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Synthroid to tirosint
I have been on synthroid for 13 years. I was slightly hypo after having my daughter. I am also on cytomel. I exercise and eat right. I switched to tirosint about 4 months ago because i thought it was more pure. I was ok on synthroid no big side effects. In June I started getting strange side effects. Hair thinning and breakage and a terrible aches in my joints to the point that I have stop running. My tsh is .33 and my ft3 and t4 are in range but leaning toward hypo. I am really concerned. I am worried about switching back to synthroid and feeling worse now. Anyone have this experience. Is my dose too high or is this just a period of adjustment. Any advice is appreciated!
Please post your actual FT3, FT4 and TSH results with reference ranges. Do you have FT3, FT4 and TSH while you were still on Synthroid and feeling better to compare the current results to?
What was your dose of Synthroid/Cytomel before the switch, and how much Tirosint/Cytomel are you taking now?
If both your FT3 and FT4 are "leaning toward hypo", I'd doubt your dose was too high.
What was your dose of Synthroid/Cytomel before the switch, and how much Tirosint/Cytomel are you taking now?
If both your FT3 and FT4 are "leaning toward hypo", I'd doubt your dose was too high.
I will get my exact lab results on Monday. That's a great idea I will compare my lab results. Thanks.
Hi. I got my results
free t3 2.8 1.7-3.7
Free t4 1.2. .7-1.5
Tsh .33. .35-4.94
Any advice?
free t3 2.8 1.7-3.7
Free t4 1.2. .7-1.5
Tsh .33. .35-4.94
Any advice?
Your FT4 is at 62.5% of the range with a rule of thumb to be at 50% or slightly higher.
Your FT3 on the other hand is only at 55%. with a rule of thumb to be about 66.7%
My first inclination would be to go back to synthroid and see if you feel better and maintain getting your blood labs.
It is a bit odd in that most people seem to have increased absorption with the liquicap Tirosint on the same dosage as compared to powdered pill T4 medication. You may for whatever reason have the opposit. But if you have the same blood labs as when on synthroid that also seems to be a mystery. UNLESS you have Hashi's and it took another toll on your thyroid gland, but that should have been reflected in lowering thyroid blood levels.
If you still have about the same labs and you still feel poorly, I would think you need to add a source of T3. Possibly with even a lowering of your T4 dosage.
Other questions:
Have you changed how you take your thyroid meds? That is are you still keeping the thyroid meds away from food and supplements?
Your FT3 on the other hand is only at 55%. with a rule of thumb to be about 66.7%
My first inclination would be to go back to synthroid and see if you feel better and maintain getting your blood labs.
It is a bit odd in that most people seem to have increased absorption with the liquicap Tirosint on the same dosage as compared to powdered pill T4 medication. You may for whatever reason have the opposit. But if you have the same blood labs as when on synthroid that also seems to be a mystery. UNLESS you have Hashi's and it took another toll on your thyroid gland, but that should have been reflected in lowering thyroid blood levels.
If you still have about the same labs and you still feel poorly, I would think you need to add a source of T3. Possibly with even a lowering of your T4 dosage.
Other questions:
Have you changed how you take your thyroid meds? That is are you still keeping the thyroid meds away from food and supplements?
Also do you think switching medication can be a shock to the system and set off a bunch of other symptoms
If your labs look about the same as they did on Synthroid and you felt better on Synthroid, I'd go back to it. Some things work better for an individual than another.
The active ingredient in both Synthroid and Tirosint are exactly the same. So, there should be no shock to your system. The only difference between the two is the inactive ingredients (fillers and binders), and since you've already taken Synthroid successfully, you know those don't cause you any problems.
The active ingredient in both Synthroid and Tirosint are exactly the same. So, there should be no shock to your system. The only difference between the two is the inactive ingredients (fillers and binders), and since you've already taken Synthroid successfully, you know those don't cause you any problems.
Yes, but do you have any experience with switching back and forth. I am worried I will have more symptoms. I am also beginning to wonder if the joint pain is something else! It is the same med as synthroid. Nothing changed , not even lab results. My hair has thinned since on tirosint. On a positive note i feel less foggy on tirosint. I don't understand why if these to meds are the same I would be having symptoms on the purer of the two! I also may consider staying on it for another 3 months. Maybe it takes a long time to adjust and balance. Thanks for your advice.
