Sunday, July 15, 2012
Summer Update
I haven't posted for awhile. So I'll update my hypothyroid recovery progress and add some day to day news.
After abstaining from DHEA for several weeks, my hypothyroid symptoms decreased while taking 52.5 mcg of T3. When I began to experience cold symptoms (sore throat, sinus pain, etc.), I took a 2.5 mg sublingual DHEA dose at least an hour after my T3 dose or late at night. The DHEA gave me immediate relief from cold symptoms. So I use it when needed, rather than taking a daily 2.5 mg sublingual dose. That seems to work well, because 52.5 mg of T3 daily has eliminated hypo symptoms for almost 3 weeks now, even while taking the 5 mcg tablets (which supposedly have too much absorption blocking cellulose). I will use my last 5mcg tablet tomorrow. So I'll try using 50mcg doses with the 25 mcg tablets. (I can easily split the 25s into halves, but have more difficulty cutting those into quarters to make up 50mcg total daily dose with 3 smaller divided doses.)
I've enjoyed the warm summer weather which helped all our garden crops (strawberries, blueberries, raspberries, grapes, brocolli, beans, lettuce, leeks, carrots, tomatoes). I played tennis, enjoyed walking around our local lake and taken some day trips. We usually plan a vacation in the fall, but enjoy local activities during the summer. I also continued to sew summer tops, but plan to begin some sun dresses after I finish some alterations.
I plan to see my doctor either after I stablize on my T3 dose or just before I run through my current prescriptions, whichever comes first. I'll give her a copy of Paul Robinson's book "Recovering with T3", which taught me how to use T3 only to eliminate my hypothyroid symptoms after T4 only and T4 plus T3 didn't work.
Monday, May 28, 2012
DHEA Blocks T3 Absorption
During the past few weeks I experienced more constipation, which is my most obvious symptom of hypothyroidism. Since I had been taking 50mcg of T3, I hesitated to raise my dose again. Instead I scanned "Recovering with T3". Miraculously I read about the author's experience with drugs which can block T3 absorption. Those drugs include hydrocortisone, DHEA, alcohol, and some antibiotics.
I began taking DHEA sublingually last December (almost 6 months ago). When I refilled my prescription in late March, I told the pharmacist that I still had immunity problems (cold symptoms). So the pharmacist suggested that I raise my DHEA dose to improve immunity. After I raised my dose to 4.0mg in early April, I experience greatly improved immunity (no cold symptoms no matter what else I did). Perhaps I got more vitamin D on sunnier days.
However, I also began to have more hypothyroid symptoms during April. So I raised my dose of T3 over a 6 week period from 42.5mcg to 50mcg. I experienced temporary relief (from constipation, low body temperature and fatigue) with each increase. However relief was short lived. After 2 weeks on 50mcg I began having more severe constipation, which was not relieved even by extra magnesium. (I already followed all the usual 'regularity' rules of fluids, fiber, exercise, etc. for years but nothing consistently resolved irregularity until I began T3 thyroid supplement therapy.)
After reading about drugs which block T3 absorption, I decided to abstain from DHEA to see what happens. The very first day without DHEA, I had relief from irregularity. If the DHEA increase blocked my T3 absorption, while I slowly increased the T3 dose, I wonder whether my current T3 dose (50mcg) may prove to be too high. I need to watch for hyperthyroid symptoms, while I'll abstain from DHEA until I notice immunity problems.
Thursday, May 17, 2012
Good Results with 50mcg T3
I've finally adjusted to 50mcg of T3 (liothyronine) only each day. After back and forthing between 47.5 and 50 total mcg of T3, I finally experienced hypothyroid symptom relief without incurring hyperthyroid symptoms. I tried 3 divided doses of 50mcg for a week. However, I still had low energy between my 2nd and 3rd doses each day. So I began experimenting with 4 daily doses again. That works well as long as I can space my doses either 1/2 hour before or 1 hour after meals. Even when I take the last dose after 8pm, I still sleep soundly. Best of all that total (50mcg) dose completely resolved my irregularity problem.
