# Starting meds - YIKES!



## sjmjuly (Mar 23, 2012)

I am new to Hashi's and just started taking a very small dose of Nature Throid Saturday. I take 1/8 of a grain at night and 1/4 grain in the morning for a total of 24mcgs. Did great Saturday/Sunday, so so Monday and then this morning,,,,,YIKES. I chewed the 1/4 grain at 4:45 this morning and holy cow, about an hour later I was climbing the walls and had to take an Ativan! For all of you taking meds, is this normal when you first start? I am taking such a low dose I am surprised it's doing this to me. I finally relaxed, but here I am at work just "speeding along"! Is this normal at first?


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## joplin1975 (Jul 21, 2011)

It's hard to say what normal is...everyone's experience is so different.

That said, you are taking a T4/T3 combo drug. T3 can be powerful stuff and some people would have a difficult time tolerating it. Especially if you still have your thyroid. That's why most people start off on T4 drugs and then, if those prove to be ineffective, more to the combination medications.

There are lots of folks with tons of T4/T3 experience, so hopefully they will chime in soon.


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## sjmjuly (Mar 23, 2012)

I took Levothroid first and it did the same thing to me. I am starting to think maybe I don't need meds yet. I am taking Thytrophin which is a thyroid supplement. I truely believe my gluten intolerance is why I have Hashimotos and that my thyroid was fine before my antibodies started beating it up. I am gluten free now, but just taking the Thytrophin wasn't getting rid of my symptoms. That's why I started the NT. Maybe I jumped the gun and didn't give the Thytrophin enough time, or maybe I really only need a very, very low dose of the NT. I seem to do better when I just take 1/8 of a grain which is about 8mcgs. This is such a guessing game in the beginning. I went to the lab this morning for two more antibody tests. Hopefully in a couple of days I will know where I am at and if they are improving or not.


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## webster2 (May 19, 2011)

I have heard chewing the Nature-Throid gets the medication into your body quicker. I just swallow mine, and have yet to notice the T3 kick in. I am still living in the slow lane! I am sure someone will be along with some real info! Best to you!


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## sjmjuly (Mar 23, 2012)

Funny you should say that! I heard chewing it gets it in your system faster and that's exactly what I did! WOW. Talk about starting your engine. I was off to the races in no time!


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## joplin1975 (Jul 21, 2011)

Just saying this as a friendly reminder...

Don't forget to ask follow up questions about that ultrasound. My labs were very similar to yours, except my TPO was a bit more elevated. In between the time I got an "indicative of Hashi's" report from my endo and my results from the FNA, I took 50mcgs of Synthroid and nearly lost my mind. As my husband, "Wow, so this is what its like to live with a meth addict!"

It *was* Hashi's but it was also cancer. My thyroid was such a hot mess that I'm convinced no matter what medication I was on, I'd feel wired.


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## sjmjuly (Mar 23, 2012)

joplin1975 said:


> Just saying this as a friendly reminder...
> 
> Don't forget to ask follow up questions about that ultrasound. My labs were very similar to yours, except my TPO was a bit more elevated. In between the time I got an "indicative of Hashi's" report from my endo and my results from the FNA, I took 50mcgs of Synthroid and nearly lost my mind. As my husband, "Wow, so this is what its like to live with a meth addict!"
> 
> It *was* Hashi's but it was also cancer. My thyroid was such a hot mess that I'm convinced no matter what medication I was on, I'd feel wired.


Joplin,
Did you have any noticible inflammation? What symptoms did you have?


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## joplin1975 (Jul 21, 2011)

Yes, my GYN was the one who found that my thyroid was enlarged. That said, it wasn't VERY noticeable. My husband, brother-in-law and sister-in-law are all PAs and I see them regularly -- none of them noticed until after my GYN did. The part that was noticeable was the largest tumor -- 3.2 cms. The other four tumors could not be seen or palpitated easily.

At the time I considered myself completely asymptomatic. I ran 20 miles a week, rode horses, and did boot camp-style training workouts. Now that the thyroid is removed and things are settling down, I realize I had muscle/joint pain, fatigue, and bouts of constipation and diarrhea (formerly diagnosed as IBS).