I don't have any experience with Tirosint. However, I have switched at will between all the brands and generics of the tablets. For me, the switch is totally seamless.
Did you have the joint pain when you were on Synthroid?
Why would you be having more symptoms on the "purer" of the two? If labs are virtually the same as when you were on Synthroid, we can rule out absorption issues. Both meds seem to have gotten to your blood stream equally well. Of course, thyroid hormone requirements are not static. Any lifestyle changes that might require more thyroid hormones so that you feel more hypo now with the same levels? Diet, exercise, other medical conditions, supplements, new job, marriage/divorce/death in the family, anything at all that's changed?
In my opinion, 4 months is more than enough time for you to "adjust and balance" to a change in meds that wasn't really a change in meds. I wouldn't waste another 3 months; I'd go back to Synthroid and see if your symptoms resolve. If they don't, you'll know that the Tirosint had nothing to do with it. You've taken Synthroid for a long time and had success with it. It's not like you're venturing into the unknown...
Did you have the joint pain when you were on Synthroid?
Why would you be having more symptoms on the "purer" of the two? If labs are virtually the same as when you were on Synthroid, we can rule out absorption issues. Both meds seem to have gotten to your blood stream equally well. Of course, thyroid hormone requirements are not static. Any lifestyle changes that might require more thyroid hormones so that you feel more hypo now with the same levels? Diet, exercise, other medical conditions, supplements, new job, marriage/divorce/death in the family, anything at all that's changed?
In my opinion, 4 months is more than enough time for you to "adjust and balance" to a change in meds that wasn't really a change in meds. I wouldn't waste another 3 months; I'd go back to Synthroid and see if your symptoms resolve. If they don't, you'll know that the Tirosint had nothing to do with it. You've taken Synthroid for a long time and had success with it. It's not like you're venturing into the unknown...
Hi need some advice! Have been taking Tirosint for about four months now. Felt good at first and then noticed the thinning hair , extereme joint pain and a bit of a weight gain. These are my labs.
free t3 2.8 1.7-3.7
Free t4 1.2. .7-1.5
Tsh .33. .35-4.94
Doctors said that I might be on the hyper side. I was on Synthroid and Cytomel before. She would like me to stop taking Cytomel.
Any advice?
free t3 2.8 1.7-3.7
Free t4 1.2. .7-1.5
Tsh .33. .35-4.94
Doctors said that I might be on the hyper side. I was on Synthroid and Cytomel before. She would like me to stop taking Cytomel.
Any advice?
No, no, no!
Your FT3 is only 55% of range, just barely into that upper half. If you don't feel hyper, then you're not hyper. She thinks you're on the hyper side because she's looking at your TSH, which is suppressed due to taking meds, especially Cytomel.
How much Cytomel do you take? A slight increase in it might actually get rid of the thinning hair, joint pain and weight gain.
Your FT3 is only 55% of range, just barely into that upper half. If you don't feel hyper, then you're not hyper. She thinks you're on the hyper side because she's looking at your TSH, which is suppressed due to taking meds, especially Cytomel.
How much Cytomel do you take? A slight increase in it might actually get rid of the thinning hair, joint pain and weight gain.
I am taking 5 mg in the morning for about 3 years. Honestly , I have not noticed a difference. She says that I am probably on the hyper side. You can have same symptoms of hypo. I have decided I will first remove the cytomel and see if I feel any better in 6 weeks. I don't think it was enough to make a difference. The doctor told me the cytomel is suppressing the TSH. So confused about this. All I know is when I switched to tirosint all these strange things happened. It doesn't make since because it is exactly the same molecule structure as synthroid minus fillers.
I switched from Synthroid to Tirosint and it took a while to get everything balanced again. I went from 150mcg Synthoid to eventually 88mcg Tirosint. My body absorbed Tirosint much better because of the lack of fillers.
Everybody is different and it takes a while to get everything balanced after switching.
Everybody is different and it takes a while to get everything balanced after switching.
