Discussions that mention synthroid

Hair Loss / Alopecia board

Quote from binks:
I really do not understand the gist of your message. What is it?What about the hydrocortisone and DHEA? I reduced my armour down to 1 grain a month ago, and am still experiencing hair loss and increased pulse. I was thinking that my hair loss and increased heart rate maybe related to the DHEA.

I am sorry if I offended you, or confused you, that as not my intention. I just jumped straight in with what I felt was pertinent information. I know some of what I say or said will be contrary to what yoru doctor may have told you or what you have read somewhere else, but I can assure you that what I am saying is from reputabel sources.

The gist of the message is that I don't think Hydrocortisone is your problem, nor is DHEA. Generally if you have too much DHEA, you will have excessive hair growth, not hair loss. (you failed to mention your sex, so if you are male, the results MAY be different).

[quote]What do you think? I have read these could be some of the side-effects of taking this hormone in high doses, even if your own serum blood level for the hormone is within range (when taking the hormone). DHEA produces testosterone and estrogen. I read that in some susceptable individuals, testosterone is converted to DHT in the hair follicles, and this causes hair loss.

Yes, this could cause male pattern baldness and hairloss, but it would more likely cause hirsutism, in a woman. I think the root (pardon the expression :)) is somewhere else. I could be wrong, but it bears looking into.

[quote]I don't know if that is happening with me. I forgot to mention when my armour was at it's highest 2 grains, my hair started falling out like crazy, and my finger nails stopped growing. The nails were very brittle and thin. Since reducing the armour, the nails are better...but my hair is not. I really don't understand what is going on, and it seems my pcp does not as well. I am very concerned. I need HELP! Please respond with any info you might be able to offer. Thanks, binks

Now, back to where I think your problem lies. Thyroid hormone levels are where I think the problem lies in your case. I think your Free T3 is PROBABLY OK, but I can't tell for sure. IF you took your meds within 6-8 hours of when the blood was drawn, then neither your Free T3 nor your Free T4 result will be truly accurate.

When your armour was at its highest, your Free T4 was likely at its lowest, and probably still hasn't recovered.

To be sure I am drawing the right conclusions, it is important for me to know wehn you took your Armour on the day that your blood was drawn for those lab results, as I am only guessing at this point. Within two hours after taking your Armour, your Free T3 (and Free T4 to a lesser degree) is elevated artificially until the proteins in your blood attach themselves to the T3 (and T4) from the Armour. The peak of this phenomenon occurs 2 hours after you take the pill and continues to be high for up to six hours after the peak. Thus it is important that if you are taking thyroid meds and having Free T3 and Free T4 tested that you wait at least 8 hours after you take your meds in order to get an accurate reading, or wait and take your meds after the blood is drawn.

My Guess is that you need to add some Synthetic T4 (Unithroid, Synthroid, Levoxyl, etc) to your Armour to bring up your T4. T3 and T4 should be in similar portions of their respective lab ranges, but you have one high, and one low--a pattern that I have sen in many people to cause symptoms.

Later, I mentioned a very common cause of hair loss: Anemia. A good doctor would have already had those tests that I suggested to see if that was a source of your hairloss.

I hope this helps clarify what I said and why. If you have any questions or any more information that might help, feel free to ask. That's what we are here for.
Quote from binks:
They continue to be appreciated. I would like to know if the increase in heart rate is something to be concerned about?

Maybe, and maybe not. You still never answered about when you took your meds that day. If you took them before the blood was drawn, then I woudl want to see them re-done. If you took them after the blood was drawn or at least 8 hours from when the blood was drawn, then I would bet that your T3 really is too high and this is why your heart rate is higher. Here's something to try. Split your Armour dose and take half in the morning and half in the afternoon. T3 has a fairly shourt half life and many of us find that we do better symptom-wise when we split our dose. I take mine at about 8:00 and 3:00.

[quote]In regards to the DHEA, the source of the info I gave you regarding hair loss, never mentions hirsutism as a side effect in women. I do not have any signs of hirsutism. One thyroid source (mary shalmon?)suggests the problem lies with testosterone and it's conversion to DHT in the hair follicles...causing hair loss.

Interesting, I had never heard of hair LOSS being associated with DHEA, so that was a new one for me. I am familiar with Mary's work and have exchanged emails with her on a few occasions a few years ago. She is really on top of things, and I would trust her sources as valid, BUT, I still maintain that it is an unlikely scenario.

