Ilovethesea's Thyroid Log

[ilovethesea]

Before February 2013:
1 grain Erfa + Synthroid 50
= 8mcg T3 + 85mcg T4
= 11:1 ratio

Before I found Ray Peat, this is the dose my ND had me on according to my "perfect" blood work. I had fatigue, premenstrual acne, elevated liver enzymes, irritability, etc.


February 2013 - March 2013:
1 grain Erfa + Synthroid 25
= 8mcg T3 + 60mcg T4
= 7.5:1 ratio

Slowly began to lower T4 since Ray told me most people feel best on a ratio of 4:1, 3:1 or 2:1. On this dose I still had premenstrual acne and felt tired and irritable.


March 2013 - April 2013:
1.5 grains Erfa + Synthroid 25
= 12mcg T3 + 77.5mcg T4
= 6:1 ratio

When I got to this dose my temperatures dropped. Maybe lowering stress hormones?


April 2013 thyroid panel results:
TSH: 0.2
Free T4: 16
Free T3: 5


April 2013 - November 2013:
3 grains Erfa
= 24mcg T3 + 105mcg T4
= 4:1 ratio

Temperatures higher now, but I recall having adrenaline issues. I must have slowly raised this dose from 3 grains to 4.5, but not sure over which months...


November 2013 thyroid panel results:
TSH: 0.01
Free T4: 26
Free T3: 9.5


November 2013 - December 2013:
4.5 grains Erfa
= 36mcg T3 + 157.5mcg T4
= 4:1 ratio

The pharmacy actually called me as they didn't want to fill this prescription. "No one is on 4.5 grains, it's dangerous to take this much thyroid..."


December 2013:
1.5 Cytomel
= 37.5mcg T3

Shortlived T3 only experiment for a couple weeks. I suspected I had an RT3 problem due to severe allergies...


December 2013:
2 grains Erfa + 1 Cytomel
= 41mcg T3 + 70mcg T4
= 2:1 ratio

Then the RT3 test came back normal so I went back to taking T4.


December 2013 - April 2014:
2 Cynoplus
= 60mcg T3 + 240mcg T4
= 4:1 ratio

Then I discovered I was in fact allergic to the Erfa so I switched to all Mexican. Increased pretty high during this time as I got very cold over the winter.


April 2014 - November 2014:
2 Cytomel + .5 Cynoplus
= 65mcg T3 + 60mcg T4
= 1:1 ratio

My nutritionist told me her clients get better results with tiny doses of T3 during the day and T4 at night. I must have increased to 1 Cynoplus in between here, but not sure which month.


November 2014 - March 2015:
2 Cytomel + 1.5 Cynoplus
= 95mcg T3 + 180mcg T4
= 2:1 ratio

I felt like I should try 2:1 since Ray never recommended 1:1. I was a bit warmer on this dose.


March 2015:
2 Cynoplus
= 60mcg T3 + 240mcg T4
= 4:1 ratio

For a few days when I ran out of Cytomel I just took Cynoplus. Started getting a few cystic acne.


March 2015:
1.5 Canadian Cytomel + 1.5 Cynoplus
= 82.5mcg T3 + 180mcg T4
= 2:1 ratio

Since I might run out of Cytomel (my doctor might not prescribe it again so I'll have to arrange a way of getting it in the country from Mexico), I lowered the dose just in case. I started to get much worse cystic acne around the chin/jaw, and cold feet. Wondering if the Canadian Cytomel is not as strong.


March 2015:
2 Canadian Cytomel + 2 Cynoplus
= 95mcg T3 + 180mcg T4
= 2:1 ratio

Went back up to the dose I was on before, but my skin continues to get worse. I can only conclude that the Canadian Cytomel is ***t??


March 2015:
2 Cynoplus
= 60mcg T3 + 240mcg T4
= 4:1 ratio

Skin is back to normal now, no more acne. I'm dosing the Cyno in 1/4 pill at a time, so 7.5mcg T3 per dose. Might split further...

