How to safely raise Tyromax dose

[apr]

Starting a new thread, as it may have been overlooked on lengthy TyroMax thread.



Hello all. Hopefully someone can help me.

My adult daughter has been on 1 tablet of Cynoplus (120mcg t4/30 mcg t3) for years now. Her main issues are a relentless psoriasis-like rash, extreme fatigue and difficulty losing weight. She notes that she feels no differently when she takes it, or when she takes short breaks from it.

So in order to move forward she decided to drop all cynoplus for two weeks to get lab tested to see where her thyroid stands without supplementation:

Results:

TSH: 2.701. (0.35-5.4)

FT3: 1.66. (1.71-3.71)

FT4. 0.61. (0.70-1.48)

Since she had been off all meds for two weeks, upon receiving the lab results she immediately began Tyromax 2 drops in AM a few days ago as her fatigue was bad and she is always cold. Now her fatigue is CRUSHING and she is having trouble getting through the day. Yesterday I told her to add another drop but she felt nothing.

Has she started with too low a dose? Can we keep raising? I told her to take it easy raising because I have read here of the problems some encounter when going too fast.

@haidut can you comment on how to proceed with this supplement?

Also I understand the ratio in TyroMax of 4:1 is what is needed in severely hypo people. I considered the above numbers to be pretty severe, plus her extreme symptoms. Tyromix is 2:1...from what I gather this would be for a milder case?

Appreciate input from anyone and Haidut as well and thank you.



Thank you

 

[xeliex]

Do you have temperatures and pulse tracked? If not, this would be a good place to start.

If you have not read Broda Barnes' indicated book, it might give you all the guidelines you need to proceed. I've heard doctor Peat recommend that methodology.

In summary:
1) Track her pulse and temp. 1st thing in the morning and an hour or two after a meal (I like lunch). Notice the trend.
2) Always start slow, perhaps with 1/4 or 1/2 a grain and increase slowly over time. No drastic increases before 3 weeks or so.

Note: Given that she has not responded to such doses, I would look into other potential problems like vitamin D status and calcium intake. Also potential systemic infections or other nutritional deficiencies.

 

[Vileplume]

I commented on the tyromax thread, but also want to add here that I did not tolerate tyromax well on its own. Even two drops gave me high adrenaline symptoms. With cynomel and tyromax though, I got benefits and could take much more. If you ratchet up the tyromax dose slowly (like xeliex mentioned of 1/2 grain increases every three weeks) and still find she doesn’t feel better, you could try some cynomel in addition to the tyromax. Some do better with more T3.

 

[apr]

Thank you for the responses.

Xeliex: While on cynoplus temps and pulse were erratic. Will track now to see if there is improvement. Her Vit D was good but after stopping supplementing went down quickly...she is already supplementing again. Other labs are good. Will try to get her to increase calcium.

Vileplume: she has not reported adrenaline...quite the opposite, she has crushing fatigue. How many drops of TyroMax would be 1/2 grain? (sorry if this has already been said). And how much T3 would you add in to a TyroMax dose of 3 drops?

Thank you!

 

[Vileplume]

Thank you for the responses.

Xeliex: While on cynoplus temps and pulse were erratic. Will track now to see if there is improvement. Her Vit D was good but after stopping supplementing went down quickly...she is already supplementing again. Other labs are good. Will try to get her to increase calcium.

Vileplume: she has not reported adrenaline...quite the opposite, she has crushing fatigue. How many drops of TyroMax would be 1/2 grain? (sorry if this has already been said). And how much T3 would you add in to a TyroMax dose of 3 drops?

Thank you!

7 drops of tyromax is a grain (roughly 60 mcg of T4 and T3) so you could bump up 3-4 drops at a time, every few weeks. Tyromax has roughly a 4:1 ratio, like cynoplus, so 3 drops is probably around 24 mcg T4 and 6 mcg T3, maybe a bit less. Adding 4 mcg of T3, spread into two doses, would put her at a 2.5:1 ratio.

 

[apr]

thank you!

 

[apr]

Sorry....but I just had another question. When she began Cynoplus she started with one pill. There was no ramping up. And as I far as I remember there were no issues then.

