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Avatar universal

amiodarone and thyroid

I've tried somethinglike this post some time ago. here goes again....iask your patience please
In 2007, apparently for a prolonged QT I was hospitalized, given 1600mg amiodarone and then 200 daily.Only one test was made, after five months. Ten months later  I had a TSH of 38. A new cardio brought it down to normal in three months with levothyroxine and put me on Rythmol instead of amiodarone..Did the amio wreck my thyroid for life? Ever since, tests have been normal but with FT3 in the 20's.  Doctor after doctor for six years  have continue the levo never suggesting a T3 med (In guatemala where I live there is no Cytomel).On my own, I have tried levo doses from zero to 150 over two years with no notable change in TSH and T4 test levels but FT3 still below 30). I cannot pinpoint  low FT3 symptoms among side effects from Rythmol 150, coreg 6.25, crestor 10, aspirin 100. I have not slept one night through for six years without two or three hour-long sweats/chills, nauseas, dizziness, weakness, fatigue etc.Daytime too. I'm 87 and tired of it. One stent 2010, RCA. Never felt angina or tachycardia. Any way out of this?
10 Responses
Avatar universal
Hi there...good to hear from you...wish the circumstances were more positive...

What are the reference ranges on your FT3s?  Would you post a recent FT4 with range?

I'm assuming that doctors in Guatemala either don't use T3 or are afraid to give it to you because of your heart issues.  T3 has a very direct effect on the beta receptors in the heart.  

Amio's effect isn't on the thyroid directly, which could be why your FT4 didn't change much no matter what dose you were on.  Amio's effect is on the deiodinases, which are the enzymes that catalyze the conversion of T4 to T3.  Amio has no known half-life.  Apparently, it's very long.  I've always thought you needed to be on some T3, but I respect the fear of that with your heart issues.    
Avatar universal
thank you.
test three months ago:FT3     2.83     (lab.  2.02 - 4.43)
                                    T4       7.14     (lab.  5.1 - 14.1)
                                    TSH     2.43    (lab  .0.4 -  4.0)

May I ask you if FT4 is a needed test?

Avatar universal
They tested your total T4.  FT4 is a better test.  Your TT4 is at 24% of range, which is low of the 50% target.  FT3 is at 34% of range, also on the low side, but FT3 is a higher percentage of range than FT4, which is the way it should be.  It doesn't look like you are converting all that badly.  

At this point, it really looks like what you need is a small increase, but I know you've tried that.  Perhaps the amio is finally letting go???  Do you have previous FT3s and FT4s (with reference ranges) that we can compare with these to see if you're converting better now?
Avatar universal
Thank you. I have years of tests ALL prnounced NORMAL by doctors despite unremitting hypo symptoms. Excepta single internist who said emphatically 'Go up to 200mcg,man!' Dare I do this as I'm ready to try anything at all!
Avatar universal
How much are you taking now?  
Avatar universal
50mcg three months now. before that 75. Results were the same- FT3 below 3. Doc said if 75 gives no better results then 50 then stay with 50. Some years ago I tried 150. FT3 was below 3 after 60 days. The rest 'normal'. The whole experiment was dull - no spikes, no deep lows. and unrelenting symptoms
Avatar universal
I absolutely would NOT go directly from 50 mcg to 200 mcg.  That's a huge increase and could even have some negative effects on your labs.  Sometimes, when FT4 levels get too high, the body converts more T4 to RT3, lowering FT3 even further.  Unfortunately, there's no replacement for the slow, but steady approach.  If you want to increase, I'd do it in no more than 25 mcg increments (less as you get closer to your FT3 and FT4 targets) while having labs drawn every 4-6 weeks.  Once you get FT4 to the middle of the range, I'd seriously consider a breather since it can take time for symptoms to resolve once lab levels are good.  
Avatar universal
Thank you for a firm confirmation of the prudent way to go. I'll follow it.
Avatar universal
  Test results todday
FT3       2.52       (2.02 - 4.43
FT4        1.15      (0.8 - 1.9)
TSH        5.85      (0.27 - 4.200)
This after two months on .50 Levo. Last TSH was 2.8 after same dose for 2 months. Doc says I cd try .75 but without much enthususiasm. Got a moment to advise?  Strong belly ache and hours dead- beat sleep the same.
Avatar universal
Your T4 has gone up a little (although we do have to remember we're comparing your previous TT4 to your current FT4).  It's now at 32% of range.  FT3 has dropped to 21% of range.  TSH is up considerably, which means your pituitary thinks your levels should be higher.

I know you've tried 75 mcg before, but what do you really have to lose in trying it again?  The half life of amio is unknown, but let's theorize for a moment that it could be loosening its hold on you.  If that's the case, then things might be considerably different on 75 mcg now than they were on 75 mcg when you tried that how long ago?  I'd go for it.
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