 

[ilovethesea]

Decided to start a log to document my ongoing thyroid saga, and since I've not been the best at remembering to keep dosing records on my computer. (Never was good at math!)

Thoughts on anything here are welcome.

I will update the log every time I make a dosage change...hopefully one day I will figure out the right dose!

NB: I have only half my thyroid gland, due to (probably completely unnecessary) thyroid cancer surgery. After that I was on Synthroid awhile, then found an ND who let me take NDT (albeit tiny amounts in combo with the Synthroid), and then I found Ray Peat and went rogue.

 

[answersfound]

If you have skin issues, you may want to increase Vitamin A intake. Also, is synthroid bad, assuming you are taking Cytomel and keep your ratio at 4:1 or lower?

 

[ilovethesea]

I'm not sure where to go with my dose from here.

My biggest problem is this crazy cystic acne all of a sudden! I need to make it stop!

I actually found one last bottle of Mexican Cytomel, so assuming the Canadian Cytomel is utter crap, my options are...

a) Switch back to pre-acne dose of Mexican Cyto + Cyno and see if skin returns to normal (even though I'll run out of the Cyto in about a month or so)

b) Try an all Cynoplus dose matching the 95mcg of T3 I was taking before. So that would mean taking 3 or 3.5 Cynoplus, to get to either 90mcg or 105mcg of T3. Then I would have to deal with the 4:1 ratio again, but not sure if that matters as much as getting the T3, which my body seems to rely on so much now. (Especially coming off winter.)

I just have this sense that the Mexican thyroid supps are stronger, they have the amount of thyroid they say, unlike the other brands...

 

[ilovethesea]

If you have skin issues, you may want to increase Vitamin A intake. Also, is synthroid bad, assuming you are taking Cytomel and keep your ratio at 4:1 or lower?

I suppose I'll have to go that route if I get stuck with this crappy weak thyroid med.

For the last month or so, I've been taking 1 tbsp raw beef liver daily, so that's already 44,000 IU of A per week (I did this not really for skin, more just for all the vitamins). But I wasn't doing much A before, just occasionally supplementing 5 drops or so of Nutrisorb every week or two, and all that time my skin was fine.

I also don't want to go too crazy with the vitamin A now, in case bigger amounts makes me even more hypo...

I do have some Synthroid. The problem is if I dose T3 and T4 separately instead of with Cynoplus (which is more economical), it makes me go through Cytomels much quicker. To get close to my "ideal" dose I would have to take 4 Cytos + 3.5 Synthroids (100mcg T3 + 180mcg T4). And I only have 1 bottle of the Mexican one left...

 

[ilovethesea]

The other question, as we discussed on the other thread, is if taking the T3 with the T4 is somehow suppressing my uptake of it.

But now I'm starting to think it's just the switch of brands.

It's called liothyronine and manufactured by Pfizer. Has some nice filler crud in it too: http://www.pfizer.ca/en/our_products/pr ... osheet/327

I wonder if I should give Erfa another go and see if I still react to it, since I seem to be ok with this corn starch and other crap now.

 

[answersfound]

If you have skin issues, you may want to increase Vitamin A intake. Also, is synthroid bad, assuming you are taking Cytomel and keep your ratio at 4:1 or lower?

I suppose I'll have to go that route if I get stuck with this crappy weak thyroid med.

For the last month or so, I've been taking 1 tbsp raw beef liver daily, so that's already 44,000 IU of A per week (I did this not really for skin, more just for all the vitamins). But I wasn't doing much A before, just occasionally supplementing 5 drops or so of Nutrisorb every week or two, and all that time my skin was fine.

I also don't want to go too crazy with the vitamin A now, in case bigger amounts makes me even more hypo...

I do have some Synthroid. The problem is if I dose T3 and T4 separately instead of with Cynoplus (which is more economical), it makes me go through Cytomels much quicker. To get close to my "ideal" dose I would have to take 4 Cytos + 3.5 Synthroids (100mcg T3 + 180mcg T4). And I only have 1 bottle of the Mexican one left...

