Low TSH, low FT3 & FT4

[Emmy4337]

43 years old. Hashi diagnosed in 2/2007, partial TT 4/2006 (negative for suspected cancer) on Armour 75 mg to 120 mg increasing does from 4/06 to 8/09.  Changed to Nature-Throid 8/09 130mg in morning.  Numbers fluxuate greatly and I feel like crap.  Any suggestions?  Endo just changed me to synthroid 137mg on 12/14. She is willing (she says) to add T3 is need be. Says can't regulate on T3/T4 mix and low TSH means will get a-fib and osteo.  Labs to be run 1/18/10 to check TSH, FT3 & FT4.  Very scared I'm going to go truely hypo.  Bone scan great 2 years ago. High cholesterol ranging from 222-305 since 8/2001. Sometimes the dr. or lab didn't run the FT 4 as requested.  Any suggestions?  Family is against dessicated and to get them off my back I agreed to try synthroid.
TSH FT4 FT3
0.29 1.14 457
2/3 of my thyroid removed
0.48 295
1.6 260
1.04 0.8 236
0.21 0.82 224
<.04 313
25.23 190
0.13 0.94 356
0.08 317
0.88 289
0.11 0.86 330
0.11 0.76 201

[Emmy4337]

Here are my last 3 labs.  My joint pain was pretty much gone after a couple of months on 4 grains of Nature Throid  so I backed it down a grain to see if it would get rid of the hand tremors.  Latest labs don't look as good as at 4 grains and the pain is coming back a little bit.  I have 7 more days of the old NT and then will be starting the reformulated version at 4 grains.  Wish me luck.  Any suggestions?  I see that my magnesium is a little low as well as my D3.  I'll start supplementing them tonight. My glucose went up as my NT went down as well which worries me.  Lots and lots of diabetics in my family and I'm trying to avoid being another one.

1/18/10 LABS (ON SYNTHROID 137 FOR 1 MONTH)
TSH - .02 range = .34-5.60
FT3 - 3.46 range = 2.39-6.79
FT4 - 1.48 range = .58-1.64
VITAMIN D3 - 93.8 range = 30-80
GLUCOSE - 87

4/18/10 LABS (NATURE THROID 4 Grains )
TSH - .02 range =.34-5.60
FT3 - 4.43 range = 2.39-6.79
FT4 - .84 range = .58-1.64
VITAMIN D3 - 93.8 range =30-80
GLUCOSE - 87

6/11/10 LABS (NATURE THROID 2 Grains or 4 Grains I alternate every other day as I was have more hand tremors in 4 grains)
TSH - .03  range =.34-5.60
FT3 - 3.31  range = 2.39-6.79
FT4 - .83    range =.58-1.64
VITAMIN D3 - 45.6 range = 30-80
GLUCOSE - 99
MAGNESIUM - 1.9  range =1.8 - 2.5
SELENIUM - 117 range = 23 - 190

[goolarra]

Yes, the T4 in both is the same, except that one is synthetic and one is an animal product.  Well, you may have my head spinning a bit at this time of day!  You have to keep in mind that T3 is about four times more potent than T4.  So, 25 mcg of T3 is roughly equivalent to 100 mcg of T4.  This complicates the equation.  Also, synthetics are measured in micrograms, NT in milligrams or grains.  The conversion of Synthroid to an equal dose of NT is not that straight line.

I don't have a chart for NT (you might find a conversion chart on their website).  However, with Armour, 150 mcg Synthroid was equal to 90 mg Armour, making 137 Synthroid about equal to 82.2 Armour.  As I said, I believe NT is somewhat different.

But, if you find the correct conversion dose for NT, you should not have to "keep upping the NT as the Syn T4 goes away".  One drug replaces the other, so as one goes away the other is there to fill its place.  Which does not mean than some adjustments may still be necessary...

I'm afraid I'm not totally following your equation...perhaps because I don't know what the NT equivalents are?  Well, that's the charitable explanation anyway!!!  Can I plead brain fog???

[Emmy4337]

Mother Hens are very helpful!  I'm very irritated at myself that I let myself be talked into trying Synthroid (although now I can say I KNOW it isn't for me).  I wish I had done more research about switching to NT and saw that more is usually needed and just upped my dose instead of all this switching and the hypo pain I had/have.  I can tell I wouldn't be a good chronic pain patient!  Wouldn't the T4 in Synthroid and the T4 in NT be the same though?  If I have Syn T4 and know that I need more wouldn't I calculate what I need to have in my system totally by taking the reducing amount of Syn T4 plus the NT. ( i.e 68.5 of Syn T4 + 114 NT T4 + 27 NT T3)?  [38 mg T4 & 9mg T3 in each 65 mg NT pill] and then keep upping the NT as the Syn T4 goes away?  That looks like an algebra equation!  My brain fog must be getting at least a little better though!  Thanks for your comments and suggestions though.  I love this forum and am learning alot.

[goolarra]

I haven't followed too much of the goings-on about Nature Throid.  But, (and you could verify this by posting another thread) I believe I've heard that people are ending up taking more of it than they would have had to take of the old Armour to achieve the same effect.  Just take it slowly.  It's better to wait an extra week or increase by half the amount now and the other half a little later than to end up hyper and having your levels jumping all over the place because you have to back off again.  Don't forget that it's going to take a while for your levels to stabilize after the meds switch.  I don't mean to be a mother hen, just think your hypo symptoms will go away sooner in the long run with a more patient approach.

[Emmy4337]

I've been back on Nature Throid since 2/13 since the cytomel wasn't helping very much.  Joint pain is gone until very late in the day.  I'm taking 130 mcg at 6:30am and 60 at 1pm.  I'm about to up the 2nd dose to 130 also.  I know 3 grains is alot but I'm not having any hyper symptoms & I want the last of the hypo symptom to go away.  I still have some T4 in my system as it has only been 2 weeks since I stopped the synthroid.  Could I have an absorbtion issue and that is why it is taking so much medicine to make me feel better?  Everyone talks about upping meds by a 1/4 grain.

[Emmy4337]

Hyper is what I thought that you meant.  I did split yesterday (the first day) as I remembered all the posts suggesting that.  Today was all one dose.  I had a decent morning (not hyper) but the afternoon has been better than before taking T3 but not as good as the morning.  No headache today though.