lab results are in

[2big4mysize]

I followed nonstickpam's directions and split the dose since starting the NatureThyroid 65g coming off levoxyl 100mcg, took it 4 hours before the blood work and the results are

TSH 2.21 range .3-3.00
free T4 1.26 range .7-1.48
free T3 2.15 range is 1.7-3.7

I'm in the roid step down phase for the next 2 weeks coming off 2 grams of dexamethasone every day for the the last several weeks for an allergic reaction and going to just 1 gram daily.

since dexamethasone is supposed to increase freeT3 and T4 and lower TSH in hypo folk and the new med has t3 in it is my T3 low cause the dose it too low from the switch? My doc left a message that I need an appointment to discuss my thyroid meds. All I want to do is sleep.

He didn't do before changing meds blood work

last yr my TSH was 1.5 and my T3 was 3.43 and free T4 was 1.1

[nonstickpam107]

You didn't get a 'switch over'. You got less. Did you take HALF the Naturethroid four hours before or all of it? Now, you are only getting 37mcg. T4 and 9mg. T3. Refresh my memory.

Are you taking ONLY 65mg. Naturethroid total? And you took HALF of that before the labs? (And I ran the dexa is supposed to lower TSH and upT3/T4 past my medical peeps and they say they can find NADA on that and don't believe it). I'll wait for ya to refresh my memory first.

Pam

[2big4mysize]

yep I only take the Naturethyroid now and I split the pills like you said and took 1/2 4 hours before the blood work.

The thyroid warning is on the warning sheets for the dexamethasone so I checked it out with hypothyroid on the web and and there are studies of its effect on TSH and T3 are on the net.

here is the TSH supression study The effect of dexamethasone on TSH and prolactin secretion after TRH stimulation

and here is the T3 increase in hypothyroid folk study Journal of Clinical Endocrinology & Metabolism Vol. 46, No. 5 784-790 doi:10.1210/jcem-46-5-784

and its use in treating hyperthyroid folk by lowering TSH and T3 Focus On: Treating Hyperthyroidism in the ED



so even without the roid I should tell him he under medicated me with the switch even though his chart said they were equal? I know my T3 is low so this appointment should get me more T3 but how much should he have given me just to switch from levoxyl 100mcg dose so I have a ballpark figure to know if the new dose is enough or does this have to be a trial and error switching?

[nonstickpam107]

Um, so you are taking ONLY one grain (Naturethroid 65mg) a day? (btw, the journals you are reading are for HUGE amount of dexamethasone and it's affect on NON medicated patients who are euthyroid). OH, and they only did it on NINE patients. Jeez...wonder if that study was done just for giggles, lol. BTW, out of the nine, only three had a suppression below TSH of 4...I found follow up studies saying that the dexa was INJECTED and it's all blood plasma studies. Doesn't compute with what you are taking. And the 'shrinking of the thyroid' was disproved by three other studies.

If it took 100mcg. T4 to get your T4 where it was and your T3 was still low, than it would have been 'equal to' about one and a half to two grains of Naturethroid, not one grain. One grain would have been a correct and equal switch out to about 55 to 75mcg. of synthetic T4. Now you are more undermedicated than you were with 100mcg.

See: ONE grain (which is what you are on) is equal to about 37mcg. T4 and 9mg T3. YOUR doctor is doing the 'old math' and counting T3 4x (he's doing 4x 9 PLUS 37, which STILL doesn't add up).

I'd not have any hair nor any PATIENCE if it were me.

Pam

[2big4mysize]

He has a chart that figured the conversion for him the naturethyroid folk gave him, at least it had Naturethyroid written on it so I assumed it was from their drug rep. Obviously their conversion chart isn't correct.

So at the appointment friday I say forgret the roids and just fix my thyroid levels back to last yrs with more meds. Since my T4 is higher then last yr on the lower mecication level but my T3 is tanked should I just ask for some T3 and if so how much?

[nonstickpam107]

Well, if I were YOU, I'd ask for 100mcg. T4 and 25mg. Cytomel (split the Cytomel half in am, half in early afternoon). Yep, that's what I'd do. OR I'd just go right to two grains Naturethroid, one grain am, one early afternoon. (And I'm betting you'd be increasing to 2.5 in four weeks, and than 3 in four more...).

Pam

[2big4mysize]

UGGGG!!!!! okay so he should ahve checked my labs before he changed my meds

Since I wasn't sleeping because of the roids and the antihistamines I said I'm so tired and I've got those nasty night time leg cramps again. I feel like I did back before I was diagnoised hypo and poof he said he had a new med I'd do better on and I was switched to Naturethyroid.

I will need to be more careful how I express my symptoms to him in the future.

Thanks

oh do you know if the inert ingredient in synthroid is still soy? I had to switch to Levoxyl back in 2002 cause it was soy then and levoxyl was milk sugar.

[nonstickpam107]

The biggest 'ingredient' in Synthroid is corn. If he can't look at labs and discern how much you need...well, you need to teach him. I just would FREAK OUT if my doc had to look at a chart and not at my individual labs. It would bring me to ask: "Gee, doc, so you have to look at charts and read in order to treat me? Are you sure you know what you are doing?" But I'm evil like that.

Pam

[2big4mysize]

I sort of felt the Naturethyroid drug rep had resently visited him was why I got changed over.

so based on the T3 being currently at 2.15 25mg of Cytomel along with upping my T4 back to where it used to be should fix things.Will another blood test in 2 weeks show if this is the corect dose? or will the meds need more time to get the tyroid levels stable?He usually does them at 2 weeks, 6 weeks, and 6 months until I'm stable on a dose and then it is just once a yr unless I have symptoms.

[nonstickpam107]

Two weeks isn't long enough to show change in FT4, and four weeks will show change with T3...so waiting five weeks to do labs on a switch like that should put ya just right....you might want to do 75mcg. T4 with 25mg Cytomel to start....you might not like that high of T4 (JMHO). As you go along, you may even drop the T4 a bit more...depending on how YOU feel and what YOUR labs say.

Pam

[2big4mysize]

thanks cause I hate those funky heart beats when my T4 dose was too high before.