So I can finally stick with one prescription (25mcg tablets), rather than needing a 25mcg and a 5mcg prescription to get the appropriate sized doses. I'm splitting 25mcg pills in half and taking 4 halves daily 3-1/2 to 4 hours apart. That keeps me evenly warm and energetic, but doesn't cause heart palpitations. I hope I can stick with this dose for awhile. I've taken T3 only for 19 weeks now (almost 5 months). So I suspect my natural T4 very suppressed (as well as my TSH) and all the synthetic T4 cleared from my body 2 months ago.
I plan to see my doctor in late June or early July after a month or so on the 50mcg dose. By that time I should know whether I've stabilized (complete symptom relief, but especially normal regularity) on the 50mcg dose. Then I'll request a new prescription of 25mcg tablets (2 daily). I just hope I don't need to increase again (and need those litte 5mcg tablets to get the necessary amount). Maybe I should 'manifest' (ala Wayne Dyer's approach) 50mcg in 4 divided doses is my longterm stable T3 dose. Of course I'll give my doc a copy of "Recovering with T3' to convince her that I don't need T4 (as well as my history since early January of taking T3 only).
Friday, April 27, 2012
Liothyronine Dosage Changes
After doing well with 42.5 mcg of liothyronine (T3) in 3 divided daily doses for 5 weeks, I noticed obvious hypothyroid symptoms (my usual constipation, fatigue and low body temperature). So I tried increasing to 45mcg (in 3 divided doses) for 9 days, but still didn't experience complete symptom relief. Then I tried 47.5mcg (in 3 divided doses) for 3 days.
I have always wanted to try 4 divided doses with 25mcg tablets, which would eliminate the necessity of 2 prescriptions (one for 25mcg tablets and one for 5mcg tablets). So after only 3 days on the 47.5mcg level, I decided to try 50mcg in 4 divided daily doses. Unfortunately I slept in the first day and took my first pill late, which moved all my subsequent doses later. I took my last dose about 8pm and didn't sleep well last night. However, I suspect reflux from a high fat with onions dinner challenged my sleep more than feeling too warm or hyper from the late t3 dose.
Nevertheless, I tried another day of 4 divided doses for a total of 50mcg today. Perhaps because I didn't sleep well last night, I didn't feel more energetic with 4 divided doses. I also suspect the doses are actually too small to provide symptom relief. Trying to schedule 4 divided doses around eating meals and taking supplements (especially magnesium) is more difficult than my 3 divided doses which I've taken for almost 4 months now.
Sooooo ... I'll backpedal tomorrow and return to 3 divided doses of 47.5 mcg, which I really didn't give a fair trial. Coincidentally I started having more hypo symptoms after 13-14 weeks on t3 only. That makes me suspect that T4 has completely cleared from my body and I rely only on my T3 supplement for thyroid hormones. That makes me wonder whether I will eventually need as much as 50mcg daily. I also could try the circadium method of taking my first t3 dose a few hours before I normally get up. I've tried that method a few times, but I usually don't return to sound sleep. I need sound sleep as well as thyroid supplements to feel energetic the next day. However, for now, I'll return to 47.5mcg in 3 divided doses and give that a week before I consider another increase.
Thursday, March 8, 2012
Rx Comedy of Errors
The prescription refill saga continued all day yesterday. I said in my last post that I called my pharmacy to order a prescription refill request. Because I needed to change the total amount and dosing directions, I was referred to a pharmacist. She heard my request and promised to fax my refill request to my doc's office.
I left several messages with my doc's assistant to alert him about my refill request from my HMO pharmacy. At 4:30pm I finally connected with that assistant, who said he never received a refill request fax from my pharmacy. I told him that I needed the refill soon, because I would soon run out of my current prescription. So he promised to call my pharmacy and tell them my refill request, which they could fax to him. After getting my doc's signature, he would fax the request back to my pharmacy the next morning. Then they could fill the prescription that day, which means I could pick up and pay for both prescriptions with one trip.
