Not sure this went through - re; possible pharmacy screw up

[Guest guest]

Hi all,

I may have an interesting dilemna on my hands and won't know for sure until tomorow when my compounding pharmacy re-opens. Here is the situation. I was on 120 mg of Armour when we realized I had a reverse t3 problem and 8 weeks ago started what I thought was SRT3 only from a compounding pharmacy. The first prescription according to the RT3 website is that I should have started at 25 mcg per day and then gradually increase. However, I was prescribed 88mcg twice a day (176 mcg per day). I questioned the pharmacist about the conversion and on the phone he double checked and said no this was correct.. So, for two days I did as he advised only to have my heart rate go nuts and scare me to death. So I ramped it down to 20 - 25 mcg per day and gradually increased to 100 mcg SRT3 per day split into 4 daily doses. I was

having mixed results. My temps were gradually increasing but only to upper 97s with occasional 98.4 readings. My pulse fluctuated from low 60s to upper 80s with it staying mainly in mid 70s. My hair loss seemed to improve. I was sleeping like a baby and waking up rested. Fatigue and energy were good. What was not so good is that my metabolism is shot and I have a tightness in my chest along with elevated blood pressure and heart rate that seemed to medication related.

Ok, so here is the weird part, yesterday, I happen to notice at the bottom of ALL of the bottles from the pharmacy, it said "synthroid" -- which leads me to believe they were compounding a syntroid slow release mimic and put me on T4 only all this time instead of t3. That initial dose of 88 mcg twice a day would fit with a T4 conversion from Armour instead of T3 conversionn of 12.5 mcg twice a day... See lab results below from 8 weeks ago and then last week. Unfortunately, the lab failed to report FT3 in latest labs. Nick and Val -- if I was on T4 only, does any of my improvement make since? My RT3 decreased from 34 to 19. What are your thoughts?

8 weeks ago before stopping Armour and starting with what I thought was SRT3:

T3 Free 325 (230 - 420)

T4 Free 2.4 (1.6 - 3.7)

TSH .02 (.40 - 4.5)

T4 Free direct dialysis 2.4 (.8 -2.7)

RT3 - 32 (11-32)

Labs last week: No FT3 reported:(

T4 Free 1.8 (1.6 - 3.7)

TSH - 2.22 (.4 - 4.5)

RT3 - 19 (11-32)

I also had a prescription filled yesterday for generic cytomel -- I have 25 mcg tablets. I thought I would go ahead and switch over to this to make sure I am taking T3 only -- since I was on 100 mcg of something up until yesterday -- am trying 6.25 mcg every few hours and so far doing ok. Tried a 12.5 mcg last evening but heart rate went up too much. Any thoughts about these lab results or what to do?

Thanks,

Beth

[Guest guest]

>Labs last week: No FT3 reported:(

>T4 Free 1.8 (1.6 - 3.7)

>TSH - 2.22 (.4 - 4.5)

>RT3 - 19 (11-32)

>

>I also had a prescription filled yesterday for generic cytomel -- I have 25 mcg

tablets.  I thought I would go ahead and switch over to this to make sure I am

taking T3 only  -- since I was on 100 mcg of something up until yesterday -- am

trying 6.25 mcg every few hours and so far doing ok.  Tried a 12.5 mcg last

evening but heart rate went up  too much.  Any thoughts about these lab results

or what to do?

Gut feeling is that it was T3 but the pharmacist gets confused between

T3 and T4, set the dose for T4, and then gave you T3!! This would

explain the rapid pulse after taking it and why the dose was chosen!

If that's what happened then they are stunningly incompetent and may

not admit it.

Those labs indicate you are pretty hypo but without the FT3 are

useless.

If you have Cytomel now I would start low and work up, the changes are

you were not getting the equivalent of more than 50 of Cytomel

whatever you were on.

I think I would start at 37.5 the first day and go up by 12.5 a day

until you get to 75 of pulse comes up and then fine tune from there.

It takes 3 days for a T3 dose to stabilise but you have T4 production

going on still so you will feel the conversion decaying from that and

need to increase again every week or so,

Nick

--

for more information on RT3 and Thyroid Resistance go to

www.thyroid-rt3.com

[Guest guest]

Nick,

Thanks so much. I agree with your gut and felt the same way that they probably filled T3 at tthe T4 dose.. I'm lucky I didn't go into cardiac arrest!! One further quick question. It is the generic Cytomel made by Paddock -- (liothyronine). Does this change your dosing instructions at all?

Thanks,

Beth

To: RT3_T3 Sent: Mon, January 18, 2010 3:30:44 AMSubject: Re: Not sure this went through - re; possible pharmacy screw up

>Labs last week: No FT3 reported:(>T4 Free 1.8 (1.6 - 3.7)>TSH - 2.22 (.4 - 4.5)>RT3 - 19 (11-32)>>I also had a prescription filled yesterday for generic cytomel -- I have 25 mcg tablets. I thought I would go ahead and switch over to this to make sure I am taking T3 only -- since I was on 100 mcg of something up until yesterday -- am trying 6.25 mcg every few hours and so far doing ok. Tried a 12.5 mcg last evening but heart rate went up too much. Any thoughts about these lab results or what to do?Gut feeling is that it was T3 but the pharmacist gets confused betweenT3 and T4, set the dose for T4, and then gave you T3!! This wouldexplain the rapid pulse after taking it and why the dose was chosen!If that's what happened then they are stunningly incompetent and maynot admit it.Those

labs indicate you are pretty hypo but without the FT3 areuseless.If you have Cytomel now I would start low and work up, the changes areyou were not getting the equivalent of more than 50 of Cytomelwhatever you were on. I think I would start at 37.5 the first day and go up by 12.5 a dayuntil you get to 75 of pulse comes up and then fine tune from there.It takes 3 days for a T3 dose to stabilise but you have T4 productiongoing on still so you will feel the conversion decaying from that andneed to increase again every week or so,Nick-- for more information on RT3 and Thyroid Resistance go to www.thyroid- rt3.com

[Guest guest]

>Thanks so much.  I agree with your gut and felt the same way that they probably

filled T3 at tthe T4 dose.  I'm lucky I didn't go into cardiac arrest!! 

Yep

>One further quick question.  It is the generic Cytomel made by Paddock --

(liothyronine).  Does this change your dosing instructions at all? 

I'm told by people who have tried it that it seems weak, possibly

absorbtion issues.

I still advocate start low and build up, far safer than the other way

round.

As you take your doses for the first few days check pulse and maybe

temperature each time you are about to take some, if it's high then

delay the dose for an hour or a few until it drops down again.

Nick