# What to expect? Taking my first Synthroid in the morning!



## kat92

Finally got some results from a doctor! yay!!

He is starting me on Synthroid. 88mcg's. I really don't know a lot about it, other than it's supposed to help me with my "angry thyroid" and all the symptoms i've had for a couple years. (weight gain, hair loss, cold intolerance, etc)....He also said it's possible that some of the nodules I have my shrink. Didn't promise that, but he said it's a possibility!!

Is there anything special I need to know about this stuff? Will it help with weight loss? (been gaining steadily for 3+ years even WITH diet and excercise)...and really hopes it stops the hair loss!! ugggh.

Thanks!


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## joplin1975

Probably not much. It'll take 6-8 weeks to feel the full effects. You might feel revved up, a little jittery...that should pass and if it doesn't, 88 might be too high for someone with a thyroid. You'll just have to sit back and enjoy the ride for a while.

Remember to take it on an empty stomach, take it with lots of water, don't eat until 30-60 mins after taking it, and avoid calcium supplements for four hours.


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## kat92

A little "reving" might do me some good! haha! Make up for the last few years of under-reving! 

I just didn't know if there would be nausea or anything like that. I think I read it takes quite a few weeks for it to even make a difference on lab results!

Was just hoping I wasn't going to be sitting at work tomorrow puking my guts out or somethin! I'll take it first thing in the morning and wait to stuff my face for a couple hours.:rolleyes:

As far as zantac...when should I take/not take that? If I take that in the evening, and the synthroid in the morning, will that be ok?


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## bigfoot

Congrats! Excellent news!

Hmm... what to expect? Everybody is going to respond differently. But I think a good rule of thumb is to keep in mind that the thyroid is the precise master thermostat for your body. Too little hormone, and your body slows everything down to conserve energy. Too much, and things speed way up. Here's a few tips:

* It takes 6-8 weeks for the thyroid hormone you will be taking (T4, aka, levothyroxine) to fully build up in your system. But, getting back to everyone responding differently, you might notice changes far sooner than that (days instead of weeks).

* Be consistent. Take it at the same time each day, ideally at least 1/2 hour before food, or 3-4 hours after food. Don't take it at the same time as calcium-containing supplements. Heck, ideally, take it all by itself anyway just to be safe and optimize absorption. You can take it first thing in the AM when you wake up, or even late at night right before bed (research shows it can be more effective this way).

* Keep track of changes. Maybe jot them down in a logbook somewhere. If you have a thermometer and are so inclined, you could take your temps at around 9am, 12 noon, and 3pm. Combine and average them out together for each day, and use this as a rough & fun guide to watch your progress. Same goes for taking your weight in the AM; before starting the day and having breakfast. If all this data isn't your thing, a note or two here and there is probably plenty.

* Watch what you eat. Drink lots of water. Avoid the calcium at the same time (ideally, hours away from taking your meds), as mentioned above. Be aware that the higher in fiber your diet, the more medication you might wind up needing. T4 is absorbed through the digestive system, so if you eat a lot of fiber that can speed things through, reducing effectiveness. Not that eating fiber is a bad thing! It all comes back to being consistent. Stay away from soy and big amounts of raw goitrogenic veggies (broccoli, cabbage, etc.). If you can avoid or eliminate gluten, all that much better. Same for junk food.

* Get regular labs, keep copies of them for reference. Your doc should be following up with you, and getting routine TSH, Free T4, and Free T3 labs every 6-8 weeks for a while, until they not only show you as stable, but you FEEL good & stable. A number on a piece of paper is only a guide. This stuff is part art, part science. Beware the docs who treat only by TSH. I know it's mentioned here a lot, but I'll repeat it: most feel good with a TSH around 1.0, and Free T3 and Free T4 in the upper 75% of the range. Gives you something to work towards.