How long do you think it took? I am going on 4 months now and I am beginning to think that I need less of that T4 and more of the T3. I think I will drop the Cytomel to go by the doctors orders and in six weeks I imagine My labs will not have changed And I will pretty much feel the same. Then I will ask my doctor to possibly decrease the T4 and put me on 10 mg of the Cytomel what do you think? The reason I want to go by the doctors orders is because she has always been pretty aggressive in treatment and has pretty much done the right thing. So I want to follow her orders just in case She is right.
Also, she Said that everyone is different. And some people operate at a higher TSH. With myself I know in the past when I am a little under one I feel pretty good when I go below .7 I start feeling kind of strange
You can have the same symptoms hypo as hyper, but weight gain is rarely hyper. How's your apetite? Are you gaining weight despite eating well and exercising, or are you gaining weight because your apetite is out of control?
I agree with your doctor about one thing...it's most likely that the Cytomel is supressing your TSH. So what? Seriously, low TSH causes NO symptoms. If it's suppressed due to taking T3, we all just have to agree to ignore it. Once on meds, TSH becomes irrelevant in many cases.
I also agree with you that 5 mcg is probably too little to make a very significant difference. So, there are two choices here, I guess...either eliminate it since it doesn't seem to be helping or increase it so that it does. With FT3 at 55% of range, I'd be thinking about adding a little and forgetting the TSH. Just my opinion, of course.
Whether you eliminate it or increase it, T3 is fast acting. In about a week, you should be able to retest and see what the change has done to your FT3 and evaluate how your symptoms have reacted. With a change only in T3 meds, you don't have to wait 6 weeks like you would if T4 meds had been changed.
I agree with your doctor about one thing...it's most likely that the Cytomel is supressing your TSH. So what? Seriously, low TSH causes NO symptoms. If it's suppressed due to taking T3, we all just have to agree to ignore it. Once on meds, TSH becomes irrelevant in many cases.
I also agree with you that 5 mcg is probably too little to make a very significant difference. So, there are two choices here, I guess...either eliminate it since it doesn't seem to be helping or increase it so that it does. With FT3 at 55% of range, I'd be thinking about adding a little and forgetting the TSH. Just my opinion, of course.
Whether you eliminate it or increase it, T3 is fast acting. In about a week, you should be able to retest and see what the change has done to your FT3 and evaluate how your symptoms have reacted. With a change only in T3 meds, you don't have to wait 6 weeks like you would if T4 meds had been changed.
Actually, for women hyper can increase there appetite and gain weight. Especially if you are thin to begin with. It is almost a survival mechanism. Your body reaches a point and cant lose any more weight your appetite increases and you seek out food. That is why we thyroid meds are not the solution to obesity. Also, dr said if you are feeling miserable and can't exercise thatcan do it too. I am going to do what she says. But I think that my tirosint should be reduced and t3 increased. I will keep you posted
Yes, that's what i was getting at when I asked about your appetite. Hypo weight gain tends to happen regardless of how little you eat and how much you exercise, whereas hyper weight gain usually comes with an increase in appetite and food consumption. As I said, both can happen, but from what I read here, weight gain is overwhelmingly hypo.
Another cross over symptom is fatigue, and the distinguishing elements there are whether you are tired despite sleeping as much or more than usual (hypo) or you are tired becuase of insomnia and/or inabilty to sit still for more than 5 minutes (hyper).
I definitely think you should do what your doctor has advised. Just keep the other option in the back of your mind as something else to try. It may be in the back of your doctor's mind as well.
Good luck with the change.
Another cross over symptom is fatigue, and the distinguishing elements there are whether you are tired despite sleeping as much or more than usual (hypo) or you are tired becuase of insomnia and/or inabilty to sit still for more than 5 minutes (hyper).
I definitely think you should do what your doctor has advised. Just keep the other option in the back of your mind as something else to try. It may be in the back of your doctor's mind as well.
Good luck with the change.