Hmm I'm trying nutripak thyroid in combination with Cytomel for the t4. The nutripak eliminated my frequent urination. I overdid it last time and got rt3 issues. But now with the right ratios I think things will start working. Cytomel only has been really rough. I don't know how people do t3 only.

 

[answersfound]

"jb4566 wrote:
The hormone in NDT is bound to a protein that has to be digested before any hormone can be released into your body, so if you take NDT with food the release of hormone will be so slow that you don't have to worry about the 4mcg per hour.

I take a 1 grain or 1.5 grain at a time."

Wouldn't this make NDT a much better option, assuming you get your hands on a good quality one? That sounds so much simpler that using Cytomel. I don't get it.

 

[ilovethesea]

Hmm I'm trying nutripak thyroid in combination with Cytomel for the t4. The nutripak eliminated my frequent urination. I overdid it last time and got rt3 issues. But now with the right ratios I think things will start working. Cytomel only has been really rough. I don't know how people do t3 only.

I don't know anything about Nutripak. Is that considered NDT?

I'm curious as to whether I could legally get it into Canada. Our lovely govt confiscates my Farmacia del Nino orders, Pimpom says they can't guarantee it will ever get here, and IAS in UK won't even ship here...

I think the key with T3 is making sure you are getting plenty of calories and sugar, and never going hungry. Once I stepped those up the adrenaline issues went away. I also took 2mcg doses instead of 4mcg. Did you try that?

It could also be a matter of just sticking with it and riding it out until your body gets used to it... I don't know. I got used to the T3 now and feel like it does much more than the T4 ever did.

 

[ilovethesea]

"jb4566 wrote:
The hormone in NDT is bound to a protein that has to be digested before any hormone can be released into your body, so if you take NDT with food the release of hormone will be so slow that you don't have to worry about the 4mcg per hour.

I take a 1 grain or 1.5 grain at a time."

Wouldn't this make NDT a much better option, assuming you get your hands on a good quality one? That sounds so much simpler that using Cytomel. I don't get it.

Yes it would definitely be simpler to just take NDT (or Cynoplus) and not have to worry about all these calculations and hourly doses!

There were a few reasons I switched to more T3:

- The pharmacy was so alarmed when they got my prescription for 4.5 grains of Erfa, they didn't even want to give it to me. Thats how indoctrinated they are here. My doctor wasn't willing to keep me on that dose either, as my TSH was 0 during this time. (I think the excess T4 was suppressing it.) So I thought if I tried lowering T4 then it wouldn't be seen as such an extreme high dose, and maybe I could bring my TSH up to a better number.

- I felt like I plateaued on the NDT anyway... despite the non existant TSH, my temperatures were still suboptimal and I had some remaining hypo symptoms to still clear (like weak/peeling nails and dry callus prone feet)

- The nutritionist I work with (http://www.thenutritioncoach.com.au/, she works and trained with Dodie) said her female clients get much better results when they do tiny T3 doses throughout the day and then T4 at night.

- I discovered the Erfa was giving me a runny nose so I had to ditch it regardless. I'm not aware of any other NDT that I could legally get in Canada, other than the compounded type which is very expensive and I've found to be very weak.

So as you can see I'm in a real bind here :?

 

[ilovethesea]

I found some people chatting here (on a steroids forum lol) about how widely the strength varies with Cytomel depending on the manufacturer. Seems the Mexican one is the best, so no surprise it's what Ray suggests: http://www.anabolicsteroidforums.com/sh ... heck/page3

There appears to be a significant variation in the apparent strength between the various brands of T3 medication. This is probably due to differences in absorption in the body rather than differences in the amount of hormone in the tablet. A few brands that we know of and comments on them are:-

