Tirosint Dosage?

[Bttrfly62]

My dr put me on 200 MCGs of Tirosint and Cytomel (5 MCGs) per day. I noticed that this seems to be a rather high dosage of Tirosint since it's supposed to have a better rate of absorption than the other thyroid meds on the market. I'm wondering if anyone else is taking a dosage this high? i went to have labs drawn today because while i've only been taking this dose for 5 weeks, i am either hyper now, or the symptoms are coincidence. Will others share their Tirosint dosage?

Thanks!!

[goolarra]

All the thyroid tests vary a lot intraday.  That's why it's important to have blood drawn at approximately the same time of day every time.  TSH varies as much as 70% just depending on time of day.  Using all three together, you can draw some conclusions.  Testing FT3 every time and creating a historical record gives you even more information.  If FT4 is consistently at or above 50% of range, and FT3 remains low, you have your answer.  I'd either insist on FT3 (I know that can be difficult) or consider ordering FT3, FT4 and TSH online so at least you will know what it is you need.    

[goolarra]

Your doctor should be testing FT3 as well.  When you're on a relatively high dose of T4 and still have hypo symptoms, the most likely culprit is low T3.  Five mcg of Cytomel may not be enough for you.  If your FT4 is on the high side (doesn't necessarily have to be over range), it can give you hyper symptoms.  You really need to find out what your FT3 is doing.

[Bttrfly62]

i actually suggested that to her, but she said that the FT3 numbers are not like the other numbers and fluctuate not just day to day, but hour to hour and are not reliable. I'm not sure how true that is.

[Emily443]

Never mind my answer, I answered wrong, I wish there were edit and delete options:(

[Bttrfly62]

No! I appreciate the feedback!

[Bttrfly62]

Yes, I was on 275 MCGs of Levothyroxine (it had been slowly increased from the initial 150 9 years ago). At 275, the levels were still uncontrolled and I felt awful. Endo said, no Levo, ever again. You aren't absorbing it and it's having negative effects (i was really swollen and fatigued all the time). She switched me from Levo to Synthroid. She was sure that Synthroid would work much better and that the dosage could be much lower. We switched to 175 of Synthroid and she asked me to keep an eye out for symptoms of hyper as that dosage should be more than enough for full replacement at my weight if there were no absorption issues. On that dosage of Synthroid:

TSH 23.50 m[IU]/L 0.36 - 3.74 m[IU]/L
THYROXINE FREE 0.86 ng/dL 0.76 - 1.46 ng/dL

She upped the Synthroid to 200 +5 MCGs Cytomel. On that dosage:
4.51 m[IU]/L 0.36 - 3.74 m[IU]/L- TSH
THYROXINE FREE 1.05 ng/dL 0.76 - 1.46 ng/dL- Free T4
She decided that malabsorption must be playing a role in high doses with minimal response. She had me see a GI to get tested for Celiac. 3 of the 4 tests came back positive. However, the endoscopy did not show any signs of damage at this point that would be preventing me from absorbing or continuing to eat Gluten (I do not have negative physical symptoms from consuming gluten). She then highly recommended Tirosint (not cheap!!) because it absorbs better (her words). I'm game. I would like to hit a good stride of not constantly changing my meds. I did wonder why if this medication absorbs better than most, why I didn't start on a lower dosage than the last script? But I'm not MD. So she prescribed 200 MCGs Tirosent (which is a massive package for a 3 month supply) + continuing the 5 MCGs of Cytomel. This change was made 5 weeks ago.

I did go to have my blood work done. and i suppose that will tell me definitively. I just wondered if anyone else found this dosage to be their "sweet spot". I know we're all different with different meds and different symptoms, just curious.

My symptoms are your standard "hyper" symptoms. Sleeplessness (even though i'm constantly fatigued), being on fire (especially at night when i normally run very cold), anxiety/restlessness, headaches, dry eyes, oddly enough constant throat clearing (not sick), excessive sweating- you know, the standard, I guess.

I do have to say, initially i really appreciated the addition of Cytomel. She said T3 burns through the system so quickly that many people don't necessarily find it helps them, but I did feel a nice little burst of energy, mid-day, most days. Not so much now. I just kinda feel slow and draggy all the time.

Thanks for the feedback!!

[Emily443]

Yes, I was on 200mcg Liothyroine for two years, I'm pretty sure many doctors won't recommend you to be on that high dosage of T3 only medication for longer time. I switched to 160mg Armour thyroid, which worked for me. Why are you on Cytomel?For me, I had problems in converting T4 into T3  Later on my doctor figured out my ferritin was too low, so when it went back to optimal level I could switch to Armour.

[Bttrfly62]

She did say that many have a positive reaction to Armour, but that she did not recommend it for someone with potential absorption issues because she believed it would be too difficult to regulate from month to month. I asked for the Cytomel and she did not object. I had read many people on here say that often T4 replacement alone would not be enough to really feel "normal". I'm 33. I weight 150 pounds. I would like to feel "normal" again.

[Bttrfly62]

She did say that many have a positive reaction to Armour, but that she did not recommend it for someone with potential absorption issues because she believed it would be too difficult to regulate from month to month. I asked for the Cytomel and she did not object. I had read many people on here say that often T4 replacement alone would not be enough to really feel "normal". I'm 33. I weight 150 pounds. I would like to feel "normal" again.

[Barb135]

200 mcg is a relatively high dosage, but the dosages other people take really don't have anything to do with your dosage... it's all a matter of what your body needs.  

What medication/dosage were you on prior to switching to Tirosint? Did you have labs done just before you switched?  If so, could you please post them so we can see where you were at that time?  Be sure to include reference ranges, since ranges vary lab to lab and have to come from your own report.

What symptoms are you having that makes you think you might be over medicated?  

[goolarra]

We are all so individual that you really can't compare your dose with someone else's.  That being said, 200 mcg is a larger dose, not just of Tirosint with its supposed better absorption, but of any T4 med.

Were you switched from another T4 med to Tirosint?  If so, how much had you been taking?