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## sjmjuly (Mar 23, 2012)

I am going to insist on an ultrasound. All the docs that I have seen have said there isn't any inflammation, but I don't trust them. I have had CT scans, an MRI, so much blood taken out of me I am surprised I am walking around still and saliva test to check my cortisol levels. The only thing that came back weird was my thyroid numbers. The other weird thing is that my TSH has decreased over the past 4 yrs. In 2008 it was 4.62, in 2011 it was 4.4 and now it's 3.9. I have been having symptoms for a year and blamed them on perimenopause as I am 49. I started out having panic attacks and anxiety along with nausea. Those are pretty much gone, but now I just feel like crap. I think it's because my T3 & T4 levels are in range, but on the very low side. AND my TPO at last check was 439. But with that said, I have had gut issues for YEARS. Horrible heartburn especially after eating wheat anything. Big surprise. I hope I don't have cancer,,,,


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## Andros (Aug 26, 2009)

sjmjuly said:


> I am new to Hashi's and just started taking a very small dose of Nature Throid Saturday. I take 1/8 of a grain at night and 1/4 grain in the morning for a total of 24mcgs. Did great Saturday/Sunday, so so Monday and then this morning,,,,,YIKES. I chewed the 1/4 grain at 4:45 this morning and holy cow, about an hour later I was climbing the walls and had to take an Ativan! For all of you taking meds, is this normal when you first start? I am taking such a low dose I am surprised it's doing this to me. I finally relaxed, but here I am at work just "speeding along"! Is this normal at first?


Is NatureThroid 65 mgs. to the grain? Is that right about the 24 mcgs? Or should it be mgs.?

Do you stay busier on Sat. and Sun. than you ordinarily would during the week? By that I mean physically busier?


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## sjmjuly (Mar 23, 2012)

Andros said:


> Is NatureThroid 65 mgs. to the grain? Is that right about the 24 mcgs? Or should it be mgs.?
> 
> Do you stay busier on Sat. and Sun. than you ordinarily would during the week? By that I mean physically busier?


My doc gave me a bottle of 1/2 grains which is 32mcgs. I cut these in half and take a 1/4 in the morning and a 1/8 (I cut the 1/4 in half) at night two hours before I eat dinner. I seem to do better with this amount. No jitters like this morning. 
I felt like CRAP on Saturday and went to a horse expo all day. (My husband I have horses) I LOVE going to these events and I about died as it was all day. When I got home, I started the NT - I took 1/8 and then early Sunday morning I took a 1/4. I felt great on Sunday. Best I had felt in a year. I took another 1/8 Sunday night and another 1/4 Monday morning and felt awful Monday. SO here it is Tuesday and this morning the 1/4 about did me in. It's Tuesday afternoon now and I still have the tinnitus, but I am not as tired.


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## Andros (Aug 26, 2009)

sjmjuly said:


> My doc gave me a bottle of 1/2 grains which is 32mcgs. I cut these in half and take a 1/4 in the morning and a 1/8 (I cut the 1/4 in half) at night two hours before I eat dinner. I seem to do better with this amount. No jitters like this morning.
> I felt like CRAP on Saturday and went to a horse expo all day. (My husband I have horses) I LOVE going to these events and I about died as it was all day. When I got home, I started the NT - I took 1/8 and then early Sunday morning I took a 1/4. I felt great on Sunday. Best I had felt in a year. I took another 1/8 Sunday night and another 1/4 Monday morning and felt awful Monday. SO here it is Tuesday and this morning the 1/4 about did me in. It's Tuesday afternoon now and I still have the tinnitus, but I am not as tired.


Glad the NatureThroid is kicking in.

Here is info. You are taking MG, not MCG. 
http://www.nature-throid.com/

Nature-Throid™ (Thyroid USP) Tablets, micro-coated, easy to swallow with a reduced odor, for oral use are
natural preparations derived from porcine thyroid glands (T3 liothyronine is approximately four times as
potent as T4 levothyroxine on a microgram for microgram basis). They provide 38 mcg levothyroxine (T4)
and 9 mcg liothyronine (T3) for each 65 mg (1 Grain) of the labeled content of thyroid.

http://www.nature-throid.com/images/Nature-Throid-PI-Rev041121-03.pdf

It may take some time but I do believe this will help alleviate the tinnitus as well. I sure hope so!


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## sjmjuly (Mar 23, 2012)

I am concerned though because just the smallest dose is making me jittery. I took just an 1/8 of a grain and woke up with the jitters & pounding heart. Had to take an Ativan to relax. Why is this happening?


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## lainey (Aug 26, 2010)

What were your original labs?

Are you still chewing it? This medication is meant to be swallowed with a full glass of water.

Some people do not handle T3 very well, it packs a punch and can take some getting used to.


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## sjmjuly (Mar 23, 2012)

lainey said:


> What were your original labs?
> 
> Are you still chewing it? This medication is meant to be swallowed with a full glass of water.
> 
> Some people do not handle T3 very well, it packs a punch and can take some getting used to.


