc....that sends a former asthmatic wheezing . I had not symptoms whatsoever before the FDA got hold of it. Now, when my TSH levels rise, the symptoms show up. Right now I have an endocrinologist watching me.  She is not too happy with me for wanting to get back on Armour.
Thank you for your post....I will save it.  Arlene 606


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Not a doctor.  Just a hypothyroid patient like you that went through over 30 years on T4 meds and still had lingering hypo symptoms.  After finding thids Forum I learned from the good people here that Free T3 was the most important of the thyroid tests, and if your body was not converting T4 to T3, then you could still have a problem, even if taking a large dose of T4 med.  Got my Free T3 tested and confirmed as low in the range.  My doctor agreed with a trial dose of Armour, and after some tweaking of dosage, I felt best ever.  At that time my TSH was .05 or less, my Free T3 was 3.9 (range of 2.3 - 4.2) and Free T4 was .84 (range of .6 - 1.50).  I also learned that testing TSH after starting on thyroid meds was a waste of time and money.  

Tirosint is hypoallergenic, but if you only take T4, you may have the same problem, of low Free T3 due to lack of conversion.  If you have to change due to reaction to meds, then the best approach might be to use Tirosint and Cytomel (T3) together, to simulate the Armour.
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That last post was  interesting. I do not understand all of it but did check my last testing and it was the free T3 ..the result was 2.8. The free thyroixine was .79 and the TSH was 3.07.   THe Endocrinologist didn't think it was low enough so put me on a higher dose which right now is 60 mg Armour, and I am thinking that it is too much.

Is this cheaper doing it that way and not the TSH only?  Where did you find a Dr. that would work with you on the meds?
I thought a good endocrinologist would do this for you but they don't seem that interested!

Arlene
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When you said your Endo didn't think it was low enough, were you referring to your TSH?  What was the dose of Armour when you felt best?  Why not convince your doctor to put you back on it?  Do you think you could use the info above to convince him?
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Scary. I just started this today.
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Wow, my thoughts exactly.  "I wouldn't know what normal was if I felt it.  It's been so long ago since I have felt good.  I have seen 5 doctors and this last one is my last resort.  He put me on 75mcg of Tirosint.  Will start that tomorrow and I'm dreading it already.  I'm not sure which is better, living with hypothyroidism without medication, or being medicated and dealing with the slew of side effects such as no motivation, tiredness, and realizing I exist but I'm not really living the life I want to live and wondering if it will ever get better..  This disease sure takes a toll on you.  I hope this works.  There are so many things I want to do, but don't have the energy to do them.  Good luck to everyone!
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I have tried levothyroxine 50mg, about 5-15 minutes after taking I would feel nautious and sick. After 10 days, could not take it anymore. after 3 weeks off meds, Doctor tried me on Synthroid 25mg to start in case I had reaction. slowly started feeling ill, lots of swelling around my eyes and feeling like crap. So I just tried Tirosint 25mg starting 6 days ago. First day, 5 minutes after taking my stomach started cramping and later I got the runs a few times during the day. I have been hurting all over, major fatigue, and now my heartburn is worsening in the afternoon. Thinking of stopping the Tirosint after this weekend if my symptoms do not improve. I am in search of a new doctor also. I have read where they have a pig hormone generated medicine which is more natural and my current doctor only uses synthetic stuff. My body seems sensitive to a lot of meds, there has to be something. I do not have much thyroid left and it is growing and I do not know what I can do if the rest is removed with the large nodules or goiter too.
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I was just recently put on Tirosint and it is driving me crazy!  I have a congenital heart condition and am on Coumadin, which was my MAIN concern, but after about the third day of 25mcg of Tirisint, my emotions are bouncing all over the place and I have leg aches and heart irregularities, eventhough, I do have a pacemaker!  I will definitely be calling my doctor's office on Monday!  Can anyone else relate to these side effects?
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I Just start on 100mcg of Tirosint. Monday today is Saturday. Levoxyl 100mcg  is what I have been on for 9 months before I started on Tirosint. Before Levoxyl and Tirosint I was on Synthroid. When I was on Synthroid I had to change dosage from time to time. The Dr. and I discussed me going on Levoxyl. She said her patients that where on Levoxyl seem to do better on it than on Synthroid. So I said I would like to try being more stable so let's try it. Well I went to get my prescription of Levoxyl refilled and the pharmacist said all Levoxyl has been recalled and the Dr. called me in Tirosint. Well in a matter of six days my hair is coming out very fast Wednesday I felt like I was on 50 cups of coffee. My husband asked me why I was so wired up, I didn't know. My muscles in my legs have been jumping and I am starting to feel just a little heavier. I have an appointment with my endocrinologist Wednesday May 15 is there any suggestions you could share with me on how to get a more complete thyroid profile? Is there a more consistent drug out there to treat hypo thyroid consistently? Please email me back Thank you, signed, tired and scared.
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I Just start on 100mcg of Tirosint. Monday today is Saturday. Levoxyl 100mcg  is what I have been on for 9 months before I started on Tirosint. Before Levoxyl and Tirosint I was on Synthroid. When I was on Synthroid I had to change dosage from time to time. The Dr. and I discussed me going on Levoxyl. She said her patients that where on Levoxyl seem to do better on it than on Synthroid. So I said I would like to try being more stable so let's try it. Well I went to get my prescription of Levoxyl refilled and the pharmacist said all Levoxyl has been recalled and the Dr. called me in Tirosint. Well in a matter of six days my hair is coming out very fast Wednesday I felt like I was on 50 cups of coffee. My husband asked me why I was so wired up, I didn't know. My muscles in my legs have been jumping and I am starting to feel just a little heavier. I have an appointment with my endocrinologist Wednesday May 15 is there any suggestions you could share with me on how to get a more complete thyroid profile? Is there a more consistent drug out there to treat hypo thyroid consistently? Please email me back Thank you, signed, tired and scared.
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It is nice to know that someone else is having the same symptoms!  Like you, I took Levoxyl for several years and was doing okay with it ... Had even  gotten my Coumadin regulated, only to find that the Levoxyl had been recalled because of some "strange smells" coming from opened bottles, thus the Levoxyl being recalled!  I have not noticed the hair loss as you have, but I am not on a large dose which might account for my not having that side effect ... yet!  But, the anxiety, the leg cramps and sleepiness is a BIG problem!  I am just glad to know I am not going crazy and that the reactions may be due to the Tirosint ... At first I thought it was depression, but my husband said that my symptoms coincided with the change from Levoxyl to Tirosint!  Then I began to "connect the dots!"
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Hi All,
I haven't been here in a long while. Still trying to figure me out. I am curious for those of you doing well on Tirosint, a couple of questions please;

For those of you who are mature (like me @ 56), do you find you need less of a dose, and with that are you needing lower levels?

Does Tirosint do a better job with conversion to T3 than your prior T4 med?

Typically it appears safe to go down a dose when starting Tirosint, do you then end up increasing after 8 weeks to your previous dose, or does this lowered dose seem to be enough?

Appreiciate your experiences.  
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I am 61 years old and was Synthoid for a very long time and switched to Tirosint a couple years ago. I was on 150 mcg Synthroid and found that I only needed 88mcg with Tirosint.  I like Tirosint as it doesn't have the fillers that Synthyoid has.  
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Thank you for your response, Can I ask what T4 and T3 levels you feel good at. I am so thrilled to hear you like Tirosint.....I ask because my T4 and T3 are at 45%.....I do take 88 syn. and 5 T3, but something was making me so nervous I started dropping the T3 down until I reached 1.25. The nervousness has lessened, but the hypo symptoms are moving in.

I actually did better with Erfa, for awhile anyway, like that T3 much better.
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I've been on Tirosint since it came out in 2009; I'd been on 100 mcg levo, so dropped to 88 mcg Tirosint, then upped to 100, but within a short period, I was back to 88 mcg (not because I felt bad, but because my endo panicked at my low TSH) and that's where I've been for over 3 years.  

I also take 10 mcg generic T3/day, in 2 doses of 5 mcg.  
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Hi Barb,
Was wondering if you could give me your thoughts on this.....was thinking since my T3 was @ 23 % before I added in generic T3, it seems I could really use T3, but it appears that is the culprit causiing the nervous/not calm state. In your experience, would lowering the T4 dose allow more a smoother flow, I am just not understanding why this symptoms persists.

Was hoping to hear Tirosint creates better conversion to T3. You are using T3, so it is not so for you. I am totally baffled. Are your free's in the midrange? And you are really happy and well with Tirosint? Thanks so much.
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T4 med is typically decreased by 20-25 mcg for each 5 mcg of T3 added. Since you're on 88 mcg, you could talk to your doctor about dropping to 75 mcg, then retest in 6 weeks to see how you're doing.  

While absorption of Tirosint should be better because it's a gelcap, I've never seen anything indicating that conversion is any better with Tirosint, than with other T4 meds, because the majority of conversion is done in the liver, so if that doesn't happen on one med, it's not likely to on another.

My last FT4 was at 30% of the range and my FT3 was at 47%.  I did have some minor hypo symptoms, but my endo refused an increase because my TSH was < 0.01, which is where it's been for the past 4 yrs. I am happy with the Tirosint and I do feel well.

Does your nervousness go away when you stop the T3 med?  It may be that you have to have a lower dose of T3, until your body gets used to having it.  What were your labs before you started the T3....... I know 23%, but what were the actual results and reference ranges?
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Forgot to mention that studies have shown selenium to help with the conversion of FT4 to FT3....... you might discuss with your doctor about adding a selenium supplement.   Additionally, adequate iron is necessary for proper metabolism of thyroid medication.  Have you had ferritin levels tested?
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Thanks for your time. Let me explain, and forgive me, this is long. Went to endo because doc didn't know what to do with me. I was overmedicated on 88 syn. and 75 Erfa- T4 1.6 (.7-1.8) ...T3 4.4 (2.3-4.2). but I didn't actually feel that bad. Of course he took me off T3.

Went on 125 syn. T4 90% ...then 112,  T4 64%... then 100 T4 64%. The lower I got the more jittery and nervous I became. No T3 was done until I hit the 100 dose.

100 dose -FT3 2.7 (2.3-4.2)  21%  FT4 1.4 (.7-1.8)  64% .