* Keep an eye out for being over-medicated. If all of a sudden you are having five BMs for days on end, or your heart is racing while watching TV, chances are you are taking too much. Call your doc, they may want to run labs sooner, and it might be time to reduce your dosage a hair. FYI: you might have a little bit of anxiety while starting thyroid meds, but this should normally wear off.

* Verify your RX. All levothyroxine (T4) medications are not the same. The FDA allows for 10% +/- potency with the meds. So if this month you are taking brand-name Synthroid, then next month the pharmacy switches you to a generic, you might notice some changes. Ideally, have your doc write you a script for a brand-name drug and add a comment like, "dispense as written" or "no substitutions", or whatever phrase is used in your area. This all comes back to being consistent, too.

That's all I can think of right now. Really, taking this stuff is not a big deal. Most of us who are hanging around here are the vocal minority that have problems that a lot of folks don't. When things are going well, people aren't likely to seek out forums for questions and advice.

hugs3


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## kat92

I think I will take it first thing in the morning. Take it, then get ready for work...hair, makeup..etc. That takes me an hour. More if I actually wanna look decent. HA! But by then I can grab something on the way to work and it'll be a good 2 hrs since I would have taken the pill.

I will try to note things at least every couple days. And if something really jumps out at me I'll be sure and keep track of it!

I hate water. Like...really really hate it. I drink flavored water. Carbonated. That's about as close as I get to drinking water. But I'll TRY...at least try and take my pill with water! I don't take calcium (yet) But I do take vitamin D. Should I take that mid day or when is that ok to take?

I love broccoli.   And junk food. I will have to find some healthy recipes it sounds like!

I have an appt. in 10 weeks for a blood draw. And of course, he said if something goes on before then to give him a call and he'll want to see me. He did say something about wanting to "get me to a 1 or .1 Tsh"..or something like that. It was a "1" in there. I should have listened closer!

He was VERY stern about the brand of medicine. He flat out said NO GENERIC!!!! So when I got to the pharmacy, they had filled the script with generic. And I said NO....he said no generic. They looked again and were like .."oops..didn't see that". So he's on top of that stuff too, brand name only, and also said wants my blood drawn at the same clinic every time so there's no difference in ranges, etc.

I can't wait to not feel like sh*t anymore. arty0049:


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## bigfoot

More water and eating healthy is never a bad thing, just hard to get started! 

Glad your doc knows to give you brand-name thyroid meds; that is very, very good. Same with trying to get your TSH around 1.0, too. Sounds like a well-informed doctor up on much of the latest. Ten weeks for a blood draw is a bit more than necessary, but I'm sure you could get it done sooner if you asked.

The Vitamin D could probably be taken around the same time as the Synthroid -- I'm not aware of any interaction. I'm not a doctor, but I did stay at a Holiday Inn last night... <drum roll> But it's nice to remove any variables, so I think a lot of us probably take our levothyroxine by itself.


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## sjmjuly

88mcgs may be a little too much to start. When I first started on meds, my doctor gave me 100mcgs and I ended up in the ER. WAAAAY to much for me. After a year of changing meds and doses, I finally had to quit all medication for a month and start all over again. I am back taking 25mcgs of Snythroid.
Do what everyone has already posted. Drink alot of water and eat healthy. Take your Synthroid at the same time every day and try to take it by itself - no food or other meds. Watch for hyper symptoms (fast or skipped heart beats, insomnia, etc) as these are possible signs for too much medication. Get new labs after 6-8 weeks.
I agree on the NO generic. They tried that first and it was awful. I guess I am a "Designer tab" girl and my body knows when your trying to give it something other than a brand name!


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## kat92

Well, I did one thing right so far at least. Took the pill with water, and didn't eat anything for about an hour and a half.

As far as healthy eating? Not so much. Eating mcdonalds as I type this!  Don't eat there that much, but it's friday, I'm kind of in a sad mood, and thought, might as well!!!!

I'm very glad he didn't give me generic! Sounds like it can be quite a mess!! I paid $19 for synthroid. So I don't see how generic could have saved me that much anyway!


