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Update on starting Tirosint! Barb are you in too??
Hi ALL! I am starting my 6th week of Tirosint. I have to say that I feel great and no longer have that foggy feeling I use to get about 2 hrs after taking my synthroid. I will be going in at the end of this week for labs to see how they look. I feel pretty darn good! I am working ....going to college full time....raising my daughter....etc....etc!
All I can say is how THANKFUL I am to feel good again!!
I am on 125 mcg Tirosint and 20 mcg Cytomel.
Barb- How are you doing on this med??
All I can say is how THANKFUL I am to feel good again!!
I am on 125 mcg Tirosint and 20 mcg Cytomel.
Barb- How are you doing on this med??
I had my thyroid removed on 2/16 and things are going smoothly so far. I am just tired. It will take some time to get the meds right. I am also switching to a new endocrinologist because my current one just doesn't seem interested in hearing my thoughts on my own body. My ENT doctor is awesome and is the doctor that removed my thyroid. I received the pathology report back on Wednesday and my nodules were benign but growing. It also once again was confirmed I had Hashimotos. The report stated "Significant Lymphocytic Thyroiditis". I started on 112MCG of Tirosint the day after surgery and I will get check in about 4 weeks.
From one hypothyroid male to another, yes we are outnumbered by somewhere between 5-8 to one.
You seem lucky to have found your Endo on the first try, since he is looking at both symptoms and numbers; however, his focus on getting your TSH to1 worries me. There are scientific studies that show that TSH is usually suppressed when taking adequate thyroid meds. I can supply links if you want. Treatment for hypothyroidism should be based on symptoms first and test results for Free T4 and Free T3 second.
Looking at your test results, with that med/dosage, your Free T4 is fine, but you were tested for Total T3, not Free T3. You should make sure they always test for both Free T4 and Free T3. If your Free T3 is comparable to your Total T3, relative to position in range, then your Free T3 would be too low and likely to cause hypo symptoms. Also, since your Free T4 is at 50% of its range, but your Total T3 is only at about 10% of its range, which indicates that you may not be adequately converting the T4 med to T3, and may need to add some T3 to your meds. You can tell more when tested for Free T3. You will also know more about your doctor when you ask about clinical treatment, as described, and willingness to prescribe T3 meds.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve hypo symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results, and especially not TSH when already taking thyroid med.
Also, hypo patients are frequently too low in the range for Vitamin D, B12 and ferritin. Low levels can cause symptoms that mimic hypothyroidism. Low D or ferritin can also adversely affect metabolism of thyroid hormone. D should be about 55-60, B12 in the upper end of its range and ferritin about 70 minimum. If not tested for those you should do so and supplement as needed to optimize.
You seem lucky to have found your Endo on the first try, since he is looking at both symptoms and numbers; however, his focus on getting your TSH to1 worries me. There are scientific studies that show that TSH is usually suppressed when taking adequate thyroid meds. I can supply links if you want. Treatment for hypothyroidism should be based on symptoms first and test results for Free T4 and Free T3 second.
Looking at your test results, with that med/dosage, your Free T4 is fine, but you were tested for Total T3, not Free T3. You should make sure they always test for both Free T4 and Free T3. If your Free T3 is comparable to your Total T3, relative to position in range, then your Free T3 would be too low and likely to cause hypo symptoms. Also, since your Free T4 is at 50% of its range, but your Total T3 is only at about 10% of its range, which indicates that you may not be adequately converting the T4 med to T3, and may need to add some T3 to your meds. You can tell more when tested for Free T3. You will also know more about your doctor when you ask about clinical treatment, as described, and willingness to prescribe T3 meds.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve hypo symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results, and especially not TSH when already taking thyroid med.
Also, hypo patients are frequently too low in the range for Vitamin D, B12 and ferritin. Low levels can cause symptoms that mimic hypothyroidism. Low D or ferritin can also adversely affect metabolism of thyroid hormone. D should be about 55-60, B12 in the upper end of its range and ferritin about 70 minimum. If not tested for those you should do so and supplement as needed to optimize.
1 Comments
Thanks for your reply. I will bring up free T3 with my endo doc before my next blood draw which is in six weeks. I take a D3 and B12 supplement daily. I just want to feel normal again. I am sluggish all the time.