The next morning I had not heard from my doctor's assistant. So I didn't know whether he connected with my HMO pharmacy and ordered the refill request fax. So I called my HMO pharmacy again (actually their call center at a different location). I told them that my doc never received the refill request fax promised by the pharmacist on Monday (around noon). I was then told that pharmacist was a 'floater' (didn't work fulltime). I said that her status wasn't an excuse for not doing her job. Then I asked why I wasn't referred to a fulltime employee, but didn't get an answer.
Nevertheless another pharmacy call center worker took my information and promised to send another refill request fax to my doc. After I talked to her, I received a call from my doc's assistant. He told me that he had received the refill request fax. Now he was awaiting my doc's approval and signature on the request. Then he would fax that back to my HMO pharmacy. So I should get my prescription filled on Thursday.
After I talked to my doc's assistant, I received a call from the pharmacy call center worker who promised to order my refill request fax. She told me that the pharmacy had faxed the request to the wrong doctor (one whom I'd never met or visited). So she ordered another refill request fax to my doc. I told her that my doc's assistant had received the refill request that he ordered. So we were just awaiting my doc's signature.
Later I called my doc's office to ask whether my refill request had been faxed back to my pharmacy. The receptionist said the doc was very busy with patients and hadn't signed the request. So by late afternoon my doc had still not signed or return faxed my request. At that point I knew that I wouldn't get my prescription that day, because my pharmacy often doesn't have enough pills to fill orders. So they need to order more pills from the call center. So they don't have enough pills to complete te order until afternoon on the following day.
Because I had a different prescription, which supposedly had been filled on Tuesday and was at my pharmacy, I called the pharmacy to verify that prescription was actually at the pharmacy, rather than waiting for more pills to fill the order (or misplaced somewhere in the pharmacy, which has also happened a few times). Per usual I couldn't talk to the actual pharmacy personnel. I got someone else at the call center. However, afer a long conversation, she convinced me that I would save money, hassle, and mistakes by ordering prescription refills online in the future. That would only work if the dose and amounts were the same, not in the present situation.
Before I left to walk to my pharmacy to pick up another prescription, I checked my HMO's website, which shows when prescriptions are supposedly filled. I noticed that my new prescription had the correct total amount (135 pills to cover 1-1/2 per day for 3 months). However, I only had 1 refill, instead of the 2 refills my doc usually gives me. So I again contacted the woman at the pharmacy call center, who had ordered the refill request which was sent to the wrong doctor. I told her that I didn't have enough refills on the order and asked if she knew what happened. She told that my doc had changed the amount from the 135 I had requested to cover 1-1/2 pills daily back to the 90 which my previous prescription contained. The call center person knew I wanted 135 per bottle/prescription. So she changed the prescription to obey my doc's order for 3 months of 90 each but still satisfy my request for 135 pills for each prescription. That meant I'd only get one refill, which also meant I'd face another week of hassles after only 6 months of my prescription.
So I called my doc's office and asked the receptionist if she knew why my doc changed my refill order. She said my doc thought 135 pills for each prescription was too much. Apparently she had not talked to her assistant, to whom I explained that I took 1-1/2 pills daily, which would deplete my prescription in less than 3 months.(That already happened with my last prescription.) So I needed 135 or 1-1/2 times the original 90 pills in each refill. I asked if my doc could correct the original refill request fax by changing the refill number. I also told the receptionist that my doc could call me at any time on my cellphone during the next 2 hours. I never received a call from my doc. However, the next time I saw my HMO's website record of my prescriptions, the description for the second prescription showed 2, rather than only one refill. That matches the number of refills for my first prescription of the same thyroid supplement.