I think I am not being patient. I am confused and don't know what to do. I don't know why the dr took me of the cytomel? I have since last Thursday removed it. I still have the aches and pains. I am beginning to wonder if the change to tirosint back in April had anything to do with this. My labs are the same almost. But it seems that everything started about 8 weeks after I started the tirosint. So I am assuming it is the thyroid med change that triggered something. Also I feel like the logical thing would have been to increase cytomel and decrease tirosint. Strange thing is my labs are pretty much the same as they were with synthroid. So is it the thyroid med. another option is to go back to my old combo but I am very nervous about doing this. I am worried it will trigger something else. Any advice would be so appreciated! Thx
Here's my impression of why the doctor took you off of Cytomel: Your TSH is below range. Period. Doctors are taught that TSH is the gold standard in thyroid testing, and they rely on it way too heavily. Because TSH is a pituitary hormone, it can be influenced by many factors besides thyroid hormone levels. One of those factors is thyroid meds, especially meds with T3 in them. When TSH doesn't accurately reflect thyroid hormone levels, it has to be ignored. TSH causes no symptoms in and of itself, so it's the least important of the three tests (FT3, FT4 and TSH).
In your last labs posted above, your FT3 was only at 55% of range, barely into the upper half, and the target for FT3 is upper half to upper third of range. Even though you were on a small dose of T3, it's most likely going to go down now that you've discontinued Cytomel.
There's no logical way to explain this, but some people just do better on one brand over another. This is why we often caution people not to switch brands if they are doing well on a certain one.
We don't know if the switch from Synthroid to Tirosint triggered this or not. Logical as it seems, coincidence can be incredible. However, I don't think that going back to Synthroid, which you felt better on, is going to trigger anything else. Of course, I don''t KNOW that, but typically people go back to meds that worked better without triggering any new symptoms. Another bonus: If you go back to Synthroid and your symptoms don't resolve in a few weeks, you'll know that Tirosint didn't have anything to do with it and can pursue other avenues.
You discontinued Cytomel six days ago. I'd give it a few more days, just to be absolutely certain the T3 is completely out of your system (i think it probably already is, but give it a little extra time just to be sure). If your symptoms don't start to resolve soon (within a week to ten days) after that, then I don't think Cytomel was the cause. The beauty of T3 is that it's fast and doesn't try your patience quite as much as T4.
In your last labs posted above, your FT3 was only at 55% of range, barely into the upper half, and the target for FT3 is upper half to upper third of range. Even though you were on a small dose of T3, it's most likely going to go down now that you've discontinued Cytomel.
There's no logical way to explain this, but some people just do better on one brand over another. This is why we often caution people not to switch brands if they are doing well on a certain one.
We don't know if the switch from Synthroid to Tirosint triggered this or not. Logical as it seems, coincidence can be incredible. However, I don't think that going back to Synthroid, which you felt better on, is going to trigger anything else. Of course, I don''t KNOW that, but typically people go back to meds that worked better without triggering any new symptoms. Another bonus: If you go back to Synthroid and your symptoms don't resolve in a few weeks, you'll know that Tirosint didn't have anything to do with it and can pursue other avenues.
You discontinued Cytomel six days ago. I'd give it a few more days, just to be absolutely certain the T3 is completely out of your system (i think it probably already is, but give it a little extra time just to be sure). If your symptoms don't start to resolve soon (within a week to ten days) after that, then I don't think Cytomel was the cause. The beauty of T3 is that it's fast and doesn't try your patience quite as much as T4.
Thank you so much for clarifying things! I actually called the dr and asked her to decreas tirosint and increase cytomel I feel that tirosint is pure and consistent I just think dose may be too high. If she agrees I will do that. If not. I will go back to synthroid/cytomel. I will keep you posted. Thanks.
Hi , the first medicine I took when diagnosed with hypoth, was Tirosint, back then I remember my hair started to fall off and I had very bad knee pain, but I thought It was becaise I started exercising, but this pain lasted for months and I was worry about it, but never thought it was because of the medicine. then i switched to the generic one, and felt more tired than before, that is why my doctor said i should switch to Synthroid and dont go back to Tirosint because it has less side effects. With Tirosint I felt better that with Synthroid i had more energy, with the Synthroid one my TSH is in 4, with Tirosint was in 2,5. I talked with my doctor aabout it and she said that we are going to wait for 3 months and may be change the dose , but definetedly no Tirosint. I am going to wait ..... and see what happens..
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