As I guessed previously my dosage was pushed up to 100MCG. Hopefully this gets me where I need to be.
Hello. I started on Tirosint about 13 weeks ago. Prior to that I was on Levothyroxine 88MCG. I first started on 75 MCG and after 6 weeks my endo checked my blood work. Here are my numbers from 10/16.
Free T4 1.3 (Range .8 - 1.8)
Total T3 86 (Range 76 - 181)
TSH 4.77 (Range .4 - 4.50)
My endo is looking at both symptoms and numbers. My TSH was high enough for him to ask if I was even taken Tirosint. He then upped me to 88MCG and last week he checked the TSH level and it is now at 3.19. He wants it 1.0. I see him tomorrow and I am guessing he is going to up my dosage to 100MCG. I am hoping it helps because I am always feeling tired and warn out so much so that I have been also been diagnosed with moderate depression and prescribed an AD for it. I do have Hasimoto's and some nodules which they are monitoring closely. They check the nodules every three months. It appears I am a rarity on the boards because I am male but this stuff runs on my mom's side of the family. She had her thyroid removed when she was a teenager. I am also going to ask him why he switched me to Tirosint. I didn't ask initially, I just accepted that he knew what was best for me. This is the first endocrinologist I have seen and he was highly recommended to me by my ENT doctor.
Free T4 1.3 (Range .8 - 1.8)
Total T3 86 (Range 76 - 181)
TSH 4.77 (Range .4 - 4.50)
My endo is looking at both symptoms and numbers. My TSH was high enough for him to ask if I was even taken Tirosint. He then upped me to 88MCG and last week he checked the TSH level and it is now at 3.19. He wants it 1.0. I see him tomorrow and I am guessing he is going to up my dosage to 100MCG. I am hoping it helps because I am always feeling tired and warn out so much so that I have been also been diagnosed with moderate depression and prescribed an AD for it. I do have Hasimoto's and some nodules which they are monitoring closely. They check the nodules every three months. It appears I am a rarity on the boards because I am male but this stuff runs on my mom's side of the family. She had her thyroid removed when she was a teenager. I am also going to ask him why he switched me to Tirosint. I didn't ask initially, I just accepted that he knew what was best for me. This is the first endocrinologist I have seen and he was highly recommended to me by my ENT doctor.
Yes, she is putting me on the same 100 mcg dose for Tirosint. She did not feel that I would benefit from lowering the WP dosage and still end up with FT4 numbers that would still be low.
We're doing a trial run with Tirosint and Cytomel and checking levels again in 6 weeks. She did mention that if I'm still having issues with the synthetics then we can try compounded medication in which she's had experience with. I am happy that I found a doctor who is open to different options which was a struggle for the last 5 years.
We're doing a trial run with Tirosint and Cytomel and checking levels again in 6 weeks. She did mention that if I'm still having issues with the synthetics then we can try compounded medication in which she's had experience with. I am happy that I found a doctor who is open to different options which was a struggle for the last 5 years.
COMMUNITY LEADER
I agree with your doctor that your FT3 was too high and FT4 was too low... it would have been very simple to lower your WP dosage and add a bit of T4 vs starting all over, but you're into this regimen now, so I do hope it works for you.
The advantage of taking synthetics is that you can adjust them individually, whereas with desiccated hormones, you can't.
You said you'd been on 100 mcg levothyroxine... is that the same dose of tirosint she put you on?
The advantage of taking synthetics is that you can adjust them individually, whereas with desiccated hormones, you can't.
You said you'd been on 100 mcg levothyroxine... is that the same dose of tirosint she put you on?
