Thyroid Disorders Community
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Avatar universal

Switched from Synthroid to Nature Throid and new test results questions

I am a 35 year old woman diagnosed 8 years ago with hypothyroidism following birth of my second child.  Over the years I have been on Levothyroxine and more recently Synthroid.  In October of '09 I had what appeared to be Hashitoxicosis and my tsh was at .22 at that time. I'm not sure what the free t4 and free t3 was.  In January of 2010 I was finally tested for TPO antibodies and I was at 600 well above the normal range so it was therefore determined that I had Hashimotos.  I was told to lower my dose of synthroid to 80mcg from 100/112 mcgs alternating. I was feeling very hyper at the time of the switch: anxiety, weight loss, hungry all the time, hot, insomnia, crazy mood swings, no menstrual, hair loss, etc.  After this diagnosis, I decided to look into natural dessicated thyroid hormone and found a NP who prescribed Nature Throid.  My last TSH before seeing her was at 6.2 so I had cycled down to hypothyroid.  Again, I lost the free t4 and free t3 results.  After being on Nature Throid 1 grain for a month my labs are as follows:
TSH: .22 range -  .34 - 3.0
Free t4: .7 range - .58 - 1.64
Free t3: 3.13 range - 2.5 - 3.9
Tpo = 264 (down from 600)
My concern is this: My tsh is really low and from what I have researched about dessicated thyroid, it is common for people to feel better only when the TSH is repressed as long as the Free T3 and Free T4 are high normal range.  My Free T4 is in the low normal range while my Free T3 looks really good.  Should I be concerned about the Free T4 at this point? Is this a commonality when switching from Synthetic T4 only to Natural T4/T3 combination and will this number go up on the current dose or should I be asking to increase my dosage? I currently have some lingering hypothyroid symptoms of acne, hair loss, and minor depression. I would love to hear from somebody else who has made the switch from Synthroid to natural and if their t4 labs came up eventually.  Thanks for the help!!!
33 Responses
988694 tn?1332363079
I have been on NT for some months now and I am having difficulties finding the right dose.

The problems that I have had, and some other members have experienced something similar, is that FT3 usually goes up fast and FT4 remains in the middle range or even lower. Actually I have not seen tests where the FT4 gets in the upper range  as the FT3 does.

My doctor does not care about the TSH. He concentrates in the other two.
I think you probably can increase a little bit more, so you can bring thet FT4 a little bit up. It is too low. No wonder you are still with symptoms.

You have to watch your FT3 though. Some doctors prescribe some T4 only medicine along with NT so the FT4 gets higher.

My doctor says he is happy just by seeing my FT4 above 1.

If you decide to add some FT4 medicine only your doctor might have to adjust your NT dose.
499534 tn?1328707778
Yes some people require the addition of a small dosage of T4 med along with the NT. NT and Armour have a higher ratio of T3 in them.
Anyone on a combination med will have a very suppressed TSH which will make them look hyper......you have to go by the Free's only when on a combo med.  Most people feel optimal with a free t4 in the mid normal range and free t3 in the mid to high normal range.  :)
734073 tn?1278899925
Are you on the original Nature-Throid or the new reformulated Nature-Throid? If it is scored down the middle (line for dividing) then it is the new formula. The t4 and t3 seem to be further apart in the ranges on the new formula for many, as was the case for people who were on the New Armour compaired to the original Armour.The binders and fillers in both of these brands of desiccated meds have been changed in similar ways it seems. (More cellulose and less dexstrose is what we are told-more GI friendly is the story, however, I believe as many do, that this is not the whole truth or the real reason behind the tampering with our medications ( the FDA has a reason and it is NOT about the few who may be lactose intolerant-give me a break!!!)). The original Nature-Throid keeps the freet3 and freet4 closer in the mid to upper range. The old Armour was also good at this, however when we got into the new formula of the Armour at refill, the t4 dropped to the bottom of the range where yours is now. The t3 was also some lower after the reformulation. The new Nature-Throid seems to be effecting the t4 in a similar way, however the t3 remains somewhat too high! Lazy Moose called it t3 from Super Pigs! We have not had to try it yet as I have enough of the original formula to make it awhile, however, I am on lookout to see how others are doing, and you seem to fit the profile of people who are seeing such drastic differences in their labs t3 and t4 levels on the newly reformulated Nature-Throid. The t4 and t3 should be closer in range and atleast mid range or higher. If you up your Nature-Throid then the t4 will come up, however your t3 will be even higher, making it even more out of range and that's not good either. I'd stay where you are for several months testing blood at 4 week intervals and if the difference in the two ranges does not get better, then adding in some t4 I'd think might be called for with a small decrease on the new Nature-Throid. Just my opinion! Please keep me posted on your progress as we will be crossing this same bridge sooner then later!  
Avatar universal
Thanks everyone for your responses! I have a really great nurse practitioner who is really knowledgable about these items and I will be seeing her in a week to go over the lab results and my lingering symptoms.  I will mention the possibility of adding a T4 only med and tweaking both natural and synthetic doses so that it is more optimal for me.  I've never seen my T3 in that range and while a lot of my symptoms that I had on T4 only have gone, I've had some new ones crop up that I believe that must be in relation to the loss of T4 (specifically acne - never  had in my life as bad as this....)  In response to Magpieannie, I do indeed have the scored Nature Throid so that is the reformulated version I believe.  I feel better emotionally for certain and am happy for the switch.  Just impatient to work out the kinks! I know we all feel that way!! Maddening process ;) I will update my progress and what steps we take to figure it out and please all do the same.  It's so much nicer having others going through the same process to talk to.  Thanks again!
734073 tn?1278899925
Please keep me in your loop. Thanks and best of luck on everything!
Avatar universal
I can confirm same results on new formulated NT...Upper middle range FT3 and Low FT4.

