TyroMix - Liquid T3/T4 Mix For Lab/R&D

PeskyPeater

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@haidut Requesting an increase of t4 in the formula (T4/T3) to 3:1 or at least 2.3:1 please, so it is more brain favorable and also to compensate for coffee use and calcium supplements.

Also I don't understand the origin of practice used for the logic of 3:1 ratio. Is this based on taking say cynoplus in a fasted state or with food? It seems tablets with t4 in them have a lowered absorption rate that results in an effective ratio of 2:1. Unless it is taken in a fasted state, then 3:1 would also be favorable in this liquid form at least to compensate for some losses that i'm describing below..

Looking at the bio-availability of T3 from tablets 95% is absorbed when taken with food, no problemo. And thyroid in liquid form is better absorbed than in tablet form:
*... Among 102 patients, dissatisfied with their therapy with L-T4 tablets (in a mean dose of 88 ± 34.7 µg), taken before the meal, 66.6% reported improvement in the quality of life and better adherence after switching to liquid L-T4 ingested with breakfast [45]. Treatment with liquid l L-T4 formulation can be considered also in patients who are willing to keep their daily habits [46].

But it seems T4 has a somewhat lesser bio-availability when taken with calcium carbonate, 25.8% less [10], study referenced in Absorption of Levothyroxine When Coadministered with Various Calcium Formulations
In a previous cohort study performed by Singh et al. (8), subjects received 1200 mg of elemental calcium as calcium carbonate taken as a single 3000 mg daily dose with their levothyroxine for a period of 3 months. This resulted in a modest but significant decrease in mean serum free T4 and total T4 levels as well as an increase in serum TSH (the mean serum TSH increased from 1.6 to 2.7 mIU/L). A follow-up single-dose pharmacokinetic study was performed with 2000 mg of elemental calcium (5000 mg of calcium carbonate) given simultaneously with 1 mg of levothyroxine and similarly showed a reduction in the expected rise of serum total T4, free T4, and total triiodothyronine levels (10).

And it seems liquid T4 has lesser bio-availability when taken with coffee, average of 32.5% less. See attached study below.

2.4. Impact of Food
Intake on Pharmacokinetics and Pharmacodynamics of Levothyroxine L-T4 absorption and bioavailability, with regard to the food, depend on the drug formulation (tablets, an oral liquid form, or soft gel capsules). In some countries tablets are the only available L-T4 formulation

Taken with a meal with coffee or in fasted state the absorption of liquid T4 is similar:
2.4.2. Liquid Form
In vitro studies proved the stability of liquid L-T4 formulation in beverages such as milk, tea, coffee, coffee with milk, and orange juice [39]. The liquid form has also a faster onset of absorption, compared to tablets (AUC0-2h (ng*h/mL): 99.1 ± 22.7 vs. 68.4 ± 32.8; tmax (h): 1.96 ± 1.07 vs. 2.25 ± 0.99). Greater early exposure and faster time to maximal concentration can minimize the risk of drug-food interactions [15].
Marina et al. [40] examined fT4 levels in 14 patients taking 200 µg of oral liquid L-T4; seven of them administered L-T4 while fasting, and seven with breakfast consisting of six cookies (132 kcal, 9.1% fat, 76.9% carbohydrate, 7.7% protein, 3.8% fiber) and one cup of espresso or cappuccino, both with 5 g of sucrose. The results were comparable in both groups.
In another study on 59 hypothyroid patients, Morelli et al. [41] found no significant differences in the TSH level when administering liquid L-T4 with breakfast, or 10 and 30 min before (1.52 ± 0.73 mU/L, 1.46 ± 0.81 mU/L, and 1.25 ± 0.7 mU/L respectively).
Cappelli et al. [42] conducted a randomized, double-blind, placebo-controlled trial on 77 hypothyroid patients. They assessed whether the patient’s usual breakfast (mixed with tea, coffee, milk, cappuccino, orange juice, etc.) may influence liquid L-T4 absorption. Pharmaceuticals 2021, 14, 206 5 of 20 Serum TSH, fT4, and fT3 levels were comparable in patients administering liquid L-T4 formulation (in a median dose of 75 µg) with breakfast, and 30 min before. The authors concluded that liquid L-T4 can be ingested directly with the meal.
Pirola et al. [43] got similar results for the same median dose of L-T4 (75 µg), on an extensive set of 761 patients. A possibility to administer liquid L-T4 with food may have a positive influence on patient compliance and well-being [44].
...*

