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New to (hypo)thyroid meds

I’ve been suffering from Hashimoto’s for 7-8 years and I’ve never been on thyroid medication before. I was recently prescribed desiccated thyroid and my starting dose is 30 mg (15 mg twice a day). If all goes well, It’ll be upped in a month or two.

I’m getting my prescription filled tomorrow and I’m scared and excited to try it. I’ve been suffering from hypo symptoms on and off for soooooo long. Does anyone have any tips or suggestions?
What was it like when your doctor put you on thyroid meds? Did you feel any different the first time you took the medication?
How long did it take for your hypo symptoms to improve?
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Avatar universal
When being treated with thyroid med, a suppressed TSH does not mean you are hyper, unless there are hyper symptoms due to excessive levels of Free T4 and Free T3.   Yes, it is likely that your PCP might interpret that as hyper, unless he understands that taking a significant daily dose of thyroid med is quite different from the usual continuous low flow of thyroid hormone from the thyroid gland, in the UNTREATED state.    If he misinterprets a suppressed TSH as hyper, then you will have to make him aware that the med has a suppressive effect on TSH for most of the day.   That is why THYROID MED IS NOT ADDITIVE TO YOUR PRIOR LEVELS.   The med causes TSH to drop and thus it reduces the output of your thyroid gland.   Since your serum thyroid levels are the sum of both natural thyroid and thyroid med, the net effect  ON FT4 AND FT3 is basically nothing until TSH is suppressed enough to minimize output from the thyroid gland.   After that, further increases in med dosages will start to raise your Free T4 and Free T3 levels.  A recent, excellent study concluded that.  "Hypothyroid symptom relief was associated with both a T4 dose giving TSH-suppression below the lower reference limit and FT3 elevated further into the upper half of its reference range. "

T4 is converted by the body to both T3 and Reverse T3 (RT3).  RT3 is a mirror image of T3, but is biologically inactive.  Under some conditions the body wil convert excessive RT3.  There is evidence of excess RT3 binding to membrane receptors and producing hypo-metabolic effects.  So it is good to at least test for RT3 at the beginning.  

Cortisol is an antagonist of thyroid hormone.  Cortisol should be neither too low nor too high.  
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Thank you Gimel
Avatar universal
There should be very little effect either way, until after your dosage is raised enough to suppress TSH.  After that further increases will start to raise your Free T4 and Free T3 levels and that is when you should notice symptoms start to improve.   Starting on 1/2 a grain (30 mg) it will take a while for you to reach that point, dependent on how soon the doctor wants to re-test and the how much your dosage is increased each time.  

For perspective, note the following conclusion from a recent study:
"Hypothyroid symptom relief was associated with both a T4 dose giving
TSH-suppression below the lower reference limit and FT3 elevated
further into the upper half of its reference range. "

Of course, hypothyroidism is not just "inadequate thyroid hormone", but instead is correctly defined as "insufficient T3 effect in tissue throughout the body due to inadequate supply of, or response to, thyroid hormone".   So there are other factors that affect TISSUE T3 EFFECT that need to be tested to make sure they are optimal.   At the beginning of treatment with thyroid medication, tests should be done for  Reverse T3 and cortisol to make sure they are not contributing to your problem.  Also important to test and supplement as needed to optimize  Vitamin D, B12 and ferritin.  
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Thank you Gimel. I'm confused. My TSH needs to be suppressed below the lower end of the reference range? Wouldn't that make my PCP think I'm hyper? How are reverse T3 and cortisol related to hypo?
1756321 tn?1547095325
I was hyperthyroid for a week then even more hypothyroid for another 4 weeks. I also had to deal with worsening of adrenal insufficiency. Train wreck! In bed for most of the 5 weeks.
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4 Comments
Thank you Red_Star. I'm so sorry you had to go through that. I'm confused. Taking thyroid hormones made you more hypo? Weren't the meds supposed to make your hypo better? Are you doing better now?

My doctor suspects that I have adrenal inefficiency too. The thing is that the supplements are too expensive for me. Is there an affordable way to treat this condition?
Natural production of thyroid hormones slows down in response to thyroid medication. It takes 4 to 6 weeks for thyroid medication to built up in the blood so you can feel more hypothyroid during this time. I'm fine now and still take 50 mcg daily of Eutroxsig. I tried Armour but I was not absorbing this. I do fine on T4 only though. Here is some info from Dr Axe...

"Some of the top superfoods for adrenal health include:

Coconut
Olives
Avocado and other healthy fats
Cruciferous vegetables (cauliflower, broccoli, Brussels sprouts, etc.)
Fatty fish (e.g., wild-caught salmon)
Free-range chicken and turkey
Bone broth
Nuts, such as walnuts and almonds
Seeds, such as pumpkin, chia and flax
Kelp and seaweed
Celtic or Himalayan sea salt
Fermented foods rich in probiotics
Chaga and cordyceps medicinal mushrooms

These foods help overcome adrenal fatigue because they’re nutrient-dense, low in sugar and have healthy fat and fiber."
Thank you Red_Star. Im glad you're doing better.
:)
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