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  1. #1
    healthy11's Avatar
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    hypothyroid medication question...

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    Hello...

    My mom is hypothyroid and her doctor just prescribed a medication for her based on her TSH test. His message said "the thyroid medication is a synthetic form of the "T4" thyroid hormone naturally occuring in your body. It is one of just a handful of medications that is SO SAFE that it is pregnancy category A (totally safe for the fetus)"

    I have done some reading on the "stop the thyroid madness" website and also on this website about synthetic forms of thyroid being a bad idea and that they should be dessicated thyroid... am I right? If she is to take the synthetic form should it be a combo of T3 and T4? Also, she hasn't had her free T3 or T4 tested... how important is that at this point? Should she just take the prescribed medication and see how she responds or ask for more testing and dessicated thyroid medication?

    Ugh... doctors!
    Last edited by healthy11; 08-25-2012 at 10:43 AM.

  2. #2
    Bosnic's Avatar
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    I can't answer your questions, but I recommend she ups her dietary intake of iodine (kelp, seafood, eggs), and selenium.

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    JamesS's Avatar
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    Quote Originally Posted by healthy11 View Post
    Hello...

    My mom is hypothyroid and her doctor just prescribed a medication for her based on her TSH test. His message said "the thyroid medication is a synthetic form of the "T4" thyroid hormone naturally occuring in your body. It is one of just a handful of medications that is SO SAFE that it is pregnancy category A (totally safe for the fetus)"

    I have done some reading on the "stop the thyroid madness" website and also on this website about synthetic forms of thyroid being a bad idea and that they should be dessicated thyroid... am I right? If she is to take the synthetic form should it be a combo of T3 and T4? Also, she hasn't had her free T3 or T4 tested... how important is that at this point? Should she just take the prescribed medication and see how she responds or ask for more testing and dessicated thyroid medication?

    Ugh... doctors!
    T4 is the less active between T4 and T3. Therefore, it really does not make sense o take T4 when there is no guarantee that the T4 will convert in to T3. That is regulated by adrenal function. Because of this glandulars are in a way superior to to T4 drugs such as Levoxyl.

    On the other hand all of these drugs, including the glandulars will atrophy the thyroid over time, creating a dependence on the drugs.

    If possible it is best to look at possible causes of the hypothyroidism and address those to correct the hypothyroidism rather than mask and contribute to it in the long run. There are a number of things that can lead to hypothyroidism, so it can take some investigation.

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    Many people do perfectly well on synthetic t4 - I wouldn't start worrying about it unless she has side effects, such as hypothyroid symptoms remaining even though her TSH levels are 'normal'.

    I personally had no luck on t4 OR natural t4/t3, as a lifetime of dieting caused my body to rebel against me, creating ridiculously high levels of rt3 in my blood stream to combat the thyroid meds and make me hold to on all my fat for dear life, and gain weight eaily, and have yellow skin and cold extremities and no energy. I am finally on a t3 only medicine, but still waiting for all the other junk to clear from my blood stream.

    However, my mum has been on synthetic t4 for over 30 years, has had no problems on it - she however has never done any restrictive diet or excessive exercising, as I have.

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    Interesting. I haven't read any of the Thyroid threads and haven't really educated myself about T3 Vs T4. I'm currently taking Thyroxide ( i really don't notice any differences whether I take it or not, so most of the time I don't bother) . Anyway, I'm taking it beause I had a brain tumour so my brain is no longer making thyroid hormones. So just wondering if anyone can tell me which form of Thyroid hormones I should be taking?
    I don't really trust doctors so your advice would be great. I should start doing my own research on it but any advice would be really great! Thanks

  6. #6
    healthy11's Avatar
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    Do you think that a primal diet can correct it?

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    MY TAKE:
    Everyone is different and different replacement hormones ( Synthroid [T4], Cytomel[T3], Armour [combo],etc.) all work depending on the individual. TSH can, (may not always) be a good diagnostic too. However, IMO, after diagnosis testing and prescribing by free T4 and free T3 is paramount.