But taken with coffee, less is absorbed:
2.8. Levothyroxine–Coffee Interaction

Several studies on patients with hypothyroidism revealed that coffee could decrease the efficacy and safety of L-T4 treatment. The proposed mechanism for this interaction was the sequestration of L-T4 by coffee and in consequence, altered intestinal absorption of the drug [60]. Benvenga et al. [61] investigated the influence of espresso (without milk or sugar) when co-administered with L-T4. Six hypothyroid and nine healthy women were administered two 100 µg L-T4 tablets swallowed with (1) coffee, (2) water, or (3) water followed by coffee 60 min later. Th authors measured average and peak incremental rise of serum T4 concentrations and time to reach maximal serum level. Compared to water, coffee significantly lowered the incremental rise of serum T4 level, both average (by 36% in thyroid patients and 29% in volunteers) and peak (by 30% and 19%, respectively). It also significantly delayed time to reach maximal serum level (by 38 and 43 min). As no significant difference was found between groups (2) and (3), it was suggested that 1h break between coffee and L-T4 is enough to prevent the interaction.
 

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PeskyPeater

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Oh wait a minute, I misread something thing about the coffee, they were using tablets:

The above cases refer to L-T4 in tablets. Recent studies suggest that coffee-induced malabsorption of L-T4 can be reduced by replacing the tablets with soft gel capsules or liquid form.
And yet another advantage of liquid form preventing loss of T4 absorbtion from calcium.
Interaction with calcium can be avoided by switching from L-T4 in tablets to oral liquid form. Benvenga et al. [87]
I apologize,
Oke I need to get some sleep.
 
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brix

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Been using 2 drops before bed last few nights. I have been waking up with morning wood every single time. I can't remember the last time I had them.

Is this suggesting I am very hypothyroid? or possibly just a benefit of being a sleep-aid?
 

:M :B.

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Added a counter because I am too hypothyroid to keep track.

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inurendotoxin

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Tyromix will make it across with no issues.

I live in Canada as well, never any issues with idealabs products.

It's listed on the bottle for R&D... they cannot block it.
I'm also in Canada (Ontario). Looking to place a Tyromax order. Just curious if you select the DHL or USPS option in your case?

Thanks for any help.
 

exile

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I had a tsh of 3.10 on 6/14/22, used one drop of tyromix with dinner 2-3 weeks before 8/23/22 labs and tsh was .89 (didn’t change other supplements or eating and both were drawn at similar times in the morning.)
 
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Peatness

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I had a tsh of 3.10 on 6/14/22, used one drop of tyromix with dinner 2-3 weeks before 8/23/22 labs and tsh was .89 (didn’t change other supplements or eating and both were drawn at similar times in the morning.)
Did your temperature and pulse change?
 

exile

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Yeah temp up .4 or so and pulse 5-10. Still have elevated cortisol (which I had prior) so trying to figure that out.
 
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exile

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Cortisol is a tough one to tackle. What have you tried?

I’ve only really tried the thyroid since I read Peat said that could be a factor and after I saw the 3.10 tsh. Looking back at labs I see one from 2016 where cortisol was also high, but the doctor didn’t seem to care. Seems to be some issue maybe with the autonomic system cause I have adrenaline problems sometimes and have had long standing issues with histamine. Maybe gut related. It seems like everything is either gut or thyroid.
 
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Peatness

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I’ve only really tried the thyroid since I read Peat said that could be a factor and after I saw the 3.10 tsh. Looking back at labs I see one from 2016 where cortisol was also high, but the doctor didn’t seem to care. Seems to be some issue maybe with the autonomic system cause I have adrenaline problems sometimes and have had long standing issues with histamine. Maybe gut related. It seems like everything is either gut or thyroid.
Cortisol is not always a bad thing I guess when it's too high and stress is also high then it's a problem. I have this issue too. I think mine is related to the many health complaints I've posted about on the forum. Anyway, you might find these quotes useful.