Then 75 and after begging added in 5mg. T3 with labs of FT4 1.0 (.7-1.8)  27%  FT3 2.7 (2.3-4.2)  21%

88 dose with 5 T3 --FT3 3.1 (2.3-4.2)  47%  FT4  1.2 (.7-1.8)  45% this is where I should feel great, but the jitters and nervousness were still pretty strong here, until I lowered my T3 to 1.25.

I had actually revisited the 100 dose with the 5 T3, couldn't handle it and back to the 88.

My ferritin last year was 255 (15-322) midrange 168.

Any thing jump out at you, I have questioned the dyes/fillers. Have read the yellow dye actually causes anxiety.  Which the yellow dye is in the 125's, 100's and 88's, probably more saturated in the 100's because that pill is yellow. I am at a loss, I do not know for sure.
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Your ferritin level is higher than I would have expected with you being hypothyroid.  Most often hypo patients seem to have ferritin that is low in the range.  So one thing I think you should do is to test for ferritin again and also a full iron test panel, including serum iron, TIBC/transferrin, % transferrin saturation.
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One thing that jumps out at me is the number of times you changed your dosages.  How long did you remain on each of these different doses?  It often takes a while for the body to get used to a new dose/med, whether you're increasing or decreasing.  It takes at least 4-6 weeks for the dosage to stabilize in your blood, then, often even longer for your body to adjust.

The other thing that jumps out at me is that your FT3 has been consistently low, except the 3.1 result, which still left plenty of room for increases.  The nervous jittery feeling, as well as other symptoms, can be present with hypo, as well as hyper.

What type of T3 med are you taking?  Cytomel, generic or compounded?  How are you getting 1.25 mcg?

My own ferritin level just came back high, also, at 265....... my doctor (and my own subsequent research) says that ferritin is not only an iron storage protein, it's also an inflammation marker.  I agree that you should get the complete iron panel, but think you should also add a CRP, as well, which is another inflammation marker. My doctor thinks my level is high, due to inflammation, since my CRP is also high.  Another possibility is that the iron is not being released to the blood stream.

I've also run across some articles that link high ferritin levels with insulin resistance and/or metabolic syndrome.  I'm still researching this aspect.  If you have either/both of these (I do), inflammation would be expected.
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I am at work right now, but I have that full panel at home. I am 6 years post memopause. At one time I actually supplemented my ferritin because it was low when still menstrating. But my levels jumped up last couple years.
I suspected hemochromotosis, but unles dangerously high all my docs just waved it aside. I even called the Hemo instittute and they did the same thing.
What are your thoughts on the iron blood testing?
Thanks for your comments.
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Hi there, all my dose changes were minimum of 6 weeks, most were 8-12 weeks.

Taking Mylan generic T3 by cutting that little pill in fourths, not highly acurate, but close.

Not sure what an inflamation (inflammation) marker is. What's a CRP involve, not sure what that is. Or insulin resistance. Just know my blood sugars were high at one test, I tend to get low blood sugar issues, depending where my thyroid levels are....guess I have some reseach to do. Thanks so much for your input, appreciate it. There is some reason I can't get optomoized, I need to fiugre that out now.
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Getting back to you with labs taken january 2012
Bun  24 (7-18)
glucose 151.0 (70-110.00)
bun creat ratio  26.7 (12.0-20.00) These above were flagged high.

iron 82 (50-170)
TIBC  290  (250-450)
%SAT 38 (15-50)
Ferritin 255 (15-322)
These were all done same time as FT4 1.6 (0.701.8)  FT3 4.4 (2,3-4.2)  

3/12 the bun, glucose and bun creat ratio were down under top of range.With T4 still at 90%, not on T3 this round of labs. Have not had these tests done since.
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It often takes quite some time to get adjusted to a dosage. Can you describe your nervousness/jitters a bit more clearly?  Have you considered adding a beta blocker to see if that would help?  Have you had any adrenal testing done?

An inflammation marker is a test that indicates high levels of inflammation in your body.  

"Inflammation is the body's attempt at self-protection; the aim being to remove harmful stimuli, including damaged cells, irritants, or pathogens - and begin the healing process."

Inflammation can have a lot of causes, from arthritis to ingrown toenails, pneumonia to a hang nail.

Certain blood tests, ferritin being one, can indicate whether or not you have a high level of inflammation in your body.  C-reactive Protein (CRP) is another inflammation marker.  In other words if your CRP is also high, that would indicate there's something going that your is trying to "heal".  

Your iron level is not real high, so it's possible that iron isn't being released from the ferritin, adequately.

Insulin resistance is when your body doesn't use insulin properly.  This can result in higher than normal blood sugar levels. Both high and low blood sugar issues can result in Type II diabetes.

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Thanks Barb,
I have not had any adrenal tested lately. Wouldn't that mean I would be sick often if I had those issues? I  work full time and have not missed a day for sickness since last year.

The jittery/nervousness is hard to explain, perhaps like drinking a full pot of coffee, feeling revved up and not handling simple situations calmly, like nervous energy.

Can inflamation (inflammation) then be from not enough thyroid hormones?

Is this fixable, or even  a problem if iron isn't being released from ferritin. I see where my iron levels are not that high.

Still feel it is all relevant to thyroid, just don't know how to fix. Thanks so much for your time.
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I have recently begun the search for a doctor once again in an effort to go back on meds after years of suffering with hypothyroidism.   I DO NOT have it in me to experience symptoms due to over and under medication ANY MORE.   Is there a doctor you can recommend in the Lewiston/Auburn, Maine area??????  I have had one appointment and one blood draw with an endo who doesn't believe in Armour so she's gotta go --and fast.  She laughed because my TSH  results from a blood drawn by my PCP was only 5.86 and said, "Your symptoms aren't from that!"  She was willing to prescribe 25mcg of Levothyroxine which immediately caused serious heart arythmia and diarrhea. However, after her own blood draw  four days later my TSH was 10.  On that day I reported the side effects and shortly thereafter she switched me to 25mcg Tirosint but I don't want ANY side effect nightmares and I see there are plenty.  I don't go back until September!!!!!!!!   I will have to rely on this forum while being a guinea pig on this Tirosant for the next 8 weeks or just get REAL HELP from a knowledgeable and genuinely concerned doctor.  
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As I noted above, inflammation can be from a wide variety of things, or even multiple things going on at the same time, in the body.  Yes, it could be from not enough thyroid hormones, particularly if you have Hashimoto's, because the antibodies tend to inflame the thyroid gland.  

Do you have any arthritis?  I have some, which causes inflammation,  mostly in my hands/fingers, so that, along with Hashimoto's, insulin resistance and metabolic syndrome could easily account for my high ferritin and CRP levels.

I'm sure that if iron is not being released from the ferritin, there would be something to do about it; I haven't been long with high ferritin long enough to have time to research it fully.

Your symptoms may, or may not, be thyroid related.  Sometimes we get so focused on one issue (thyroid), that we forget to look at the rest of our body.  The whole thing has to work together in order for us to feel well.

You might talk to your doctor about trying a beta blocker just to see if that helps.
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Hmmmm definitely seems that you need a new doctor; unfortunately, I don't have the name of a good thyroid doctor in your area, but I can do some checking and see if I can come up with any prospects.  

Otherwise, you can call different doctor's offices and ask questions regarding the manner in which they treat thyroid conditions.  You'll want to know if they test both FT3 and FT4, along with TSH, whether they are willing to prescribe what medication works, including those with a T3 component, such as cytomel and/or desiccated and last, but certainly not least, is whether they treat by symptoms, as much as blood test results.  Answers to all these questions should be "yes"... if there's any "no" answer, move on.  The doctor does not have to be an endo, as many endos are not good thyroid doctors, since they specialize in diabetes.

Some of our members use their pcp, others go to internal medicine doctors.

All of that said, I guess I'd have to give your doctor credit for putting you on the Tirosint, because of all the thyroid meds, you're least likely to have side effects from Tirosint.  Because it only contains 4 ingredients, levothyroxine sodium, gelatin, glycerin and water, there are no fillers or dyes to worry about.  It's as hypoallergenic as it comes.  Whatever "side effects" you  have will be symptoms of over medication.

It's going to be next to impossible to find a medication that will fit you exactly right, on the first dose.  Be aware that it's not uncommon to have either worsened symptoms or different/new ones, when starting on a thyroid medication.  It simply takes your body time to get used to it and it takes 4-6 weeks for the medication to stabilize in your blood, then you have to allow time for your body to "heal".

Sept is a long time to wait for follow up testing, when you've just started a new med.  Typicallly, testing is done 6 weeks after each med/dosage change, then adjustment made as needed, then retesting in 6 weeks, until you reach an optimal dosage.  

Yes, you definitely need a new doctor.
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I very much appreciate all your time and thought with responses. I also have arthritic fingers, espeically thumbs. So yes, there are other things besides thyroid to look at. I do have an appointment now scheduled with a doc and plan to visit concerning some of these issues. Your very kind to share your knowledge with this forum. Thank you for being available to help others through this Hypo process.

Have the very best summer.
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I am new to the thyroid issues, mine was recently removed due to thyroid cancer in April.  One month ago I started my Tirosint 88mcg.  I was completly balanced before the removal.  I am feeling shakey (shaky) all the time from the inside out and sick to my stomach all the a time and feeling like I want to pass out and I have lost weight.  This all made me think that my medicine was to strong but I went to the Dr 2 days ago and did blood work and he said my TSH was still a little low and told me it was probably aniexty and gave me medicine for that.  I know my body and I really think the medicine is making me sick .  Help , I dont even know if he is a good doctor. If he isn't, I am not even sure were to look! Did any of you guys get sick at first on your medication.  Does it take your body that long to get used to it?
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If your TSH is too low, that indicates that you've gone hyper from the med, but it's not unusual for symptoms to get worse for a while, until your body gets used to having the hormones.  

Did your doctor start you out at the full 88 mcg?  It's generally best to start lower, retest after 6 weeks, then adjust as needed. You might talk to him about a lower dose (25 mcg is usually a good starting point), or taking one pill every other day, which would average 44 mcg/day, then as you can tolerate that, you could work up.

Is TSH the only thing he's testing for?  If so, you need to ask for Free T3 and Free T4, which are the actual thyroid hormones.  If he refuses to test FT3 and FT4, you need to run, not walk, to a different doctor.