Why now should she have to go so slowly to get to where she was just a few weeks ago on Cynoplus? Should she have just gone straight to 7-14 drops?

I am assuming because NDT is more powerful? Any other explanation?

She was only two weeks off of cynoplus to get her labs done to get a clear picture.

 

[Vileplume]

Sorry....but I just had another question. When she began Cynoplus she started with one pill. There was no ramping up. And as I far as I remember there were no issues then.

Why now should she have to go so slowly to get to where she was just a few weeks ago on Cynoplus? Should she have just gone straight to 7-14 drops?

I am assuming because NDT is more powerful? Any other explanation?

She was only two weeks off of cynoplus to get her labs done to get a clear picture.

In his book, Broda Barnes states that “a teenager or adult may safely be started on one grain daily. For a particularly large man or woman, two grains may be used—but no more than that at the beginning” (284).

according to that, you can start higher than the 1/2 grain we’ve recommended. If your daughter was fine on a whole cynoplus (roughly two grains), without adrenaline or stress symptoms, that might be okay in tyromax even. But since people respond differently to different forms of thyroid, it would safer to start with no more than one grain, to avoid overshooting the dose and stressing the heart.

 

[apr]

Ok thank you.

Will try adding some more today.

 

[Vileplume]

Ok thank you.

Will try adding some more today.

Sounds good. Keep us updated!

 

[apr]

Sounds good. Keep us updated!

Update:

Ok she is up to 6 drops a day and is still feeling awful. Crushing fatigue. Her next dose raise isn't until next Tuesday but she says she may add one drop tomorrow to see. She has added Vit D again and will try to consume more calcium.

We are now looking at the FAO angle as it was brought up as a possible solution to being able to handle TyroMax.

So far, what I have read is that aspirin, niacinamide and pyrucet can be used for this. Which of these or combo of these has been most effective...from people here perspective? Also which doses prove best? She has tried niacinamide in the past at 500 mg and did not have any issues but did not notice anything positive either. So it should be taken with aspirin? Pyrucet?

Also, is this something one does for a few days until you feel the TyroMax working and then stop? Or do you continue during the entire ramp up process?

Sorry for so many questions.

Thanks in advance!

 

[Vileplume]

Update:

Ok she is up to 6 drops a day and is still feeling awful. Crushing fatigue. Her next dose raise isn't until next Tuesday but she says she may add one drop tomorrow to see. She has added Vit D again and will try to consume more calcium.

We are now looking at the FAO angle as it was brought up as a possible solution to being able to handle TyroMax.

So far, what I have read is that aspirin, niacinamide and pyrucet can be used for this. Which of these or combo of these has been most effective...from people here perspective? Also which doses prove best? She has tried niacinamide in the past at 500 mg and did not have any issues but did not notice anything positive either. So it should be taken with aspirin? Pyrucet?

Also, is this something one does for a few days until you feel the TyroMax working and then stop? Or do you continue during the entire ramp up process?

Sorry for so many questions.

Thanks in advance!

I think you’re on the right track investigating FAO, calcium, vitamin D in addition to the thyroid. If she goes from 6 to 7 drops before her next raising day, that one drop should not make too big a difference. People often go up by 1/2 grain all at once. Although the two week waiting period after a new dose is helpful, I usually find that after a week or so I can determine if the dose is too low, too high, or just right. Since today was Tuesday, did she raise the dose further? What is she at now?

For FAO, I remember reading a post from @ecstatichamster that he knew someone on thyroid who overcame adrenaline by using pyrucet, aspirin and niacinamide. I think aspirin is the most widely stabilizing, benefitting more than just FAO, so I’d start with that, even up to 500 mg or so a day would be fine.

In addition to calcium, vitamin D, and thyroid, Peat also mentions sodium and magnesium as critical factors in t energy production chain. How is your daughter’s sodium and magnesium intake?