"A simple protein deficiency has many surprising effects. It lowers body temperature, and suppresses the thyroid, but it increases inflammation and the tendency of blood to clot. Since the brain and heart and lungs require a continuous supply of essential amino acids if they are to continue functioning, in the absence of dietary protein, cortisol must be produced continuously to mobilize amino acids from the expendable tissues, which are mainly the skeletal muscles." - Ray Peat

“The excess cortisol of depression, old age, and hyperestrogenism often comes down with use of a thyroid supplement, but pregnenolone has a very direct action (in opposition to serotonin) that can quiet the pituitary, reducing ACTH and cortisol.” -Ray Peat
 

exile

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Cortisol is not always a bad thing I guess when it's too high and stress is also high then it's a problem. I have this issue too. I think mine is related to the many health complaints I've posted about on the forum. Anyway, you might find these quotes useful.


"A simple protein deficiency has many surprising effects. It lowers body temperature, and suppresses the thyroid, but it increases inflammation and the tendency of blood to clot. Since the brain and heart and lungs require a continuous supply of essential amino acids if they are to continue functioning, in the absence of dietary protein, cortisol must be produced continuously to mobilize amino acids from the expendable tissues, which are mainly the skeletal muscles." - Ray Peat

“The excess cortisol of depression, old age, and hyperestrogenism often comes down with use of a thyroid supplement, but pregnenolone has a very direct action (in opposition to serotonin) that can quiet the pituitary, reducing ACTH and cortisol.” -Ray Peat
Thanks for that. Have you taking Pregnenolone? If so brand and dosage?
 

chompie

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Thanks for that. Have you taking Pregnenolone? If so brand and dosage?
I've had very high cortisol (as confirmed by a.m. and p.m. serum draws, 24-hour cortisol urine, and the saliva) as well and a hell of a time getting it under control.

Progesterone, pregnenolone, and dhea have done nothing. Cortinon didn't touch it as confirmed by labs.

I'm still trying to sort it out, but the thing that seems to help the most is novelty (obviously tough), salt and sugar, and relatively high dose zinc picolinate.

Work in progress. If you handle cyproheptadine, I think that relatively high doses will bring down cortisol. I can't quite take 8 mg without feeling so wasted that I haven't gotten there yet.
 

exile

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I've had very high cortisol (as confirmed by a.m. and p.m. serum draws, 24-hour cortisol urine, and the saliva) as well and a hell of a time getting it under control.

Progesterone, pregnenolone, and dhea have done nothing. Cortinon didn't touch it as confirmed by labs.

I'm still trying to sort it out, but the thing that seems to help the most is novelty (obviously tough), salt and sugar, and relatively high dose zinc picolinate.

Work in progress. If you handle cyproheptadine, I think that relatively high doses will bring down cortisol. I can't quite take 8 mg without feeling so wasted that I haven't gotten there yet.
Thanks for this. I kind of wonder if mine came from years of lower/moderate carbs. I think I might try to up my carbs. I have enjoyed Cyproheptadine in the past although I only ever did .5 mg. I might try to add it back in.
 

eimearrose

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I started Tyromix on 1st October. 2 drops 3 times a day. The rationale for the dose is I'm trying to approximate one grain but with more T3, as I think my liver isn't great.I get cold when I get hungry, wake up hungry through the night, so I think I would benefit from the 2:1 ratio. I'm splitting it up over 3 doses as I think 6mcg T3 at one time is enough. I have these doses with a full meal.
The first few days I had a bit of a lump in my throat sensation, but I had my 'retirement' race from competitive running the day I started. That is normal enough- I get huge surge in stress hormones from hard running that can last for days. My starting TSH is 3.16, pulse mid 50s (improved from mid 40s by cutting down drastically on training for the preceding two months), waking oral temps 35.5-36.2 celsius. From day 5 I have been sleeping all the way through the night for the first time in years and years. Mood is drastically improved. Temp and pulse have improved only very slightly (36.3-36.5, 57-60) but I take that as a good sign- a dramatic increase would make me think I'd overdone it.
Bowel function is best in a good while, but I'm also using cascara (1/4 teaspoon of powder in hot water before dinner, kind of like a digestive bitters). I wasn't responding to it before adding in thyroid though. I had chronic diarrhoea for a few years caused by exocrine pancreatic insufficiency that was quite resistant to Creon, but this went away and was replaced by constipation in the middle of the summer when I stopped training hard. Cascara wasn't really doing much but I've been good since adding in Tyromix. I will probably try cutting out the cascara to see if Tyromix on its own is working, but I also like the other benefits of cascara/emodin.
Anyway, that's my early impressions- so far, so good.
 
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Peatness

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Does tyromix come in a clear bottle or is it still the white bottle?
 

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