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Old 05-17-2013, 02:18 PM   #1
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Converting to different Meds - Question

Hello

I am set to see my Dr tomorrow and would love some input so I am armed and ready when I speak to him

I have been on armour plus cytomel for about 1.5-2 years now and have never gotten to where I need to be. Over the last several months I have seen my FT4 fall to the low end of the range (almost out of it completley) and my FT3 has been slightly over. My TSH is GREATLY depressed (.005 or along those lines). My numbers are here:

http://www.healthboards.com/boards/thyroid-disorders/857153-hi-im-back-would-love-feedback-labs-4.html

As you can see, with my currently meds, there is no way to address the low FT4 without shooting my FT3 any higher. I am going in tomorrow to ask that I be switched to synthroid + cytomel as I feel that I will have greater control in making adjustments. Plus, I am begining to suspect, that perhaps I am one of the unlucky ones whom armour just doesnt work for.

My question is this: what would be an approprate dose of synthroid and cytomel to mimick the below dose? I ask bc I see so many people not getting the right meds and I want to make sure my Doc recommends the right amound so that I can have a good conversation with him about it.

My current dose it
Morning: 1.5 grain armour, plus 2.5 mcg cytomel
Afternoon: .5 armour, plus 2.5 mcg cytomel...so in essence, I'm on 2 grains of armour + 5 mcg cytomel for the entire day

I was origionally placed on armour then they added cytomel when it looked like my FT3 wasnt going up....just FYI


THank you for any input. If there is a conversion chart or calculator out there anywhere I'd love to see it!

 
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Old 05-18-2013, 01:53 AM   #2
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Re: Converting to different Meds - Question

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Originally Posted by nuttmegs17 View Post
My question is this: what would be an approprate dose of synthroid and cytomel to mimick the below dose?

My current dose it
Morning: 1.5 grain armour, plus 2.5 mcg cytomel
Afternoon: .5 armour, plus 2.5 mcg cytomel...so in essence, I'm on 2 grains of armour + 5 mcg cytomel for the entire day
The amount of T4 in 2 grains of Armour equals about 75 mcgs of levothyroxine and I think you're getting a total of 23 mcgs of T3 right now. Maybe you need a bit less of T3 and a little added T4.

Last edited by FinnMaid; 05-18-2013 at 01:56 AM.

 
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Old 05-18-2013, 11:55 AM   #3
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Re: Converting to different Meds - Question

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Originally Posted by FinnMaid View Post
The amount of T4 in 2 grains of Armour equals about 75 mcgs of levothyroxine and I think you're getting a total of 23 mcgs of T3 right now. Maybe you need a bit less of T3 and a little added T4.
Thank you! Just got back from my dr and he agreed that I need to be on synthroud and cytomel. He just gave me a perscription and says he likes to scale back and then dose up which makes me nervous. He's giving me 50 synthroid and keeping my cytomel dose at 10mcg (I made a mistake when I gave my dose previously. It's 10 bit 5). So for the first part if this I angling to have less t4 and t3 than I'm used to. I'm confused by this. Is that normal protocol? I'm so tired at is...got my latest lab back too and now it's showing my ft4 below range and my ft3 within range again. So scared for next week

 
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Old 05-18-2013, 12:02 PM   #4
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Re: Converting to different Meds - Question

I'm not happy about your doctor's plans either, I don't think your T4 dose should be lowered if your FT4 is already on the low side. Doctors sometimes do crazy things, hope he's not planning to keep you on this tiny dose for too long

 
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Old 05-18-2013, 12:22 PM   #5
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Re: Converting to different Meds - Question

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I'm not happy about your doctor's plans either, I don't think your T4 dose should be lowered if your FT4 is already on the low side. Doctors sometimes do crazy things, hope he's not planning to keep you on this tiny dose for too long
Me too

My fr4 is now .84 ( range is .89-1.77)
My ft3 is 4.2 (2.0 -4.4)

They said call them in a week and they'd up the ft3. He said my ft4 is fine where it is. He just doesn'like to see it at .60! That doesn't seem right either I mean upping my t3 med will need to happen but I dont want then to get that up too much and the I'm stick with not enough ft4 med

 
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Old 05-18-2013, 12:41 PM   #6
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Re: Converting to different Meds - Question

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He said my ft4 is fine where it is. He just doesn'like to see it at .60!
(no wonder we don't always trust doctors ). Is there any way you could see another doctor

 
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Old 05-18-2013, 01:09 PM   #7
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Re: Converting to different Meds - Question

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(no wonder we don't always trust doctors ). Is there any way you could see another doctor
I wish. Sometimes he and his staffis open to my suggestion but I've never converted on meds. Going to call this week. I'm just not sure what I should suggest to them. I think if I make the case to the np she'll listen any advice?

