# Switching to Synthroid



## Isthmus123 (May 19, 2016)

Hello it's me again!

I met with my Endo earlier this week and he does suspect I was having a tough time tolerating the T3 in NDT. He suggested back to T4 medicine, so I started name brand Synthroid on Tuesday.

I have a question about my dosage. He suggested I start at .50mcg Synthroid since I am hypo (labs below in signature) and have been mostly taking 0.375 grain of NDT for the past 3 months. Is this Synthroid dose a good starting point for me? Is it too high too fast or is it ok because I've been taking some type of replacement hormone since last April? I weigh about 190 lbs right now (I look and feel great at 160-165 normally).

I did take 0.25mcg Synthroid this week just to get started- I felt FANTASTIC the first 2 days, but I have felt very hypo the last 2 days (very cold hands and feet, drop in energy, insomnia, more heart palps, maybe some muscle weakness, muscle twitching, needed naps to do stuff in the evening).


----------



## my3gr8girls (Mar 18, 2016)

I started at 50 mcg, and I have only half my thyroid. I think it's a good starting dose. Name brand Synthroid is so much better than generic. I think you'll do well on it. I'm am actually just moving up from 88 mcg to 100. I feel overall normal and well now though which is amazing. I hope it helps you! I really don't think 50 is too high. It's a normal starting fose.


----------



## Lovlkn (Dec 20, 2009)

> Name brand Synthroid is so much better than generic.


I'm not sure where you get that information -

Synthroid in my opinion is overpriced - there are a number of great generic's. I for one take Unithroid and have for almost 13 years without issue and stable labs. Levoxyl is another one with success as far as generic goes.

Isthmus123, I hope going to a T4 only medication is what you needed, however your labs while on NDT have been hypo. Because many thyroid symptoms do overlap, it is not uncommon to have what seems to be hyper symptoms when actually hypo.

You absolutely need to test both FT-4 and FT-3 at every lab to dial in your thyroid hormone replacement.


----------



## Isthmus123 (May 19, 2016)

Thanks my3gr8girls. I think I have about 75 percent of my thyroid but I do not have the isthmus, which I was told is where the biggest burst of thyroid hormones come from. Anyone ever heard that one?

And yes Lolvkn I know I've been hypo on NDT...I just couldn't deal with that half grain dose long enough to get unhypo!


----------



## Lovlkn (Dec 20, 2009)

Isthmus123 said:


> Thanks my3gr8girls. I think I have about 75 percent of my thyroid but I do not have the isthmus, which I was told is where the biggest burst of thyroid hormones come from. Anyone ever heard that one?
> 
> And yes Lolvkn I know I've been hypo on NDT...I just couldn't deal with that half grain dose long enough to get unhypo!


https://www.google.com/#q=isthmus+definition

"a narrow organ, passage, or piece of tissue connecting two larger parts. plural noun: *isthmi"*

Who told you that the Isthmus throws out the biggest burst of thyroid hormones? If you only have 25% of your thyroid is this what they left?

Did your doctor refuse to increase your NDT dosage?


----------



## Isthmus123 (May 19, 2016)

No I do not have my isthmus anymore. Also missing a teeny part of the right side.

A psychiatrist told me about the isthmus producing the most hormone but I've never heard that before.

No, my Endo prescribed me 1/2 grain NDT but I tried 3 different times to reach that dose and felt worse (look zoned out/stoned) everytime. The longest I tolerated it was 3 weeks at one time. I complained about this issue in a different post


----------



## creepingdeath (Apr 6, 2014)

Levoxyl is a name brand.

In my opinion all synthetic is poison.

1/2 grain of NDT is nothing.

And it takes along time to accumulate in your system.

It doesn't matter how much of your thyroid is left.

Thyroid hormone is designed to stop your thyroid from producing anything anymore.

The drug is supposed to take over the thyroids job theoretically but everyone is different.

Why is a psychiatrist explaining thyroid disease to you?

All these tests and ranges?

I found just experimenting with different doses I got where I feel close to normal by myself.

I basically from research and this forum cured myself.

All I need the doctor for is to get the script.

I could care less about what range I'm at as long as I feel OK.

I take 2 grains and I'm 5 foot 4 inches and weigh 130 pounds.


----------



## Isthmus123 (May 19, 2016)

1/2 grain is nothing"...
OK? Isn't it actually 19mcg T4 and 4.something of T3? I think that can effect the body can it not?. It certainly helped my energy at least, but it came with other problems (for me). What worked for you might not work for me. That's the bottom line with all of this hormone replacement stuff isn't it?

And I think that's one issue with this forum is that while many people are helpful, some of these general statements (e.g. all synthetic is poison) are just not helpful. It can confuse people seeking help. 
The psychiatrist isn't treating me for the surgery induced hypo- he simply made that one statement about the isthmus. And he wasn't trying to explain the disease either.


----------



## creepingdeath (Apr 6, 2014)

I said my opinion.

Everyone is different.

This disease is confusing I'm sure you figured that out already.

It has no cure just treatment.

I just started out with a small dose like 1/2 and increased every month or so till I felt 100% better.