My apologies. I had my labs drawn at Quest and their reference ranges are as follows:
T4 Free: 0.8-1.8 (ng/dL)
T3 Free: 2.3-4.2 (pg/mL)
TSH: 0.40-4.5 mIU/L
Yes, you are correct,the labs were posted while I was still on WP. I discontinued WP and switched over to the synthetics on 11/14. I am hoping in combo with the Cytomel that I can find a balance because dealing with the symptoms is affecting me in all areas of my life. I have a 5 year old son to chase after, so I'd love to be more of an active participant in activities with him than being an observer. That's how tired I've been for awhile now, especially before my Hashimoto's diagnosis in August 2013 :(
T4 Free: 0.8-1.8 (ng/dL)
T3 Free: 2.3-4.2 (pg/mL)
TSH: 0.40-4.5 mIU/L
Yes, you are correct,the labs were posted while I was still on WP. I discontinued WP and switched over to the synthetics on 11/14. I am hoping in combo with the Cytomel that I can find a balance because dealing with the symptoms is affecting me in all areas of my life. I have a 5 year old son to chase after, so I'd love to be more of an active participant in activities with him than being an observer. That's how tired I've been for awhile now, especially before my Hashimoto's diagnosis in August 2013 :(
COMMUNITY LEADER
What are the reference ranges for your FT4 and FT3? Reference ranges vary from lab to lab and have to come from your own reports.
These labs posted are when you were taking the WP?
We've had some members that have reactions to fillers/dyes in the meds, but that's really quite rare.
Most people tolerate Tirosint quite well, because there's really nothing in it to be allergic to - that's why it's considered hypoallergenic. The biggest problem with Tirosint is that Tirosint is better absorbed than other T4 typr meds, and doctors often try to start patients on too high a dose. Another problem is that many patients don't stick with it long enough for it to work.
I was on it from the time it came on the market in 2009 until August of 2014 and I did great on it. I hope you do, also...
These labs posted are when you were taking the WP?
We've had some members that have reactions to fillers/dyes in the meds, but that's really quite rare.
Most people tolerate Tirosint quite well, because there's really nothing in it to be allergic to - that's why it's considered hypoallergenic. The biggest problem with Tirosint is that Tirosint is better absorbed than other T4 typr meds, and doctors often try to start patients on too high a dose. Another problem is that many patients don't stick with it long enough for it to work.
I was on it from the time it came on the market in 2009 until August of 2014 and I did great on it. I hope you do, also...
I was off generic levothyroxine for nearly two months and switched to WP THYROID 65 MG. I felt better than I had in years and then some symptoms returned. I no longer had body aches and pains, eye problems, fatigue issue, insomnia and actually dropped a few pounds. And then my labs came back, so my doctor took me off of WP and put me on Cytomel 5mg and Levothyroxine 100 mcg. Within a day, the brain fog returned, fatigue, eye problems and body pain were present again.
My brand of generic Levothyroxine is made by Lannett, so I checked the inactive ingredients. I have Hashimoto's, so two ingredients caught my attention: corn starch and a form of potato starch. I am highly intolerant to corn in particular and learned that corn, rice and sesame is cross reactive which causes the body to trigger an immune response as if one consumed gluten.
I called my doctor and waited a day for a call back. I explained to her I suspect that the corn and potato starches (potato being in the nightshade family) is triggering an immune response and that I must get off this stuff pronto. She said I could try compounding my medication but was open to my suggestion of trying Tirosint before going that route.
I loved WP Thyroid and felt good, not perfect, but bearable, however my doctor was not happy with how my numbers changed so dramatically. She said I was getting too much T3 and my T4 was way too low. She did not want to lower the dosage on WP, so here I am. Below are my latest lab results from my WP Thyroid trial (6 week period) reported on 10/31/15:
TSH 2.79 (was 3.36 on 9/5/15)
T4 Free: 0.09 (was 1.3 on 9/5/15)
T3 Free: 4.5 (was 2.7 on 9/5/15)
B12: 1419 (was 332 on 9/5/15) - now I take my B12 every other day to lower this number
I hope that I tolerate Tirosint. I adjust to medication very quickly and rarely have side affects. I just wish as a Hashimoto's patient that I knew that the levothyroxine that I was on for the last 5 years was doing more harm that good due to the fillers by contributing to my symptoms and exacerbating my disease state. I would have had better results prior to finding my current provider had I known,
Did not make the connection until trying both synthetic and natural desiccated medications. I am curious to know if other Hashimoto's sufferers have made a connection with medication fillers aggravating their symptoms.