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I have been taking Synthroid 175mcg for 20 yrs. A yr ago, lowered to 150mcg. In April, I suddenly am being covered with a rash, Dermatologist called ot Granuloma Annular, says it may be caused by the dyes in synthroid.I just started a new endocrinologist today, and he gave me  a 14 day sample of Tirosint, 150. I was excited to start it.. til I started reading all of these comments. Now I am fearful to try it.  (did I mention, I also have joint pain, and redness of feet, which can be caused by the dye in synthroid..I have been tested for everything else) .
I do not wqnt my hair to fall out. yikes. has anyone used the dye free 50mcg synthroid?
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The only ingredients in Tirosint are the levothyroxine, water, glycerin and gelatin.  It's as hypoallergenic as any thyroid med can get.  

As has been noted several times, throughout this thread, the symptoms, such hair falling out, are typically caused by being hypo, rather than from the med itself.  Your joint pain is quite likely a symptom of hypo, as well.

Your endo was right to start you on a lower dose than you were on with Synthroid, because many people find that, because Tirosint is more fully dissolved and better absorbed, they don't need as high dose.

Also, just because one person had a symptom they "thought" was caused by Tirosint, doesn't mean you would have that same one.

We have had some who used the 50 mcg synthroid, with no dyes.  Problem with that is that you'd have to take several pills every day.... but there could be worse things.

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I am new to this drug.  I think my dr. Started me high.  I was on Levoxil 125 when he switched me to this one at the same dose.  Actually for the most part I am feeling better.  My nails are growing and my hair has stopped falling out for the first time in years.  Only side affects seem to be sweating more than normal, slight headache in the morning, weight gain (still), and a bit of stomach discomfort.  I had my first labs drawn this week so we will see.
How do people handle the weight gain?  Does it ever get better?
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I had a similar reaction to Synthroid but it was only the 25 dose.  After a good two week try I could no longer handle the mouth rash.  Dr was stumped then I tried Levoxil....no rash.
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Because Tirosint is, typically, so much better dissolved and absorbed, than pill type meds, it's not unusual for people to need a lower dose than they were on prior.

You have both hyper and hypo symptoms, so it's really hard to say what might be going on.  If you've just had labs done, you might post the results, when you get them, so we can see what your actual situation is.  Be sure to include reference ranges, which vary lab to lab and have to be posted with results.

Weight gain tends to be a bit difficult for some of us.  I originally, gained my weight from being hypo, but have been unable to lose it, despite more than adequate exercise and a good diet, so my doctor started doing more tests, and I've recently been diagnosed with insulin resistance and metabolic syndrome.  You might want to look into that.  

Insulin resistance is when your body doesn't all insulin to usher sugar into your cells for energy.  If it can't be used for immediate energy, insulin shuttles it into fat cells, and once there, it's really hard to get rid of it.

Metabolic Syndrome is a set of conditions, including high blood pressure, high triglycerides/cholesterol, higher than normal blood sugar (fasting over 100) and over weight/obesity, particularly around the middle.  Having just one of these conditions does not constitute metabolic syndrome, but 2 or more, may. I happen to have them all; fortunately, I'm simply over weight, not obese.

You should talk to your doctor to see if there's a possibility you might have one of these conditions.

Also, you're right at the age where perimenopause or even menopause may be causing reproductive hormones to change, which is also notorious for causing weight gain/inability to lose.
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Thank you for the quick response.  I have been menopausal for a good 7 years now with not too many symptoms.  Though I did feel like I have been having low grade hot flashes when I get out of bed in the middle of the night.  It's more the sweating that's a pain.
As for the metabolic syndrome....I will do some reading.  I have always had blood pressure right around 112/60 so it's good.  Cholesterol has been high since starting thyroid treatment 4 years ago.  I would say I am I ease with it mainly being in my middle.  So a possibility.  So when I see the dr on Tuesday I should ask to be checked for metabolic syndrome?  How is that done?
Thanks
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There is no particular test for metabolic syndrome.  It's a combination of 2 or more of the conditions I listed above.  

Your blood pressure looks good; I should be so lucky.......  Have you ever had higher than normal blood glucose levels?  That's one of the conditions that make up metabolic syndrome.  High cholesterol is a symptom of hypothyroidism and a factor in metabolic syndrome. And of course, the weight issue, which could be from hypothyroidism, insulin resistance or metabolic syndrome, as well as menopause. It just wouldn't hurt to discuss the possibility of metabolic syndrome.

Do you have current thyroid labs that you could post, so we can see where you are with those?  Be sure to include reference ranges, which vary lab to lab and have to be posted with results.  Even if your levels are "in range", they may not be right for you, as we are all different and don't all fit into the neat little packages, they try to put us.
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Your comment about individuals reminded me of a scientific study that concluded the following.

"High individuality causes laboratory reference ranges to be insensitive to changes in test results that are significant for the individual.

The width of the individual 95% confidence intervals were approximately half that of the group for all variables.

Our data indicate that each individual had a unique thyroid function. The individual reference ranges for test results were narrow, compared with group reference ranges used to develop laboratory reference ranges. Accordingly, a test result within laboratory reference limits is not necessarily normal for an individual."

Andersen S, Pedersen KM, Bruun NH, Laurberg P. Narrow individual variations in serum T(4) and T(3) in normal subjects: a clue to the understanding of subclinical thyroid disease. J Clin Endocrinol Metab. 2002 Mar;87(3):1068-72.
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My last full blood panel had my glucose level fine.  It's been a while.  I will ask for a copy of the blood work Tuesday then post.  Thanks.
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"Accordingly, a test result within laboratory reference limits is not necessarily normal for an individual."   WE have long understood that; now we need to figure out a way to get doctors to understand it.  LOL
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Yes you are right, we know it, but most doctors do not.  My thought here was that we all can use this scientific study to help enlighten our doctors that the group reference ranges should not be used as pass/fail decisions for individuals.  Rather, the ranges should be used as guidelines within which to adjust as necessary to relieve the patient's symptoms.  A study such as this gets a lot more acceptance from a doctor than does what we tell them we read on the internet, or experienced ourselves.  Of course some doctors will not pay any attention, and never change, because it is so much easier for them to just diagnose and treat based on "Reference Range Endocrinology", rather than clinical treatment.
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Ok I got my levels today.  Will give you April and now.  I went in April because I felt horrible wil many of the symptoms of hypo.  I thought.  Either way one should not have to sleep 12 hrs a night to function.  
THS. 0.23.      FT4.  1.3.      FT3.  3.4
At this point I was switched from Levoxil 1.25 to Tirosint 1.25 more due to the recall than anything.
So now my levels are as follows....
THS. 7.45.  FT4.  1.0.  FT3. 4.0
My dose has been raised to 1.33.
Seems a struggle to get it right.  But I do feel better on this med even though I did gain yet another two pounds.
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Could you or Barb take at look at these labs run. I know some are the inflamation (inflammation) markers Barb spoke of, I just don't understand them.

Nurtrophils 73.1 H (46.0-66.0)
Lymphocytes 18.7 L (34.0-44.0)
Monocytes 6.8 H (0.0-5.0)
MCH 32.2 H (27.0-31.0)

Vitamin D 32 (25-80)

Iron 93 (37-170)
Total Iron Binding  297 (265-497)
% Saturation  31  (18-50)   Do these show I am anemic. Ferritn was not done, last year my ferritin was 255 (15-322) To me this does not show anemia. There is another kind of Anemia of Chronic Disease with inflamation (inflammation) when ferritin is higher, to supplement with iron would actually be dangerous. Anyone up on this topic?

One last question, my thryoid labs done in May were T3 and T4 both at 45%. Along with all the other zillion tests she ran she also did a T3 (same dose), and T4, are the T3 helpful at all:
T3 Uptake  35 (20-37)
T3 Total 96 (80-190)
T4, Thyroxine  7.4 (5.5-11.0)  
FT4 1.06 (.59-1.61)

I think I have lab over load, anything jump out at you?
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Hi. Read your post and I am in similar boat. I am on tirosint since April and feel lousy. When you went back to synthroid did you have a period of feeling lousy?
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Just read your post. Did lowering your dose help?  I am in similar situation.
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Hi Barb,
I hope you get this message.

I've been reading a lot of posts here, because I'm having symptoms.  Trying to find solutions.  I see in this post that you take a beta blocker.  I am not on any prescriptions other than Tirosint.  But I'm not doing too well.  I swear I think this stuff zaps my system.  I'm taking supplements (that helps some) with anxiety and heart palps (pounding), etc.  I am also very perimenopausal.  So, some symptoms must be from that.  I'm applying natural progesterone cream.  

The last few nights, I sleep only 3-4 hours a night.  I feel kind of hyper alert.  It feel aware of sense of pulsating in my body.  My thyroid labs are in "normal" ranges.  But another forum said my FT3 (for a person without a thyroid) should be higher than my level (2.5), to be without symptoms.  

I am befuddled and do not know what the next step should be.  Get my female hormones checked?  See an Endo and change thryoid meds or add cytomel?  I just finished series of labs and visits with doctor in town.  This is overwhelming.  

So, now I am wondering if a beta blocker would help me.  I am borderline hypertensive.  I changed my diet and monitor my BP at home.  It dropped a little, thus far.  

Are there any common negative side effects to taking a beta blocker?

I appreciate your input.
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Here I am.... Your symptoms sound like you need more thyroid hormones; those are all symptoms I had when I was very hypo.

You said your FT3 is 2.5; what's the reference range for that?  Ranges vary lab to lab and have to come from your own report.  Also, what is your FT4 level, with reference range, and your TSH?

From what you've described, I'm not sure you would benefit from a beta blocker, but we can address that later.  FYI - since my levels are now stable and where I need them, I've been off the beta blocker for nearly a year.

Do you know if you have Hashimoto's?
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Recent labs:
TSH    1.08  
FT4     1.2     Ref: 0.7 - 1.4
FT3     2.5     Ref: 1.7 - 3.7

Oh my, the past few days I've been having bouts of intense chills and higher BP; nausea, loss of appetite.  Ugh.  Miserable.  I took my BP during one of these 'episodes' and it was 139/93; pulse of 83.  I drank OJ; had a banana.  VERY hard time sleeping last night.  Got about 3 hours tops.  Took BP this morning:  122/86; pulse 70.  Feel better.  I wonder what is causing those episodes and sleeplessness?!  I started apply Progesterone cream last week (reduced amount) and taking some supplements.  A couple to help curtail anxiety.  I didn't think I would have anxiety with a TSH of 1.08, but I am.  

I will get cortisol checked.  And female hormone levels.  But I am thinking of changing thyroid med to one like Levoxyl.  It was not perfect, but not as bad as now.

