Synthroid and cytomel dose

[KZL]

I have taken taken thyroid medication for 25 years and have been on 1.75 grains of Armour thyroid for a number of years. Recently it's effectiveness for me declined.  According to my Allergist and lab results (a high Antithyroglobulin Ab and my nutritionist, but negative Thyroid Peroxidase Ab; TSH 0.9), I could be producing antibodies to the natural thyroid so he suggested a switch to Synthroid and Cytomel.  At the time I was also showing some signs of too much thyroid medication.

My primary care Dr. then put me on 150 mcg of Synthroid and 15 mcg of cytomel per day.  I ended up with WAY too much thyroid hormone in my system after 2 to 3 weeks (TSH 0.04). It was awful - rushing heart beat, couldn't concentrate or think, highly fatigued, hot all the time.  As a result, once I figured it out it was the medication, I totally went off thyroid for 3 weeks to clean out my system. Now I am having to build back up because without thyroid medication, I am still definitely hypothyroid.  Three weeks ago I had a TSH of 64 and started at 50 mcg of synthroid and have been increasing by 50 mcg per week.  My TSH was still high (88 this week) so I am now back at 150 mcg of Synthroid at the Drs direction. I feel much better with some T3, so I've added 5 mcg of the cytomel generic in the am.  My Dr. did a Reverse T3 test just this week that came back as 171 pg/ML (range 90-350), but didn't explain the result and whether or not I do need the T3. Very frustrated.

My question is how much synthroid and cytomel should I take to equal approximately 1.5 to 1.75 grains of Armour? I saw posts about the potency of T3 medications, so now understand that I was definitely overmedicated! The 150 mcg of Synthroid and 15 mcg Cytomel was way too high. Appreciate any guidance.  Am considering going to an endocrinologist.

Thank you!

[magpieannie]

If it is aproblem with the Armour reformulation, as my daughter was also having, then why not switch to another desicrated hormone, since that has been what your body is use to for so many years? We switched from Armour to Nature-throid 1 month ago and she's doing better and better with each passing day. I will  warn you that  the conversion chart is a little off (well, really alot off!) 60mg Armour does not equal 65 mg Naturethroid. My daughter was on 120mg Armour which is suppose to equal 130 mg Naturthroid. Instead, we are on 195 mg (1 whole grain more) We however started with the recommended amount and have had to work our way up slowly by adding 1/2 grain every week or so. We will stick with this dose (3 pills)  one 65mg. tablets given three x per day at 4 hour intervals, until labs in three weeks.Anxious to see results. I feel that we still may need another slight increase, however I can tell by her slow improvement in symptoms ( energy, attitude, sleep patterns,joint ache complaints etc... that we are getting  closer to her specific/correct dose. stella5439 is on 2 grains more of the Naturthroid then she was with Armour and she is doing great! Post her if you need to go back to desicated, if the Synthroid with Cytomel doesn't cut the mustard for ya! Good luck and please let me know how this all plays out for you. God Bless! I

[gimel]

You can look at this site and see the equivalent amounts for various thyroid meds.  From your experience, I'd say you definitely need a good thyroid doctor.  First, the Armour manufacturer recently changed their formulation and some members here have reported it as less effective than before.  So this could be the actual reason, rather than the one your doctor came up with.  Second, you should not be treated based on TSH.  TSH is a pituitary hormone that is affected by many variables, including the time of day when blood is drawn.  Far better is to test for the actual, biologically active thyroid hormones, which are FT3 and FT4.

http://thyroid.about.com/library/drugs/blconversionchart.htm

You should also be aware that not all Endos are good thyroid doctors.  Many specialize in diabetes.  In my opinion a good thyroid doctor is one that is willing to listen to patient symptoms and test and adjust FT3 and FT4 with whatever meds are required to alleviate those symptoms.  If you can get a personal recommendation for a good thyroid doctor, that is the best way.  If not, some of us have resorted to calling prospective doctor's offices to find out if they are willing to treat patients based on symptoms and FT3 and FT4 levels and, if appropriate,  also use meds other than synthetic T4 meds.

[Barb135]

I can't answer your specific question about the conversion to synthroid/cytomel, but I have to ask - about a generic for cytomel?  According to both my endo and pharmacist, there is no generic for cytomel......

[magpieannie]

laura1967 switched from Armour to Synthroid w/Cytomel successfully. Post her for advice on this. Please let me know how it ends up for you dosage wise. Thanks and good luck!