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## sjmjuly

kat92 said:


> Well, I did one thing right so far at least. Took the pill with water, and didn't eat anything for about an hour and a half.
> 
> As far as healthy eating? Not so much. Eating mcdonalds as I type this!  Don't eat there that much, but it's friday, I'm kind of in a sad mood, and thought, might as well!!!!
> 
> I'm very glad he didn't give me generic! Sounds like it can be quite a mess!! I paid $19 for synthroid. So I don't see how generic could have saved me that much anyway!


Be happy it was only $19. I am covered by two insurance plans and neither one of them covers Synthroid. It costs me $80 for 90 days worth. It's a good thing I have the ability to afford it. 
Try and give up some the junk food. Bad for you and if you drink soda, that is even worse. Diet is worse than regular. I gave it all up when I found out I had hashi's. No soda, no gluten, no caffeine, no milk (I still eat some cheese) The ONLY thing I CAN'T give up is my glass of red wine!hugs6


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## Andros

kat92 said:


> Finally got some results from a doctor! yay!!
> 
> He is starting me on Synthroid. 88mcg's. I really don't know a lot about it, other than it's supposed to help me with my "angry thyroid" and all the symptoms i've had for a couple years. (weight gain, hair loss, cold intolerance, etc)....He also said it's possible that some of the nodules I have my shrink. Didn't promise that, but he said it's a possibility!!
> 
> Is there anything special I need to know about this stuff? Will it help with weight loss? (been gaining steadily for 3+ years even WITH diet and excercise)...and really hopes it stops the hair loss!! ugggh.
> 
> Thanks!


This is an exciting day and I hope you are on the pathway to wellness. You may or may not feel something for as pointed out by a fellow poster and friend, it takes 6 to 8 weeks to build up.

In the meantime will your doc be seeing you at the 8 week mark for labs?


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## kat92

Sjmjuly: Yea, I was expecting in to cost a lot more!! Im fortunate to have good insurance. I can't imagine going thru something like this without it!
I need to eat better, You are right. And I do like diet pop! I always think it's better to have less calories, but people tell me all the junk in the diet pop is way worse for you than just the sugar in the regular.

Edited to add.....I totally understand the red wine thing. However my new downfall is the Strawberita's that bud light came out with. It's an 8 oz can of happiness!

Andros: Took my pill this morning. I don't feel any different. I don't think anyway. I slept like crap last night. Night sweats, then cold. Then woke up with my mind racing.....etc etc. So Im exhausted! Gonna try and sleep good tonight and see how I feel in the next few days after being on the medicine. Hopefully it works so good I just one day realize how much better I feel...and it will have just snuck up on me gradually!!


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## sickofbeingfat

Yay for us, I start my levo this week too!!! I am so excited to feel better!! :hugs:


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## kat92

What's funny is, I've never really thought I felt "bad". Kinda blah...but never like ...omg...this is horrible...i can't take it. But I think I just got so use to feeling like this (whatever this is), and just chalked it up to age, stress whatever. I knew something wasn't right, but figured I'm not 20 years old anymore. Not everything is going to be "right"! haha!

So we'll see if I pick up on anything that changes. Or if all of a sudden one day I recognize I feel different...a good different!

** really hoping for some weight loss.. now THAT would be a good feeling for me!!!. arty0006:


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## sjmjuly

The crap in diet soda (the fake sweetner they use) is HORRIBLE for even the healthy people. For people with hashi's, it's worse. In addition to having all sorts of hypo/hashi symptoms, my gut was in really bad shape. Bad heart burn and throwing up all the time. Had a food sensitivity test and that's when I found out I was alergic to grains. Went gluten free and that's really helped. 
The Synthroid will take awhile to build up in your system, though some people feel relief in a week or so. Remember to watch for hyper signs indicated you may be on too much. If so, call your doctor right away and let him know what's going on. They usually have you back off it for a day or two and sometimes lower the does until you can adjust. The trick with meds is to go low and slow. Start out on a low dose and slowly increase.


