Thinking About Changing Thyroid Medication

[Franny2016]

Hello there!
It's been a while...  I hope you are all doing well.

I am considering switching from Tirosint 125/Liothyronine 5mg to something natural like Armor.  Need your thoughts on this, please.

I had a Total Thyroidectomy in 2012 - and 10 years later, I am still not "back to normal".  It seems as though over the years there are times when it appears all is well, then symptoms creep up again.  I am really challenged by this, and I need to keep pushing through to find a viable solution.

I started doing 30 minutes of exercise 4 times weekly since September 2022. I am not losing weight and I don't feel right about 50 % of the time.

I drink coffee every morning, or the day goes by in slow motion. I can have some now, actually - but then I would not be able to sleep.  My diet is 50/50. Sometimes good, sometimes not so good.

I remember about 8 years ago, I told my primary care that I didn't like how the levothyroxine made me feel. She did not want to change it, so I sought out a holistic doctor.  He suggested I use the purified form of Tirosint.  That has been my primary source of the thyroid hormone. I'm thinking it must be the real culprit...

Here are my most recent labs:
8/28/2022
TSH   0.373   (0.450-4.500)
T4, Free   1.57   (0.82 - 1.77
T3, Free  3.5  (2.0 - 4.4)
B12  1309H  (232-1245)
Vitamin D  50.2  (30-100)
Selenium   225   (110 – 330)
Ferritin   217H   (15-150)
Zinc tested 12/23/2021   1062  (878-1660)
Potassium  3.4L (3.5-5.2)

My current symptoms:
Not losing weight
joint pain
groin pain
brain fog
anxious
dry skin
hair loss
prefer not to socialize
part of my body cramping/"feeling numb" while I am sitting
tailbone pain sometimes when I get up from sitting
moody
Not energized
Doing what I need to get by - but there is soooo much I want to do.

This is totally out of character, and it bothers me.  I appreciate your thoughts! :)
I see my holistic doctor tomorrow.

[Franny2016]

Hi Gimel, nope. I appreciate your insight! :)

A little backstory - I tried Naturetroid in 2016 and did not have a good reaction to it.  So part of the small change is me trying to transition to Armor gradually.  Today 11/20, I took Tirosint 100 at 5:30 am, and half of the 30mg :) Armor around 9 am. (I was taking 125 Tirosint and 5mg Liothyronine as of Saturday 11/19 before)  He said the high Ferritin could be due to inflammation.  This has been a lingering issue I need to address.

I agree. Let me hold off until after the labs - since it has been a year since I got a good picture of what is happening from the lab results perspective.  I will do labs this week!!  

[gimel]

Since your other iron tests were okay, it appears tht your doctor may be on to something regarding inflammation.   This is supported by the high result for C-Reactive protein.  You should talk to the doctor about steps to identify the cause and reduce inflammation.  

As for your continuing hypo symptoms \, your Reverse T3 is higher than desirable.   This reduces the effect from FT3.  A good rule of thumb is that the FT3 to Reverse T3 ratio should be at least  1.8 and some say 2.0.  Yours is only 3.3 times 100 divided by 20.4, which equals  1.6.   In addition, your cortisol test is indicative of cortisol being too high.  A much better test would be a diurnal saliva cortisol test at 4 different times of the day.   If the doctor won't order, you can order a kit online for about $140.   If your cortisol is high, that requires higher FT3.   They need to be fairly well  balanced.

If it were me I would reduce the T4 med in order to reduce FT4 and thus reduce conversion to RT3.  I would also increase FT3 levels, but not by Armour Thyroid.  It is too hard to adjust, when taking T4 med also.  Why not just take T4 and T3, so they can be adjusted separately?  Other than that I would just continue with whatever supplementation you are doing.  

[Franny2016]

Thank you Gimel! Yep - I need to focus on reducing inflammation. I can get a diurnal cortisol saliva test (I've done this before), and certainly agree that sticking with the separate T4 and T3 is the way to go.  So it's not necessarily the levothyroxine...but the inflammation that is causing issues.

I am thinking about trying 100mg T4 and 10mg T3mg...then go down to T4 88mg and T3 15mg...then T3 20mg. I am now 240.1 lbs.

Looks like I need to give up whole milk and any other inflammatory foods...  