[quote]This person suggests evening primrose to help with this problem. I have tried Borage oil for 1 month but notice no help. I am aware that primrose oil apparently differs in that it is a phytoestrogen. Is this why it works? Does it matter what type of GLA one uses? I was concerned about using additional estrogen, since I already take some.
This is an area where I need to do more homework before I feel comfortable giving an answer. I am suspect of phytoestrogens as a rule, though. If you need estrogen, the real thing is always better. Phytoestrogens compete with estrogen in attaching to the cell receptor sites and may decrease the efficiency of your estrogen.

If you are supplemeting with estrogen, estradiol is the best. Premarin and Prempro are not natural to your body and are known to cause a host of problems in humans. Besides, I disagree with the manufacturer on how the animals they derive the hormones are treated. (Premarin means PREgnant MARe urINe--honestly! look it up!)

[quote]I am VERY concerned about regaining the weight I lost since on the armour and dhea. Is this a valid concern? What can I do to maintain the weight I am at now?
If it is important to you, then it is a valid concern. I can tell you that once you stabilize your hormone levels that gaining or losing weight will be the same as it is for any other healthy adult. If you were low on DHEA before supplementing, then keep taking it--it is helping. On the Armour, I know you have changed from dose to dose. Again, tell me when you took your meds that day and when you had your blood drawn so I can make a valid interpretation of the results.

[quote]Why must the FT3 and FT4 be at similar levels? What does this do to the body's metabolism?
Because in a healthy person that is what you would find--balance. This is what is required to keep your metabolism up where it should be. Another reaosn is that some tissues can't use T3 from your bloodstream very well and require T4 which is converted within these individual tissues. The brain is one such organ that doesn't use T3 from the blood, but requires T4 to function properly. If your brain isn't getting adequate T4, then the function in your body that it supports may very well suffer, especially in the long run.

[quote]I was on 1mg of levoxyl previously, and could not loose weight. I was also severely fatigued etc. The doc then put me initially on l grain armour. During the conversion process, I started to loose weight and felt alot better. Why is this?
On the Levoxyl, your T4 level would have been pretty good, but your T3 probably dropped low enough to cause symptoms. (there are ways to help this, by the way, if your doc switches you back to a T4-only med).

T4 has a long half life. When you switched over to the Armour, your T4 was still in a good range, and the T3 in the Armour also brought your T3 up quickly. Within a few weeks, your T4 was dropping to a point where you started experiencing symptoms and 6 weeks into the Armour regimin, T4 had stabilized where it is now--low enough to be a source of symptoms.

[quote]Now, she is thinking I need to be off the armour and back on the levoxyl. I can't go back to that state! She doesn't want to bother with armour. I get the impression she has other patients on it having a lot of problems. They have a lot of symptoms, and I am not sure she knows how to adjust the armour.
I don't blame you for not wanting to go back to that state. I am glad that Armour has worked somewhat for you, and that you are asking questions to learn what else can be done. It IS possible to feel better, and I believe that you will. The problem with thyroid meds in general, regardless of the type of med you are on, is that there is NO one-size-fits-all solution. Armour is not the answer, but it helps many people feel better. On the other hand some people do terribly on Armour but feel fine on Levoxyl (or Unithroid or Synthroid...). Some people do thier best on a combination of Armour and a synthetic T4 (I fall into this category, and most likely do, too), some do better on a synthetic T4 and Cytomel (a synthetic T3), and rarely, some people do their best on Armour and a synthetic T3 (this definitely wouldn't be you).

[quote]What do you suggest I tell her, so she will continue to work on this with me? Why does armour feel so much better than levoxyl, yet it seems to have alot more problems in fine tuning the T4 and T3?
Ask her to humor you and see if she will work with you on this plan:

Throughout your treatment, do NOT take your meds before your blood is drawn. This is imperative for accurate results. I can provide references if your doc needs them or you can just follow my advice and let your doc think you are taking your meds before your blood is drawn, if that is what she prefers. I cannot stress how important this is to getting your thyroid levels balanced properly!

Take Armour alone until your Free T3 is consistently above 3.4. shoot for getting it between 3.4 and 3.6 or so. You can have labs and dose adjustments done as often as weekly when adjusting T3 levels.

Once you get to that point, add in small amounts of the T4 med of your choice (Unithroid, for example, is my choice), having labs done every 6 weeks and adjusting doses until you get your Free T4 right, targeting about 1.5 (somewhere bbetween 1.4 and 1.6). This may have the effect of bringing your T3 up a little, too, so that's why I left a little room at the top of the T3 scale, so there is room it to increase, if needed.

Once you get your T4 where I suggested, hold there for at least 6 months and see if that doesn't make a big difference in your symptoms. Meanwhile, pay attention to make sure you are eating adequately.

