Ilovethesea's Thyroid Log

johns74

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Jun 17, 2014
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To not bother with taking thyroid many times throughout the day, maybe the following can give some ideas?

These rats had a time-release T4 pellet implanted subcutaneously in the interscapular region of the back.

Link
 

marsaday

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Mar 8, 2015
Messages
481
I have read this blog a little.

Can you clear one thing up. What do you feel like on the big T3/T4 amounts ? Do you feel better. If you dont then more thyroid meds is not the answer. LESS is often more.

The body has been swamped by the T4/T3 so it just closes down and wont let the T3 into the cells.

Best thing to do is strip back to a stable maintenance dose of T4 which achieves an Ft4 in the mid to high teens. Then use this as your basline med. Then you add in T3 to really tune up the system. Small doses work better.

Also try taking the T3 at different times in the day. eg, all in the morning or all in the mid afternoon. Is there a difference ? T4 taken at night can also be a good idea because we make the T4 in the first part of our sleep. This batch of T4 then tells the adrenals how much cortisol to make for the next day. Cortisol is made in the latter part of the night. You want to work on the balance between the T3 and the cortisol. Very often cortisol will be too high, especially if you take a huge thyroid amount. So this impairs conversion and blocks absorption.
 
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ilovethesea

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johns74 said:
To not bother with taking thyroid many times throughout the day, maybe the following can give some ideas?

These rats had a time-release T4 pellet implanted subcutaneously in the interscapular region of the back.

Link

Ha! Well at this point I'd be willing to do almost anything - even get it implanted in my back - if it meant a regular supply of the hormones I need to feel normal. Being at the mercy of clueless doctors is no way to live! :cry:

Speaking of rats, I just found this. http://www.peoplespharmacy.com/2015/01/ ... thyroxine/

A team of investigators led by endocrinologists at Rush University Medical Center (in Chicago, IL) has just published studies in the Journal of Clinical Investigation (online, Jan 2, 2015) and the Journal of Clinical Endocrinology & Metabolism (online, Jan. 8, 2015).

Their animal research involved removing rat thyroid glands. When the scientists tried to normalize hormone levels with just levothyroxine (L-T4) they were unsuccessful. The animals demonstrated signs of hypothyroidism, especially within the brain, which might account for why some humans complain of cognitive dysfunction on T4 alone. The investigators were able to normalize circulating T3 levels and improve symptoms by supplementing T4 with extra T3.

Their human study uncovered genetic variability in patients suffering from hypothyroidism. They estimate that the mutation exists in 12% to 36% of the population. It makes it harder to convert T4 to T3. The scientists detected negative brain changes in patients that have difficulty making the T4 to T3 conversion. Such patients generally prefer a treatment regimen that involves both levothyroxine together with T3 supplementation (Journal of Clinical Endocrinology and Metabolism (May, 2009).


Unfortunately I've learned it doesn't matter what studies you bring into a doctor's appointment or anything you tell them - they don't care.
 
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ilovethesea

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marsaday said:
I have read this blog a little.

Can you clear one thing up. What do you feel like on the big T3/T4 amounts ? Do you feel better. If you dont then more thyroid meds is not the answer. LESS is often more.

The body has been swamped by the T4/T3 so it just closes down and wont let the T3 into the cells.

I feel better with more, but it's the T3 I need the most. T4 I can take or leave. My TSH is already suppressed enough on a couple grains of NDT, but there's not enough T3 in there for me. I would take mostly Cytomel (and have in the past), but the problem is I have an extremely hard time sourcing a consistent supply of it. So right now I am relying on Cynoplus just to get my T3 dose. Make sense?

I haven't had an RT3 problem, but I don't think having more T4 is good. But I don't have another option at the moment.

As Ray said here: http://www.functionalps.com/blog/2012/0 ... e-and-tsh/

The bulk of our active T3 hormone is produced in the liver, as part of a quickly adaptive system for adjusting the metabolic rate in relation to nutritional status, but the pituitary is also able to convert T4 to T3 and a high level of T4 will cause suppression of TSH secretion, even if the liver is failing to produce the active T3, as in aging, stress, cirrhosis, and various other diseases. Thyroxin can literally make hypothyroidism worse. In this case you have suppression without a compensating absorption of active hormone.

marsaday said:
Best thing to do is strip back to a stable maintenance dose of T4 which achieves an Ft4 in the mid to high teens. Then use this as your basline med. Then you add in T3 to really tune up the system. Small doses work better.

