Switching from Synthroid to WP Thyroid

[MellyH2015]

Hello, I am a 34 yo female. I have hashimotos. I have been taking Synthroid since I was 18yo. I see an endo usually every 3-6 months and have slight dosage adjustments usually bouncing from 150-137mcg. Recently I was on 137mcg and started feeling major hypo symptoms coming on. My hair was falling out in MASSES as well. I have never had hairloss this bad and felt so horrible from my thyroid.

I took a lab test and the results were

01/16/15
TSH 1.17
T4Free 1.1   (0.8-1.8)
T3 Free 2.9  (2.3-4.2)

I asked the doctor to up my dosage to 150 mcg and she did. I took that for a few days but was feeling tightness in my chest and thought maybe I was having hyper symptoms since my labs a month prior my TSH was 1.83 and had actually dropped so I went back to my 137.  By 01/27/15 10 days later I was feeling like death so I went and had my labs done again thinking maybe there was a lag in my symptoms and blood work or maybe a deficiency.

01/27/15 labs

TSH 2.26
T4Free 1.27 (0.82-1.77)
T3Free 2.6 ( 2.0-4.4)
Vitamin D 44.9  (30.0-100) Already taking 6000 a day to bring this up
Vitamin B12 599 (211-946) taking supplements for this as well
Ferritin 91   (15-150)

Looks like I should've stuck with the 150mcg for longer but after reading all these boards and looking over old blood work I realized my free T3 has never been over a 3.0. When I spoke to the doctor today I asked about adding Cytomel and she suggested switching to NP Thyroid instead and gave me a months worth to try.

Since I have been on Synthroid so long I am a little nervous to switch. I should've been on 150mcg of synthroid so she gave me the equivalent in NP Thyroid of 1.5 Grain. She suggested I split it and take it twice a day and repeat labs in 4 weeks. Is that too much NP to start?

[MellyH2015]

So after the first week of taking 1.5  grain the doctor increased to 2 grains because I was miserable. So I was taking 1 grain in the morning and 1 grain in the afternoon. Every day my symptoms have been worse and worse hypo. 3 hours after taking the pill I can hardly keep my eyes open. I've been freezing cold with low body temps. Hair loss etc etc. After 2 weeks of taking the ndt I'm ready to throw in the towel and return to synthroid. My thyroid is extremely swollen. I'm wondering if I'm having a reaction to not because I'm hashimoto's.  

[goolarra]

You might try experimenting with the best time to take the second half.  Most people take it sometime in the late morning or early afternoon.  Two o'clock sounds like it was too late for you if you fell asleep before you were due to take it.  

You're taking 56 mcg of T4 and 14 mcg of T3.  T3 is 4-5 times (depending on who you read) more potent than T4.  So, 18 mcg is about 56-70 mcg of T4 equivalent.  So your at an equivalent of 112-126 mcg T4.  However, T3 is faster acting and harder to control than T4, so it's often better to be safe than sorry.  If you're having no adverse reactions and still feeling like you need an increase after a couple of weeks, perhaps your doctor would reschedule labs to an earlier time???

[MellyH2015]

Thanks for your reply. I cut the 1.5 pill in half and took half this morning around 7 and took the other half around 2.  No rush feeling. I did feel some tingling when it was wearing off. In fact I'm exhausted and fell asleep just before 2 for about an hour. Feel like my starting dose could have been higher actually. Maybe it will take time getting in my system. I hope so because I'm not getting an increase for 4 weeks until I do a set of labs. :-/

[goolarra]

I don't think you'd want to start a whole lot lower.  1.5 grains is a significant drop in T4, from 150 mcg to about 56 mcg.  But, you are also adding in about 14 mcg of T3.  So, overall, adjusting for the higher potency of T3, you are still low of the 150 mcg T4 you've been taking.  That being said, T3 can take a little getting used to, so if you get a T3 "rush" after taking your meds, you might ask your doctor about cutting back briefly (to say 0.75 gr in the am and 0.37 gr in the pm).  You'll probably want to increase that fairly soon (as soon as any T3 symptoms go away).