NDT challenges

[Norty1]

Hi, I have been struggling to find a thyroid medicine for the last year that will relieve my symptoms.  I was on Naturethroid for about six years and did great.  Switched to WP Thyroid without a problem and then switched back to Naturethroid after the shortage in 6/19.  Massive hair loss, joint pain and fatigue.  Switched to NP thyroid and started to improve until the next refill which smelled like ammonia and started a return of the symptoms minus the hair loss.  Next was combo synthetic t3/t4 which any amount of 1/4 grain equivalent caused leg cramps and headache so Armour was next.  Hair loss started again and cramps with anything over 1/2 grain and so relief of hypo symptoms.  Labs were not terrible but showed the need for more medicine as did the symptoms.  Then tried and failed with compounded porcine.  I know that NP thyroid and now Naturethroid had recalls and some people are saying NDT's are not what they used to be.  I am going to give Tirosint and slow release a shot on Monday but honestly have lost hope and am worried if all this switching around is doing me in.  Any thoughts would be helpful.  My doctors are stumped.  Is the porcine powder in circulation now bad and causing all these problems?

[Barb135]

I was started on NatureThroid at the end of April and other than the fact that my endo won't give me a high enough dosage, I'm not having any trouble with it.  I do have horrible muscle cramps, but I've had those for a while now.  Cramps can be symptom of hypothyroidism, but they can also be symptoms of other things, such as Magnesium or Potassium deficiency.  Your other symptoms (hair loss, joint pain and fatigue) are pretty typical hypo symptoms.

If you can post your actual thyroid hormone levels, perhaps we can help you sort out the problems.  Be sure to post reference ranges with any lab results, as ranges vary from lab to lab and have to come from your own report(s).  

[Norty1]

Thank you for your reply!  My last thyroid test was online through Paloma and I have a lab one coming up this Thursday although I don't think it will give an accurate picture since I have been playing with medicines to keep me going.  This Paloma one doesn't test RT3..  This is on 1/4 grain of compounded porcine and 1/4 grain of synthetic t3/t4 combo.  I was trying to find a combination to keep my hair and not have leg cramps which wake me up at night.  I do not have any other conditions diagnosed:
FT3 - 3.3 (2.1 - 4.2)
FT4 - 1.1 (.8-2.0)
TPO - 51 (0-60)
TSH - 1.7 (.5-4.7)

[gimel]

Regardless of the med you take, for which there may be some variation in results, the only thing that should matter is that your FT4 and FT3 levels are high enough to relieve hypothyroid symptoms.  Before commenting on your test results, we need to know if you took your thyroid med in the morning before  the blood draw.  Also, have you been tested for Vitamin D, B12 and ferritin?  If so, please post those results.

Also, it is not clear how much T4 and T3 you are currently taking.  Please clarify.  

[Norty1]

I did not take my thyroid medicine before my test in the morning.  It equated to 19 much of t4 and 5 mcg of t3.
Ferritin is 84 (15-150)
B12 is 1089 (232-1245)
Vitamin D is 50.4 (30-80)

[Norty1]

Hi Gimel!  Not sure you saw my answers.   If you have any thoughts I would appreciate it.

[gimel]

Your ferritin is a bit lower than recommended (100 min.).  B12 and D are okay.

Looking at your thyroid tests, your FT3 of 3.3 is is at 55% of its range, but your FT4 is only at 25% of its range.   I am really surprised by your levels, with those small doses of thyroid med.  I think if it were me I would fall back on your statement:  "I was on Naturethroid for about six years and did great.  Switched to WP Thyroid without a problem and then switched back to Naturethroid after the shortage in 6/19."   What was your dose of NatureThroid and what was the dose of WP Thyroid, and the dose of NatureThroid after you switched back?    

Why not consider going back to what worked for you: the NatureThroid at the prior dose?  Also, if you have test results from the time you were originally on NatureThroid, please post them, with ranges.

[Norty1]

I would love to do that but fear something has changed with it.  I understand they now use lactose monohydrate but have no reason to believe that would cause me a problem.  I was on 1 grain of Naturethroid, then switched to 1 grain of WP and back to 1 grain of Naturethroid.  Two weeks later the hair loss and joint pain started.  It was presumed to be from the "new" Naturethroid.  The first prescription of NP thyroid was working and those symptoms were dissipating and the next refill started the symptoms again and had an odor I have never smelled before (not the normal order that comes from NDT).  Is it possible something in going on with the porcine powder now?  Results from original Naturethroid time frame 6/18:
TSH  - .145 (.45-4.5)
t3 -  4.3  (2.0-4.4)
t4  - .99.  (.82-1.77)

[gimel]

I would not expect that such symptoms would occur in such a short time after switching back to Naturethroid.  As Barb mentioned, there has been a recall, so anything still available I would expect to be okay.  I am again surprised that you would have those FT4 and FT3 results from taking only one grain of Naturethroid.   I would go back to what worked, and give it some time to have full effect.

[Barb135]

There isn't "anything" available for NatureThroid or WP as they've recalled all unexpired lots in any dosage... I've been having trouble getting my NatureThroid script refilled for several days - that's how I became aware of the recall.  I'm having to switch back to Levoxyl.  

[Norty1]

Than you Gimel and Barb.  I'm sorry you can't get Naturethroid now.  I hope all this stuff gets fixed soon.