Re: Positive news!! T3!!!

[Guest guest]

Great news Fiona. You have worked so hard to get it prescribed. Really pleased

for you.

Judy

>

> I have had my hospital appointment and believe it or not there is progress.

>

> I am to drop to 75mcg Levothyroxine and have

>

> 20mcg T3!

>

[Guest guest]

Hi Fiona,

That's fab news!! Really pleased for you... You can start getting better now...

Lv

>

> I have had my hospital appointment and believe it or not there is progress.

>

> I am to drop to 75mcg Levothyroxine and have

>

> 20mcg T3!

[Guest guest]

Looks like your high free 4 result made up his mind for him,

even without the free T3 result. The high T4 could be that you were not

converting it to the active T3, so it remains in the blood, doing nothing and

with nowhere to go. Good for you Fiona, I am delighted that yet once more,

another doctor cares about how to treat his patients with the symptoms of hypothyroidism.

I hope his students learn from him.

He is right that he cannot predict what dose you will end up on

at the end of the day, he probably can't even predict whether you will need to

stay on a combination dose, or come off levothyroxine completely one day and

just take T3 on its own.

Splitting the dose of T3 tablets really doesn't matter whether

they are even doses or not. You are putting out different amounts of thyroid

hormone throughout the day and night, so long as you take ALL the dose at some

time, even the bits of powder created (wet your finger and pick it up that way

and stick it in your mouth).

If you are still getting energy crashes after taking 20mcgs T3

daily (however you split it) then your endo. will likely increase the dose by

another 10 mcgs until you get the dose right.

I wouldn't worry about getting your FT3 checked, now that you

are taking T3, you will know very quickly if you are taking too much. The T3

peaks in the blood a couple of hours after taking it, and when you start to

increase the dose, when you finally find the dose that you will need for the

rest of your life, this will probably be done after you have taken an increase,

and a couple of hours later, you will start to get the symptoms of taking too

much. Dizziness, sweating, feeling jittery, feeling spaced out and hyper

symptoms. You don't take any more that day, and the following day, you go back

to the dose you were taking the previous day - and that, Fiona - will be the

dose you will probably need for the rest of your life, with no more increases.

Oh, perfect day!

Luv - Sheila

My results that were on 100mcg Levothyroxine, selenium were:

TSH 1.42 (0.35-5.5)

T4 20 (10-24)

T3 NOT DONE -

He is also very vague about what combination/dose I will end up on in the end

and how long it will take. He did say that once I get on a set dose, that will

be it for life, unless there is a specific reason to change it.

Any thoughts about this side of thing? Because I know you don't get an accurate

dose when cutting tablets. If you still get the pm energy crashes, is that a

sign that you need 2 tablets of T3 a day and that perhaps dividing the dose

will tide you over, but not fix it?

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18:26:00

[Guest guest]

> That's fab news!! Really pleased for you... You can start getting better

now...

>

Cheers and Judy!

I have to say, I am relaxing and treating myself to a beer tonight.

Not before time, with this starting to get better thing eh. Yep I have worked

hard in this direction. Having been a Dr P patient for a while and clearly

self-funding things and no official diagnosis. With any luck, things are moving

in the direction, of firstly official recognition, now to a spot of T3. All I

need then is optimum dose of meds (but that's another story, take one step at a

time).

Fiona.

[Guest guest]

>The high T4 could be that you were not converting it to

> the active T3, so it remains in the blood, doing nothing and with >nowhere to

go. Good for you Fiona, I am delighted that yet once >more, another doctor cares

about how to treat his patients with the >symptoms of hypothyroidism. I hope his

students learn from him.

Cheers Sheila! You know what? I also feel delighted he-he.

I can understand him not being able to predict my future dose, but a bit more

reassurance wouldn't have been appreciated. Needless to say, I know to push to

be kept on as long as possible and continue with trial and error, until I know I

have peace of mind. i.e. rather than a doctor telling me it's fixed...

If we assume by nature I have had a lot of problems with doing nothing with my

T4...

What levels of TSH and T4 and T3 ought I be aiming for? Or is it more about my

functioning and symptoms? And as you say, making sure I am not going hyper...

What I feel inclined to do for the moment, is take my T3 and Levothyroxine as

soon as I wake up in the mornings. Then take it from there.

Going off past performance, I am sure I don't need to worry about taking too

much T3 yet. Bearing in mind, a year ago I was on 2 Grains of Armour and 2

Cytomel. So I wonder what the NHS equivalent will be, to bring back that level.

(Indeed assuming that all this good old days of a year ago, was optimum thyroid

dose).

You are right, I can look forward to the day when I am optimum dose and stick

with it.

Believe it or not, I have had a better afternoon already!! I can look forward to

a better weekend now.

Cheers! Because without TPA, I wouldn't have got this far!

Fiona.

[Guest guest]

>future levels of TFT's should not be aimed at - it is losing all >your symptoms

and signs that should be your target.

That's fair enough! It's just that at the start of all this, there was a lot of

talk about aiming for high end normal T4, to get the most out of the

Levothyroxine. Then of course it becomes clear, that there is poor conversion.

So I can see how that even though the T4 is within brackets, it can build up and

not convert.

There is obviously a lot of trial and error, to do with the time of the day I

take my meds, over the next few weeks.

So far so good.

This morning I took the T3 and Levothyroxine together at 07:30.

No mid-morning crash at 10am or anything. I feel a little sluggish now, but not

too bad.