I don't pay much attention to blood tests for thyroid levels. They were perfect for many years but that's when I was very hypothyroid and never felt right. I'd rather go by symptoms, temperatures, pulse and how I feel. Not to mention I loathe having to go through the stress of a doctor visit.

marsaday said:
Also try taking the T3 at different times in the day. eg, all in the morning or all in the mid afternoon. Is there a difference ? T4 taken at night can also be a good idea because we make the T4 in the first part of our sleep. This batch of T4 then tells the adrenals how much cortisol to make for the next day. Cortisol is made in the latter part of the night. You want to work on the balance between the T3 and the cortisol. Very often cortisol will be too high, especially if you take a huge thyroid amount. So this impairs conversion and blocks absorption.

I always dosed T3 throughout the day. Once I learned to increase calories to match the increased metabolic rate, I haven't had any problems with T3 dosing. I only take 4-6mcg at once - any more than that is unphysiological.

And yes, I took T4 at night. Right now I'm dosing Cynoplus throughout the day because it's all I have.
 
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ilovethesea

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Feb 9, 2013
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Latest update...

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. :lol: 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..." :roll:


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. :eek:


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. :cry: 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 s***??


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...


March - April 2015:
1 Canadian Cytomel + 2 Cynoplus
= 85mcg T3 + 240mcg T4
= 3:1 ratio

Giving the Canadian Cytomel another shot but cystic acne coming up again... WTF!


April - May 2015:
2 Canadian Cytomel + 1 Cynoplus
= 80mcg T3 + 120mcg T4
= 1.5:1 ratio

Started tapering down the Cynoplus, since it's running out and hoping I could get away with less given it's summer. I swear the Cytomel is inactive.


June 2015:
2 Canadian Cytomel + 3 grains Erfa
= 74mcg T3 + 105mcg T4
= 1:1 ratio

Ran out of Cynoplus so replaced with my leftover Erfa, which I'll have to get a new Rx for if my T3 orders don't come soon!!!! I feel about the same as in April-May - still cold extremities and a surge of premenstrual acne right before my period. I am definitely more hypo.
 
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ilovethesea

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I don't know what I'm going to do if I can't secure a steady source of my own T3.

There just isn't an option for proper treatment for me here in Canada.

I seem to need at least 60-80mcg of T3 daily.

The only NDT available is Erfa, and when I convinced my doctor to give me an Rx for 4.5 grains - that is only 36mcg of T3, so still not enough. Yet my doctor thought it was an excessively high dose, would only prescribe me 2 months' worth, and the pharmacy actually called me as they didn't want to fill the prescription. "Nobody is on that high of a dose so it must be a mistake". Also having that much T4 drives down my TSH to 0 so my doctor thinks I'm hyper... there is no convincing her otherwise.

After going through a bottle and a half of Canadian Cytomel (Pfizer), I am convinced it is nearly inactive. I get no results from it and it does nothing to warm up my extremities or clear my skin, which are immediate results I got from Grossman T3. At $130 a bottle it's way too expensive for not any noticeable benefit.

So those are the 2 options the "system" can offer me, other than paying out of pocket for visits to a bioidentical hormone doctor. I don't want to take any of their medical advice, I just need an Rx, so again a waste of $100s listening to fake advice about adrenals, fish oil, etc. Plus, who knows if they would even give me a high enough Rx? Bioidentical docs will also only work with compounded meds. My experience so far with compounding has not been positive, as it is very expensive and seems much weaker than regular meds.

The only option I can see is to go rogue... possibly get as much Erfa as I can through my MD but top it up with my own T3... but I don't know if my MD would be willing to go along with that, or what would show up on blood tests. (Maybe that would cause her to drop dose even further.) Last time I saw her she said I was hyper and had to drop my dose... even though I had already been there before and felt like crap! "Well you're just going to have to feel bad for a while." And doctors are supposed to be intelligent???

I'm so frustrated with this situation!
 
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ilovethesea

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Feb 9, 2013
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The biggest problems I'm having after being forced to reduce thyroid dose are a mild decrease in mood (just seem a bit less happy at times in my cycle), cold feet and acne issues!!!

My skin is perfect for about 2 weeks and then about 48 hrs before my period, all goes to hell. I'm breaking out around my chin and a bit on the forehead. Within 2-3 days of menstruation, it starts calming down - it is THAT closely tied to my cycle.

I know Ray said the cause is premenstrual stress caused by low thyroid (and related progesterone drop/estrogen surge I guess). I tried doubling my Erfa dose about a week before my period this time, but it didn't seem to really help. I think I still need to be above 60mcg of T3 to maintain good skin. I take Progest-E throughout my cycle but it doesn't have any effect on me.

Since I'm not able to get T3 I wonder if there are other things I can do to alleviate the premenstrual stress so I don't break out as bad? I was thinking maybe aspirin. I do red lights and they do rev my metabolism, but not enough. I did cascara for a while but didn't seem to help, just gave me loose bowels. I take cypro and occasionally activated charcoal.