It's not perfect. I don't feel like I used to and don't think I ever will.

This disease changes you. It's the hormone or your Life.

The synthetic did nothing and I was dying.

All experiences should be considered while choosing your individual treatment.

It's part of your research every thyroid patient needs to do.

Your in charge...

Good luck

Sorry for telling you like it is but it's an American thing...................


----------



## jenny v (May 6, 2012)

Synthroid, levoxyl, levothyroxine and other synthetics work great for some people. Armor, Westhroid, Naturethroid and other NDTs work great for others. Some people only take Cytomel or liothyronine.

It's different for every thyroid patient; every patient is unique and no one medicine is wrong or "poison" if it works for that person. So let's avoid statements like that, because they don't help anyone (which is the point of this forum).

*Isthmus123*, have you ever had a reverse T3 test run since 2014? Sometimes when a patient has a hard time raising on NDT it's because they have a high rT3.


----------



## Isthmus123 (May 19, 2016)

Hi Jenny- Thank you for the reply.
So I did have reverse T3 run recently...I am going to see if I can get the result today.

If someone's reverse T3 is high then what do they do?


----------



## jenny v (May 6, 2012)

I had high reverse T3 and my doctor has added in Cytomel (and dropped my NDT) to help it clear out as we work on the issues that were causing it in the first place. Apparently, the thinking is that you reduce the T4 and add in straight T3 so your body doesn't have to do the work of converting the T4 to T3 itself, and it burns off the rT3 built up in your system.

Some issues that can cause high rT3 are adrenal problems (which was my issue), iron issues, inflammation, liver issues, etc. My doctor thinks my adrenals got messed up from years of thyroid issues and the resulting stress on my system. My rT3 has come down to a good level with a combo of NDT and Cytomel and once I get my adrenal issues worked out for good (it's taking a while), I hope to switch back to just NDT.


----------



## my3gr8girls (Mar 18, 2016)

The reason I said that Synthroid is better than levothyroxine is because for me it worked 100% better. I had lots of symptoms on 88 mcg of generic levo but now on the same dose of Synthroid I am pretty much symptom free so they can't be exactly the same. It was my last ditch effort. Levo plus cytomel didn't completely resolve things and neither did NDT. All it took for me was Synthroid. It's crazy! Everyone is different though. I don't even need cytomel now. I actually think raising my FT4 levels is what helped me feel better. That's the only lab result that is significantly different now from any of the other meds. My FT3 is lower than when I was taking T3 but I feel better without it since switching to Synthroid. It might work for others and it might not, but I think it's good for people to know all the different solutions others have found in order to find what works for them.


----------



## my3gr8girls (Mar 18, 2016)

They did remove my isthmus too, so I'm missing the left lobe and the isthmus. I really wasn't happy when I found out they took it but maybe they had to. I always wondered how much of the hormone might have been produced by it. Very interesting. No wonder I need replacement.


----------



## Isthmus123 (May 19, 2016)

So I took 0.25mcg synthroid for a few days then I moved up to .50mcg. I've been at that dose for a week now.
I'm feeling very energized today. Pretty restless when I'm sitting still...too much too soon?
My hands aren't cold anymore at least.


----------



## jenny v (May 6, 2012)

Sometimes it can take the body a few days to adjust to a new dose. I would just suggest watching your heart rate and make sure it doesn't climb too high.


----------



## Isthmus123 (May 19, 2016)

Looking for advice again...Ugh.

I started Synthroid 25mcg on Feb 7th and then moved to 50mcg on Feb 11th. After feeling wired and restless my doctor suggested I go back down to 25mcg for a few days. So from Feb 16 until today I've been back to 25mcg. I was starting to feel hypo this past week again (more anxious mood, tired, trouble focusing, shaky muscles, etc).

My next blood draw and appointment isn't for another 5 weeks so I went and got a lab last night (on my own dime).

As of yesterday the results were:

TSH = 2.09 (0.45-4.5)

Free T4 = 1.06 (0.82-1.77)

I know I need to get Free T3 but it was going to be an extra $50 for that so I opted out of that.

I don't know what to do. My doc wanted me to stay at 50mcg until the next blood draw but I just felt so wired and restless after that dose for a few days. But I do feel too hypo just taking 25mcg for over a week. What dose can I take and stay at for the next 5 weeks? I felt good initially starting Synthroid and then a few days after switching from 50mcg to 25mcg.

I was thinking I could stay at 25mcg and then take the 50mcg M,W,F perhaps? Or should I stay at 25mcg? I do want to keep it steady for the next 5 weeks...


----------



## jenny v (May 6, 2012)

Maybe you could try 37.5mcg by taking a 25mcg pill and half of a 25mcg?


----------



## my3gr8girls (Mar 18, 2016)

I would alternate days with 25 and 50 mcg.


----------



## graves84 (Oct 7, 2013)

.25 of Synthyroid is very low but it depends on your symptoms. Sounds like you might need to ask the Dr to increase it and see how you feel. I was on 100mg when it worked best for me.