 

[apr]

I think you’re on the right track investigating FAO, calcium, vitamin D in addition to the thyroid. If she goes from 6 to 7 drops before her next raising day, that one drop should not make too big a difference. People often go up by 1/2 grain all at once. Although the two week waiting period after a new dose is helpful, I usually find that after a week or so I can determine if the dose is too low, too high, or just right. Since today was Tuesday, did she raise the dose further? What is she at now?

For FAO, I remember reading a post from @ecstatichamster that he knew someone on thyroid who overcame adrenaline by using pyrucet, aspirin and niacinamide. I think aspirin is the most widely stabilizing, benefitting more than just FAO, so I’d start with that, even up to 500 mg or so a day would be fine.

In addition to calcium, vitamin D, and thyroid, Peat also mentions sodium and magnesium as critical factors in t energy production chain. How is your daughter’s sodium and magnesium intake?

Vileplume: She raised only one drop yesterday (Tuesday) so she is now on 7 drops. Her next dose raise is next Tuesday.....depending on how she is feeling we may go the full 3 drop raise to move this along.

She is not worse, maybe a little bit better but is really hoping to restore prior energy levels soon. She is also gaining weight quickly but hoping it is water retention and not fat gain. Psoriasis is not worse but is not gone either.

She eats a lot of salt....I will ask her about her mag intake.

Do you happen to know the thread title you referenced from @ecstatichamster?

I appreciate your help!

 

[Vileplume]

Yes, here is the post by ecstatichamster: Strong Heart palpitations on Tiromel

So she experiences low energy levels that so far haven't been helped by thyroid, even taking a full cynoplus. With a TSH at 2.7, it would be nice to bring that down below 1, at least according to Dr. Peat. I frequently hear him recommend sodium, magnesium, vitamin D, and calcium along with thyroid, and progesterone during the luteal phase, because these all work synergistically. In my experience, magnesium bicarbonate has prevented the tachycardia that I sometimes get from thyroid, so if you haven't verified her magnesium intake, it's something to try.

Then, if you can check all those boxes, my next guess would be some sort of irritation of the digestive tract. Does she have a daily bowel movement? Eating a carrot salad and well-cooked mushrooms? Minimal bloating, gas?

Then, after that, my next guess would be excessive fatty acid oxidation, so the aspirin and pyrucet and niacinamide might help.

With all that in effect, if her TSH is still high and the one grain of thyroid isn't making any difference, I would bump it up to 1.5 grains, wait two weeks, and then try again, keeping track of temps and pulse this whole time.

I hope this helps. I don't mean to suggest the same things over and over again, just sharing what my personal checklist would be.

 

[apr]

Yes, here is the post by ecstatichamster: Strong Heart palpitations on Tiromel

So she experiences low energy levels that so far haven't been helped by thyroid, even taking a full cynoplus. With a TSH at 2.7, it would be nice to bring that down below 1, at least according to Dr. Peat. I frequently hear him recommend sodium, magnesium, vitamin D, and calcium along with thyroid, and progesterone during the luteal phase, because these all work synergistically. In my experience, magnesium bicarbonate has prevented the tachycardia that I sometimes get from thyroid, so if you haven't verified her magnesium intake, it's something to try.

Then, if you can check all those boxes, my next guess would be some sort of irritation of the digestive tract. Does she have a daily bowel movement? Eating a carrot salad and well-cooked mushrooms? Minimal bloating, gas?

Then, after that, my next guess would be excessive fatty acid oxidation, so the aspirin and pyrucet and niacinamide might help.

With all that in effect, if her TSH is still high and the one grain of thyroid isn't making any difference, I would bump it up to 1.5 grains, wait two weeks, and then try again, keeping track of temps and pulse this whole time.

I hope this helps. I don't mean to suggest the same things over and over again, just sharing what my personal checklist would be.

Well I certainly appreciate all of your suggestions. We had a plan in place to work on the FAO and she has come down with covid....so we are treating that now and praying she will recover quickly. She is on Ivermectin and Vit D, zinc and aspirin. Once fully recovered we will readdress the thyroid...but surprisingly enough this past week she felt somewhat better (not great) on the 7 drops. Her next dose adjustment is this Tuesday...we were going to do 3 drops but will play it by ear when the time comes.

Will read the link you sent and thank you!