Cytomel made by King Pharmaceuticals. This is the main branded T3 drug in the USA against which others are compared. It is available in 5mcg, 25mcg and 50mcg doses (splitting the 50mcg tablets can be a way of saving money).
Generic Cytomel by Paddock. The reports from people on this generic are that they need more than when they were on branded Cytomel. One report indicated a 15% difference.
Generic Cytomel by Mylan, again reports are that it is subjectively weaker than King Pharmacuiticals brand. (updated 10/10)
Cynomel (Spanish spelling) from Mexico. Manufactured by Grossman Laboratories and available for private importation from some mail order pharmacies. This is very competitively priced and is reported to be as strong as Branded Cytomel but at a fraction of the price. The 25mcg tablets are scored in half and can be quartered with care. This is our "best buy" recommendation
Cynomel from Aventis France. Another brand of cynomel. This is reportedly weaker than the branded Cytomel but is several times the price or Grossman Cytomel. It can be good for starting off on as the tablets are larger than the Grossman and are scored in quarters. It is expensive to remain on long term.
Tertroxin (UK and Australia). This is available in 20mcg tablets. It is reportedly weaker than branded Cytomel or Grossman Cynomel
Generic T3 made by Goldshield, has had good reports from one of our readers. It is not as cheap as the Grossman but worked well for her.


Val gave me this report on the various brands she's tried.
Strengths of T3 brands.. OMG I have tried almost all of them. Cynomel
from Aventis is pretty weak.
Tryotex from Mexico is a total waste of money,
UniPharma T3 is VERY weak,
Geneza Pharmaceuticals T3 is about the same as Unipharma,
Tiromel from Turkey is about the same as Aventis Cynomel.
LA Pharm T3 is OK and cheap but weaker than cynomel and about the same as Tertroxin form the UK,
So from strongest to weakest:-

Cynomel Mexico (Grossman)
Cytomel USA (branded)
Tertroxin UK
LA Pharma (not sure where from)
Aventis Cynomel
others not worth buying!

 

[sweetpeat]

Ilovethesea, this is coming at it from a completely different angle and maybe totally unhelpful, but there is a thread from awhile back about surrogates for t3. Here is a link to the discussion: http://www.raypeatforum.com/forum/viewtopic.php?f=10&t=3480&hilit=surrogate

Briefly, it's about using things like coffee/caffeine and some other over-the-counter supps to boost metabolism in place of using t3. I don't know if it would work for you in your situation (having only half a thyroid), plus it's more experimenting with stuff to see what works, which may only muddy the waters. but I thought I would throw it out there in case it could help you in a pinch while you figure out how to get more t3.

 

[ilovethesea]

Ilovethesea, this is coming at it from a completely different angle and maybe totally unhelpful, but there is a thread from awhile back about surrogates for t3. Here is a link to the discussion: http://www.raypeatforum.com/forum/viewtopic.php?f=10&t=3480&hilit=surrogate

Briefly, it's about using things like coffee/caffeine and some other over-the-counter supps to boost metabolism in place of using t3. I don't know if it would work for you in your situation (having only half a thyroid), plus it's more experimenting with stuff to see what works, which may only muddy the waters. but I thought I would throw it out there in case it could help you in a pinch while you figure out how to get more t3.

Thanks! I will read that thread next! I recently increased coffee to 4-6 strong cups daily and found it helped. Unfortunately I am still having trouble with aspirin allergy. I have the pure (horse) powder but it gives me terrible runny nose/sneezing for hours. Not sure why.

I think I may check out "RUI T3" for "research purposes".

 

[ilovethesea]

Found more evidence that Canadian Cytomel is probably crap:

I ordered cynomel and cynoplus once from Canada, thrice from Mexico - I dont get any results from the cynomel, no matter how high the dosage and cynoplus give me a headache after 20 min.
I have tried every brand, even Armour, even from European Pharmacies with prescription, natural and synthetic - NDT Thiroyd from Thailand are the only ones which work and dont have side effects for me and my family.

From this thread: viewtopic.php?f=52&t=1477&start=45

 

[ilovethesea]

Further on that thread with Rayser...

I am using NDT from Thailand. I have no idea what's in there exactly but it works well for me.
I use 5 pills during winter and 2 to 3 in summer.
Always checking my temp.