In IL...my doctor has said that my NT Rx has to be filled by a mainstream pharmacy now. My doctor has about 30K worth of Rx in house and was told he can no longer fill his own Rx's. Gotta love Big Govt! He is giving it all away. Should be fun finding a Walgreens that carries NT
Avatar universal
Thanks everyone for your input.  I was beginning to worry that it was more pituitary than thyroid. I can't believe there could be such a difference in formulations. Its really makes me sad, not just for myself but for everyone who finally found the right treatment and feeling better just to have it taken away by bureaucracy.  Best of luck to all of you and keep us all posted on your progress :)
Avatar universal
Anyone know if you can have symptoms with low Free T4? My FT3's are good, but FT4's really low....

Any ideas on treatment...synthetic?

798555 tn?1292791151
With low FT 4, converting to T3 will be compromised. So your body will get most of the T3 from the dessicated med. The body uses T3 meds very quikly you might get tired out in the afternoon / evening if you only take the med in the morning. I had a mix of hypo / hyper symptoms on NT, but labs stated severe hypo.

Ive been hypo for 4 months now, trying to get back crawling up from a tsh of 58 with ft4 off (completely under) range and t3 low to mid. In my 'climbing out' of hyponess on ERFA thyroid, I take it through out the day, since I was living on FT3 only when my levels were low.

Once FT4 was up a bit, the tiredness was less noticeable, since I could convert better - even though my tsh was still in the teens (very hypo)..
393685 tn?1425816122
lawson - a few things come to mind here on the abnormals levels. In almost all cases a hypothyroid patient will respond quickly on any T3 med regardless of synthetic - for NT. the first reaction would be the FRee T3 level elevated which is most responsible to rid those symptoms. The FT4 can take some work building up - but if you were on a T4 Synthroid and switched immediately then you most likely should not see a drastic depletion based off that lab. Did you happen to drop your Synthroid or Levothyroxine for a while prior to going to NT?

for a patient opinion based off me - all your levels are off including TSH. If you were on a optimal dose of thyroid medication with using NT - almost all patients will see a minimal level on TSH i.e. 0.00 or slightly above or below with the frees being high so the increase thought may work too to move all those levels into more of a "normal" optimal level as many see when they feel good.

Another equasion to throw into the mix - you have autoimmune Hashimoto with your hypothyroidism as over 90% of Hypo's have and rarely are tested. When you have antibodies in the mix reading TSH or even free labs can be challenging. Your feeding the thyroid the needed medicine and actually regaining health but the Hashimoto antibodies are actually being fed too with that medicine. Hashi feeds off healthy thyroid tissue so if you are giving the thyroid what it needs to be heathy the antibodies are rearing harder to kill off the good you are doing. This is why Hashi is SO hard to control. Hardly ever - ever do physicians take Hashimoto into its own catagory seperate from HypoT but expect the same results using the same meds.

