Increasing Medication, but levels going down?

[Hypointx]

Hi all - it has been awhile since I have been on the forum but I am stuck and so is my doctor so I am hoping you can help.
Since November I have had 3 different sets of labs, since then in spite of increasing my medication each time (I am on a compounded time release T3/T4) my labs for the first time since I started medication both my T4 and FT3 are going down. I am now on 50/95 T3/T4 compound, which was increased from 40/80 in February, and from 30/70 in November, yet my levels are now lower than they were back in October. I began the compound in September of last year, each lab cycle my levels would go up a little bit and we would increase the medication, each time they worked to increase my levels. Yet all of a sudden in spite of increased medication they are going down? We tested my reverse T3 several twice in a row back in September and they were normal so my doctor didn't see a need to continue testing. However, in light of the recent labs, I am wondering if that has changed? Why else would they go down with added medication? What else could cause this? I also recently started a progesterone supplement as I had estrogen dominance (I am 37) my last labs show that my levels are close to being where they need to be. However my ferritin is still low (it is actually the same as it was when I had my original labs: 28 range 20:200). So my doctor is prescribing an iron cream....
She is baffled about my levels and literally doesn't know what to do, called the pharmacist to ask their thoughts....they suggested the low iron might be  factor? But the reason I disagree is my iron levels have always been this low nearly identical yet for the first 6 months my levels were going up with each dosage increase....
My symptoms have definitely eased up a bit but the main ones right now are: major aching/pain in my ankles, just a constant need to roll them. Constipation, what I wouldn't give to not have to deal with this anymore. Dry brittle hair and a rash on my arms that itches and hasn't gone away for 2 months....
Thanks in advance for your help...

[Barb135]

I don't have a lot experience with the estrogen/progesterone issue; I was on them both for a while, but had nothing but trouble and ended up with a hysterectomy, anyway.  I was put on estrogen after that, but could never tell that it made any difference. I quit taking anything about a year after my hysterectomy, though I did take Black Cohosh for a while and it did seem to relieve some of the symptoms of menopause, but it didn't take long for that to become ineffective, as well.

It would appear to me that the reason you had so much trouble with NatureThroid was the way you were  taking it.  With 2 whole grains in the morning, you were getting 18 mcg of T3 all at once, then adding 7.5 mcg additional later in the day.  Had you taken only 1 grain in the morning (9 mcg T3) and the other grain (9 mcg T3) around noon or so; it would have leveled out over the course of the day and you might not have needed that other 7.5 mcg T3.  Additional T4 might have been in order, also.

The time release capsules release aren't meant to be split as they release continuously.  I agree that you might not actually be getting what the label says.  The other person I mentioned who had been on compounded time release med, simply went to compounded, not time release and did much better.  There seems to be something about the time release part that may not work as intended.

How long have you been on the Seriphos?  From a quick bit of research, instructions say to take it only for 3 months.

While I do take digestive enzymes for absorption/constipation issues, I'm not a fan of the whole leaky gut theory, so I'll refrain from commenting on that, as well.

It's a known fact that hypothyroidism causes issues with periods, so my contention might be that if your thyroid levels were brought up to therapeutic levels, you might not need all the other hormones.

The real question is whether or not you feel confident in the treatment protocol and comfortable maintaining the status quo on your thyroid, for 3 months?  

[Hypointx]

Would love your feedback when you get a moment! Thanks.

[Hypointx]

Wait, I am not sure I am following you about the compound?
Regarding the naturethroid, I believe I was on 35/74 and then switched to 2 grains of naturethroid. I would take 2 grains in the AM and then take a 7.5 dose of T3 only in the PM....I dunno but it was BRUTAL.

Here is the email I got from her, not sure if it makes sense or not:

"So I just had a chat with one of my colleagues and she agrees that having the estrogen/progesterone imbalance increases both your sex hormone binding globulin as well as your thyroid binding globulin which will then affect your thyroid levels as more will be bound up and not free.  Therefore the progesterone being on board is really important.  Signs of progesterone deficiency are HEAVY bleeding and cramps.  The heavy bleeding was why you went on the lysteda to begin with.  Since being on the thyroid I remember that you've reported better periods, however that is likely because your thyroid has helped with metabolism of hormones though it didn't correct the imbalance between estrogen and progesterone.

This increase in the binding globulins does take time, so we concluded that this is likely why your levels went up initially and then have gone down.

Next, she recommended a supplement called Moducare by Thorne, it has a great affect on modulating the immune response, she said she has had great results with people taking this.  It helps shunt the immune system away from the autoimmune response.  A number of colleagues said they use this instead of LDN.  It is up on the Natural Partner's site for 10% off, I'm also sure you can elsewhere on the internet.  This is to be taken 1 three times per day away from food.

My feeling is that we need to keep your thyroid dose the same while you are on the progesterone for 3 complete cycles as well as adding in the Moducare and the iron cream.  I'd like to retest your thyroid and progesterone after 3 complete cycles."

Thanks for your thoughts!!!

[jacrjacr]

I meant to say on NT , I had the same reaction as you, migraines terrible and headaches and felt hyper , flushed in a very short amount of time, in a week.

[jacrjacr]

I  used to use compounded thyroid and used it for 2-3 years but after a while I started noticing that I began having a lot of aches and pains in feet and arms etc and weakness.
They switched me to nature throid too and I had the same reaction but since then we have found out that the compounded couldn't have been as strong as it was labeled bec I on half of the equivalent of the so called compounded I was taking.
Since the compounded all comes from the mfg in a bag I am told, you may want to check into this. The reason I had the bad reaction to NT was two things, not splinting the pills to take am and afternoon early and because it was way too strong.
Then they switched me to synthroid and I just added t3 to it in small doses split.
Hope this helps.

[Hypointx]

Barb- I have  actually tried the natural disected medication of naturethroid, back in February for about a month. It was a nightmare. I had a major reaction to it, migraines (4 in a 10 day period), extreme bloating to the point I couldn't wear any of my clothes, couldn't sleep. So we went back to the time release formula. Although my levels were dropping, I hadn't had any negative side effects so we went back to that added the progesterone (thinking that was part of the issue) and upped the dose.
My last lab levels were as follows:
FT4: .94 (.73 - 1.95)
FT3: 3.1 (2.3 - 4.2)
TSH Didn't test for some reason....has been supressed at less than one for the past 8 months every lab.
Vitamin D: 68 (30 - 100)
Ferritin: 26 (10  - 220)
Insulin: 4 (4 - 13)
Magnesium: 2.1 (1.3 - 2.3)
TPO: 120: <9
I think that is it.....I don't know what the pharmacy uses for fillers, I will check.
Yes we are going to treat the iron with an iron cream. With my constipation issues I have been very sensitive to iron pills even while taking it wit 1000 mg of Vitamin C.
Here is what I am presently taking:
Thyroid compound of 50/95
Probiotic
Selenium
Seriphos (for adrenal support)
Panplex D (for leaky gut)
D3 (3000 iu)
B12
Fish Oils
Progesterone sublingual

Thanks for your help!!!!

[Barb135]

Have you thought about switching to a different medication?  We had someone else on a compounded, time release medication and it simply didn't work; as soon as they went on regular med, their levels changed.  Do you know what fillers are being used in the compounded med?  Is your doctor willing to try desiccated hormones or synthetic T4 with a T3 added?  

Are you working to bring the iron levels up?  Just because it's always been that low, even when your thyroid levels were increasing, doesn't mean it can't be affecting you now.

Please post your actual current thyroid levels, and as usual, be sure to include reference ranges, which vary lab to lab and have to come from your own report.