I guess when female hormones are depleting due to onset of menopause, it can affect BP, cholesterol, etc.  

I have to make some changes!
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Hi.  I am currently on Tirosint (for tad over 2 months) and I'm having miserable waves of symptoms.  Severe chills, nausea, anxiety, higher BP, sleeplessness. I am also near menopause, but did not have these drastic symptoms while on Levoxyl.  

I see you were on Tirosint had reactions.  Did you ever switch to something else?  And how is it working for you?
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Oh and I have had no diagnosis of Hashimoto's.  
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Your symptoms are all indicating hypo.  Looking at your labs it, it would appear that you should cut back on the Tirosint and add a small amount of T3 medication, such as cytomel.  

TSH is a pituitary hormone and does not correlate, at all, with symptoms, particularly, anxiety.  TSH neither causes, nor alleviates symptoms and should not be used as means to adjust dosages. FT4 and FT3 are much more important, with FT3 being the one that correlates with symptoms.

Your FT4, at 1.2 is at 71% of its range.  Rule of thumb is to have FT4 about mid range, so you can stand to cut back on that.  On the other hand, your FT3 is way too low.  Rule of thumb is to have FT3 in the upper half or third of the range; yours is only at 40%.

FT3 is the hormone that's used directly by the cells, so if you don't have enough, you will continue to have hypo symptoms.  FT3 is mostly converted from FT4, so it appears that you aren't converting adequately.

What's your actual dose of Tirosint and did you start Tirosint as the same dosage you were on Levoxyl?  Because Tirosint is more fully dissolved and better absorbed many people find they have to have a lower dose than they do on pill type meds.  What supplements are you taking?  The progesterone cream could have something to do with anxiety.

You should ask to be tested for Hashimoto's; if you have it, you will know that your thyroid hormone production will continue to decline until your thyroid produces no more hormones.

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I do not have a thyroid. Had TT over 20 years ago.  I started two doses lower on Tirosint than what I was on with Levoxyl.  I have considered asking doctor to lower Tirosint or another levo and add a small dose of Cytomel.  Or find a doctor who would consider putting me on Armour.  I just would like to avoid anxiety.  A number one enemy of mine.  There is a DO who treats the entire person and works with each patient based on their individual needs, who is located not too far away.  I made an inquiry with them to get more info.  

Yes, I decided to curtail the progesterone cream for now and see what happens.  I had used it in the past without a problem.  I am getting more lab work done tomorrow for female hormones, heart, etc.  Will get results in about ten days, cause doctor will be gone next week.

I appreciate your input.
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Also...I've been really hypoT in the past and my symptoms were different than now.  I was tired, foggy headed, lethargic, sallow breathing and miserable.  I had some anxiety then, too, I guess.  But not a lot.  I am wondering if this Tirosint is just too fast acting for me?  I kind feel like I'm being 'zapped'.  Tinnitus increased, as well.  The doctor prescribed me Synthroid 125 mcg today.  I have not started on it yet.
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I forgot to mention the supplements I take.  A good multi with all B's & a lot of stuff, CoQ10, Omega 3 & joint supplement almost daily.   Calcium magnesium & D3 daily.  Some days: garlic & resveratrol.  

Since having the flare ups the past few days, I was not taking or eating much.  Since this afternoon, I started feeling some relief.  I did NOT apply progesterone cream today.  I took a leftover Levoxyl instead of Tirosint this morning.  I know it takes weeks to notice a difference when changing.  And now my Doctor prescribed Synthroid.  

I am feeling better, but now I'm confused about what scrip I'm going to take for the time being.  Tirosint or Synthroid (or other - can get diff at pharmacy).  

Within next few months, I would like to see a doctor who knows more about thyroid meds and can help me get on the best regiment for me.


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What dose were you on for Tirosint? I just started it myself at 88mcg, but was told I'd may need to go lower since it can be pretty potent.
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Hi.  I am on 112 mcg Tirosint.  Was on 137 mcg Levoxyl before switching.  I have no thyroid, so I need more than a supplemental dose.  I have friend who also is without a thyroid.  She is taking 88 mcg Tirosint and 5 mcg Cytomel and she feels great.  She works out regularly and even with other unrelated minor health issues, is doing very well.  I am hoping to attain the same productivity level she is at.  Every person is different.  I guess it takes a willingness to give things a proper trial period when making a change.  
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It could be you need to add just a touch of Cytomel, seeing your FT3 is still on the low end of the range. Your FT4 is almost right at the high end of your lab range, so I think cutting back on that just a dose might help too. Like you said, everyone is different-we all need different things, and all experience symptoms of over or under-active thyroid at various levels.   Hopefully you'll soon find a dose that's good for you, whether it be continuing on the Tirosint or switching to the Synthroid.
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For what reason did you have TT?  

Are you maintaining at least a 4 hour separation between your thyroid med and all those supplements?  Particularly, calcium and magnesium.. they can interfere with metabolism of thyroid med.

We don't always have all the same symptoms, every time we have a hypo period.  Our bodies react differently, depending what stresses (or lack of) that we have going on, at any given time.

You'll need to settle on a med and stay on one, not keep switching around.  Levoxyl isn't an option, right now, so it will either have to be the Tirosint, synthroid or generic.  If you keep changing the med, you will end up on a roller coaster that will be really hard to get off.

It sounds like you need to find a doctor who is willing to prescribe a T3 med.  Since you're already on the synthetic T4, it would probably be easier to just add cytomel (or generic T3), as it's easier to balance them when you take them individually, and many of us don't need the higher amount of T3 that's present in desiccated hormones.   I, personally, am on 88 mcg Tirosint and 10 mcg generic T3 (I take 5 mcg of the T3 in the morning, and the other 5 mcg around noon) and I feel good.

Anxiety is one of those things that can be hard to eliminate, because it's a symptom of so many different things.  I had it really bad, when I was hypo, but I also had a lot of things going on in my life that sent my stress level out of sight.  I even had to resort to an anti-anxiety med for a while.  I've been off that, now for most of this year.  
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Yes.  I wait appx 4 hours before eating or drinking anything, except water, after taking my morning thyroid pill.  Take it early, then go back to sleep.

So, you did not have any edginess taking Tirosint?  Years ago, when I had too much Synthroid in my system, I had to take klonopin (quartered pills) for about a year, til leveled off.  I may need to again.  

I am going to resume Tirosint in the morning.  I am just not too sure about starting Synthroid.  I had hoped Tirosint would be good for me.  It's just so-so, thus far.

I plan to find a doctor who will look at my health symptoms and see if I could try adding Cytomel.  But somehow my body must be converting to T3, even if it's not quite up there.  The lab puts it in 'normal' range.  

So, if my free T3 is in upper range, I won't have med induced anxiety?
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You don't have to wait 4 hours to eat/drink anything after you take your thyroid medication; you only have to wait 30 min to an hour (I usually don't wait that long); maybe that's part of your problem.  You only have to maintain a 4 hour separation between thyroid med and supplements, particularly, calcium and magnesium.

I don't understand why would you have to go on Klonopin when you had too much synthroid?  Makes more sense to just cut back on the synthroid?  While anxiety is often attributed to hyperthyroidism or over medication, that's not always the cause.  I have never been hyper or over medicated, since I started on thyroid replacement med, but I certainly  had the anxiety.

It doesn't matter whether your FT3 is in the lab's "normal" range or not.  It's all about how YOU feel and since you still have hypo symptoms, your FT3 is not adequate, even though it's "in range" and your FT4 is quite high.  There are some labs, for which just being "normal" isn't good enough and FT3 is one of them.  

"So, if my free T3 is in upper range, I won't have med induced anxiety?"  From what I can tell from your labs, you don't have med induced anxiety, now; you have hypo induced anxiety, unless the progesterone contributed to the anxiety, in which case, that had nothing to do with the thyroid med.

You need to decide on either the Tirosint or the synthroid, certainly not both of them, or switching back and forth.  It's not the least bit unusual for symptoms to worsen, or for new ones to appear, when changing med or dosage.  

You should only ever make one change in medications/dosages at a time.  In your case, you added the progesterone very close to the switch to Tirosint, so you don't know which you might have reacted to. Now that you didn't take the progesterone, you say you've gotten some relief.  I'd give it a couple more weeks, without is and see what happens. But do get on a thyroid med and stay on one med.

It takes 4-6 weeks for a T4 med, such as Tirosint or Synthroid to reach full potential, so you have to stay on one or the other, then retest in 5-6 weeks to see what's happening.  Because Tirosint is a gel cap, you might feel some effects sooner than 4-6 weeks, but you still have to let reach potential.
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About 13 years ago, I experienced Synthroid Poisoning.  It was a very serious situation.  Had to go the hospital a few times; they had to get my heart rate down cause it was through the roof; blacking out; tremors; sallow breathing; etc, etc. The dose was reduced, but it still took a long time to recover.  Thankfully, I did.  But now it seems too easy for me to have anxiety.  I'm fine most of the time.  I've been told I should get a cortisol test, which I am doing.  I try to avoid as many stressors as possible, which helps.  Yes, I guess hypo can bring on anxiety, too.  But I really do not feel hypo.  If I am, it is just slightly.

I really do think it was the Progesterone cream that caused the reactions I had.  I'm now using evening primrose oil with black current for a gentler way to calm perimenopause symptoms.  No problems with that.  

That's good to know I don't have to wait four hours to eat after taking Tirosint.  I have always been careful to not consume calcium, iron or most supplements until a few hours after.  I started eating a food that soothes the tummy in the evening; like oatmeal.  That is helping settle the rumbling and discomfort.

I had been convinced that if I tried a T3 med, it would increase anxiety.  Even an Endocrinologist didn't want to put me on it.  Maybe she didn't have much experience with how to dose patients on it, IDK.  But a friend has recommended another endo who does adjust the T4 med to add T3.  So, I am thinking of going to her within the next few months.

I'm going to stick with Tirosint.  I actually feel less brain fog at this time.  And reduction of body aches.  My tummy didn't rumbling and ache today after taking it.  Having some hope today.


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Hi.  I thought eliminating the progesterone cream was helping.  But the cold chills came back this evening.  Was not quite right all day; then it escalated.  Body temp is in the 97 range.  I now cannot help but think that my body is reacting to this Tirosint.  I had been on Levoxyl for 13 years prior to starting Tirosint 2 months ago.  I cannot live like this.  At least on Levoxyl, I was managing.  I am wondering if Synthroid is close enough to Levoxyl for me try it.  The doctor was willing to let me do that and get new labs after about a month.  I do not know what to do.  Any thoughts?

