T3 & T4 Prescription Question -- for Chris

[DeepSquatter]

Hey Chris & All,

Currently on TRT (by physician, not my own diagnosis)

180 mg T a week, divided; 25 mg DHEA a day, .5 mg Anaztrazole/wk, and 500 iu HCG 3 times a week).

I'm also on thyroid medication, after a full panel and thyroid antibodies check.

T3 & T4 were both low, so doc set me on 20 T3 and 100 T4 a day. He assured me this wasn't high. 3 months later my numbers improved to normal, and I felt better, yet still low side normal. He suggested raising the T3 to 25 and T4 to 125.

I am little concerned as that T3 dosage is similar to what bodybuilding friends will use (at least initially) and I'm supposed to be on this for life. I suggested maybe spinning onto Armor and my doc said that would result in considerable trial and error. He then assured that what I am doing is addressing a physiological need, which is what the meds are intended for. In other words, not to worry.

Your thoughts?

 

[Vettester Chris]

DS, for various reasons I would take the NDT's over any of the T4's, one main reason being they're natural with none of those polymer fillers and other synthetic substances. Not saying one can't achieve optimal wellness with these medications, but I just think natural is the better way to go more times than not. I suspect that your physician isn't totally up to speed with NDT's (like Armour), otherwise I doubt he would be that hesitant.

The protocol he has you on will equal approx. 1 grain to possibly 1-1/2 grains of NDT when adding the extra Cytomel. There's lots of people taking 3 to 4 grains/day, some even more. I'm not one of them, but it just goes to show everyone's needs are different, and metabolism rates vary from patient to patient

Personally, I wouldn't worry too much that this dosage is overload, but I wouldlike to see your lab results and where your lab reference range percentagesfall-in with the current regiment. Seeing your FT4, FT3 and Reverse T3 would behelpful before titrating any T4 and the Cytomel. If you have these labs please post them up.

 

[Vettester Chris]

Harry Cat has some first hand experience with some of the T4's, so he might also be able to chime in on some of this ...

 

[DeepSquatter]

Thank you for the prompt and courteous response.

T: 584 (348-1197)
Free T: 11 (6.8-25)
Estradiol: 8 (3-70)

TSH: 3.07 (.45-4.5)
Rev-T3- 8.9 (9.2-24)
T3- 2.0 (2.0-4.4)
T4- .91 (.82-1.77)

I currently have about 3 months worth of my meds then have to "re-up."

Warm Regards,
DS

 

[Vettester Chris]

Were you on thyroid medications with these labs, or is this baseline? If you were on medication, when was your last dosage in relation to the lab work?

Also, I would hold off on any AI treatment until you can get the E2 up a bit (mid 20's, low 30's) just my .02

 

[DeepSquatter]

Yes, I was already 100 T4 and 20 T3. They were taken the day of the blood draw. Though I have heard that a T3 I had been using was over dosed (research chems)....at the time of this draw thought they were pharmaceutical from Europe.

Agreed about the E2. I since cut way down -- to basically never!

 

[HarryCat]

As for how "natural" NDT is, just check out the STTM page that lists the fillers and additives that these "natural" medications contain: http://www.stopthethyroidmadness.com/armour-vs-other-brands/
You'll see they contain many of the same ingredients found in synthetic T4 meds.

NDT is also not without it's issues with regard to how people react to all the additives and fillers. I remember well when Armour changed their formula in 2009 and all of a sudden many patients said they felt completely miserable on the new formulation. http://thyroid.about.com/od/thyroiddrugstreatments/a/armour-reformulation.htm

Also see the kerfuffle early this year regarding Erfa: http://www.stopthethyroidmadness.co...stop-nonsense-change-desiccated-thyroid-back/

Then, of course, there was the time a few years ago when Armour was inexplicably taken off the market. I believe it was off the market for at least a year. That sent people scrambling to find alternatives.

Of course, T4 meds have many of these issues as well. A year and a half ago, Levoxyl was taken off the market only to return earlier this year.

Now on to your specific question. I remember when I was first learning about hypothyroidism. I went and got a copy of "Harrison's Principles of Internal Medicine" out of the local medical school library because I wanted to know why what all the doctors were telling me differed so much from what I had learned on websites such as STTM. In the section on hypothyroidism, it says that Armour thyroid can't be relied upon to give consistent doses of T4 and T3 and should not be used (this is not true). I suspect that this is why your doctor doesn't want to prescribe it.

It sounds like your concerned that your dosage is too high. As Chris said, the dosages your doctor is recommending are not unreasonable. I also don't think it is unreasonable to request a trial of Armour.

Since you say you do feel better since starting your current therapy using synthetics, I suspect you shouldn't have much trouble switching to NDT.

 

[DeepSquatter]

Thanks everyone.

So I have a bottle of 60-grain Armour.

Were I to replace 125 T4, 25 T3, what would be the equivalency?

Would there be any reason/rational for doing a few months of "natural" sups, a few months of synthetic meds?

Warm regards,
DS

 

[DeepSquatter]

A friendly bump?

A bottle of 60-grain Armour -- Were I to replace 125 T4, 25 T3, what would be the equivalency?

Would there be any reason/rational for doing a few months of "natural" sups, then a few months of synthetic meds?

Thanks again

 

[Vettester Chris]

A friendly bump?

A bottle of 60-grain Armour -- Were I to replace 125 T4, 25 T3, what would be the equivalency?

Would there be any reason/rational for doing a few months of "natural" sups, then a few months of synthetic meds?

Thanks again

If it were me, I'd start with 1-1/2 grains, and would probably add 10mcg to 15mcg of Cytomel the first week til the body gets adjusted to the NDT, and T4-T3 conversion is fully active. You could possibly titrate up to 2 grains from there. Obviously keep an eye on how you feel, watch your body temps, and run labs within 4 weeks. Avoid taking the Armour with any iron supplements, and if possible split it 2x per day. Also, with cellulose in the mix with Armour, I suggest chewing it and just let it dissolve and swallow.

Based on your follow up labs, you and your doctor may want to increase or decrease the medication. Some patients even add a little T4 since the NDT (porcine) ratios are different than that of human thyroids.

 

[DeepSquatter]

Thank you Chris!

Sorry, it appears I misspoke -- the Armour says 1 grain (60mg) with each tab = 38 T4, 9 T3.

In light of my docs 125 T4/ 25 T3 prescription, jumping right to 3 tablets of Armor wouldn't be wise?

As an aside, is the Erfa form of Armour any better now or still problematic?