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## kat92

I'm lazy today. Too lazy to even search. :ashamed0001:

So What all "hyper" signs should I watch for?


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## jenny v

I agree with sjmjuly, ditch the diet soda. It is horrible for your system, esp. for those of us with thyroid issues. I had to cut out all caffeine cold turkey a few years ago and while it sucked big time for a few weeks, in the long run my digestive system is so much better.

I wouldn't research everything to death right away, just be mindful of your body. One thing to remember with thyroid problems (and Synthroid) is that it takes time to get things sorted out. Unfortunately, most thyroid problems are a marathon, not a sprint, and we have to have patience.


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## sjmjuly

jenny v said:


> I agree with sjmjuly, ditch the diet soda. It is horrible for your system, esp. for those of us with thyroid issues. I had to cut out all caffeine cold turkey a few years ago and while it sucked big time for a few weeks, in the long run my digestive system is so much better.
> 
> I wouldn't research everything to death right away, just be mindful of your body. One thing to remember with thyroid problems (and Synthroid) is that it takes time to get things sorted out. Unfortunately, most thyroid problems are a marathon, not a sprint, and we have to have patience.


Ditto. I totally agree with Jenny. 
Hyper symptoms are rapid or skipped heart beats, insomnia, sweating, anxiety, feeling jittery, etc. Which with hashi, can also be a sign that your antibodies are on the war path and attacking your thyroid. (Not sure if you said you had hashi's or not) Hashi's is a whole other barrel full of laughs. Not only do you have to deal with a dying thyroid and all the fun that goes with that, you also have the autoimmune issue to contend with. I personally think the doctor's just need yank the damn thing out when hashi's is present and call it a day. In my next life I am coming back as an endo and removing everyone's thyroid,,,,:tongue0013:hugs4


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## kat92

sjmjuly said:


> Ditto. I totally agree with Jenny.
> Hyper symptoms are rapid or skipped heart beats, insomnia, sweating, anxiety, feeling jittery, etc. Which with hashi, can also be a sign that your antibodies are on the war path and attacking your thyroid. (Not sure if you said you had hashi's or not) Hashi's is a whole other barrel full of laughs. Not only do you have to deal with a dying thyroid and all the fun that goes with that, you also have the autoimmune issue to contend with. I personally think the doctor's just need yank the damn thing out when hashi's is present and call it a day. In my next life I am coming back as an endo and removing everyone's thyroid,,,,:tongue0013:hugs4


Ok...that made me giggle out loud. "coming back as an endo and removing everyone's thyroid". :anim_63: I've never heard that, but I love it. Way better than most people's "I'm coming back as a cat, a dog..or a bird". Endo is WAYYYY better!

I honestly don't even know if I have Hashi's. He said i "probably" do, most likely. No blood test was done or anything to confirm it though. Just going off my symptoms and off some of the lab. (not to mention the positive ANA, so something is being attacked somewhere in my body! Too bad its not fat cells)
But yea, I have all those symptoms anyway! Insomnia, sweating (hot flashes night sweats), anxiety. Its a variety depending on the day. Im just really tired of the hair loss and weight gain. Why can't those two be switched around!?!?! ha! Hair gain. weight loss. Sign me up!

I maybe have one diet pop every couple days. Other than that, I drink carbonated flavored water. Probably not much better than diet pop. But baby steps...... I'm trying!!!!!!!!!


