Thyroid Meds Update... tweak? Or...???

Katty

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I've been on my new thyroid meds for about 2 weeks. Seems to be going ok, but I'd love some input on a couple things.
I was on NDT (47.5mcg of T4, 11.25mcg of T3) and I switched to Synthetic T4 (56.25mcg) and T3 (12.5 mcg). Temps and pulse are good, but they were pretty good before. I do feel like I radiate a bit more heat though. So here are the questions:

1) ENERGY: my energy is ok, but I'd still like it to increase. I can walk in the sun (1-2 miles) without getting too fatigued, but I'd like to be able to do slightly harder workouts and also to be able to really concentrate on a task/reading. I sleep well for 8-9 hours, but I never want to get out of bed- I feel like lead in the mornings. I only get up because I'm starving/have to go to work. Once I get moving and eating I feel better and get really warm after breakfast, but I could definitely keep sleeping. Also had a couple sleepy mid-afternoons.
Already on 200mg of B1. Thinking about adding in niacinamide next, but wondering if anyone has another suggestion. It's only been 2 weeks on the new meds, so maybe I just need to give it more time? I keep thinking maybe I need to add more food for more energy, but I keep gaining weight and would like to lose 20-25 pounds, so I'm worried about increasing calories too much.

2) OILY: hair and skin are a bit oilier. This is probably a good thing (oily skin/hair like a teenager!). But wondering if it indicates I'm deficient in some mineral or if I should tweak something.

3) T4: I take the T4 on an empty stomach before bed. It produces slight nausea... nothing horrible, and I'm sleeping like a rock. But thinking I should eat it with a snack to avoid the slight nausea--- but will this decrease its efficacy?

4) COLD NOSE: at bedtime. I thought this was an adrenaline response (but my pulse drops a bit before bed, so maybe not??) Does this have something to do with taking all the T4 on an empty stomach right before bed? Or maybe it means I'm not eating enough during the day, causing increase in adrenaline at bedtime??

Thanks for any thoughts!
 

SQu

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congrats on a smooth transition! Going by my own experience only, I'd wonder if you need more time, and possibly at some stage more t3 in that ratio. But as you say, it's only 2 weeks, so I'd make changes slowly, and possibly aim for a month on this regime first. If tolerable.( Keep rereading that dosing thread and the other info. )There are hypo symptoms there I think, hence my t3 mention. I can't really give details of amounts as my dose started minute and is still much smaller than yours. So it may not be helpful. I'd also suggest that Walking1-2 miles seems plenty when hypo. When I feel that leaden , I'm overdoing things.
Re calories I think.many of us feel the same, don't want to gain more, but if too low you might not get the health results you want.
 

managing

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Too low calories w/ thyroid can cause weight (fat) gain (stress response) too. Its a great check in stage, but I would stick with the dose for 6 weeks minimum before considering changes (unless something really bad is happening of course).
 
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Katty

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Thanks for the responses sueq and managing!

Yes, it's probably too soon for changes, but I tend to get impatient. I've been at this so long it feels like things should be going more quickly by now.

It's nice to be able to check in with people on the forum for a reality check and some encouragement that I'm heading in the right direction. Thanks again!
 

ilovethesea

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I take thyroid and I've done a lot of adjusting and switching brands myself, so here is my 2 cents...

I agree it's 'ideal' to give yourself 6-8 weeks on each dose change. Unless you feel like you're obviously too low - I have raised sooner when I felt like I was moving in the wrong direction with the dose adjustments.

I've found even going from the same T3/T4 amounts on the labels that some brands are more potent than others. So you can't always trust that you're getting the same amount of thyroid... I find NDT can be much weaker. My preference is definitely Cytomel and Cynoplus.

You might want to experiment with a T4:T3 ratio that is lower than the standard 4:1. Ray told me most people feel best between 2:1 to 4:1. I'm currently doing 1:1 and feel much better now than I did on just NDT or just Cynoplus. (Probably later I will test 2:1 but doing this for now.) I think excess T4 is a real problem especially for women with our higher estrogen which impairs conversion. Too much T4 is anti-thyroid.

The oily hair, morning tiredness and cold nose all lead me to believe you're under-dosed right now. All of those symptoms should go away when you're getting adequate thyroid. I wouldn't be looking to other supps to fix that as they're clearly low thyroid symptoms. Where are your temperatures and pulse at?

One thing you might try is tiny (1/6) daytime doses of Cytomel, and then your T4 at night. It doesn't matter if you take it with food or not.... they only say that because of supposed calcium interference but see here: viewtopic.php?f=3&t=558#p2626.

Anyway I've been much more responsive to the daytime T3/nighttime T4 combo so just something to consider :)
 

managing

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The problem with "unless you're obviously too low" is this: Its like a freight train or a rocket. It takes tons of effort to get going, but then its unstoppable.

I went too far too fast because I was "obviously too low". I shot right past the ideal mark and suddenly gained 20 lbs in the blink of an eye. I had to taper off as quickly as possible and endure considerable imbalance before I could come back at it carefully.

It takes several weeks for your current dose to stabilize. It might take you months to find the right dose. Take it from someone who has been there, its worth the wait.
 

ilovethesea

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managing said:
The problem with "unless you're obviously too low" is this: Its like a freight train or a rocket. It takes tons of effort to get going, but then its unstoppable.

I went too far too fast because I was "obviously too low". I shot right past the ideal mark and suddenly gained 20 lbs in the blink of an eye. I had to taper off as quickly as possible and endure considerable imbalance before I could come back at it carefully.

It takes several weeks for your current dose to stabilize. It might take you months to find the right dose. Take it from someone who has been there, its worth the wait.

I meant that in the context of someone who is already on thyroid meds and is moving from one brand to another. I wouldn't recommend increasing sooner than 2 months for someone who hasn't been on any thyroid at all. But if you're moving from one brand to another like we're talking about here, and your temperatures start to tank after the change, then to me it doesn't make sense to stay at that level for 2 months. The things she is describing have happened to me pretty much exactly.
 

managing

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Good point. It does seem to suggest that her NDT was "really" stronger if we assume that synthetic is at least more consistent. Perhaps very small, but relatively rapid increases might make sense. I think rapid in this context might be around 2 weeks which is the half life of t3 mol if I am correct?
 
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Katty

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Thanks managing and ilovethesea! I didn't see these new posts here until just now =)

I'm still only about 3 or 4 weeks, so I'm going to wait a bit before adjusting any dose. I may lower my T4/T3 ratio at the end of the time to see how I feel. I am doing the T4 at night and then biting the T3 throughout the day.

I'm surprised to hear that the oily hair is a hypothryoid issue. My hair has been pretty dry otherwise, so an increase in oil production seemed like a positive to me... but maybe not?

My temps didn't tank on this dose, they actually seemed to increase a bit. Although now that I'm a little farther along, I might not feel quite as warm all the time as I did when I first switched... but I am hungrier-- so maybe the meds have increased my metabolism and now I need more calories... that's the one thing I'm always afraid to increase.
 

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