Clearly I am aiming for a similar amount of energy throughout the day. It seems

to me, that if you can rid the mid-am crash, it's possible to rid the 3-5pm

crash.

I was also thinking that if I had to be somewhere in the morning, take the meds

like today. If I have to be somewhere in the afternoon, take the Levothyroxine

first thing, then the T3 at lunch to prevent the pm crash.

Clearly if only one crash can be eliminated, or if by halving the doses the

crashes only half go, it's obvious that more T3 is needed isn't it.

The problem with all this is the logistics because I also have Caclichew D3

Forte and Ferrous Sulphate prescribed. We all know you have to keep them away

from the thyroid meds. Therefore if I was taking thyroid meds am and noon, that

only leaves time for dinner time and bed time to take these other meds. The

problem will arise if I have to take thyroid meds split between three times a

day!

I am not doing to bad on the front of waking up refreshed actually! This is good

news to share, because in the past this used to be a problem and you couldn't

get me out of bed before 9am. I feel more refreshed than I used to, and I feel I

am getting a healthier/deeper night's sleep.

For me, I can see that my objective of sustaining a similar amount of energy

through the morning, afternoon, and evening will be the key. So there are not

highs and lows and having to consider if you leave the house before x time of

the day, or get back home before a cetain time of the day due to anticipated

energy crashes... In the way I was before, I would have a window late

morning/early afternoon, but as I say before then I would crash from the

exertion of showering and dressing and putting on laundry. Then mid/late pm I

would crash.

So I am sure over time the key would be spreading out the dose, to prevent this

nonsense. Like it keeps you going or something and as you say 'tops you up'

Fiona.

[Guest guest]

> The final problem is- will the GP prescribe- he's not duty bound to do so?

>

there will be trouble if the GP doesn't prescribe after all this! Thinking

of the lines of chaining myself to the raidiator and demanding I get the help

ha-ha. (Mustn't joke about these things).

To be honest, they are aware of the hospital letter from last time that

mentioned if I am no better, to try a combination... They are aware of it and

didn't say they wouldn't prescribe it... They give me the impression that if

guidance is there from a specialist, they usually follow it, that is what a GP

said to me, when I mentioned it. So I have a hint that I should get it, although

I will be due a celebration this weekend and I won't believe it, until I am

actually swallowing the NHS version and not just my left-overs from the past.

They were happy to prescribe the selenium, so fingers crossed eh!

Val mentioned about that it's not important about keeping the T3 away from food.

Val are you taking Cytomel, or is it the NHS prescribed T3?

Otherwise if it's the synthetic and you still have to keep it away from food, I

could always take it at noon and have my lunch at 1pm or something...

Everything is pointing towards having two chunks of T3, be it half a tablet, am

and half a tablet noon, or one whole tablet twice - thus eliminating the crashes

in the morning and afternoon.

Fiona

[Guest guest]

" People whose adrenal glands are also underactive. In prolonged and severe

hypothyroidism, the adrenal glands can become less active. When treatment with

this medicine is started, the thyroid hormones and hence the body's metabolism

increase faster than adrenal glands recover, and as a result the adrenal glands

may not produce sufficient levels of natural steroid hormones. In this case,

your doctor may need to prescribe you supplemental corticosteroids until the

adrenal glands adjust to the new metabolic rate and produce enough natural

steroid hormones. "

http://www.netdoctor.co.uk/medicines/100002563.html

It just goes to show that at some point, I ought to re-do the saliva test, to

see if the adrenal supplements are enough. After all you need peace of mind...

HAVE YOU SEEN THIS? Err no wonder people get trouble in getting the help they

need...

http://www.guardian.co.uk/lifeandstyle/besttreatments/underactive-thyroid-treatm\

ents-liothyronine-plus-levothyroxine

Saying that they sometimes use it in emergencies, to me implies that there is

little need for T3 and how ill do you have to be to get it?...

" Research shows that levothyroxine alone works just as well as levothyroxine

plus liothyronine. Most people don't get any extra benefit from taking

liothyronine as well "

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=search & db=pubmed & term=Clyde%20[AU]%\

20AND%202003%20[DP]%20AND%20JAMA%20[TA]

Regarding studies conclude that combination treatment is no better...

Perhaps these studies didn't take into account if symptoms were fully alleviated

by standard levothyroxine in the first place or not. Perhaps I can see why a

combination wouldn't be better if somebody was well in the first place on

Levothyroxine. There is never a distinction between if they have studied just

any thyroid patient, or have studied those who had symptoms only half-fixed with

Levothyroxine. Plus another pitfall I can see is that what about appropriate

dose? Is it that the study time-frame was too short, i.e. not long enough for

the dose to be increased to give optimal benefits. What I think is that I bet

things were inconclusive due to not selecting the people who still have symptoms

and are not giving enough of a dose.

Here is something more positive:

http://www.fpnotebook.com/Endo/Pharm/Lthyrn.htm

" A therapeutic formulation of the primary physiologically active form of

endogenous thyroid hormone. In vivo, triiodothyronine enters the nucleus and

binds to nuclear thyroid hormone receptors that subsequently bind to thyroid

response elements (TREs) located in target genes. Receptor binding by

triiodothyronine in combination with recruited coactivators results in maximal

transcriptional activation after binding to TREs; in general, binding of thyroid

hormone receptor alone to TREs leads to repression of gene transcription

(NCI04) "

Fiona