Maybe my 4.5 grains of Erfa wasn't that excessive then, considering I only have half my thyroid gland, and live in freezing cold Canada (I think she's in Germany?).

 

[ilovethesea]

I was also thinking about my brittle (peeling) nails symptom. I never had great nails quality, but since finding Ray Peat they became worse.. very weak and the tips look similar to this: http://img.webmd.com/dtmcms/live/webmd/ ... ernail.jpg

I had assumed they were a hypo symptom since that's what the internet medical info says, but now I don't know. Wouldn't they be getting better with my thyroid supplementation, not worse?

I wonder if it's some sign of a nutrient deficiency. But which one...?? Vitamin D? B12? Protein? Gelatin?

I had measured low D and low B12 before. I take high D doses every few days the last month or so. I eat 1 tbsp raw liver daily and that has B12. My protein is 100-120g but maybe all these things should be even higher???

 

[ilovethesea]

I dumped the Canadian Cytomel and switched back to 2 Cynoplus a day, even though it's back to the 4:1 ratio. Now the acne is gone.

Was the Canadian Cytomel CAUSING the acne?

Or does this just mean I can't go below a minimum level of T3, i.e. 60mcg/day.

 

[ilovethesea]

It's bothering me that despite ramping up thyroid for 2 years, I've made no progress with allergy symptoms (runny nose/sneezing) with so many foods/supplements.... I tried both kinds of Great Lakes gelatin, pure aspirin powder, Erfa NDT, all starches, all commercial juices, honey, eggs, tomatoes/nightshades, alcohol, unripe fruit... none of it I can tolerate. I'm not making any progress in improving my tolerance despite being less hypo than I was before.

I also get blotchy skin, maybe that's histamine too.

I read some people had good luck with tianeptine for getting rid of allergies (serotonin-histamine pathway??) so I have that on order.

Also wondering if my estrogen is still high and I need higher doses of Progest-E / pregnenolone. I read someone else say estrogen is behind allergies.

I'm testing cascara now to see if that helps anything.

Other idea could be it's some kind of resistant gut bacteria...

 

[tara]

It's bothering me that despite ramping up thyroid for 2 years, I've made no progress with allergy symptoms (runny nose/sneezing) with so many foods/supplements.... I tried both kinds of Great Lakes gelatin, pure aspirin powder, Erfa NDT, all starches, all commercial juices, honey, eggs, tomatoes/nightshades, alcohol, unripe fruit... none of it I can tolerate. I'm not making any progress in improving my tolerance despite being less hypo than I was before.

I also get blotchy skin, maybe that's histamine too.

I read some people had good luck with tianeptine for getting rid of allergies (serotonin-histamine pathway??) so I have that on order.

Also wondering if my estrogen is still high and I need higher doses of Progest-E / pregnenolone. I read someone else say estrogen is behind allergies.

I'm testing cascara now to see if that helps anything.

Other idea could be it's some kind of resistant gut bacteria...

Hi ilovethesea, (so do I :)) You've been at this longer than I have, so it wouldn't surprise me if you've considered all things I can think of, but just in case ...

Sugar and salt can both have antihistamine effects. Are you eating enough sugar? Do the allergic reactions coincide with not eating recently/possibly low blood sugar? I don't usually get bad allergies, but I've had mild morningitis for years, which usually resolved after breakfast. Had much less of it lately, since eating much more sugar.

Have you tried increasing salt a little? I don't suggest going to where it tastes bad, just as much as you can enjoy.

How's your breathing? Relaxed, diaphragmatic, nasal? Does bag-breathing help? Having adequate CO2 in the system tends to be soothing.

I think cyproheptadine and diphenhydramine are the specific anti-histamine drugs that Peat has mentioned favourably. Have you tried either of them?

 

[tara]

Another thought ... you haven't had a change in environment that corresponds to your allergies? Could it be some local plant or local factory or something else in the air that is getting to you chronically, so that every minor thing pushes you over the tolerable histamine limit? Mould? Animals?