My brand of generic Levothyroxine is made by Lannett, so I checked the inactive ingredients. I have Hashimoto's, so two ingredients caught my attention: corn starch and a form of potato starch. I am highly intolerant to corn in particular and learned that corn, rice and sesame is cross reactive which causes the body to trigger an immune response as if one consumed gluten.
I called my doctor and waited a day for a call back. I explained to her I suspect that the corn and potato starches (potato being in the nightshade family) is triggering an immune response and that I must get off this stuff pronto. She said I could try compounding my medication but was open to my suggestion of trying Tirosint before going that route.
I loved WP Thyroid and felt good, not perfect, but bearable, however my doctor was not happy with how my numbers changed so dramatically. She said I was getting too much T3 and my T4 was way too low. She did not want to lower the dosage on WP, so here I am. Below are my latest lab results from my WP Thyroid trial (6 week period) reported on 10/31/15:
TSH 2.79 (was 3.36 on 9/5/15)
T4 Free: 0.09 (was 1.3 on 9/5/15)
T3 Free: 4.5 (was 2.7 on 9/5/15)
B12: 1419 (was 332 on 9/5/15) - now I take my B12 every other day to lower this number
I hope that I tolerate Tirosint. I adjust to medication very quickly and rarely have side affects. I just wish as a Hashimoto's patient that I knew that the levothyroxine that I was on for the last 5 years was doing more harm that good due to the fillers by contributing to my symptoms and exacerbating my disease state. I would have had better results prior to finding my current provider had I known,
Did not make the connection until trying both synthetic and natural desiccated medications. I am curious to know if other Hashimoto's sufferers have made a connection with medication fillers aggravating their symptoms.
COMMUNITY LEADER
Yes, the tread is still active as long as someone posts on it.
You went off thyroid med, after you had a thyroidectomy?
It's not unusual for symptoms to worsen when starting a new med or when adjusting dosages.
Were those T3 and T4 tests, Free T3 and Free T4 or were they Total T3 and Total T4? They aren't the same tests... Can you please post the results, with reference ranges so we can better assess your situation?
You went off thyroid med, after you had a thyroidectomy?
It's not unusual for symptoms to worsen when starting a new med or when adjusting dosages.
Were those T3 and T4 tests, Free T3 and Free T4 or were they Total T3 and Total T4? They aren't the same tests... Can you please post the results, with reference ranges so we can better assess your situation?
Hi, is this thread still active? I just started Tirosint a week ago and was on Levothyroxine(137mcg). I started having carpal tunnel, tarsal tunnel, joint pain, and muscle aches 4 months ago(the muscle pain a year ago.) Had thyroidectomy 20 years ago and did well on Levoxyl. I did go off all medicine for a year a couple years ago(financial problems.) My symptoms are worse on Tirosint and my doctor didn't do a complete thyroid blood work, just TSH, T3, T4. What blood work do I need and should I demand to try a T3 medication?
COMMUNITY LEADER
You're welcome. Will look forward to seeing your labs; you might like to start a new thread with them, in order to separate from this old thread. Be sure to post reference ranges, as well, since ranges vary lab to lab and have to come from your own report.
COMMUNITY LEADER
Be sure to post your labs when you get them, so we can see where you're at.
I get my labs done in couple days. Will get: TSH, Free T4 & Free T3 (and misc other). I had total thyroidectomy, so I do not want to any lower dose than have to. Maybe 112 mcg Tirosint. Eek! I hope this goes well!
COMMUNITY LEADER
Anxiety is often a symptom of hypo. I had it horribly bad when I was hypo.
What do you mean "Synthroid poisoning"? Were you over medicated?
Of course, I'm not a doctor so I can only make suggestions for you to discuss with your doctor.
The first thing I recommend is getting tested for TSH, Free T3 and Free T4; that will give an idea of what your actual hormone levels are.
Many people find that they have to start Tirosint at a lower dose than they were on, with another medication, because it's dissolved and absorbed better than pill type meds. Since you've been alternating 125 mcg and 137 mcg, and are sensitive to med, you might discuss with your doctor about starting at 100, or maybe even 75 of Tirosint, test TSH, FT3 and FT4, after 5-6 weeks, then adjust based on those results and your symptoms, if any.
