New Labs- Thyroid Dose Suggestions

Katty

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Jan 3, 2013
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396
Just received some lab results, wanted to get some feedback on thyroid med dosing. I think I know what the feedback will be (based in part on the recent cynoplus/synthroid thread in the supplement section- I read Peat's thyroid article that was posted). But since I have my lab results now, I'd just like to make sure I'm not overlooking anything.

RT3: 10 (range 8-25ng/dl)
DHEA-sulfate: 215 (range 61-337 mcg/dL)
Testosterone, Free: 2.5 (range 0.2-5.0 pg/mL)
TSH: 0.54 (range 0.30-5.00 mcIU/mL)
Free T3: 2.6 (range 2.0-4.4 pg/mL)
Free T4: 0.76 (range 0.80-1.80 ng/dL)

I've been taking 1 & 1/4 grains of Nature-throid, which is 47.5 mcg of T4 and 11.25mcg of T3. Based on these labs, Dr. wants me to change to Synthroid 75mcg and Cytomel 10mcg. So here are my questions/options:

1) With the dose my Dr. wants, the ratio of T4 to T3 would be 7.5 to 1. I know Peat prefers a ratio of 3 or 4 to 1. But would there be a reason, either based on these labs or some other symptoms I should look for, that this ratio of 7.5 to 1 would be preferable for me? (Why does the Dr believe this ratio is optimal?) My T4 is below range, so that could be a reason. Does Peat ever talk about where the T4 or T3 should be in the range?

2) In order to keep the ratio about 4 to 1, I could fill the Dr's Rx and just take half of the Synthroid pill. However, the dose overall would be about the same I'm taking right now, so if I need to increase my dose, this option wouldn't do much for me, other than determining if my body likes synthroid/T3 better than the desiccated thyroid that I'm currently taking.
It's possible I don't need more thyroid meds but just need to tweak something else...?? If so, this option actually might not be a bad idea. But I think I might like to increase my dose.

3) I could order Cynoplus online. I believe 1/2 pill of cynoplus would be 60mcg of T4 and 15mcg of T3. That's close-ish to what the Dr wants, but with the 4 to 1 ratio Peat suggests. I'm guessing this is the option that I'm supposed to do based on Peat's work. If I want to take 1/2 pill of cynoplus per day, and then break that half up into about 3 times per day, how easy is it to break up those pills into halves and then thirds (1/6 of the pill)?

4) I could fill the Dr's Rx but order extra cynomel online (my Rx only covers 10mcg) and then take 75mcg of the Synthroid and about 18mcg of the T3. However, this seems like a pretty big jump from my current dose.

5) If I do fill the Dr's Rx, what do people think of generic Synthroid or generic T3? The Cytomel brand is quite a bit more expensive than the generic T3. Does it make a difference?

6) I'm nervous about ordering meds online. What if the store runs out of stock or is late with a shipment? Has anyone had problems with receiving their thyroid meds from online ordering?

Anything else I'm overlooking or need to consider? Thanks for any feedback!
 

aguilaroja

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Jul 24, 2013
Messages
850
Katty said:
With the dose my Dr. wants, the ratio of T4 to T3 would be 7.5 to 1. I know Peat prefers a ratio of 3 or 4 to 1. But would there be a reason, either based on these labs or some other symptoms I should look for, that this ratio of 7.5 to 1 would be preferable for me? (Why does the Dr believe this ratio is optimal?)...?

2)... this option wouldn't do much for me, other than determining if my body likes synthroid/T3 better than the desiccated thyroid that I'm currently taking.
It's possible I don't need more thyroid meds but just need to tweak something else...??

what do people think of generic Synthroid or generic T3? The Cytomel brand is quite a bit more expensive than the generic T3. Does it make a difference?

6) I'm nervous about ordering meds online. What if the store runs out of stock or is late with a shipment? Has anyone had problems with receiving their thyroid meds from online ordering?

There are many questions. For the moment, in response to a couple:

It is suggested to ask the prescribing practitioner directly about the rationale for the 7ish to 1 T4/T3 ratio. It is hoped that in this "day and age" that a practitioner would convey the rationale at at least an abbreviated rationale for a prescription. If the provider is going to be an ongoing resource, it is good to develop a rapport. Whichever view is followed, it is best to see if it works in practical terms for you, and is accessible, sensible and sustainable.

My guess, and it's just guess, is that this provider is using the T3/reverseT3 ratio as part of decision making. Dr. Peat's way of thinking has been more useful for myself and those I know. YMMV.

The last I knew, Dr. Peat thought the "synthetic", that is, bio-identical, T4 & T3 formulations were preferred, in part due to "reformulations' of the "natural"/NDT products over the years. I and a number of friends have the experience that equivalent amounts of synthetic T4/T3 work more effectively than NDT. But NDT seems to work fine for some.

I found found the generic liothyronine to be comparable in effectiveness to the brand name Cytomel.

My experience in online ordering is that the main issue is time lag, up to a few weeks, so it is necessary to have lead time and reserve supply.
 
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Katty

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Jan 3, 2013
Messages
396
Aguilaroja, thanks for taking the time to reply! Yes, sorry for the length and so many questions. I'm just a bit concerned about dosing on my own and having orders take a long time to arrive. I guess there are a lot of Peaters doing it, though, so I suppose I can just jump on in. :eek:
 

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