I'm so annoyed with these skin issues that I'm close to just throwing in the towel and getting an Rx for spironolactone, since apparently T3 will kill me, or something. **** doctors.
 
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ilovethesea

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Feb 9, 2013
Messages
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Latest update.

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. :lol: 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..." :roll:


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. :eek:


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. :cry: 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 s***??


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...


March - April 2015:
1 Canadian Cytomel + 2 Cynoplus
= 85mcg T3 + 240mcg T4
= 3:1 ratio

Giving the Canadian Cytomel another shot but cystic acne coming up again... WTF!


April - May 2015:
2 Canadian Cytomel + 1 Cynoplus
= 80mcg T3 + 120mcg T4
= 1.5:1 ratio

Started tapering down the Cynoplus, since it's running out and hoping I could get away with less given it's summer. I swear the Cytomel is inactive.


June 2015:
2 Canadian Cytomel + 3 grains Erfa
= 74mcg T3 + 105mcg T4
= 1:1 ratio

Ran out of Cynoplus so replaced with my leftover Erfa, which I'll have to get a new Rx for if my T3 orders don't come soon!!!! I feel about the same as in April-May - still cold extremities and a surge of premenstrual acne right before my period. I am definitely more hypo.

July 2015:
2 Canadian Cytomel + 2 grains Erfa
= 66mcg T3 + 70mcg T4
= 1:1 ratio

This is what my doctor was willing to give me an Rx for. Not as much as I wanted.

August 2015:
2 Canadian Cytomel + 1 grain Erfa
= 58mcg T3 + 35mcg T4
= 1:5:1 ratio

Give my doctor thinks I was taking too much, I tried gradually lowering the Erfa - with it being summertime, thought maybe I could handle a lower dose. Taking pregnenolone so it's harder to see if low thyroid symptoms are still there. Also I wanted to take as little thyroid as possible before I get a blood test, just in case it gets reduced again :/

September 2015
2 Canadian Cytomel + 2 grains Erfa
= 66mcg T3 + 70mcg T4
= 1:1 ratio

Ok didn't do so well on the lower dose... seem to have lost some eyebrow hair and PMS symptoms coming back especially sore breasts. Temperatures around 37.5 midday. I really think I need to be taking more thyroid than this dose.... but what is available that is effective?
 
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ilovethesea

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Feb 9, 2013
Messages
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Next steps:

- Get thyroid panel done to see where TSH is at, etc.

- See what prescription I can get from my doctor

- Consider finding new doctor for Rx

- Test Tiromel to see how it compares to the Pfizer Cytomel (my Tiromel arrived)

- Figure out alternate thyroid brand/dose that approximates the Grossman products... as backup source or a way to "top up" the Rx

- Get more light

- Continue taking coconut oil throughout the day to rev metabolism
 
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ilovethesea

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Feb 9, 2013
Messages
1,115
I know that I felt my best during summer 2014 taking 2 Grossman Cytomel + .5 Cynoplus... but replicating that dose in other products is not even close to producing those same results.

Recently I noticed eyebrow hair loss and one eye appearing larger than the other in photos. I think these are hypo symptoms - my hypo has come back. I did not have these symptoms 1 year ago... but then we had the thyroid shortage and I had to change dose many times in the past 6 months.

The problem is, I will have to go outside the system to get my meds because my doctor won't understand that 50mcg in Grossman is like double the strength of 50mcg in Pfizer....
 
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ilovethesea

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Feb 9, 2013
Messages
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2016
1 Tiromel + 2 Thyroid-S
= 43mcg T3 +76mcg T4
= 2:1 ratio

January - February 2017:
1 Tiromel + 1 Cynoplus
= 55mcg T3 + 120mcg T4
= 2:1 ratio

Starting to feel the return of cold extremities and some acne - probably because it's the end of winter? Or maybe my Cynoplus has lost potency since it's old! Going to increase this dose to

1 Tiromel + 1.5 Cynoplus
= 70mcg T3 + 180mcg T4
= 2.5:1 ratio

Hopefully will be able to handle the extra T4!
 

tomisonbottom

Member
Joined
Apr 17, 2013
Messages
920
2016
1 Tiromel + 2 Thyroid-S
= 43mcg T3 +76mcg T4
= 2:1 ratio

January - February 2017:
1 Tiromel + 1 Cynoplus
= 55mcg T3 + 120mcg T4
= 2:1 ratio

Starting to feel the return of cold extremities and some acne - probably because it's the end of winter? Or maybe my Cynoplus has lost potency since it's old! Going to increase this dose to

1 Tiromel + 1.5 Cynoplus
= 70mcg T3 + 180mcg T4
= 2.5:1 ratio

Hopefully will be able to handle the extra T4!

How did it end up working for you? That's a lot of t3, and t4!
 

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