Maybe I should clarify, that I have gotten (for the previous 3 months) 2 prescriptions with 2 different amounts of T3 thyroid supplement. I wish I could just get one, but I would either have to count out many small amount pills daily or I'd need to split the larger amount pills into tiny increments which wouldn't be very accurate. While I'm still adjusting my thyroid supplement levels, I want the flexibility of 2 different total dose pills, from which I can assemble my 3 daily divided doses Right now my first morning dose is larger than my second midday and last afternoon dose. Who knows what I'll need in another 9 months? I may be on an even dose which I can divide. Meanwhile I have enough different sized pills to assemble my daily thyroid supplement dosage needs.
.
I left several messages with my doc's assistant to alert him about my refill request from my HMO pharmacy. At 4:30pm I finally connected with that assistant, who said he never received a refill request fax from my pharmacy. I told him that I needed the refill soon, because I would soon run out of my current prescription. So he promised to call my pharmacy and tell them my refill request, which they could fax to him. After getting my doc's signature, he would fax the request back to my pharmacy the next morning. Then they could fill the prescription that day, which means I could pick up and pay for both prescriptions with one trip.
The next morning I had not heard from my doctor's assistant. So I didn't know whether he connected with my HMO pharmacy and ordered the refill request fax. So I called my HMO pharmacy again (actually their call center at a different location). I told them that my doc never received the refill request fax promised by the pharmacist on Monday (around noon). I was then told that pharmacist was a 'floater' (didn't work fulltime). I said that her status wasn't an excuse for not doing her job. Then I asked why I wasn't referred to a fulltime employee, but didn't get an answer.
Nevertheless another pharmacy call center worker took my information and promised to send another refill request fax to my doc. After I talked to her, I received a call from my doc's assistant. He told me that he had received the refill request fax. Now he was awaiting my doc's approval and signature on the request. Then he would fax that back to my HMO pharmacy. So I should get my prescription filled on Thursday.
After I talked to my doc's assistant, I received a call from the pharmacy call center worker who promised to order my refill request fax. She told me that the pharmacy had faxed the request to the wrong doctor (one whom I'd never met or visited). So she ordered another refill request fax to my doc. I told her that my doc's assistant had received the refill request that he ordered. So we were just awaiting my doc's signature.
Later I called my doc's office to ask whether my refill request had been faxed back to my pharmacy. The receptionist said the doc was very busy with patients and hadn't signed the request. So by late afternoon my doc had still not signed or return faxed my request. At that point I knew that I wouldn't get my prescription that day, because my pharmacy often doesn't have enough pills to fill orders. So they need to order more pills from the call center. So they don't have enough pills to complete te order until afternoon on the following day.
Because I had a different prescription, which supposedly had been filled on Tuesday and was at my pharmacy, I called the pharmacy to verify that prescription was actually at the pharmacy, rather than waiting for more pills to fill the order (or misplaced somewhere in the pharmacy, which has also happened a few times). Per usual I couldn't talk to the actual pharmacy personnel. I got someone else at the call center. However, afer a long conversation, she convinced me that I would save money, hassle, and mistakes by ordering prescription refills online in the future. That would only work if the dose and amounts were the same, not in the present situation.
Before I left to walk to my pharmacy to pick up another prescription, I checked my HMO's website, which shows when prescriptions are supposedly filled. I noticed that my new prescription had the correct total amount (135 pills to cover 1-1/2 per day for 3 months). However, I only had 1 refill, instead of the 2 refills my doc usually gives me. So I again contacted the woman at the pharmacy call center, who had ordered the refill request which was sent to the wrong doctor. I told her that I didn't have enough refills on the order and asked if she knew what happened. She told that my doc had changed the amount from the 135 I had requested to cover 1-1/2 pills daily back to the 90 which my previous prescription contained. The call center person knew I wanted 135 per bottle/prescription. So she changed the prescription to obey my doc's order for 3 months of 90 each but still satisfy my request for 135 pills for each prescription. That meant I'd only get one refill, which also meant I'd face another week of hassles after only 6 months of my prescription.