NDT nearly killed me. Not everyone can tolerate t3. You can also take something more reliable than a random dead pig thyroid which has an different amount in every pill you can't measure. Depending on that pigs diet or thyroid function you never know. Also having sweat that smelled like pork was really gross.

The best way to dose IF you do not convert t4 to t3 is taking a legit t3 supplement in addition to Levo like Cytomel etc. This way you know exactly how much t4 and t3 you are adding to your body and can increase and decrease and needed reliably.


----------



## MoreDrivel (Mar 2, 2017)

Hi Isthmus123

After feeling "just ok" for the last year and then feeling truly awful, I decided to be brave and try switching from NDT to Synthroid / Cytomel combo (something I had never tried before). My thinking was that although I had been stable on NDT, I wasn't feeling good and perhaps I needed to vary the T4 / T3 ratio. In NDT, the drugs are combined into one pill, so the ratio is fixed and can't be altered.

I kept detailed data each day during my "trials". I didn't really feel any better regardless of the various mcg. combinations I tried. After many failures and false starts, I got discouraged and eventually went back to my regular NDT dose. But, what I noticed was that *every time* I "crossed over" from one trial to the next I felt great for 2-3 days.

That lead me to suspect that the "ratio" idea might be valid. Perhaps I needed a different ratio...but what one? I did some research and found that some people do better somewhere between a 10:1 ratio or even up to 15:1 ratio. (The ratio of T4 to T3). I looked at the product monograph for my NDT and did the calculations to conclude that my NDT was a ratio of 4.5: 1. I decided to try increasing my T4 / T3 ratio. As I write this I am 4 weeks into my study which is early days, but I have been feeling really good -- I've even gone running which is unheard of for me. My endo appt was yesterday and he confirmed that this is a reasonable course of action and to stay the course. I am currently taking 3 x 30 mcg NDT (90 total) and 1/4 tablet of Synthroid which equals 31.25 mcg T4.

My 30mcg NDT pills have 18 mcg T4 and 4 mcg T3

T4 in the NDT = 3 x 18 = 54

PLUS 31.25 from the Sythroid

Total T4 = 85.25

Total T3 = 12

Ratio = 7.1

My endo suggested if I need to alter the dose that next time I should reduce my NDT to 75 mcg and add 1/2 tablet of Sythroid. But only to do this after 6 full weeks at the first combination before trying altering or adjusting anything. If I were to try this next new combo, the ratio would then change to 107.50 T4 to 10 T3 ( which works out to around 10:1 ratio.

I hope the "ratio" idea can help someone else out there.


----------



## Lovlkn (Dec 20, 2009)

MoreDrivel said:


> Hi Isthmus123
> 
> After feeling "just ok" for the last year and then feeling truly awful, I decided to be brave and try switching from NDT to Synthroid / Cytomel combo (something I had never tried before). My thinking was that although I had been stable on NDT, I wasn't feeling good and perhaps I needed to vary the T4 / T3 ratio. In NDT, the drugs are combined into one pill, so the ratio is fixed and can't be altered.
> 
> ...


Interesting idea and one that I have had a friend try in the past. She however ended up switching completely to Levothyroxine/Cytomel vs taking Armour with a small dose of levothyroxine. She reports she feels better on the synthetic combination than on NDT/levothyroxine.

Few people supplement T4 hormone when taking NDT. A compounding pharmacy could mix you up any combination you ask for so the fact you are making your own "mix" is not unreasonable.

I've had good luck with Levothyroxine/Cytomel and like the idea that I can dial it up or down easily based on how I feel. Having recently switched to generic lilothyronine - the adjustments have been more common as the absorbtion of the generic seems higher than brand Cytomel for me. I also take calcium 3x a day which interferes with absorption so I wonder if that alone is the issue as I occasionally miss a calcium dose.

There are so many factors involved - consistency is key.


----------



## Isthmus123 (May 19, 2016)

Thanks y'all! I have been holding steady at 37.5mcg for the past week and I doubled my afternoon iron supplement (which I was, er, supossed to do a while ago). A little bit tired here and there but it's going ok. I can see that I might need more in the future but I hope to wait a few weeks at this level so we know for sure. Really appreciate the support. What's nice is that zoned out/hyper focused feeling from before gone. Phew.


----------



## Isthmus123 (May 19, 2016)

And wow MoreDrivel that is quite the applied math equation! Impressive. Now that I think about it, hard to believe there's not a med that does this (correct t4 plus t3 for humans) already? Or there needs to be a conversion test to help determine exactly which ratio of t4 and t3 people need to supplement first. Someday maybe.


----------



## Tori64 (Mar 7, 2017)

I recently was switched from 100 generic T4 to 112 synthroid..about 8 days ago..also was on 10 mcg t3 and doc told me to drop down to 5mcg t3 although my labs are low.

I decided to stay on the 10 t3. it has been 8 days and i feel worse on the sythroid that i did on the generic. I was wondering if this is normal? i am thinking of trying a couple days on generic to see if i feel any better. I have been wanting to sleep all day and feel really heavy.

for the folks that have been able to feel well just on synthroid, yay! how did you know it was time to stop the T3?

thank you


----------