 
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Old 05-18-2013, 01:25 PM   #8
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Re: Converting to different Meds - Question

Also he confused Me bc he said to split up my synthroid dose between morning and then 6-10 hrs later. I get why I do this for t3 but why the synthroid should t I just take that in the morning?

 
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Old 05-18-2013, 09:14 PM   #9
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Re: Converting to different Meds - Question

There's no reason to split the T4 dose unless one gets some side effects from taking a single dose.

Last edited by FinnMaid; 05-18-2013 at 09:15 PM.

 
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Old 05-23-2013, 05:17 AM   #10
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Re: Converting to different Meds - Question

So I finally had my dr increase my dose. It's still not at what the prescription chart said is the equivalent that I was on but it's closer. I'm now on 125mg synthroid plus 10mcg cytomel. And have for a few days...

Upon taking the synthroid I felt better than I had when on the armour combo within the first day( I was falling asleep at dinner prior to the new meds) . I wasn't expecting that but ill take it. I know I'm not leveled out yet and most likely not at my correct dosage but since yesterday I've grown more tired again

Is it normal to feel a little better at first then maybe worse and maybe when it's been a few weeks feeling better? Or is this a bad sign?

Thanks for any feedback!

 
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Old 05-23-2013, 06:49 AM   #11
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Re: Converting to different Meds - Question

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Originally Posted by nuttmegs17 View Post
Is it normal to feel a little better at first then maybe worse and maybe when it's been a few weeks feeling better? Or is this a bad sign?
It may be just your body adjusting. Your T3 dose is now lower so you may feel it leaving your body and it probably takes a few weeks before you see the real effects of your new dose. I'm so happy you got the increase to your T4 dose

 
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Old 05-23-2013, 06:54 AM   #12
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Re: Converting to different Meds - Question

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Originally Posted by FinnMaid View Post
It may be just your body adjusting. Your T3 dose is now lower so you may feel it leaving your body and it probably takes a few weeks before you see the real effects of your new dose. I'm so happy you got the increase to your T4 dose

Thank you! Me too. I have to really stay on top of them. They kinda are scarring me bc they said 1. FT4 doesnt really matter as long as it doesnt get below .6! Where as my goal is to get it back into range, and even at the upper part of the range, and that 2. only FT3 matters and TSH doesnt

I do believe TSH matters somewhat - I dont think its good that mine is as surpressed as it is. I know its not the only thing to go on, but I do think the whole picture should be kept in mind. The nurse p, kinda argued with me at first saying "only FT3 matters" but that didnt make any sense. bc if you look at my numbers, my FT3 is GREAT yet, I felt anything but. As my FT4 has fallen, I've felt worse and worse despite a good FT3 - that should mean something.

I do need to find a new Dr who might be more in line with my goals. I think they are great overall and listened to me when other Drs would not, but it might be time to go my seperate way.

I did think about the fact that I am on less FT3, however, I felt BETTER for a few days (not 100% - still not a lot of energy). Now I'm really dragging again. Is there hope it will feel better wo an adjustment? I'm not used to dealing with T4 drugs

Thank you!

 
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Old 05-23-2013, 07:56 AM   #13
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Re: Converting to different Meds - Question

It takes longer for T4 to properly work, you really need to give it more time. Your T3 dose is now significantly lower so I wouldn't be surprised if it turned out to be too low - but it's still early days.

 
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Old 05-23-2013, 07:58 AM   #14
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Re: Converting to different Meds - Question

Thank you. So basically I need to give it time to balance out and also to convert to deal with the less amount of T3 i currently have in my system? patience is a virtue I guess. Just hate feeling so rundown especially as I initially felt better upon the switch. kinda discouraging

 
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Old 05-23-2013, 08:15 AM   #15
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Re: Converting to different Meds - Question

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So basically I need to give it time to balance out and also to convert to deal with the less amount of T3 i currently have in my system?
Yes. Hang in there

 
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