If you've had TSH, Free T3 and Free T4 tested recently, please post your results and we might be able to comment further. Be sure to include reference ranges with your results, since ranges vary lab to lab and have to come from your own report.
What do you mean "Synthroid poisoning"? Were you over medicated?
Of course, I'm not a doctor so I can only make suggestions for you to discuss with your doctor.
The first thing I recommend is getting tested for TSH, Free T3 and Free T4; that will give an idea of what your actual hormone levels are.
Many people find that they have to start Tirosint at a lower dose than they were on, with another medication, because it's dissolved and absorbed better than pill type meds. Since you've been alternating 125 mcg and 137 mcg, and are sensitive to med, you might discuss with your doctor about starting at 100, or maybe even 75 of Tirosint, test TSH, FT3 and FT4, after 5-6 weeks, then adjust based on those results and your symptoms, if any.
If you've had TSH, Free T3 and Free T4 tested recently, please post your results and we might be able to comment further. Be sure to include reference ranges with your results, since ranges vary lab to lab and have to come from your own report.
The posts here have been helpful. I will be changing to a new thyroid replacement, due to Levoxyl recall; soon, as I am almost out of pills.
I am sensitive to meds in general. I have never taken a T3 drug. Endo was concerned about my anxiety symptoms. My symptoms have been up and down over the years. Now, compounded by perimenopause (getting closer to menopause). Had long bout of Synthroid poisoning (felt near death for months), several years ago. So...I prefer to avoid escalated anxiety symptoms.
I am thinking of going to TIROSINT. I have alternated with Levoxyl doses of .137 and .125. I am anticipating having to suggest a dose to my doctor (local, not Endo), but not sure which one to start on. Otherwise, I may have to go on a generic. Not sure yet.
Appreciate suggestions.
debGardenia7
I am sensitive to meds in general. I have never taken a T3 drug. Endo was concerned about my anxiety symptoms. My symptoms have been up and down over the years. Now, compounded by perimenopause (getting closer to menopause). Had long bout of Synthroid poisoning (felt near death for months), several years ago. So...I prefer to avoid escalated anxiety symptoms.
I am thinking of going to TIROSINT. I have alternated with Levoxyl doses of .137 and .125. I am anticipating having to suggest a dose to my doctor (local, not Endo), but not sure which one to start on. Otherwise, I may have to go on a generic. Not sure yet.
Appreciate suggestions.
debGardenia7
Yes I do have hasimotos, despite my levels I have hypo symptoms currently. But I sometimes have hyper also. I really hope this medication will help. Yes I've had 2 ultrasounds no nodules are present. The results I initially posted we're from my memory... Upon coming home and looking at the levels clearly I was way off.. Sorry about that.
COMMUNITY LEADER
It looks like you might have been in a hyper phase last month, with your FT levels very high. You may be cycling between hyper and hypo, which sometimes happens with early stages of Hashimoto's.
When were these tests taken?
"My TSH is 0.018 - Normal is 0.400 - 4.000
My T3 was normal
My T4 was 1.84 - Normal is .89-1.76"
These are the ones you posted originally, but don't match either of those in your last post.
Have you had an ultra sound to determine if you have nodules that may be leaking hormones, independently of the thyroid? If not, you should.
PCOS is Polycystic Ovarian Syndrome......... it can cause irregular/lack of periods, weight gain and other thyroid like symptoms.
When were these tests taken?
"My TSH is 0.018 - Normal is 0.400 - 4.000
My T3 was normal
My T4 was 1.84 - Normal is .89-1.76"
These are the ones you posted originally, but don't match either of those in your last post.
Have you had an ultra sound to determine if you have nodules that may be leaking hormones, independently of the thyroid? If not, you should.
PCOS is Polycystic Ovarian Syndrome......... it can cause irregular/lack of periods, weight gain and other thyroid like symptoms.
I just turned 25. I haven't had a period sine 5/17. I first discovered this disease due to a stopping of my menstral cycle.i was told that I had trouble converting my t4 to t3, I now have my labs in front of me and I have them from last month also...
This month
Free t3 4.08 normal is 1.80-4.70 last mth it was 7.78
Free t4 .75 normal is 0.89-1.76 last mth it was 1.63
Tsh 0.182 normal is 0.400-4.000 last mth it was 0.005
I've never been told I had pcos.