Its not that easy - you must suppress these attacks before you can do any good to your health and you will still have symptoms until things either die off or are in a suppression. Here is where many things come up you need to investigate and speak to your doctor about to see what may work to achieve suppression.

1. selenium = lots of good things with Hashi patients can happen adding 200mgs selenium to the regulare supplements they take daily.

2. Avoid gluten entirely. = There are lots of successful things happening to some here on MH thyroid and globally when they follow a protacol majority to start ridding gluten in there diet. Google up Kharrazian and see that information and speak to your NP about if they know this information. Based off your symptoms lingering you could fall in this catorgy well and could try avoiding gluten and track your progress.

3. and this one IS controversial in high degrees and I must write WARNING on this one - Iodine supplementation. There are articles out there claiming iodine is beneficial to thyroid patients even with Hashimoto antibodies. It is an anti viral antidote for many things and in some articles claim can kill off antibodies. Why I warm on this is there is proven reseached documentation that taking iodine could be hazordous to you with Hashimoto. It is critical you speak with your doctor and learn more on this if it is an option you want to consider. Why I bring it up is I as Graves/Hashimoto - hashitoxicosis and in remission and it has suppressed my antibodies so far permanently. I had good result taking it and still do.

I would not consider pitutiary issues as a valid things based off what is said here.  

4. Another possible thing is the filler byproduct MCC in all the US desiccated Rx's now is causing you to still remain hypo. There is tons of adverse reactions being documented by patients that taking the new meds now - vs- when they were on old formulas is backfiring for them and they are back to feeling miserable. Avoiding MCC may be what you need to do to balance out and only compound thyroid ( if your request NOT using MCC as the filler) or looking at lower forms of filler MCC as in ERFA thyroid ( many say like OLD Armour) may be better for you if you want to stay on a NT medication. ou can always go the synthetic T4 w/ adding another medication called Cytomel which are the synthetic bio-identical thyroid hormone combo - but again if MCC is the reason for you not getting totally thyroid right - this could be bad too.

Alfonsa - look into liver cleaning and I think you may notice your meds will work better. I am not thinking a full harsh detox either. Simply adding lemon with your water and flushing things could vamp things up and you could see good things. This could be something I could list as #5 too - on suggestions to have the original poster discuss with her NP to get the best results fast too.

Fuel - its going to be tough finding Walgreens will be plentiful on NT ever again. It will be hit and miss for a long time. You may want to research compounding and ERFA if you chose to stay on stable NT options. You also may benefit going gluten free and liver health in case you can't move to other NT options.

Sounds like you have a week to research more lawson. I listed some key points for you to check things out and seek the opnion of your doctor on what options you have.

I hope all goes well - keep us posted.

734073 tn?1278899925
Great post/advice N. You are the greatest! Call me tomorrow morning if you can? Want to catch up! Miss you!
393685 tn?1425816122
Avatar universal
Thank you stella for your in depth reply. In fact, in January, after being exhausted by months of symptoms of hyperthyroidism, I did lower my dose to less than half of what I had been on.  For approximately a month and a half I felt a little bit better, but by mid march I began to get the beginnings of the acne and my muscles were feeling incredibly weak to the point that I was tired just from washing my hair.  I realized that I needed to increase the dose again but didn't want to go back to what I had been taking and experience hyper symptoms. So I went from 50 mcgs to 80 mcgs synthroid.  Still 20 mcgs less than what I had been on at the time of the hyper symptoms.  This was the end of March and into early April.  In early to mid April I switched to Nature Throid.  My labs from May 10th are the most recent on Nature Throid 1 grain.  When I first started taking Nature Throid I would swallow the tablet whole first thing in the morning.  I've since began to half the dose in the morning and half in the early evening.  I've also began chewing the tablet.  My followup appt with the NP resulted in adding a half dose of Nature Throid two times a week and monitoring for hyper symptoms.  She said that when the levels have been regulated for maybe about 6 months, we should see other things related fall back into place such as periods and acne. She had put me on Thyrosol and fish oil back in April and was pleased to see the level of TPO antibodies come down so quickly since tested in January so I am to continue on that in the hopes that the nutrients in the Thyrosol and the nature throid will continue to do their job.  I'm to go back in a few months if no other symptoms appear before then.  I forgot to ask her about basal body temperature and was wondering about your take on that.  I have been only in the low 97's each morning since beginning NT and wasn't sure if some people are just naturally low temp.  I'm afraid to keep increasing NT just to make the temp go up in case that brings hyper symptoms.  Any thoughts?  
And thanks again to everyone for being so helpful! You really have no idea how much I appreciate it.  Nobody else in my family has ever had to deal with this so they have no idea how much it affects a persons life and emotional health.  So, thanks ;)
393685 tn?1425816122
on basal temp - that can sometimes struggle getting up where it should be until other things heal. That's a low temp regardless and no - its not something that just some people have.. Its a signal of something not quite right.

