How to dose Synthroid to Nature-Throid?

[mhanan4]

Hello!

I was recently switched from my 113.75 mg Nature-Throid medication to 88 mcg Synthroid and 20 mcg Liothyronine per day because my Endo said it was easier to regulate.

I feel fine taking the Synthroid and feel as though the Liothyronine has been helping greatly, however the cost of Synthroid is way too expensive for me! I was paying $10 per month for Nature-throid and now have to pay $40.00 per month for Synthroid. I have tried Levothyroxine in the past and it disagreed with me greatly.

I am waiting for a response back from my doctor about using Nature-throid again due to how much lower the cost is, but I really would like to keep the Liothyronine as I can take it in multiple doses throughout the day and feel it helping immediately after I take it. My energy level has been greatly stabilized throughout the day after starting the Liothyronine 2x per day (10 mcg each time).

Would it be comparable to take a lower dose of Nature-throid (1.5 grains) but still be able to take 10 mcg Liothyronine per day? When just trying to raise Nature-throid exclusively my labs showed signs of over-medication and my RT3 was extremely high. I am trying to just raise the FT3 while keeping my RT3 low if that makes sense.

Thanks for your help!

[gimel]

Since one grain of desiccated thyroid med is equivalent to about 66 mcg of T4, your old dose of 113.75 mg of NatureThroid (1 3/4 grains) was the equivalent of about 116 mcg of T4 (1.75 times 66 =115.5).  T3 is about three times as potent as T4, so your current dose of 88 mcg of Synthroid and 20 mcg of T3 is equivalent to 148 mcg of T4 (88 + 3 times 20 = 148).  So with that dose increase you are feeling better; however, it increased your T4 from about 68 to 88, which is the wrong direction when having high RT3.  

To switch to NatureThroid plus T3, I think the best dose would be 1 1/2 grains of NatureThroid plus 10 mcg of T3.  This would give you 58.5 mcg of T4 and about 23 mcg of T3, which is equivalent to about 127.5 mcg of T4, which is an increase from your original 1 3/4 grain dose of NatureThroid, but not as much as your current 88 plus 20 doses.  

When you said that trying ot raise NatureThroid exclusively showed signs of over-medication, did you mean a suppressed TSH or did you have hyper symptoms?

[mhanan4]

Hi Gimel,

When trying to do the math I also believed 1.5 grains of Nature-Throid + 10 mcg Cytomel would be the way to go. My doctor is out of town for this week and I didn't want to overdose myself!

When raising Nature-Throid exclusively my labs showed signs of overmedication (My TSH extremely low) but more importantly I wasn't feeling well. I had extreme ups and downs with energy. Now that I'm on a consistent dosage daily and implementing the Liothyronine I feel more stable.

[mhanan4]

Granted I was on a weird dosage schedule with the Naturethroid previously and taking 113.75 mg T/Th/Sa and 227.5 mg M/W/F/Sun so I'm not surprised I am feeling better and more stable now!

[gimel]

Well, that dosage schedule was ridiculous for meds with T3.  No wonder you had ups and down.   And don't forget that when taking adequate thyroid medication TSH usually becomes suppressed, but that means nothing unless you also have hyper symptoms due to excessive levels of Free T4 and Free T3.

[mhanan4]

Yes I don't believe I was overmedicated on that dosage, just unstable due to the schedule. I'm feeling fine on 88 mcg t4 and 20 mcg of t3. Main goal is to get reverse t3 down and increase ft3.