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## sjmjuly

kat92 said:


> Ok...that made me giggle out loud. "coming back as an endo and removing everyone's thyroid". :anim_63: I've never heard that, but I love it. Way better than most people's "I'm coming back as a cat, a dog..or a bird". Endo is WAYYYY better!
> 
> I honestly don't even know if I have Hashi's. He said i "probably" do, most likely. No blood test was done or anything to confirm it though. Just going off my symptoms and off some of the lab. (not to mention the positive ANA, so something is being attacked somewhere in my body! Too bad its not fat cells)
> But yea, I have all those symptoms anyway! Insomnia, sweating (hot flashes night sweats), anxiety. Its a variety depending on the day. Im just really tired of the hair loss and weight gain. Why can't those two be switched around!?!?! ha! Hair gain. weight loss. Sign me up!
> 
> I maybe have one diet pop every couple days. Other than that, I drink carbonated flavored water. Probably not much better than diet pop. But baby steps...... I'm trying!!!!!!!!!


Oh and I also forgot to add in there perimenopause/menopause! That adds MORE fun to the mix! I turned 50 this year and now I don't know if it's hashi's or perimenopause causing my symptoms! I haven't had a skipped heart beat in weeks and BAM. They started this morning and SO DID MY PERIOD!:tongue0013:


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## kat92

ohhh. no no no!! I'm gonna top ya on that one!!! 

I was "told" I was going through menopause......6 years ago!!! I was 32!!!!!!!!!!! That was when I was dumb and didn't ask questions. So all this "menopause" the last 6 years has probably been my flippin thyroid!!!!! So I could have been on top of this YEARS ago, but of course "your labs are fine...take some birth control and that will help with the menopause symptoms". They even sent me to an obgyn who thought I needed an endometrial ablation. Wth? NO!...step away from my uterus.

hot flashes, weight gain, strange periods, hair falling out. And gee....look now...it's my thyroid!!!! Stupid STUPID doctors!!! I had just had a baby a few years before they told me that. But then all of a sudden I was in the throws of menopause?!! Whatever. I wish I would have bugged them more about things back then.

**sorry about the heartbeat thing though. Those aren't fun. throws ya off kilter for a while. 

And my period is late. Watch me be pregnant. That'd be just my luck. FML.

hee hee!


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## sjmjuly

kat92 said:


> ohhh. no no no!! I'm gonna top ya on that one!!!
> 
> I was "told" I was going through menopause......6 years ago!!! I was 32!!!!!!!!!!! That was when I was dumb and didn't ask questions. So all this "menopause" the last 6 years has probably been my flippin thyroid!!!!! So I could have been on top of this YEARS ago, but of course "your labs are fine...take some birth control and that will help with the menopause symptoms". They even sent me to an obgyn who thought I needed an endometrial ablation. Wth? NO!...step away from my uterus.
> 
> hot flashes, weight gain, strange periods, hair falling out. And gee....look now...it's my thyroid!!!! Stupid STUPID doctors!!! I had just had a baby a few years before they told me that. But then all of a sudden I was in the throws of menopause?!! Whatever. I wish I would have bugged them more about things back then.
> 
> **sorry about the heartbeat thing though. Those aren't fun. throws ya off kilter for a while.
> 
> And my period is late. Watch me be pregnant. That'd be just my luck. FML.
> 
> hee hee!


Yeah they kept telling me it wasn't my thyroid either and that I needed Prozac! REALLY???? The idiots. All they ever tested was my TSH and it was high (4.6) BUT this was in "their range" so they never tested anything else. When I finally got mad enough and researched, I finally got my free's and my antibodies tested. Oh gee look dipstick, moron, idiot doctor, I HAVE HASHI's! And he wanted me on Prozac. I switched doctors immediately. 
I hate the skipped heart beats. They are scary and disrupt my day when they happen.


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## bigfoot

I could probably copy your story and replicate it 1000's of times here on this site and others, not to mention the folks I know of in my personal life. I honestly think they should pass a law forbidding drug reps from entering doctors' offices. The negatives outweigh the positives. Yes, docs need to be up-to-date on the latest treatments, but not at the expense of pushing them on patients just because they don't want to turn over a few stones.