So I called my doc's office and asked the receptionist if she knew why my doc changed my refill order. She said my doc thought 135 pills for each prescription was too much. Apparently she had not talked to her assistant, to whom I explained that I took 1-1/2 pills daily, which would deplete my prescription in less than 3 months.(That already happened with my last prescription.) So I needed 135 or 1-1/2 times the original 90 pills in each refill. I asked if my doc could correct the original refill request fax by changing the refill number. I also told the receptionist that my doc could call me at any time on my cellphone during the next 2 hours. I never received a call from my doc. However, the next time I saw my HMO's website record of my prescriptions, the description for the second prescription showed 2, rather than only one refill. That matches the number of refills for my first prescription of the same thyroid supplement.
Maybe I should clarify, that I have gotten (for the previous 3 months) 2 prescriptions with 2 different amounts of T3 thyroid supplement. I wish I could just get one, but I would either have to count out many small amount pills daily or I'd need to split the larger amount pills into tiny increments which wouldn't be very accurate. While I'm still adjusting my thyroid supplement levels, I want the flexibility of 2 different total dose pills, from which I can assemble my 3 daily divided doses Right now my first morning dose is larger than my second midday and last afternoon dose. Who knows what I'll need in another 9 months? I may be on an even dose which I can divide. Meanwhile I have enough different sized pills to assemble my daily thyroid supplement dosage needs.
.
Wednesday, March 7, 2012
Rx Refill Problems
I felt really well on 42.5mcg total T3 yesterday. I took 15mcg early morning, 15 mcg 5 hours later and 12.5 mcg 5 hours after that (5pm). I had even energy levels until about bedtime (10pm). I slept well and had no regularity problems this morning.
However, I'm still waiting for my pharmacy to fax a refill request to my doc's clinic to okay my different presciption of 1/2 of a 25mcg tablet 3x daily, rather than 2x daily, which was my prescription level over 3 months ago. So I need a new total amount per prescription as well as different dosing directions. Ironically, I'm telling them what I'm already doing and they're printing the directions on the bottle as though I needed to know that. Of course pharmacists assume that doctors are gods and patients are idiots, rather than the other way around. SIGH
I called my pharmacy with the refill/dosage change request on Monday. I spoke to a pharmacist who said she would send the fax to my doc's office. My doc's office has a 24-48 hour turnaround time for prescription renewals. So I expected to hear from my pharmacy or see on my online prescription page that the prescription was ready sometime today. When that didn't happen, I called my doc's assistant. He never received the fax from my HMO's pharmacy. So he promised to call them and remind them of the refill/dosage change request and call me back. Over an hour later I still haven't heard from him. I tried calling my pharmacy and got put on hold indefinitely. I want to keep the line open to receive my doc's assistant's call. However, I also want to learn what happened at my pharmacy with my refill request fax. GRRRRRR!!!
Good thing I started this process of hurry up and wait on Monday, because I will be totally out of my 25mcg tablets after Saturday (3 days away). Fortunately my pharmacy says my prescription for the 5 mcg tablets is ready. I want to pick up and pay for both prescriptions at the same time. I sure hope they don't lose my 5mcg prescription by the time my 25mcg prescription is finally ready. (That happened 2x before. My pharmacy loses new prescriptions, filled prescriptions and now refill requests. What next?!!!