This month
Free t3 4.08 normal is 1.80-4.70 last mth it was 7.78
Free t4 .75 normal is 0.89-1.76 last mth it was 1.63
Tsh 0.182 normal is 0.400-4.000 last mth it was 0.005
I've never been told I had pcos.
COMMUNITY LEADER
With your TSH at 0.018 and T4 (was that Free T4?) at 1.84, which is above the range, I doubt your doctor will give you an increase in med; in fact, s/he will probably want to decrease it.
Please post the "normal" T3 result, reference range and specify whether it was Free or Total. Free T3 and Total T3 are not the same tests and don't give us the same information. I have to wonder if you are having an issue converting the T4 to T3.
There are 2 types of carbs - simple, such as those found in sugar, pastries, white bread, white rice, potatoes, etc. and complex, which are those found in veggies, fruits, whole grains (your oatmeal and whole grain bread would fall in this category). The complex veggies are the "good" ones........ their fiber doesn't allow them to be broken down quickly, so they don't spike the blood sugar.
Now that we've established your gender, would you mind telling me if you are at an age where you might be close to peri-menopause or menopause, or whether you are younger and might have PCOS?
Please post the "normal" T3 result, reference range and specify whether it was Free or Total. Free T3 and Total T3 are not the same tests and don't give us the same information. I have to wonder if you are having an issue converting the T4 to T3.
There are 2 types of carbs - simple, such as those found in sugar, pastries, white bread, white rice, potatoes, etc. and complex, which are those found in veggies, fruits, whole grains (your oatmeal and whole grain bread would fall in this category). The complex veggies are the "good" ones........ their fiber doesn't allow them to be broken down quickly, so they don't spike the blood sugar.
Now that we've established your gender, would you mind telling me if you are at an age where you might be close to peri-menopause or menopause, or whether you are younger and might have PCOS?
My TSH is 0.018 - Normal is 0.400 - 4.000
My T3 was normal
My T4 was 1.84 - Normal is .89-1.76
Opps, I just changed that. No I am a female .. 25. other than low sugar oatmeal for breakfast and a piece of whole wheat bread for lunch I don't eat any other carbs. When I overload with carbs or sweets I feel like i'm in a trance and its horrible so I try my best to stay away.
I just called my dr and asked if I can up my triosint to 100mcg from the 88.
My T3 was normal
My T4 was 1.84 - Normal is .89-1.76
Opps, I just changed that. No I am a female .. 25. other than low sugar oatmeal for breakfast and a piece of whole wheat bread for lunch I don't eat any other carbs. When I overload with carbs or sweets I feel like i'm in a trance and its horrible so I try my best to stay away.
I just called my dr and asked if I can up my triosint to 100mcg from the 88.
COMMUNITY LEADER
Do you have current labs that you could post, so we can see what your actual thyroid hormone levels are? Be sure to include reference ranges, since those vary lab to lab and have to be posted with results.
Typically, the weight gain is caused from being hypo, not by the medication. You might also look into insulin resistance, which is quite prevalent. Insulin is the hormone that determines how your body handles sugar/simple carbs. Insulin is often called the "fat storage" hormone, because if the cells won't let the sugar in, for energy, insulin shuffles them off to the fat cells. Try eating a low glycemic diet, which is one that contains very little sugar and simple carbs, and lots of protein, vegetables, good fats, etc - things that won't spike the blood sugar. Even if you don't have insulin resistance, the low glycemic is a good diet to be on.
Your profile says you're male; is that correct?
Typically, the weight gain is caused from being hypo, not by the medication. You might also look into insulin resistance, which is quite prevalent. Insulin is the hormone that determines how your body handles sugar/simple carbs. Insulin is often called the "fat storage" hormone, because if the cells won't let the sugar in, for energy, insulin shuffles them off to the fat cells. Try eating a low glycemic diet, which is one that contains very little sugar and simple carbs, and lots of protein, vegetables, good fats, etc - things that won't spike the blood sugar. Even if you don't have insulin resistance, the low glycemic is a good diet to be on.
Your profile says you're male; is that correct?
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