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## jenny v

I had one PCP tell me that perhaps I should being seeing someone for mental issues since it "obviously wasn't physical" issues causing my symptoms. I was so stunned I just gaped back at him as he left the room (he's lucky I wasn't swinging hyper at that point and been all raging or I would have punched him in the face, lol!). Oddly enough, I just got a letter from his office this week informing me that he had passed away recently and it brought back that whole memory.

I actually don't really mind the skipped beats anymore (after 10 years, I'm used to them!). They're annoying, but strangely it does remind me that my heart is working away in there to keep me going. Makes me appreciate the things that are working correctly in my body.


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## sjmjuly

jenny v said:


> I had one PCP tell me that perhaps I should being seeing someone for mental issues since it "obviously wasn't physical" issues causing my symptoms. I was so stunned I just gaped back at him as he left the room (he's lucky I wasn't swinging hyper at that point and been all raging or I would have punched him in the face, lol!). Oddly enough, I just got a letter from his office this week informing me that he had passed away recently and it brought back that whole memory.
> 
> I actually don't really mind the skipped beats anymore (after 10 years, I'm used to them!). They're annoying, but strangely it does remind me that my heart is working away in there to keep me going. Makes me appreciate the things that are working correctly in my body.


So Jenny you have the skipped heart beats too????? I hate them. But that's a great way to look at it: Your heart is in there working!


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## kat92

My trust in doctors is very minimal. Especially when they don't listen!!!


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## sickofbeingfat

I get the skipped beats too, they scare the sh*t out of me, like I can feel my heart fluttering, it takes my breath away. Why do we get these, is it the antibodies or something? I get them when I am hyper or hypo.

Oh and I agree it's crap what thyroid patients have to go through... Six years ago I was in the ER tachycardic with a TSH of .01 actually it was less than that it didn't even register so they just said .01 That day they asked me like a thousand times if I did drugs becasue my heart rate was so high, so I said go check my blood and my pee for drugs in my system before you sit here and treat me like a dam criminal....I remember the ill from the hospital mainly consisted of drug test. but what ****es me off was that when I was there two years prior they did blood work and even then it showed I was hyper, I just never knew it, I guess they either noticed it and did nothing or just didn't see the high tsh in my lab results.... Then I went up and down for three years and now I am finally hypo and just now get meds. I feel like ten years of my life has been stolen from me. Oh and I remember when they realized I had a thyroid problem, my PCP says, "Oh that is why you are like this" seriously!


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## ives6797

My mom has to take brand name Synthroid, she can not take the generic. I am not exactly sure of the cause.


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## jenny v

> So Jenny you have the skipped heart beats too????? I hate them. But that's a great way to look at it: Your heart is in there working!


 Oh yeah, had them for years! That's actually how my thyroid problems were finally diagnosed, it made my heart go bananas when I was crazy hyper and I ended up in the ER while on vacation. One of the ER docs asked if I had ever had my thyroid checked and bingo, it finally all came together from there. I'm on a daily anti-arrhythmic drug and a beta blocker, which both help a lot (even though when my thyroid swings it can often override the drugs).


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## sjmjuly

jenny v said:


> Oh yeah, had them for years! That's actually how my thyroid problems were finally diagnosed, it made my heart go bananas when I was crazy hyper and I ended up in the ER while on vacation. One of the ER docs asked if I had ever had my thyroid checked and bingo, it finally all came together from there. I'm on a daily anti-arrhythmic drug and a beta blocker, which both help a lot (even though when my thyroid swings it can often override the drugs).


You and I were diagnosed with hashi's at just about the same time. I was March of 2012 after feeling crappy for a whole year. The skipped heart beats are better now that I stopped taking Naturethroid and started Synthroid. I took the NT for over a year with no issues and then all of a sudden my body couldn't tolerate the T3. Made my heart go nuts. The Synthroid has been great so far and skipped heart beats are few and far between. I also ended up in the ER on vacation before I knew it was my thyroid! Thought I was having a heart attack.


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