For the hair loss, make sure you are not anemic, also. If your red blood cell count, hemoglobin, B12, Iron or Ferritin are low, then you will likely shed hair, and getting your thyroid levels right won't help with that.

Also, keep a symptom journal through all of this. Make entries at least once a week, but don't read over them until at least a month or more has passed. This will serve two purposes. 1. It will show you how you have progressed, since many of the symptoms tend to fade away slowly, and 2. it will be a central location where you can show your doc your progress and have a guage of how well things are working.

You will notice that I didn't mention TSH anywhere in my plan There is a reason for that, and I have a reference for that if you and/or your doc needs them.

[quote]I am also concerned about the dhea. I don't want to go off of it, it seems to help me so much. What about 7-keto dhea? Do you have any experience with this? My other doc put me on dhea because my own values were so low, and as a preventive measure for osteoporosis.
Your other doc is a wise doc, but apparently a littel flighty. I haven't used the 7-keto DHEA, though I have heard good things about it. it might be a good idea to try it. If you are concerned about being on the DHEA, then have it tested to see where you are. I don't know your age, but you want DHEA to be about in the middle of the range it should be in for a 25-29 year old for optimum results. As long as you keep it there, and no higher, you shouldn't worry about any adverse effects from it

[quote]When I started having hair loss (very concerned about it) and increased heart rate, she took off on me. I can't afford to loose another doctor. PLEASE HELP. If you could answer the questions I have posed, and try to explain, and deal with the concerns I have voiced, I would greatly appreciate it. Thanks! binks I hope to hear from you soon.

If you are worried about hair loss look at all the possible causes. Listen to me about the Ferritin, especially. It is a MAJOR contributor to hairloss, even if other iron levels are "normal". Ferritin scores below 50 almost always mean you will be losing hair.

I hope this helps!
[quote]The doc pretty much left the hydro levels to me. I tested low for cortisol in the am. So...what is the best dosage regime for me to follow?

In my opinion, I think taking a higher dose early in the day when you need it, (and wehn you tested low) makes more sense than taking the same (or almost the same) dose all day long. You are taking 18.75mg daily, so I would split that up 10-5-3.75 (Breakfast-Lunch-Supper) to mimic what nature would provide you with. If you go to 20 mg a day, 10-5-5 liwk I am doing would be a good plan.

[quote]Did you gain weight after taking the hydrocortisone as well? If so, what is a reasonable amount to expect? According to Jeffries, one shouldn't gain weight. He suggested I take 5mg x 4. The original doc who prescribed the hydro had me taking a total of about 15mgs/day in divided doses of four. I didn't seem to gain weight on this dose. It was only after I started raising this dose, I began to have weight gain.

I actually LOST weight at first. If you gained weight, then perhaps the dosing schedule is wrong for you. Try the schedule I have described and see if it works. Also, speaking from personal eperience, watch how you eat. Hydrocortisone DOES increase your appetite. You may unwittingly be eating a little more without realizing it. I know my appetite increased alot, but I knew to watch it and learned to compensate by snacking and making sure I don't overeat.

[quote]Then she split in midtreatment, and I was left floundering around. That could be grounds for a mal-practice suit if you are inclined to pursue it. The grounds: failure to provide continuation of service. She should have referred you, and continued to treat you until you had another doctor rather than to leave you scrambling.

[quote]The pcp I have handling it now, isn't really doing anything to address the dosage. Thinks weight gain is a normal reaction to this steroid.Weight gain IS a common side effect of hyydrocortisone--at supraphysiological doses, that is. In other words, if you take more thna what a healthy adult would produce on their own, then you woudl expect weight gain. Sinc eyou are on a smaller dose than that, the weight gain probably has more to do with timing of the dose or other factors (other health issues like thyroid*, appetite, exercise, blood sugar issues, etc) (*I honestly believe that incorrectly treated hypothyroidism is your problem)

[quote]She doesn't know about Jeffries. I told her, and it still didn't change her attitude. No one has ever addressed the issue again with me test wise. I told you I was under the impression the adrenals should be balanced with the thyroid. What do you think?I am not surprised that your PCP hasn't heard of Dr. Jeffries. Sadly, his work is largely ignored by mainstream practitioners, and it isnt' taught in medical schools.

I think it is not so much a matter of "balancing" adrenals and thyroid levels as making sure that the adrenal response is healthy or that you are supplementing with hydrocortisone if the adrenal response isn't healthy. That is what the Shames' are referring to. It is necessary to have healthy adrenal response, or your thyroid treatment will be less than optimally effective.

[quote]How does one do this? You are doing it already by taking the hydrocortisone. I don't think you are taking it to the best advantage by spreading the doses equally throughout the day, but that is my opinion, only. I am not a healthcare professional, only a well-educated patient.