Here are my original labs:
2008 - TSH - 4.62
2011 - TSH - 4.4
No T3 or T4 because my old doctor didn't run them and I didn't even know I had a problem until February 2012.
Recent Labs:
TSH - 3.9 (range .03 - 3.0)
Free T3 - 2.8 (range 2.5 - 6.5)
Free T4 - .09 (range .07 - 3.0)
TPO - 439

I am taking vitamins C, D, B12, B complex, magnesium, calcium, zinc & selenium. I am also taking Thytrophin which is a natural thyroid supplement which gives me no issues. I tried Levothroid 25mcgs and I went hyper. Trying 1/8 grain of Nature Throid (not chewing it anymore) and it's making me jittery. I am gluten intolerant and think this is how my hashi's started. I have since gone gluten free, but it's only been two weeks. My symptoms have improved somewhat but still dealing with an off balance feeling & tinnitus. Blood pressure is usually 107/75 to 115/77, temperature is usually 97.7 to 98.4. I am still intolerant to cold though - can't seem to get past it yet. Not as tired as I used to be which is good, and the anxiety is gone. I drink a ton of pure water everyday. 
I am starting to think my thyroid is trying to fight back and maybe if I get a grip on the antibodies it might delay the death of my thyroid for awhile. I know there is no cure for this, but I am hoping for remission. I just don't know what to do about the NT. I can't cut the pills any smaller than I have been! I suppose I could just lick one!:tongue0013:


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## lainey (Aug 26, 2010)

The medication generally does not impact the antibodies. They run their own course.

You would not be the first person with subclinical labs to have problems taking thyroid replacement meds--ie, they make you feel hyper. It may just be that you are not all the way there yet.


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## sjmjuly (Mar 23, 2012)

lainey said:


> The medication generally does not impact the antibodies. They run their own course.
> 
> You would not be the first person with subclinical labs to have problems taking thyroid replacement meds--ie, they make you feel hyper. It may just be that you are not all the way there yet.


Meaning my thyroid is still fighting for its life? I would agree with you. I know the meds do nothing for the antibodies. I am trying (with diet & the thytrophin) to give them something else to "eat" other than my thyroid.


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## joplin1975 (Jul 21, 2011)

lainey said:


> You would not be the first person with subclinical labs to have problems taking thyroid replacement meds--ie, they make you feel hyper. It may just be that you are not all the way there yet.


Again, this was me. And, again, the usual course is to try T4 only meds first and then work towards combo medications if the T4 only medications aren't helping...because, as noted, T3 is powerful stuff. I never tried combo medications, but I am absolutely convinced if I had while I still had my thyroid, I would be in big, big trouble. I have some difficulty changing doses with T4...guess I just happen to be sensitive. If your symptoms don't get better, you might want to ask about T4 only meds.


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## sjmjuly (Mar 23, 2012)

joplin1975 said:


> Again, this was me. And, again, the usual course is to try T4 only meds first and then work towards combo medications if the T4 only medications aren't helping...because, as noted, T3 is powerful stuff. I never tried combo medications, but I am absolutely convinced if I had while I still had my thyroid, I would be in big, big trouble. I have some difficulty changing doses with T4...guess I just happen to be sensitive. If your symptoms don't get better, you might want to ask about T4 only meds.


Thanks Joplin, I think you are right. I haven't taken the NT since Monday and had another nightly episode of heart palpitations. Woke up at the same time I did the night before with a pounding heart. Man I hate that. Had to take an Ativan and wait it out. It lasted about 15 minutes then I was able to go back to sleep. Now I am afraid to go to bed tonight in fear of it happening again. No more meds for me for awhile. I just don't think my thyroid is trashed enough to take them. I feel crappy, but I feel worse taking the medication. Even the low dose of Levothroid (which IS T4 only) made me hyper. I am going to continue with the Thytrophin, vitamins, minerals and gluten free diet for awhile and wait for my thyroid to sing it's "swan song" before I get on the med train.


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## Andros (Aug 26, 2009)

sjmjuly said:


> Thanks Joplin, I think you are right. I haven't taken the NT since Monday and had another nightly episode of heart palpitations. Woke up at the same time I did the night before with a pounding heart. Man I hate that. Had to take an Ativan and wait it out. It lasted about 15 minutes then I was able to go back to sleep. Now I am afraid to go to bed tonight in fear of it happening again. No more meds for me for awhile. I just don't think my thyroid is trashed enough to take them. I feel crappy, but I feel worse taking the medication. Even the low dose of Levothroid (which IS T4 only) made me hyper. I am going to continue with the Thytrophin, vitamins, minerals and gluten free diet for awhile and wait for my thyroid to sing it's "swan song" before I get on the med train.


The Thytrophin combined with the NT is the reason you are going hyper. Thytrophin is bovine dessicated thyroid.

Does your doctor know you are taking this?

They state that Thyroxine (T4) is removed but they do not state that Triiodothyronine (T3) is removed.

What is your input on this? Since you are taking it, you may know more about the product.

http://www.standardprocess.com/disp...e=/Public/Lit/TabSheets/thytrophinpmg8025.pdf


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## sjmjuly (Mar 23, 2012)

Andros said:


> The Thytrophin combined with the NT is the reason you are going hyper. Thytrophin is bovine dessicated thyroid.
> 
> Does your doctor know you are taking this?
> 
> ...