I took some calcium magnesium supplement, had oatmeal and half a banana.  The chills reduced after about an hour.  

I have an appointment with an Endo, but not until March!
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Hi.  I saw your posts on Tirosint.  I am trying to take it now and wondering if it's causing the 'buzzing' sensation in my body.  I wondered what you ended up taking for your thyroid replacement and how it's working for you.  
Thanks.
Deb
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Hi.  I saw your post on Tirosint issues.  I am on it and wondering if the 'buzzing' sensation in my body is from this stuff.  I think it might be contributing to lack of sleep, as well.  I woke up this morning and the 'buzzing' had calmed down.  But about an hour after I took a Tirosint get cap, the buzzing intensified again.  I am also in menopause.  But I did not have this issue when I was on Levoxyl.  There are just two benefits I see with Tirosint for me:  the aches have left and I breathe more freely.  Just wish the dang electrical-like buzzing would stop.  

What has been your experience?  And how are you doing now?
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Sorry I haven't responded to your recent posts; life has been crazy.

As far as adjusting T4 med and adding T3 med, many doctors, including endos refuse to prescribe T3 medication, no matter what.  Those doctors often leave their patients very ill.  You really don't want anything to do with a doctor that's not open to the proper testing or willing to treat to eliminate symptoms.

It is completely false that T3 med will increase anxiety.  For many of us, that's what we need to lessen anxiety, because anxiety is a major symptom of hypothyroidism.

There's  nothing in Tirosint for your body to react to.  Its only inactive ingredients are water, gelatin, glycerin; all 3 of which are found in products we use every day.  The active ingredient, levothyroxine is the exact same active ingredient that's in synthroid, or levoxyl.

When Levoxyl was recalled, many doctors switched their patients to synthroid; some switched to generic Levo.  I actually did better on generic than I did on synthroid.

You've only been on the Tirosint for about 3 weeks, now, is that right?  Will your doctor retest at about the 4-5 week mark?  If so, it would be good to get a new set of labs to see where your levels are.  I'd guess your FT4 to be even higher than the ones you posted previously, but I'd venture to say that FT3 won't have changed much, if at all.

You might also ask your doctor to order a Reverse T3.  FT3 is converted to either usable FT3 or inert RT3.  RT3 is a mirror image of FT3 and it blocks metabolism of FT3.  

As far as your  med, I stand by my original thoughts, that you should decrease the Tirosint and add a T3 component.

Do you take magnesium on a regular basis?  Magnesium deficiency can cause some pretty nasty symptoms; you might want to research that a bit.

I'm glad to hear that you got an endo, unfortunately, it does often take a couple of months to get into one.

Just so you know, you attached to a very old thread and neither librarygirl2 or 702mft are active on the forum.
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Thanks for your reply.  I started on Tirosint in early September.  The benefits are that I breathe more freely and body aches are greatly reduced.  This darn 'electrical' sensation (sometimes cold chills) is the whole problem.  I took L-Theanine and it seemed to reduce it.  Yes, I'm trying to get magnesium (and other nutrients) in increments throughout the day.  I'm only sleeping a few hours at night now.  I got female hormones tested.  Shows I am in post-menopausal ranges.  It\ don't know if the progesterone cream I quit apply a little over a week ago is the culprit.  I would think that would subside any day.  Do you know if low Estradial can cause uncomfortable symptoms?  I will be talking to local doctor next week.  I will not go on HRT.  But would consider natural forms.

I would love it if I can stay on Tirosint.  My family is encouraging me to switch, but I know they would like to see a quick solution.  

I wondered if it's the type of absorption of Tirosint that could be a problem for me.  It might be too quick for system that was used to slow absorbing Levoxyl for 13 years.  
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"My family is encouraging me to switch, but I know they would like to see a quick solution."  Let me assure you that there is no quick solution when you're on a T4 only med (whether it be Tirosint or Synthrois), every med/dosage change takes 4-6 weeks to reach full potential in your body, then once you reach optimal levels, your body still has to "heal" from this illness you've had... this can take weeks, months or years, depending on how long you were hypo and how your body reacts to the meds.  

Please understand that I'm not trying to talk you into or out of anything; I just want you to know the facts..  you've been on the Tirosint for a little over 2 months now (I misread your original post; thought it said weeks instead of 2 months - sorry - can I claim thyroid brain fog?  LOL); some of your symptoms have been reduced, so that means it's doing "something" for you, just not enough.

If you switch to Synthroid, you will have another 4-6 week adjustment period.  Tirosint has no fillers/binders that you can be allergic, Synthroid does.  Because you really won't be changing the active ingredient of the med, I'd not expect Synthroid to make you feel any better.

The bottom line is that your FT4 is too high (even though it's "in range") - remember the "mid range rule of thumb" for FT4?  And your FT3 is too low (even though it's "in range") - remember the "upper half to upper third rule of thumb"?  

Many people find that when they switch to Tirosint, they have to have a lower dose, because of the better absorption - that happened to me.  Your issue is not just the T4 med; you also have way too low FT3, which indicates that you aren't converting adequately.  I'd almost bet that dropping your Tirosint by about 25 mcg and adding a few mcg of T3 med, you'd see a huge improvement.

As far as your peri-menopausal situation - yes, that can cause some similar symptoms.  Your reproductive hormones and thyroid hormones are both part of the endocrine system, as are the adrenals, the pancreas (produces insulin), etc and all the hormones have to balance in order for you to feel optimal.  Sometimes that's hard to do and you have to ride it out.

I'm curious about the "electrical" sensation... can you describe what it feels like?

Have you had vitamin B12 levels tested?  If not, I strongly suggest that you do..
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Another forum member posted that it might be a good idea for me to decrease my T4 med for awhile before adding a small dose of T3.  A friend of mine went from a high dose of Synthroid to 88 mcg Tirosint and 5 Cytomel.  She said she feels really good.  She had a partial hysterectomy years ago and is not going through any menopause symptoms.  But, I cannot make any thyroid med change right now, except to switch to either Synthroid or a generic. Do you think I would have different symptoms if I switched to Synthroid, just to see if this electrical, buzzing stops?

That 'electrical' sensation is always there.  It seems to reduce some after I ingest nutrients.  But wow, it is a roller coaster of a very uncomfortable feeling!  And it's definitely interfering with my life right now.

A relative suggested taking an anti-depressant med.  Which worked for me years ago when I was overdosed on Synthroid.  (Took for just a year.)  I would like to find a less drastic help for this.  Maybe an Estriol cream since my estrogen level is low.  I  just feel like I have to get some relief from this before I do end up in the Pysch ward.  I cannot just do nothing.

Other women experience this, too.  I found this info:

http://www.34-menopause-symptoms.com/electric-shocks/articles/understanding-electric-shock-sensations-during-menopause.htm

Thank you for sticking with me with your input.

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Well...I stopped Tirosint!  And thankful I did!  Those debilitating electrical-like impulses have stopped!  My body cannot tolerate a gel cap delivery method.  I have to take a levothyroxine pill.  I also took 100 mg L-Theanine to reduce the anxiety and tension brought on by the Tirosint reaction.  It helped me tremendously!

I am going to talk to a pharmacist who specializes in finding the right medications for people.  He considers a person's symptoms.  Does blood draws, etc, and sends to the lab.  He also does compounding.  He has a relationship with a medical research facility and its doctors. This is good news for me!

I feel like I am finally on the right track!
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I'm glad the electrical impulses have stopped.

A pharmacist can't prescribe medication; will he be able to get doctors to do that?  I think it's considered malpractice for a doctor to prescribe something for a patient that s/he's never seen.
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I still have to get more information on this.  But from what I have found out so far, he will only discuss the medical end of it and offer suggestions and referrals.  Then I can bring my prescriptions to him.  The other part of it is for  supplementation.  Heaven forbid the government taking that away from us so they can give more bucks to pharmaceuticals!  There is nothing illegal about doing saliva tests or labs for supplementation or results that we can take to our doctors.  

By the way, I strongly feel that many doctors are out of the loop when it comes to getting to the root cause of symptoms!  My current doctor didn't think my symptoms were caused by a synthetic thyroid med!  Wow!  But she is willing to discuss things with me and work with me so I could find some relief.  Med schools need to make some changes, for sure.

Yes, my stint with Tirosint is over!  It's not for me!  And my doctor did not diagnose that!  I did!  I hope that is not illegal.  If it is, I do not care!

Thanks for all your input.