With antibodies thyroid meds can sometimes backfire on you. Healing the low thyroid can sometimes aggravate the antibodies as well and get them to rear up. Remember - there "job" is to "kill" healthy tissue, so if your healing they will hit harder.

Suppression is key - you say its being done so thyroid meds will eventually win. It will take time.

393685 tn?1425816122
You made this comment above --

Actually I have not seen tests where the FT4 gets in the upper range  as the FT3 does.

On my lastes lab my FT4 was 1.5 ( .8-1.5 reference ) and my FT3 was 502 (reference 380-520)

Both labs are high on the reference chart and I feel fantastic after years of suffering. The labs should be high on the frees but it takes time tweeking.
734073 tn?1278899925
Are these numbers based on Erfa alone and if so how many grains? It's good to see that the t4 is not in the tank as it is on the new Armour and the new Nature-Throid. Don't forget to call me!
798555 tn?1292791151
My sky high FT3 I had on NT (with FT4 below range!), has improved on ERFA. Seen my posting?  

It funny, there was so much T3 in me from NT, it was still high after my first ERFA lab test, but has now dropped and FT4 is slowly going up.

Its been quite a ride! Still feel a little hypo but I now sleep, and have less body pain. Heart palps and 'ear' beats are very minimal. High BP on NT has dropped to normal.
734073 tn?1278899925
I really don't think I am going to chance it on the new Nature-Throid with my daughter. I think I will keep her on the old until it runs out (Thanksgiving) and then will probably put her on the Erfa. Please keep me posted on how you continue to do. I did see your post on your labs the other day, and found it very interesting. I had labs done today on my daughter as I reduced her by 1/2 a grain 1 month ago on the original Nature-Throid. She's been acting great, so I am hoping the labs are just perfect. She leaves for summer camp for the first time in her life (2 weeks) next Sunday with her older brother, so I felt it best to check labs a little sooner then usual just to be sure we are where we need to be. I'll have results next Friday, so I will post you then. Take good care of yourself and I am so glad you are slowly feeling better and better.
393685 tn?1425816122
I am glad Lexi and LM are finally living again.

Both of them were miserable.

Good Luck!
798555 tn?1292791151
I had a battery of tests, some not covered by insc too.  So far it all points to what changed - Nature Thyroid. It amaises me what that stuff did to my levels. The morning I woke half blind (for a very long ten minutes) was the end of NT for me. How is it that the makers are unaware of hypo and other scary side effects of their reformulation. I called them , and they acted like they never herd of side effects of the new formula. It was worse for me that the reformulated Armour was late last summer.

I've been on ERFA for six weeks climbing out of a TSH hole of 58 from NT. My body was a mess. So it is taking a while. I do feel less like 'reptilian road kill', (as opposed to regular road kill - just warmer).
734073 tn?1278899925
what pharmacy in cananda are you using for your Erfa. Can you send me a message with all the info. Someone just posted on Mary's forum that they just got some in from a Canadian pharmacy that does not seem right. (smell not there, and hard) I forgot which pharmacy, but I'll go back and look and let you know.
734073 tn?1278899925
Universal Pharmacy in Canada. She said she just took it and it chews up differently(harder). Hope she doesn't notice any onset of hypo. symptoms over time. Are you using the same pharmacy as Stella?
798555 tn?1292791151
***Why cant I PM you?***

I get ERFA from middle man in southern US.

ERFA 1 grain says EC1 over 60 on one side, tastes VERY sweet and smells like frozen pork.

I have run into people here that thought they had ERFA but did not. The Canadian sites very rarely say its ERFA, since its a generic, they just call it THYROID.

One lady awhile back getting Canadian med described NT and she thought it was ERFA!!!!
798555 tn?1292791151
Can you send the link to Marys page with that persons comments ?(that site , although good) is hard to navigate, needs organization!
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