The following is my experience, with a couple Websites at the end:
I was on T4 (Synthroid). Did everything I could to get enough absorbed and
converted to T3, but I still needed 150 mcg plus about 8 mcg (from cutting a
25 mcg into thirds) to get enough T3 into my system to function somewhat
normally. In Sept. my TSH was still practically nil, my left over T4 was
high, and my Reverse T3 was high out of range, but my free T3 was sort of
okay.
In Oct. I saw Doc Don (Dr. Donald Michael, MD). He prescribed Wilson's
Thyroid Syndrome Protocol. I received graduated amounts (increments of 7.5
mcg) compounded time release T3 (Liothyronine). The doses are taken twelve
hours apart and I am to take my temperature and pulse during the day three,
six and nine hours after the morning dose. My average temps would go up
slightly with each increase, and then it went down again. Eventually I got
up to the F 98s and was thrilled to get up to F 98.6 . I got up to 60 mcg
morning and night.
My local doc is skeptically continuing the protocol with me. Until I could
find a local (within 30 miles) compounding pharmacy (taking my insurance)
that would at least try the Wilson's Protocol, I have been on Cytomel. Big
difference! The closest pharmacy that had Cytomel could only get 5 mcg and
50 mcg doses. While there were no side effects with the timed release
Liothyronine, Cytomel hits with a wham (heart and head feel it). I divided
the doses (cut the 50 mcg pills with a pill cutter and added the 5 mcg pills)
to spread them out. I read that Cytomel has a half life of about 8 hours.
Meanwhile, during that time I have reduced the amount of Cytomel I take each
day.
I see my local doctor on Thursday and hope he make the Rx to the compounding
pharmacy I found that takes my insurance. I will have to adjust the dosage
again, checking temperatures and pulse. (I had trouble counting my pulse, so
I got one of those self-testing machines that does pulse and blood pressure.)
One reason why the doses can go up and then down, Doc Don said, is that if
the thyroid gland was suppressed by the straight T4 (the dosage needed to get
enough normal T3 to the cells) and not totally destroyed by Hashi's, the
gland may be able to start producing T4, and some of it may get converted to
T3. He also gave me Cortef (small amounts) and DHEA (women's dose) to give
the adrenal glands a bit of a rest, so maybe the overproduction of RT3 might
slow down.
I do wish there was a way to calculate how much T3 to start with, but so far
it is a matter of self-adjusting. Doctors need to trust us to not do too-too
much. We want to feel normal, not sick, so they need to believe that we
really don't want to feel worse on the other side either. I suspected I
would reach a fairly high dose before going down, and apparently that did
happen.
If I only had Wilson's Thyroid Syndrome, my own thyroid might regain its
health. But I suspect I was also Hashi's, too, so I will probably be on some
T3 for the rest of my life.
There are a couple Websites that may provide information.
From the source on Wilson's Thyroid Syndrome and Protocol:
http://www.WilsonsThyroidSyndrome.com
Dr. Richard Alford had a long "white paper" (copyrighted) on types of
hypothyroid conditions. He includes an explanation of when Armour (T4 with
some T3 plus ?) or straight T3 is more appropriate:
http://www.members.home.net/dickalf
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