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I tried Tirosint, but way too potent for me. It probably would of been easier if they had started me much lower, but they refused to, so they switched me back to generic. However, I had major stomach issues without a filler in the gelcap, so I'm wary of trying it again even at a smaller dose.
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Hi.  Yes, I'm dealing with stomach issues.  It's not as bad when I eat the right foods; smaller meals; and do not go too long between meals.  I occasionally take aloe to help with the healing process.  I've read for years about stomach issues when taking any thyroid med.  I wonder if the natural thyroid meds do the same thing?  I'll have to look into that.  I'm not sure if I would be a good candidate for natural.  Hope your tummy feels better soon.
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I never got the tummy issues with the generic, but the Tirosint was just havoc on me. I switched just because they thought maybe a brand name would be better at relieving the fatigue and dizziness I felt, but the Tirosint made me extremely dizzy and so wired I couldn't sleep the short time I was on it. I know I was over-medicated on it, I had basically all the symptoms I had when I was hyper... but the stomach thing was very painful. I had terrible cramping and pain, along with an upset stomach and (a bit TMI here) a laxative effect. Luckily, since switching back, my tummy is now back to normal, thank goodness! I think my dizziness and fatigue is because I'm still a bit hypo-currently waiting new labs to see if I need just a small tweak in dosing.  Hopefully you'll have luck with that compounding pharmacist-I've heard of people having better luck getting their thyroid med done in that way.
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Glad your tummy is better.  I think mine is still recovering from 8 weeks of Tirosint.  Wow.  Yes, I am now more optimistic that I'm on the right track.  Will know more in a couple days.  I've had people tell me, based on symptoms and labs, that I might need a little T3.  If so, I would expect to start with a small dose.  I wish I could take dissected thyroid.  A lot people seem to do well on it.  I've read only an occasional comment that a person did not do well on it.  Tirosint did make me more alert; a lot less brain fog.  But the side effects make it NOT a good choice for me.  I have menopause symptoms, as well. But I've been perimenopausal for a few years.  This might contribute to some symptoms.  Just have to take care of myself the best I know how.  I need to find a new GYN soon.  But I did get my hormones checked.  It will get better.
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Hi im really glad i found this forum. I was diagnosed with Hashimotos/Hypothyroid about a year ago (I am a 32 year old female and have not had any children yet)...I started on Armour for 6 months with no real change in my Hypo/Hashi symptoms. I do see a really good Dr (Dr Arem Texas Thyroid Institue) and based on my last results and my symptoms he has decided to put me on tirosint 50mcg with t3 sr coumpounded 4mcg. I will start it tomorrow and am very eager to see how i will react to these new combonation of meds! I will let everyone knows how it goes. I have done a lot of research and really educated myself on Hypo/Hashi and understand that everyone is different and what works for one may not work for another...and that it also takes time for a medication to work...so i'm going to stick these new meds out for 2 months before i decided to make any changes! I'm praying i will have nothing but good things to report! Good Luck to everyone!
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Hi im really glad i found this forum. I was diagnosed with Hashimotos/Hypothyroid about a year ago (I am a 32 year old female and have not had any children yet)...I started on Armour for 6 months with no real change in my Hypo/Hashi symptoms. I do see a really good Dr (Dr Arem Texas Thyroid Institue) and based on my last results and my symptoms he has decided to put me on tirosint 50mcg with t3 sr coumpounded 4mcg. I will start it tomorrow and am very eager to see how i will react to these new combonation of meds! I will let everyone knows how it goes. I have done a lot of research and really educated myself on Hypo/Hashi and understand that everyone is different and what works for one may not work for another...and that it also takes time for a medication to work...so i'm going to stick these new meds out for 2 months before i decided to make any changes! I'm praying i will have nothing but good things to report! Good Luck to everyone!
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Hi Barb. I am a thyroid newby. Was just recently diagnosed with Hashimoto's after 2 (benign) thyroid nodules were discovered and biopsied. The largest is about 2cm. The endocrinologist has not done a superb job in explaining the labs to me. And trying to learn on my own is proving to be very confusing. I'm 45 and am also in perimenopause and only have intermittant periods about 6 months of 12. Mother menopaused at 43. Symptoms (of something?) have been HORRIBLE and completely changed my quality of life for the past year. Although many symptoms to a lesser degree have been present for the past 3 years. Most notably, terrible anxiety and panic attacks. All the while, with an underlying daily fatigue. Hot flashes-all day-everyday. Chronic feeling of shortness of breath, although lungs and heart have been ruled out. Have spent thousands of dollars at PCP, Endo, and Nutritionist. Also am B12, B5, B6 and Vit D deficient, but am supplementing and using proper nutrition to bring these up. GYN has been worthless. Just sat there staring at me with a blank look on her face. Endo has prescribed 12mg of Tirosint- lowest due to not wanting to increase anxiety symptoms. Can you please help me make heads or tails of this? I would be so grateful!

TSH .59 (N)
T3 Uptake 33.3
Total T4 6.54
FT3 3.3
FT4 .73
Thyroid Peroxidase Antibodies <10 (N)  Reference Range <35

Estrogen (still at lab)
Progesterone 1.3
Testosterone 31

Cortisol 5.1 (N)

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What are the reference ranged for the FT3 and FT4?  Ranges vary lab to lab and have to come from your own report.  Also need ranges for the progesterone and testosterone.

Also, what are the actual levels of your Vitamin B12 and Vitamin D?  What are you supplementing them with?

Being hypo can cause the anxiety and shortness of breath.  I had them both when I was very hypo.

In order for your situation to get the attention it deserves, it might be a good idea for you to start a new thread of your own.
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Thank you for your response! I had to wait a week for a follow up with my doctor to get the reference ranges. I have not had a full blown panic attack since July, but have a daily anxiety issue - plus shortness of breath, fatigue and a myriad of other symptoms. Just a feeling of being unwell. My B12 was 235 (reference range 230-950) at that time and I have been on a liquid B12 supplement and also weekly B12 injections reduced now to one per month. My current B12 level is 550. Vitamin D was 30 (reference range 30-100) so doctor prescribed 50,000 IU weekly and level is now 47. Here are my latest lab results:

TSH                1.190           Ref:  0.450-4.500
FRT4                0.73           Ref:  0.60-1.20
FT3                     3.3           Ref:  2.5-3.9
FOLW             >24.6           Ref:  6.9-25.3 (flagged)
SHBG               50.6           Ref:  18.2-135.5
fTSH2               0.96           Ref:  0.34-5.60
hFSH              103.3           Ref:  23.0-194.2
hLH                  50.5            Ref:  10.9-58.6
Progesterone     1.3            Ref:  0.0-0.8. (I used prog cream for 4 days only)
Testosterone      31             Ref:  80-100
Estradiol             6.9            Ref:  shows postmenopausal <6.0-54.7

Last menstrual cycle was Oct 2013

Also, just got micronutrient test results -

All B's and Biotin are near borderline for deficiency.
B6 is clinically deficient.
Pantothenate (B5) is clinically deficient.
Vit C is borderline deficient.
These vitamins and minerals are at the higher end of the normal range but not exceeding.
Vit A, Zinc, Copper, Magnesium- this one is quite high

Once again, my endocrinologist gave me a diagnosis of Hashimoto's based on mostly a pathology report after (benign) thyroid nodules were biopsied. She wants me to begin to take Tirosint 12mg to start. She says it may help reduce the size of the nodules. I have never taken a thyroid medication before. Thyroid peroxidase antibodies were <10 (N) Range <35. I so greatly appreciate any insight you can share with me!
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I'm not familiar with some of your tests... What is FOLW? and fTSH2? Those aren't tests we see all the time.

Even at 550, your B12 level is still too low, as is your vitamin D level at 47.  Don't stop supplementing those.

Your FT4 is on the floor of the range, at 21%.  That means your thyroid isn't producing enough.  Your FT3 isn't too bad yet, at 57%, because it often takes FT3 a while to track FT4, either up or down.

It's possible for your endo to diagnose Hashimto's based on pathology, but it's unfortunate she didn't test Thyroglobulin Antibodies (TGab), as wll as the TPOab.  Both TGab and TPOab are indicators of Hashimoto's.  Some of us have one or the other, some people have both.  You should as for TGab.

Like all T4 meds, Tirosint is dosed in mcg.  The smallest dosage is 13 mcg.  While I've been on Tirosint since shortly after it came out in 2009, many doctors aren't familiar with it.  I wonder if yours is, since she doesn't seem to be familiar with the dosages.

A dosage of 13 mcg is relatively small and if you have Hashimoto's, you will have to increase your dosage to keep up with thyroid destruction.  Your feeling of "unwell" could very well be the beginning of hypothyroidism, as evidenced by your low FT4, so you might be wise to go ahead and start the med, before symptoms worsen and become hard to control.
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Thanks so much, Barb! Your input is so helpful! I will begin taking the Tirosint now and see what happens. I will also ask Endo for the TGab next time I see her. I really appreciate your expertise on this subject! Be well!
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As always you should be aware of the symptoms of over medication and contact your doctor immediately.

It's not unusual for hypo symptoms to worsen or for new ones to appear when starting on a new med.
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Regarding your last post, it sounds like it is a normal period of adjustment for some? Should I have minor symptoms - I assume that I should push forward with the Tirosint and wait to stabilize a bit? My Endo did say to call her immediately if I experience any moderate to severe side effects. She is starting me on the 12 mcg since its the lowest and due to my history of heart palpitations, anxiety attacks, and shortness of breath. I thought for the longest that I was hyper, not hypo, due to my symptoms.
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Yes, there is a normal period of adjustment, and yes, try to push through with minor symptoms.

Oddly enough, many hyper symptoms also apply to hypo.  When I was at my very most hypo, I had heart palps, anxiety and shortness of breath. Once my thyroid levels normalized (for me), those symptoms went away.

AND, Hashimoto's is often characterized by periods of hyper in the beginning stages, so your symptoms could have been either one.  The most telling symptoms for hyper are rapid weight loss, for no reason and diarrhea.  Most telling symptoms for hypo are weight gain, constipation and dry skin, but many people who are hypo don't gain weight; many hyper don't lose weight.  
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Well, there you have it! This makes complete sense to me. Last Spring I experience a major anxiety attack. On April 5th to be exact. Diarreah (diarrhea) became a daily occurrence and for whatever reason I had an absolute aversion to food. Made me sick to eat. I would get dizzy and have intense heart palpitations. I lost 15 lbs in one month. Anxiety attacks would wake me from sleep at least 3 nights a week. During waking hours I compared my constant adreneline surge to holding the accelerator pedal down in the car about 2/3 of the way and holding it there. Went to my doctor (of 7 years) and he prescribed Xanax. Told him I am not a nervous, depressed or anxious person, normally. I insisted there was a medical reason for my issues. Found a new doctor and he prescribed....Xanax. I refused to take daily but did agree to fill the prescription for use ONLY at the onset of major anxiety attacks. He gave me the lowest dose and told me to cut it in half. Did have to use those 4 times, but not since July. I admit, they were very useful for me in those situations. He did only routine blood work and the only thing that stood out was my EOS level, which I'm told is a marker for allergies. He did not send me to an allergist because the blood test he ran next showed no allergies. My EOS is still sky high and I take a Zyrtec every day. I'm a mess without it. It wasn't until I found my Nutritionist that we dug further. She asked him to test B12 and D. Also sent me to the Endo for the first time due to the thyroid nodules we could feel and see. First doc said they are of no concern and very common. We have tested everything under the sun - except for Iron testing, ferritin and the like. My blood cell count is normal so doc has absolutely refused to check further. I think I will ask again. It's been almost a year now and over $10,000 in expenses which included 1 trip to the ER because I thought I was having a heart attack or something. All that said, I believe those were my Hyper days. Since then I put the weight back on, plus 10 lbs. (Hypo Phase) No energy, no libido, very dry skin, and still this nagging shortness of breath with "the sighs". I hope that the Tirosint will help. I do take supplements through my Nutritionist and they have truly helped, but there is still a piece missing and I'm just sick and tired of feeling sick and tired. So that's my complete background, for you in case something stands out, but also for anyone else reading that is experiencing similar symtoms (symptoms). Maybe something here will help them. Thanks so much, Barb! You are a real blessing and honestly, I'm giggling here a bit, but you have done a better job explaining thyroid issues on this forum than my either my doctor or Endo.
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Well, there you  have it.... LOL    I can explain it well, because I've been there, done that.... Your story sounds a lot like mine and I went through the same things with doctors... Tired, no energy, etc -- aw heck, "your just depressed".... Yes, I was, but I wasn't tired because I was depressed, I was depressed because I was so tired and nobody would help me.

