Hypothyroidism Support Group
Hypothyroidism is the disease state caused by insufficient production of thyrohormone by the thyroid gland. There are several distinct causes for chronic hypothyroidism, the most common being Hashimoto's thyroiditis and hypothyroidism following radioiodine therapy for hyperthyroidism. Advanced hypothyroidism may cause severe complications, the most serious one of which is...
I posted this on the graves board, but I probably should've put it here
So, I switched from 100mcg synthroid (all drs were telling me that I needed to lower my dose because I had a non-existant TSH) to Naturethryoid. She wanted to start me out low, though, (I think she really isn't completely up on it - she's a DO, not an endo...not that being an endo makes it any better - the last one was terrible) of 1/2 grain even though the equivalent to the 100mcg of synthroid I was on was 1 grain. But, whatever, I was happy just to get a prescription and even though I knew it wasn't enough I figured I would just take it and then get it upped in 6 weeks. Well, the 6 weeks is here and just had my labs (done by my ob since I was getting my progesterone checked as well) and my TSH is 38. Not 3.8. 38! Wow. I haven't had a tsh in years. I am shocked that it jumped that quick. Ft3 is at the very bottom of the range and Ft4 is just under range now. OB is just going to go ahead and call me in double the dose - 1 grain so I don't have to call the DO and have it done, thank god. I knew I should've started out higher, but they never want to listen to you! Luckily, even though the tsh is that high, I really don't feel all that bad. I'm really surprised. I'm hoping the 1 grain won't make my ft3 and ft4too high, though. We'll see. And, he wants to test in 2-3 weeks just to make sure the TSH is starting to come back down since its so high.
Just thought I'd share this tidbit. Hopefully it comes back down just as quickly as it jumped up.
So, I switched from 100mcg synthroid (all drs were telling me that I needed to lower my dose because I had a non-existant TSH) to Naturethryoid. She wanted to start me out low, though, (I think she really isn't completely up on it - she's a DO, not an endo...not that being an endo makes it any better - the last one was terrible) of 1/2 grain even though the equivalent to the 100mcg of synthroid I was on was 1 grain. But, whatever, I was happy just to get a prescription and even though I knew it wasn't enough I figured I would just take it and then get it upped in 6 weeks. Well, the 6 weeks is here and just had my labs (done by my ob since I was getting my progesterone checked as well) and my TSH is 38. Not 3.8. 38! Wow. I haven't had a tsh in years. I am shocked that it jumped that quick. Ft3 is at the very bottom of the range and Ft4 is just under range now. OB is just going to go ahead and call me in double the dose - 1 grain so I don't have to call the DO and have it done, thank god. I knew I should've started out higher, but they never want to listen to you! Luckily, even though the tsh is that high, I really don't feel all that bad. I'm really surprised. I'm hoping the 1 grain won't make my ft3 and ft4too high, though. We'll see. And, he wants to test in 2-3 weeks just to make sure the TSH is starting to come back down since its so high.
Just thought I'd share this tidbit. Hopefully it comes back down just as quickly as it jumped up.
I know that most conversion charts list 1 grain as equivalent to 100mcg Synthroid but, if NatureThroid is anything like Armour, the equivalence is more like 75mcg.
So, basically, you were taking something like 37.5mcg when 100mcg was too low for you - no wonder your TSH shot up like that.
I think you know there's a chance you'll start feeling those hypo levels but, I'll hope against hope that the much-needed dose increase kicks in before that even has a chance of happening.
Hey, you did it the doctor's way - now it's time for the doctor to do things your way :)
So, I had my OB do my labs this time because we were checking progesterone and he went WHoa.. This is way high. Luckily he didn't make me go back to the other dr and immediately called me in the larger dose. He also wants to check in 2-3 weeks and make sure that the tsh is on its way back down (knowing it will take a good 6 weeks for them to come back all the way).
Now, I just noticed though that he prescribed 1 grain twice a day. I'm going to call him tomorrow to verify, but I was just expecting 1 grain once a day. I'm wondering if he's wanting to throw a bunch at me to get my tsh down quicker or if it was just a mistake? You say the natural product tends to be more "potent" then? So that you don't need quite as much as synthetic t4? DO you think 2 grains is going to be wayyyyy too much? LOL like going the total opposite way?
In a way, I'm kind of glad to see such a high tsh. After it being non-existant for so long (years) I was beginning to think maybe my pituitary just wasn't producing it!
http://www.nature-throid.com/available_strengths.html
You will see that 1/2 grain has 19mcg T4 and 4.5mcg T3.
Since T3 is like 4 times as potent as T4, your equivalent dose is 37mcg T4. So, yes, 1 grain is more like 75mcg T4.
Due to the T3 in NatureThroid, many people do well with a lower equivalent dose. However, since you needed more than 100mcg Synthroid, your doctor should have started you on 1 grain with the instructions to increase by of 1/4 grain after 2-3 wks. (this is per the dosing instructions in the prescribing information).
In all honesty, while your ultimate dose could very well become the very common 2 grains, there is no way I would recommended going right up to 2 grains now.
That would be quite the shock to your system....your body just won't be able to process this much hormone and you could very well develop hyper symptoms and transient hyper labs.
Doctors that following the prescribing information increase by 1/4 grain so, maybe you could tell your doctor you'd like to increase slowly and start 1 grain for now.
Please know that, due to the T3 in NatureThroid, you should expect your TSH to be suppressed if you are optimally medicated.
You can see in paragraph 2 of the indications and usages section that NatureThroid is to be used as a pituitary TSH suppressant:
http://www.nature-throid.com/images/Nature-Throid-PI-Rev041121-03.pdf
I just don't understand why doctors don't seem to read the prescribing information - if I can find it, they should have access to it as well - right?