[quote]I told you what I am currently taking now. This caused a 30 lb. weight gain. It was only after this, the pcp told me to take some levoxyl for several years, till I was soo sick with chronic fatigue , could not get out of bed, and fibro... That is commmon, adn agina, I think that while you were on the Levoxyl, I bet your T3 was too low, and while you are on the Armour, your T4 is too low.

[quote]...she finally agreed to try me on armour. She had insisted all along priviously, ,there was no such thing as free T3! She still tells me this. She only has T3uptake
listed. I have to force the T3 issue, to get tested.In her defense, many lab requisition sheets don't have Free T3 listed as such. It may be listed as any of the following or might not be listed at all: Tri-iodothyronine, Free; Free Tri-iodothyronine; Free T3; or T3, Free.

If it isn't listed, there are blanks on the lab requisition that say "Other" and Free T3 can be written in there. Your doctor should know this. IF not, the nurse or medical assistant should know this. If they don't, you can educate them on it.

[quote]I need to know what are the best doses to take that will not cause much weight gain and the best time to take them. I used to take my hydro earlier than 9pm, but found I was getting too tired very early. Now, I still remain a night person. I can't seem to get to bed till 1am, and then have a lot of difficulty in the am. I feel like I was run over by a truck. I feel very tired. All I want to do is sleep. What possibly is wrong with this picture, and what can I do about it?

Sounds liek adrenal fatigue to me. Since Morning Cortisol was what measured low, you need more in the morning. What is happening is that your adrenals are slowly making cortisol (aka hydrocortisone) all day long and the level is rising throughout the day. You are adding to this the way you are taking your meds.

Try splitting your dose as I described above: three doses 10-5-3.75 (Breakfast-Lunch-Supper) to mimic what nature would provide you with. If you go to 20 mg a day, 10-5-5...

Taking the higher dose in the morning will help to get you going, and leaving out the 9PM or later dose will let you sleep better.

[quote]I was able to take lab test today for T3,T4,TSH and DHEA. I took the tests 8 hrs. after taking the thyroid. According to the last lab figures I gave you,what does that make me? Hypo or Hyper? Due to when you took your meds the last time, I can't tell whether you are hypo, hyper or "normal" My educated (and probably accurate) guess if hypo, though. I was able to tell that you had taken the meds before the last blood draw, right? That seems to be more than what your doctor could tell from the tests.

[quote]Will adding more T4 and having the levels equal, tend to cause me to gain weight? MOst liekly not. Restoring your metabolism to healthy levels that are optimal rather than just normal has a tendency to help people with weight loss. IT doesn't necessarily make you lose weight if you dont' get rid of other factors, though.

For example, Before my thyroid treatment I was about 25 pounds over my "ideal weight". Getting thyroid and adrenal levels balanced dropped 15 of those pounds.

The extra 10 pounds bothered me for a few years after I had my thyroid and adrenal levels where I want them. When I quit eating a snack before bed, magically, the extra 10 pounds was gone in a month with no extra effort on my part. Simple little things like that can make a big difference.

[quote]How much T4 and T3 are in 1 grain of armour? How does it compare to 1 mg. of Levoxyl?

1 grain of Armour has 38mcg T4 and 9mcg T3, and is supposely equivalent to 100mcg (.1mg) of Levoxyl (or levothyroxine, or Unithroid, or Synthroid). In practice though, many doctors and patients find that Armour is more comparable, physiologically to 75mcg levothyroxine. I tend to agree.

The reason for this can be found with a little math. T3 is about 4 times as active as T4 in the body, so we multiply the 9mcg of T3 by 4 (9x4=36) and add this result to the 38 mcg of T4 in Armour. Thus wwe get 36+38=74 --That's VERY close to the 75mcg I mentioned above, right? :)

Final answer: one grain of Armour is likely equal to about 3/4 or 75% of a 100mcg Levoxyl for most people.

[quote]In answer to your question, I started to take the hydrocortisone at the same time I started the Biest, progesterone cream and testosterone cream. My weight didn't start to shift up till I was told to increase the hydrocortisone from the l5mgs. I felt I couldn't stay at this dose, because I began to feel severe fatigue as the cortisol was wearing off too soon , I think. I could not wait till the next dose.

IF you took a larger dose of hydrocortisone in the morning, it would even out those periods when you feel you need the next dose. Been there, done that, got a closet full of T-shirts from it. Give it a try. If you want more advice on how to take that, post a message to Chris on the Addison's board. Chris posts here, too, but moe on the Addison's board and knows the adrenal stuff better than I do. I still bet you'll get the same advice from Chris that I am giving you.