However, I'm still waiting for my pharmacy to fax a refill request to my doc's clinic to okay my different presciption of 1/2 of a 25mcg tablet 3x daily, rather than 2x daily, which was my prescription level over 3 months ago. So I need a new total amount per prescription as well as different dosing directions. Ironically, I'm telling them what I'm already doing and they're printing the directions on the bottle as though I needed to know that. Of course pharmacists assume that doctors are gods and patients are idiots, rather than the other way around. SIGH
I called my pharmacy with the refill/dosage change request on Monday. I spoke to a pharmacist who said she would send the fax to my doc's office. My doc's office has a 24-48 hour turnaround time for prescription renewals. So I expected to hear from my pharmacy or see on my online prescription page that the prescription was ready sometime today. When that didn't happen, I called my doc's assistant. He never received the fax from my HMO's pharmacy. So he promised to call them and remind them of the refill/dosage change request and call me back. Over an hour later I still haven't heard from him. I tried calling my pharmacy and got put on hold indefinitely. I want to keep the line open to receive my doc's assistant's call. However, I also want to learn what happened at my pharmacy with my refill request fax. GRRRRRR!!!
Good thing I started this process of hurry up and wait on Monday, because I will be totally out of my 25mcg tablets after Saturday (3 days away). Fortunately my pharmacy says my prescription for the 5 mcg tablets is ready. I want to pick up and pay for both prescriptions at the same time. I sure hope they don't lose my 5mcg prescription by the time my 25mcg prescription is finally ready. (That happened 2x before. My pharmacy loses new prescriptions, filled prescriptions and now refill requests. What next?!!!
Tuesday, March 6, 2012
Uncertain about 40mcg T3
I'm uncertain whether 40mcg of T3 (in 3 divided doses) is enough. Maybe I haven't been on that dose long enough (continuously for 7 days) this round. I originally did that dose for 9 days. Then I reduced the total to 37.5 for a day. Then I tried 40mcg a few more days and again reduced it to 37.5. After getting more serious constipation, I increased the dose back to 40mcg for the past 6 days. However, I've noticed more irregularity, really icy hands in the afternoon and more fatigue just before dinner. So today I added 2.5mcg to my second (midday) dose. That means 15mcg when I first get up (about 7am), 15mcg 5 hours later and then 12.5 mcg 4-1/2 hours after that. I'm either taking too little at my midday dose or I'm waiting too long for my midafternoon dose. I'll see how the dose increase affects me today. Already, one hour after taking that second increased dose, I feel wide awake and warmer, but also a little jittery inside. I'll definitely wait 4-5 hours before taking my next dose.
Meanwhile I'm awaiting my doc's clinic to okay a refill request from my HMO pharmacy for my 25mcg T3 prescription. I requested a dosage change (3x a day, rather than 2x a day at 12.5mcg each dose). That will give me 135 tablets for 3 months, rather than 90 (which only lasts 60 days instead of 3 months). I considered making an appointment to see my doc and explain my divided dose and T3 only treatment strategy. However, if she will okay the dose change w/o making an appointment, I'll save $$$.
Eventually, maybe after 12 weeks w/o T3 or when I'm at a stable dose, I'll explain all this to my doc and loan her my copy of "Recovering with T3". She has been very permissive with allowing me to determine (raise or lower) my own thyroid dosage according to my signs and symptoms. She says that I'm the only patient whom she will allow to determine their own dosage and just tell her how much I'm taking, because I pay close attention to my body signs and symptoms, unlike her other patients.
Meanwhile I'm awaiting my doc's clinic to okay a refill request from my HMO pharmacy for my 25mcg T3 prescription. I requested a dosage change (3x a day, rather than 2x a day at 12.5mcg each dose). That will give me 135 tablets for 3 months, rather than 90 (which only lasts 60 days instead of 3 months). I considered making an appointment to see my doc and explain my divided dose and T3 only treatment strategy. However, if she will okay the dose change w/o making an appointment, I'll save $$$.
Eventually, maybe after 12 weeks w/o T3 or when I'm at a stable dose, I'll explain all this to my doc and loan her my copy of "Recovering with T3". She has been very permissive with allowing me to determine (raise or lower) my own thyroid dosage according to my signs and symptoms. She says that I'm the only patient whom she will allow to determine their own dosage and just tell her how much I'm taking, because I pay close attention to my body signs and symptoms, unlike her other patients.
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