The majority of my tiredness was from Pernicious Anemia, but my doctors would never test B-12 levels and when they did, even if my levels were really low in the range (like rock bottom), they said I was "fine"... I wish they would have had to  live in this body and feel the way I felt.  It wasn't until I started having neuropathy in my feet/hands that my doctor finally took another look at B-12 levels and said "by golly, we've found the problem".  Yep, the problem he'd "missed" or ignored for the previous 5-7 yrs.  He thought starting on B-12 shots would solve all my problems, but when I started putting on weight like there was no tomorrow, I finally got them to run thyroid tests, again... By then, I was so hypo; my TSH was at 55+ and it was obvious that I was sick - they couldn't ignore it anymore or attribute  my tiredness to depression... Once diagnosed I'd thought I'd be on the road to recovery, but nope, not so fast, Bucko...

I can SO identify with that adrenaline surge, but I had it after I was dx'd hypo/Hashi... so you see what I mean when I say symptoms can "cross over".

The time following my dx of hypo is a whole other story, but was a nightmare that I wouldn't wish on anyone.  

I hope you have a lot better thyroid doctor than I had to start with; you'll get better a lot quicker.
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Wow! I cannot even imagine how bad you must have felt to go undiagnosed for so long. I had the first anxiety attack in Nov 2011. But they were so far in between and I had no clue as to what was causing them. There were no other symptoms and I would recover the next day.

I have only endured daily problems since April, and that's too long for me. I don't have that kind of strength. I have read about others, like you, who were sick for nearly a decade or longer. It's a shame. A shame that mainstream doctors are not educated beyond writing out a prescription.

My husband has done his best to understand, but he tires of me feeling bad. He thinks I spend too much time (and money) trying to figure this out. It's been really hard on my kids too (which deeply saddens me). They are only 9 and 17.  But I know that YOU KNOW that we have to be our own advocate. If not, we will not get the help we need. Life is too short as it is.

As for my Endo, unfortunately I do not have a lot of faith in her. She did the FNA on my nodules in May 2013 along with blood work. Her nurse called me two weeks later to let me know that the nodules were benign and they would see me in 6 months. I was elated to get the good news and pressed forward looking for answers for my condition. Tons of doctors appointments and countless hours of studying followed. When I returned to the Endo for my 6 month check up in November she said....oh, I see you have Hashimoto's. She was looking at the report from May and showed it to me. She said I would need medication for my thyroid. The whole time I was sitting there I was thinking, May?! You've been sitting on this information since May?! It has been my lack of confidence in her that has caused me to delay in starting the Tirosint. I was waiting on new lab work to come in and searching for advice when I found you. I am not one to just say ok and put the pills in my mouth. Wish me luck! :)

I feel much better now about trying the medication. So, thank you again! And thank you for taking your time to share with us. I'm so sorry for what you've endured to get to this place. Your presence here will surely save many others from years of poor health due to lack of information and guidance.
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Hi:
I'm a 60 year old female. Had my thyroid removed 3 months ago due to complications from hashimoto's. Surgery was flawless, but I've been hospitalized twice since due to extreme side effects from taking meds. My tsh in January was 98. They've gotten it down to 42, labs to be drawn again in 1 week.  Extreme muscle pain and headaches from all meds. (including compounded & NDT) they tried me on. Currently on Tirosint, 100 mcg. (50 mcg. twice daily). Pain is horrific in calves & upper arms. Doctor said its a lupoid reaction to the med. & added prednisone in an attempt to get the lupus to settle down. My question is, can the pain be coming from the medication, or is it indeed a lupus flare? They don't know what else to prescribe for me. Thank you.
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Perhaps they simply started you on too high a dosage.  Often it's best to start very low, especially, those over 50, and work up slowly as the patient can tolerate it.

What symptoms are you getting as "side effects" from the medication?  Just the muscle pain and headaches?  It takes 4-6 weeks for any thyroid med, containing T4, to reach full potential in the blood and it's not unusual to feel worse or have new symptoms appear, while adjusting to a dose/med.

There is no point in taking Tirosint 2 X/day.  It's a T4 med and has to build.  The T4 in your system today, is from med you took a couple of weeks ago.  The only thyroid meds that should be taken in multiple doses are those containing a T3 component, which Tirosint does not.

There is nothing in Tirosint to react to.  The only ingredients are the levothyroxine, water, glycerin and gelatin.  I feel confident that the pain is not being caused by the Tirosint; it "could", however, be caused by hypothyroidism.  With a TSH of 42, I'd expect your actual thyroid hormone levels to be quite low.

If you have current lab results, please post them, so we can get a better idea of where you're at.  If your doctor is dosing you, based only on TSH, ask for the Free T3 and Free T4 tests.  If s/he refuses to test those, get a different doctor.  

Since this is a very old, long thread, your situation would get more attention if you posted a new thread, with your own information.  You can do that by clicking the orange "Post a Question" button at the top of this page, and once you've typed your comments/questions, click the green "Post a Comment" button.

There are some ways this can be handled, but I'd need to know your current FT3/FT4 levels.  I'd also wonder if they've checked your vitamin D level.
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I just began tirosint 3 days ago.  My thyroid has always been slightly enlarged and at my endo appintment they found "masses" that they believe are enlarged para-thyroids.  My endo put me on 25mcg of tirosint (I was on 100mcg Levothyroxine) and gave me a script for bloodwork in 5 weeks to reevalute.  Well 3 days in my thyroid is larger. My endo seems dismissive.  What do I need to know?! I need to ask the right questions.

When I first described my symptoms:
sleepiness
anxiety
leg & foot pain
trouble concentrating
memory problems


He told me that NONE of these have anything to do with my thyroid.  Once he did the sonogram, he changed his opinion.
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Hi everyone - I never post on these, but was thankful to find all of these posts.  I was feeling fine, but went ahead and had a Physical in Aug 2013.  My doctor said my blood results said my TSH was 4.970, indicating that my thyroid was low. So, he put me on Levothyroxin (levothyroxine) 50 MCG.  Almost immediately I was a trainwreck!  Couldn't sleep and then crash and sleep for over 12 hours, sweats hot and cold, anxious, heart racing, no patience at all and just plain mean!  The doctor wanted me to continue for 3 months, which I did with nothing getting better and feeling the worst I've ever felt in my life!  I had another blood test and the TSH was 1.620, however on Dec 23, I'd had enough and called the doctor and told them so.  They had me come in the day after Xmas and talk to doctor - he gave me the Tirosint 50 MCG to try.  More side effects!! Sleep got a little better, I've been taking it at 5 or 6 am and then try to sleep before work.  I'm having horrible headaches with it, am still more tired than I ever was, the inside of my ears itch - yep inside!! Driving me nuts! Plus, again the anxiousness, heart racing, bitchyness is a little better, but I still have melt downs and crash and energy level just plain ***** :-( I'm an avid tennis player and runner - that just  has no appeal to me these days.  Talked with the nurse about current symptoms and the only advice I got was to take them before bed and sleep through the symptoms - I don't think that is a very good answer!!  Any and all advice is welcome at this point - I'm so tired of messing with this in my life!

KeriBear
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Hi everyone - I never post on these, but was thankful to find all of these posts.  I was feeling fine, but went ahead and had a Physical in Aug 2013.  My doctor said my blood results said my TSH was 4.970, indicating that my thyroid was low. So, he put me on Levothyroxin (levothyroxine) 50 MCG.  Almost immediately I was a trainwreck!  Couldn't sleep and then crash and sleep for over 12 hours, sweats hot and cold, anxious, heart racing, no patience at all and just plain mean!  The doctor wanted me to continue for 3 months, which I did with nothing getting better and feeling the worst I've ever felt in my life!  I had another blood test and the TSH was 1.620, however on Dec 23, I'd had enough and called the doctor and told them so.  They had me come in the day after Xmas and talk to doctor - he gave me the Tirosint 50 MCG to try.  More side effects!! Sleep got a little better, I've been taking it at 5 or 6 am and then try to sleep before work.  I'm having horrible headaches with it, am still more tired than I ever was, the inside of my ears itch - yep inside!! Driving me nuts! Plus, again the anxiousness, heart racing, bitchyness is a little better, but I still have melt downs and crash and energy level just plain ***** :-( I'm an avid tennis player and runner - that just  has no appeal to me these days.  Talked with the nurse about current symptoms and the only advice I got was to take them before bed and sleep through the symptoms - I don't think that is a very good answer!!  Any and all advice is welcome at this point - I'm so tired of messing with this in my life!

KeriBear
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I too am glad to have found this site...so that I am sure I am not losing my mind. I am 32 now and had my thyroid removed when I was 21 due to Graves Disease. For 10 years I have been constantly having to adjust my synthroid dosages because my TSH levels are constantly fluctuating. I can't lose weight and have almost every symptom there is. Two weeks ago, my endocrynologist switched me over to Tirosint to try. I went from 200mcg of Synthroid, which was a tad too high, to 150mcg of Tirosint. Since then, I feel like I'm going crazy again - similar to when I first found out I had hyperthyroidism. I can't sleep, my body is achy and I'm getting cramps, I'm irritable, crying for no reason, have clausterphobia issues, and my anxiety is off the chain. My doctor wants me back in 2 months for blood tests to see how it's doing, but I don't think I can make it that long. I feel like I'm going nuts. My heart has palpatations and I feel like I'm in a fog. I agree with the person above that said it's been so long since I've felt normal, that I no longer know what normal is.
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I'm not really sure what your endo is thinking in reference to the Tirosint or your enlarged thyroid. Tirosint and I did not get along. Even though my TSH was "normal," my symptoms finally drove me to ask for Nature-Throid, which seems to be working much better.

What actually got my attention was your statement ~ "they found "masses" that they believe are enlarged para-thyroids." If they suspect a parathyroid problem, then they should definitely be checking your calcium and PTH (parathyroid hormones). Enlarged and misbehaving parathyroids can cause a whole range of symptoms. The best information around (and my endo even recommended this site) is at parathyroid.com. I have been spending a lot of time there myself, because they suspect I have an enlarged parathyroid (seen on ultrasound and scan). At any rate, it's something that should be followed-up on.
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Hi, I found this thread while seeking information on Tirosint. I was switched to generic levothyroxine when Levoxyl was recalled last year and have not done well with the switch. For me, fillers/binders are a major issue and usually if I'm not doing well on a particular thyroid med or supplement...it's the inactive ingredients that are causing problems.