My doctor is the one that prescribed both of them for me. I have a call into her now and waiting for her to return it. But I got this way taking Levothroid too and that only has T4 in it. I am confused,,,


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## Gwen1 (Sep 3, 2011)

> Even the low dose of Levothroid (which IS T4 only) made me hyper.


Hi sjmjuly, I am wondering how long you were taking the 25 mcg. of Levothroid and what do you mean when you say you went hyper on it?
If at some point you decide that your body needs thyroid medication, it would be good to get this question resolved and to know more about how thyroid medication works in the body. You came to the right place for information and advice.



> I am taking vitamins C, D, B12, B complex, magnesium, calcium, zinc & selenium. I am also taking Thytrophin


If you do decide to go back on the T4 only, I would seriously think about cutting back on some of these vitamins. Also I would cut out the Thytrophin as that could be causing some effect while taking thyroid medicine. (my opinion only) 
And just to make sure you know, we are not supposed to take our vitamin supplements til 4 hours after we take our thyroid med. as they can interfere with absorption of your med., esp. calcium and iron.

I'm just a fellow forum member who has been taking Levoxyl (T4 only) for 16 years and have made many observations on the thyroidboards.


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## sjmjuly (Mar 23, 2012)

Gwen1 said:


> Hi sjmjuly, I am wondering how long you were taking the 25 mcg. of Levothroid and what do you mean when you say you went hyper on it?
> If at some point you decide that your body needs thyroid medication, it would be good to get this question resolved and to know more about how thyroid medication works in the body. You came to the right place for information and advice.
> 
> If you do decide to go back on the T4 only, I would seriously think about cutting back on some of these vitamins. Also I would cut out the Thytrophin as that could be causing some effect while taking thyroid medicine. (my opinion only)
> ...


I litterally took the Levothroid for three days and felt like hell. On the fourth day I ended up in the ER. They decreased the dose to .25 and an hour after I took it I had hyper symptoms. (jittery, fast heart beat, etc..) AND this was before I started taking the Thytrophin. 
My labs are so boarderline that I am starting to think it's too soon for thyroid meds. It doesn't matter what I take or what dose it is, I have hyper symptoms. My doc called and I have an appt with her next week. She wants me to continue the Thytrophin & the progesterone and we are going to try and get my immune system calmed down a bit to stop the hypo/hyper swings before trying the meds again.


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## Gwen1 (Sep 3, 2011)

> They decreased the dose to .25 and an hour after I took it I had hyper symptoms.


So if they decreased the dose to .25, what dose were your taking the first 3 days?


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## sjmjuly (Mar 23, 2012)

Gwen1 said:


> So if they decreased the dose to .25, what dose were your taking the first 3 days?


My regular doc prescribed 100mcgs! He is NOT an endo and is just my PCP. After this I went to a natual doc and she started me on the Nature Throid 1/4 grain and then wanted to bump me to 1/2 grain two weeks later. We never got that far.


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## Gwen1 (Sep 3, 2011)

Sjmjuly, Well that explains why you went hyper. The 100 mcg. was too high of a starting dose. You should have been started out on 25 or 50 mcg. and then titrated up to the higher dose. There is a titration process involved when starting thyroid medication. Start low and slowly titrate up every 6-8 weeks with labs to show where your levels are at. You may not even need to be at 100 mcg. It all depends on what your labs are showing at each dosage. I hope your new doctor is explaining this process to you. 
That experience would have scared me off too.


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## sjmjuly (Mar 23, 2012)

I think 100mcgs was too much as well. The Thytrophin has NO active thyroid hormones in it and it's never given me any trouble like the Levothroid or the NT. It's simply a thyroid supplement used to boost your thyroid and it binds with some of the antibodies to help give your thyroid a break. It kinda acts like a bodyguard. I had another antibody test done a few days ago and I should have the results today. I will post as soon as I get them back.


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## joplin1975 (Jul 21, 2011)

Oh, goodness, yes, 100mcgs is way, way, way too much. I'm shocked someone would consider starting you there. Looking forward to your new lab work...


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## sjmjuly (Mar 23, 2012)

joplin1975 said:


> Oh, goodness, yes, 100mcgs is way, way, way too much. I'm shocked someone would consider starting you there. Looking forward to your new lab work...


My PCP isn't and endo and apparently knows NOTHING about Hashi's. When I emailed him and asked for an endo referral, it was like asking him for his right arm! (Geez, get over yourself I thought to myself,,,,) I also have my natural doc, but I have no insurance coverage for her so I want an endo to run my tests. I have insurance for that. :tongue0015:


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