# Thoughts on Tirosint, Synthroid, Calcium, PTH, aye aye aye



## SuzieSocialWorker (Jul 9, 2013)

Hi all - a new bump in the road! Need some input or maybe encouragement. Got lab results back. I am 7 weeks out from TT. Dose of Synthroid was 100mcg for 3 weeks, then bumped to 125mcg for the last 4 weeks. My labs are exactly the same as when I got them drawn 4 weeks ago! My TSH actually went up from 21 to 23.5.

Current Labs:

Free T4: 0.9 (0.8-1.8)

Free T3 1.8 (2.3-4.2)

TSH 23.5 (0.5-4.7)

My Calcium is holding steady at 8.6. I am still taking Calcium Carbonate 500 (1250mg), 2 pills 3x daily, and Calcitriol 0.5mg 1 pill 2x daily. This is a lot of pills!

My Endo is switching me to Tirosint 137mg. She is guessing that the Calcium is interfering with absorption, and that Tirosint does better with an "acidic PH." I wait 4 hours after Synthroid to take Calcium or anything else, and wait an hour after taking to eat or drink. While we did not test the PTH this time around, she is thinking my parathyroids have not recovered and is losing hope that they will. 

Any thoughts on this? I got my labs done so early because I'm feeling so incredibly hypo (and with good reason apparently). I thought that my positive PTH meant they woke up and I'd be on the up and up, but here we are. I've never even heard of Tyrosint!


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## HotGrandma (Sep 21, 2012)

Calcium Citrate is more absorbed by the body that carbonate. Can you see if she will let you try the citrate. Also what's your D level? May also want to see if you can take Magnesium Citrate. They're all related.


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## SuzieSocialWorker (Jul 9, 2013)

Thanks HotGrandma! I actually tried Calcium Citrate in the hospital and wasn't absorbing it which landed me in the ICU, so when they weaned me off the IV, I was on Calcium Carbonate which they want to keep me on to be safe. My D level should be high since I'm taking Rocaltrol (active vitamin D) with the Calcium to help absorption. I know she runs the renal profile and my Magnesium and Potassium have come back normal. This is just so crazy!

I will say I've noticed a difference in my mood, energy, and temperature since starting the Tirosint so hopefully it's a sign of good things to come!


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## Octavia (Aug 1, 2011)

I suspect you have a couple of things going on -

1) Are you waiting 4 hours after taking your thyroid drug to take your calcium? If not, that will impact absorption of your thyroid drug.

2) I'm guessing that your thyroid dose was just plain too low, regardless of whether it's Synthroid or Tirosint. So the increase should be good for you.


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## SuzieSocialWorker (Jul 9, 2013)

Thanks for the input Octavia!

I do wait 4 hours to take Calcium. My Endo said that with as much as I'm taking (3x throughout the day), it doesn't really matter that I wait so long, that it's disrupting my PH to have that much Calcium period and that affects absorption.

I also agree that my starting doses were way too low. I actually just read that taking estrogen (which I take a high dose birth control pill) can increase your dosage needs 20-40%. So maybe that's it as well. I just hope that I am actually absorbing some of it and will get regulated. It's disheartening to see the numbers going the wrong way!


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