[gimel]

FT3 largely regulates metabolism.  Low metabolism makes it hard not to gain weight, and harder still to lose weight.  If you look at the formula for estimating weight, if you add 100 calories per day to your diet, or your resting metabolism (RMR( drops by 100 calories, either change  would cause a weight gain over several years of about 24 pounds.   There is also info that indicated hypothyroid patients averaged over 300 calories low in RMR.  In addition, significant weight gain sometimes causes leptin resistance.  So it is a double whammy to y0ur weight.  I am sending you a PM with info.  To access, just click on your name and then go to messages.  

[Franny2016]

Thank you, Gimel! Aack! My metabolism is definitely off.  I sent you the info.  Thanks again! :)

[gimel]

First I'd like to ask if you took your thyroid med in the morning before the blood draw for those tests.  If so, that can cause false high results.  iF not, then your FT4 and fT3 levels would not at first look explain your symptoms.   Tirosint itself would not be a cause.  

If you are taking iron supplements you should cut back  (ferritin should be at least 100, but your level is high).   If not supplementing, then I suggest that you ask the doctor to do a full iron panel, including serum iron, TIBC, UIBC and % transferrin saturation.   I would also suggest a cortisol test, since it affects thyroid.  

If no other cause is identified you could discuss with the doctor the possibility of having thyroid  hormone resistance.   I have that myself which requires me to take a larger dose than I used to  years ago, in order to feel  well.

Please let us know how it goes for you.

[Franny2016]

Hi Gimel! No, I did not take my meds before the blood draw.  I checked the vitamins, and they do not have iron.  It's strange that the ferritin is high.  Yes, I will ask my holistic doctor to do a full iron panel. thanks. I will check on cortisol also.  Thanks so much!  Will do...

[Franny2016]

Update - I spoke with my wonderful holistic doctor, and we agreed on keeping Tirosint, but taking it down to 100mg and adding Armor Thyroid 30mg. also stopping Liothyronine.  I will try that for 6 weeks and see how I feel. RT3 in December 2021 was 16.4. I don't think I convert the T4 to T3 well. That is why we introduced Liothyronine.  So I will test complete iron, cortisol etc. and see how that looks. I believe gut issues can affect conversion also...

[Franny2016]

Hello all!

Happy Friday!  So below are my results from labs taken on 11/23/2022.  I'm definitely functioning on caffeine these days - been doing 2 cups some days recently.  I'd appreciate any insight! Thank you :)


TSH   0.537            (0.450-4.500)

T4, Free   1.44       (0.82 - 1.77)

T3, Free  3.3           (2.0 - 4.4)

Reverse T3  20.4  (9.2 – 24.1)

B12  1233                (232-1245)

Vitamin D  50.2  (30-100)

Selenium   225   (110 – 330)

Ferritin   164H   (15-150)

Zinc    955             (878-1660)

Cortisol    21.8     (Cortisol AM - 6.2-19.4)

Iron Bind. Cap. (TIBC)   308     (250-450)

UIBC   241            (131-425)

Iron    67               (27-159)

Iron Saturation   22%  (15-55)

Thyroid Peroxidase (TPO) Ab  <9   (0-34)

C-Reactive Protein, Quant   16   (0-10)

Vitamin B6, Plasma   19.5    (3.4 - 65.2)

[triplle1964]

You need to be put on cytomel/lilothyroinine only till your reverse T3 comes down . Then retest in 3-6 months to see where you’re at . Stop taking zinc, your Iron levels are off you have inflammation for sure, your ferritin is way to high . I tell you what you can do is join Adrenal fatigue and thyroid care and lol for Jamie Dolan in posts and post this panel there . Your have way to much going on that im not familiar with and do not want to give you the wrong info . You definitely can trust Jamie he is educated and knows what to tell you to do. Definitely get a 4point salvia kit from canary online labs they are as far as I know the only ones that can tell you what your results mean it’s a four point saliva test kit but you asked for a Google is $129 last time I know that’s cheap compared with other places of charging . Iron and thyroid panels you can get from ulta labs online labs if your doctor refuses to give you any of these panels . Please tag me in your post if you join the group ( it is on face book) your free T3 in low it should be around 3.8 or slightly higher by nicole hightowers posts in group. Good luck and for accurate info please join the group ! Tell them Bobbi Favre sent another person who deserves the right answers for a healthier you !