    I also think testing for auto-immunity is important-- TPOab, TgAb. If antibodies are high then, IMO, care needs to be taken when considering iodine supplementation.

    If, after testing, frees are approximately in the same place in there respective ranges then that indicates good T4 to T3 conversion and may not necessitate a replacement drug containing T3-- Armour, Nature-throid, Cytomel. However, if free T3 is considerably lower than free T4 then a medication containing T3 may be indicated.

    Which T3 containing medication-- Armour, Nature-throid, T4 + Cytomel, Cytomel alone --is very individual and can only be determined by trial and error. Some thrive on Armour/ Nature-throid. Others find the amount of T3 in these meds too high( Armour is dessicated pig thyroid and naturally has a higher T3 to T4 ratio than human thyroid) and add a T4 med to the mix. I do well on a T4 med +Cytomel.

    Things that help thyroid function include:
    1. Getting enough selenium (200mcg/day)
    2. Getting adequate vitamin D
    3. Getting adequate iron, including ferritin, levels
    4. Being careful with very low carb. Less than 50 grams of carbs/day can inhibit T4 to T3 conversion for some people.

    Other important info:
    1. It takes at least 6 weeks for thyroid meds to reach full effect. So, testing should be done at 6-8 week intervals until optimal levels are reached.
    2. Symptoms can lag behind blood test results so giving a few months of optimal blood results (above mid point of respective ranges) is a good idea. After that tweak slowly to a sense of well being.
    3. A good rule of thumb-- Get both FT4 and and FT3 to mid point of their ranges and hold their for a few months. If symptoms persist tweak meds upward slowly until well being is restored.
    4. Get copies of ALL test results.

  8. #8
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    marcadav,
    great post, obviously well versed in thyroid,

    Just to add/reinforce.
    Always get all 3 tests done, TSH, FT3 & FT4, each will give different clues as to status.
    Patient must be onboard with treatment protocol, if not in an educational sense, then at least with fairly good monitoring of symptoms & changes.
    Some have found taking T4 meds in evening to be more effective than morning.
    Avoid Soy as the PhytoEstrogens can play havoc with thyroid function and also avoid Flax seed for the same reason.
    Hashimotos Thyrodites has been shown to have an undeniable link with Coeliac disease, implicating gluten which may then also by inference be a player in other thyroid dysfunction like Hyper or Hypothyroid conditions, so dropping gluten may also help.
    Take T4 meds at least 2 hours away from iron supplements as these may hinder absorption.
    Just say it again:
    Get copies of ALL test results

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    healthy11's Avatar
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    Thank you for your replies... thyroid issues are complex!

  10. #10
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    The TSH is adequate for initial diagnosis, but she needs a doctor who will continue to monitor her and check both T4 and T3 levels. Often the dosage needs to be adjusted, and good thyroid doctor will respond to both the patient's symptoms and the lab results.

    I am hypothyroid (Hashi's) and have been taking synthetic T4 since initial diagnosis (about 10 years) with no problems. About 3 years ago, my T3 "tanked" (i.e., I began having conversion problems), but my endo assured me that this is characteristic of Hashi's and has nothing to do with my low carb eating (which he approves of). In fact, he's told me that it's impossible to know which patients will experience conversion problems. My own sister has been taking T4 (synthetic) only for over 20 years, and she converts just fine.

    Even if my need for supplemental T3 were due to eating low carb, I'd continue eating this way because I'm very sensitive to carbs and would rather take T3 than regain the almost 200 lbs that I've lost!

    Beware of a lot of the hysteria online about thyroid issues.

    Keep in mind that these 'meds' are supplemental hormones, and once you begin taking them, you should NEVER stop without consulting your doctor because you're taking them because your thyroid isn't producing sufficient hormones for your body's needs--and that doesn't get 'healed.'

    T4 must be taken FOUR hours away from any calcium, antacids, or iron supplements. It's always taken on an empty stomach with no food for an hour afterwards. My pharmacist provided this info, and it's on my pills as well, but I know people who were never informed of this, and it's important.

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