I've noticed that a lot of people are not responding well to Tirosint...even though it is supposed to be hypoallergenic. The thing is....gelatin is problematic for many people because it contains free glutamic acid (MSG) and sometimes sulfites. People who are sensitive can experience symptoms such as cramps, headache, chest pain, diarrhea, etc. I am betting that some of the people who respond with these symptoms while on Tirosint and then feel better almost immediately after stopping the med...are reacting to the gelatin. While it may have less ingredients than other thyroid meds...it is certainly not "hypoallergenic".  

Having said that....I'm going to give it a try...but I do not have high hopes after reading these posts and knowing how sensitive I am. I do know my reactions well enough to know if the ingredients do not agree with me...so at least I won't be suffering for long if it doesn't work out. Unfortunately, with the Levoxyl recall (and I doubt it will be coming back without having been reformulated) and after the reformulation of Armour back in 2009...it is becoming increasingly difficult to find a thyroid medication that will work for those who are sensitive to fillers/binders, such as myself. Fingers crossed that the Tirosint will at least be an improvement from the generic I'm currently on.
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While jello gelatin may have MSG and other ingredients, the gelatin in Tirosint does not.  I've talked to the manufacturer and am assured that the gelatin contains no other ingredients or preservatives.

There seem to be 2 main issues when people start Tirosint.  One is that many doctors try to start patients on too high a dose.  Because Tirosint is more thoroughly dissolved and much better absorbed by the body, many people need to start out at a lower dose than they had with the pill types of medication.  Once the body has become adjusted to the med, dosage can be increased as needed.

The other problem is not giving Tirosint a chance to work.  Whenever a T4 med/dosage is changed, it takes 4-6 weeks for it to reach full potential in the blood.  It's not the least unusual for symptoms to worsen or for new ones to appear, while the body is adjusting, but people immediately blame the med and stop taking it.

I've been on Tirosint since it came out in 2009 and while I did have a bit of issue right at the beginning, once I worked through that, I've done very well on it.

That said, Levoxyl is back on the market, with no reformulation.  Some of our members have been taking it, again, since the beginning of this month.
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I have been on Tirosint for a few years and have been doing much better. Switched from Synthroid and with Tirosint many of my allergy issues went away. You do need to start on a lower dose as Tirosint is much better absorbed, at least for us that had issues with fillers in other products.
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Hi, what I meant is that some people who are sensitive to MSG...can react to free glutamates that occur naturally as a result of processing. Many people have problems with gelatin used in gelcaps for this reason. It's not that MSG has been added to the gelatin, it's because it contains free glutamate naturally and people who are sensitive cannot handle it.

I understand that it takes time to adjust to a new thyroid med. However, in my experience...when I have been overmedicated, the hyperthyroid symptoms do not disappear within a day of stopping the meds. This is because of the long half-life of T4. So, it will take several days for the symptoms to resolve. If there is immediate relief upon stopping the med...it is probably because the symptoms were caused by an intolerance to one of the inactive ingredients. It is not uncommon for thyroid patients (especially autoimmune patients) to have sensitivities to the binders/fillers. This is why Tirosint may be wonderful for you...but a disaster for someone else. The same way Levoxyl worked great for me...but others have not had the same experience. We are all different.

I talked to my Endo about giving Tirosint a try...and she informed me that since Levoxyl is back on the market there is no reason to try a new brand. While I had no problems with Levoxyl...and felt good for all the years I've been on it...it is also possible that I may feel even BETTER on Tirosint. Or not. There's no way to know without trying it out...right? The Endo. is a fan of Levoxyl, since she takes it herself and does not want to have to pay a higher price for Synthroid. She feels as long as the demand for Levoxyl is high, we can keep it on the market....so she has her patients on Levoxyl rather than synthroid. She only has one patient on Tirosint and she was not eager to let me give it a try...to say the least. She did tell me that the patient seems to be doing ok on it.

My problem now is that my insurance no longer wants to cover the Levoxyl...only generic. I cannot be on the generic for much longer or I'm gonna lose my mind. I haven't felt this bad in years. At some point I may try Tirosint but right now I just wanna get back on track with Levoxyl. I first went over active shortly after being switched to generic...TSH was low and I thought I was about to have a heart attack and was having difficulty breathing, chest pain, etc. I stopped taking the pills for a week, then got back on at a lower dose. I get headaches and blurred vision when I take the pills...and feel better on days that I skip it. Now I'm losing a lot of hair and Im most likely under medicated since I hate taking these pills and am constantly skipping my dose. This recall has really been a nightmare for me.  I'll get back on Levoxyl even if I end up having to pay full price.
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From my discussion with the manufacturer of Tirosint, I will respectfully disagree with your comments about the contents.

Insurance will not cover Tirosint either, because it's not a preferred brand, and it's very expensive - more so than either Synthroid or Levoxyl.  I've been paying full price for it since I began taking it.  It doubled in price last fall, then just took another small hike a couple months ago.  If it continues to go up, I'll stop taking it, myself.

Sounds like your doctor has something of a conflict of interest, putting everyone on Levoxyl, just because she's on it.
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I understand why you believe what the manufacturers have told you....that there are no added ingredients...because that is the truth. But to say that someone can't have a problem with it is like saying that a person who is sensitive to sulfites (a widely used preservative) will not have any problem with naturally occurring sulfites in wine or other fermented products.

If a person is sensitive...they can still react, whether the ingredient was intentionally added...or it occurs naturally. That's all I'm saying...and it's a well known fact. But you are right that nothing has been added to the ingredients in Tirosint...they are what they are....and for some sensitive individuals, they will cause a problem. True symptoms of excess thyroid hormone do not resolve in a single day. Just as it takes time for the hormones to build up in the body....it also takes time to come down after being over medicated. As a Graves patient, I have plenty of experience with being hyper as well as being over medicated after RAI....and it would be wonderful if those symptoms could disappear that rapidly...but unfortunately that just isn't how it works.

I agree that there is a conflict of interest with this Endo. It was my first time seeing her and I will not be going back. I assumed from reading this thread that Tirosint would be more expensive. If I could tolerate the generic I would stay on it...but since I have problems with the inactive ingredients...and because I have not been well on it...I'm hoping the brand (whether it be Levoxyl or Tirosint) will be covered if the doctor approves it as a medical necessity...which it truly is. Actually, I would still be taking Armour if they had never messed with the inactive ingredients...I was on it for about 3 years and doing just fine. It's soooo frustrating to just have the rug pulled out from under you after you've been doing well for a long period of time. :(
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While some insurance companies allow exceptions for certain drugs, I've yet to hear of one issued for Tirosint.

If you check levothyroxine, there's one that people seem to have the least issue with.  If I remember correctly, it's the 50 mcg pill; it's white, so it has no dye, which seems to be an issue for some people.  You could try making your entire dosage from 50 mcg tablets or try a compounding lab who will use fillers that are compatible with your system.
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I would think that if a patient doesn't tolerate the other options...that Tirosint should be covered if the doctor is recommending it for the patient. The doctor would have to explain why it's necessary and give approval. I just called the pharmacy and they said that my prescription for Levoxyl went through yesterday. Insurance is now covering it and I can pick it up today. Yay! I'm so relieved!

I think if I had problems with Levoxyl and Tirosint was the only other option...it could probably be approved. But like I said, I've done well on Levoxyl in the past and the Endo has a thing for it...so it's highly unlikely that she's gonna go out of her way to get the Tirosint covered as long as I'm doing fine with levoxyl. So I guess I won't be trying it any time soon but I'm still curious how I would have done on it.

I have always taken the 50 mcg white pills because of the dyes. My dose is 150 mcg...so I take 3 pills. 150 mcg turned out to be too much when I was switched to generic and I went hyper for several weeks. This was my first experience with a generic and neither the doctor or the pharmacist informed me that it could be completely different than the brand..or that I would need to be tested to check my levels. It took me awhile to figure out that I'd gone hyper. I then alternated between 150 and 100 every other day. Still didn't feel good...and I'm now down to 100 on the days that I feel like taking it...which is maybe only a few times a week.

I'm gonna go back to 150 daily with levoxyl and hopefully I'll be back to normal soon. Fingers crossed! :)
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Avatar_m_tn
My feeling is that a lot of the time when people never seem to feel right on their dose...regardless of their labs or how much they tweak the dose...it is the inactive ingredients that are preventing them from feeling 100%.

It took me a long time to figure this out for myself. Even while I was on armour I felt that I was doing good (in comparison to how I'd been feeling on other brands)....but when they changed Armour and I was forced to look for something else...I found that I felt even better on levoxyl. These problems I've been having on generic levothyroxine is the same way that I used to feel ALL the time on other brands. Headaches, increased sensitivities, blurred vision, etc. It stops when I stop taking the pills. I have the same problems with supplements and I usually have to look online for brands with no fillers/binders. It's a challenge...but it's worth it to feel as good as you can possibly feel.
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Unfortunately, when dealing with insurance companies, what we think should happen, often doesn't.  I used to be on Aciphex for GERD and even with letters from my doctor, my insurance refused to cover it, once the generic omeprazole came out.

Hope the Levoxyl works out for you.  If I have to change from Tirosint, due to the cost, I'll probably ask for Levoxyl, as I didn't do well at all on Synthroid.  Did better on generic levo, but the best with Tirosint.  Because I've done so well with Tirosint, I haven't seen a need to try anything else, but now that the price is going so high, I'm having second thoughts.
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Avatar_m_tn
Synthroid gave me the worst reactions of all the thyroid meds I've tried. When Levoxyl was recalled the pharmacy said that if I didn't want generic I could take Synthroid...and pay out of pocket over $200! Crazy! That was for a 3 month supply I believe...and 3x the normal price because I take 3 pills daily.
No thanks! I wouldn't even pay $10 for synthroid. Ridiculous.

Sorry that they keep raising the price of Tirosint on you.  I hope if you end up switching to Levoxyl you will do just as well on it. Good luck! I just picked up my pills...so hopefully I'll be back to myself before Summer and no more hair loss! What a roller coaster this has been!
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