Thyroid, women, sleep...

[b fold the truth]

My girlfriend was diagnosed with hypothyroidism a few weeks ago and she started taking Euthyrox 50mg. It is by Merck. She has always gone to bed at midnight or later and just wakes up at about 7:00 am for no reason but she can't sleep any longer...

Since taking these meds she is exhausted by midnight and has no problem sleeping till 10:00 or noon. Any relation maybe? She takes the meds first thing in the morning and seems to have energy all day, but at night she is VERY tired...

Thoughts???

B True

 

[The Shadow]

I have heard about sluggishness coming OFF a T cycle...perhaps dividing the dose to 25mcg at morning and night would help

 

[wilson6]

Euthyrox is T4. T4 has more central effects vs T3 which are more metabolic. She may be getting the central energy with higher T4 levels in the morning and as the T4 is metabolized, she crashes. Perhaps take 25 mcg in the morning, then another 25 mcg in the early afternoon. She should talk to her doc.

W6

 

[b fold the truth]

She said that her doctor told her to take 1 tablet, 50 mg, first thing in the morning and thirty minutes before she eats. Said that her stomach must be completely empty and relaxed...

Is this a major problem??? She said that by 8:00 she is exhausted and has no problem falling asleep.

B True

 

[Realgains]

I have been hypothyroid since 12.

T4 is what she is taking.

T4 is an active hormone and it also converts to T3 in the system ....and she gets all the T3 she needs from this.

Absorbtion is a little better on an emply stomach but not by a great margin.

Taking it in divided dose wil not anything really as T4 has a half life of 6 days.

50 micrograms is a very low dose and may not be enough.

She needs a TSH done after 6 weeks on the T4 and this will tell you if more is needed(probably will need more) TSH should ideally be about 1-2. Anything over 4-5 indicates that she needs more T4.

Most females that are hypothyroid need between 100 and 150 micrograms per day. I am on 200 micrograms but I am 230 pounds.

RG

 

[b fold the truth]

Thanks RG. I think that her doctor told her that they would increase the dose over time if needed. It was prescribed to her overseas (she is Greek) so I often wonder about some of their practices. They practice things much differently than we do...so it always makes me a bit leary about things...

So you suggest maybe an icrease in dose?

I was worried that the T hormone was burning all of her energy and exhausting her (she has lost weight).

B True

 

[circusgirl]

it could be that because of being unable to get sufficient rest before the med that she had exhausted her body and now it's trying to recuperate?

 

[b fold the truth]

She said that because she is actually 'borderline' hypothyroidic that the doctor is trying her out on this med at a low dose...to see if it might 'kick-start' her thyroid a bit. She has gained A LOT of weight over the past 6 or 7 months and was very concerned. The doctor tested her and said that she was borderline hypothyroidic...she has lost a few pounds over the past few weeks already.

B True

 

[wilson6]

One of the things we all have to remember is that nothing is for sure.

Real, not everyone converts T4 to T3 the same. One of my colleagues uses Armour from time to time because some of his hypothyroid patients simply do not convert enough T4 to T3. They feel better because of the central effects of T4, but metabolically they don't respond as well. Blood work shows a higher T4 to T3 ratio in these people.

I myself take T4 (112 mcg/d). My TSH was running near 5 years ago but with normal T3 and T4. I felt sluggish but was lean and didn't even have sub-clinical signs of hypothyroidism. My doc suggested adding T4. This brought my TSH down to 2, increased my T4 and did nothing to my T3.

A while back I added some soy isolate to my protein mix. Not long after I started feeling sluggish again. Rechecked the thyroid, TSH back over 5 and T4 down, T3 relatively unchanged. Dumbass I was not thinking, taking my T4 at the same time as the soy protein. Put 4 hrs between the two and the TSH dropped back down to 2, T4 went up but T3 unchanged, however I felt much better. The T4 has never had an effect on my weight or metabolism, just central.

Looking at my total T3, it is bottom end of normal, but free T3 is mid to upper and my metabolism is fine. T4 upper end of normal, but fT4 mid.

T4 absorption varies widely in people, soy and other agents can kill it absorption. Circulating binding proteins and hepatic clearance can vary and the list goes on.

Saying it has a 6 day half-life so splitting the dose won't matter is like saying just because T enanthate has a 5 day half life, that blood levels are consistent. We know there is a substantial surge 24 hrs after an inj. Why not try it and see. With the long overall half life the metabolic aspect won't change, who knows?

How much of the T4 hits circulation and receptors could alter the immediate effects, we just don't know for sure unless we ran a labled dose of T4 in her to measure her individual clearance and binding.

Anyhow, my point is that there are white zebras out there. As a research scientist I never look at responses as absolutes like many clinicians do unless I have proven it. Assuming something in someone, just because it happens that way in 90% of everyone else is a mistake and we've learned that the hard way when designing studies.

She might not need more T4, maybe less to start if she's feeling tired and losing weight. Then again, maybe she needs to eat more. Could be many other things.

W6

 

[Realgains]

You made some good points.

Very true some people do not convert t4 to t3 as well as others.

The most active of the two hormones is T3 so we ned to get enough of this hormone.

People that are hypothyroid need to maintain a T4 that is somewhat above high normal. Generally speaking T4 needs to be 20-25 percent above the high normal figure. This extra T4 is needed as no T3 is being taken. This extra amount of circulating T4 is needed to make adequate T3 and to keep the TSH in the normal range.

You do not need to take any T3 at all although some people take a T3/T4 combo supplement. You will get all the T3 you need from the T4 ....its just that some need a little more T4 than others in order for this to be seen. As I mentioned though, all hypothyroid patients need to have their T4 a little above the high normal limit.

So all you every need to look at in primary hypothyroidism is TSH.
Keep adding T4 until the TSH drops between .5 and 2 which is thew ideal range.
The pituitary will sence your free T3 and free T4 levels and will put out TSH as needed...TSH is the master indicator.

About the half life thing....... Test E has a half life of about 5 or 6 days just like T4. You get the best blood levels by taking that Test E quite frequently and absolute best levels by taking it daily.
But taking it twice a day would be overkill IMHO as it wouldn't really have much impact on the stablility of circulating blood levels.....I think the same can be said of T4. You can only do so much with frequent dosing of long half lifed drugs. There is a very small spike that happens after dosing T4 and thats why they recommned that you take it in the am as you awake as some individuals are sensitive to even a very small spike.


Now if the drug had a shorter half life like T3 then yes by all means take the stuff twice daily.

b fold.......just keep an eye on her TSH. What was her initial TSH, before any supplementation? Borderline hypothyroidism has a tSH around 5-8 but this borderline state is usually a sign that the hyyroid is slowly running out of gas and that full blown hypothyroidism is around the corner.
As I said most ladies end up taking 100-150 mcg of T4 per day. Most men take around 150-200 mcg.
Sounds like W6 still has some thyroid function left as he only take 112.

As a side.....I have noticed that TSH goes up while on gear, especially Tren...but it doesn't go up a lot.

T4 supplementation to "kick start" the thyroid???? Bro thats like saying that taking androgel will kick start T production in the testes or that a bridge will help restore HPTA.....perhaps you misunderstood him...if he is serious and you did not misunderstand him then he is a quack and you need to find another doctor.

RG

 

[wilson6]

"T4 supplementation to "kick start" the thyroid???? Bro thats like saying that taking androgel will kick start T production in the testes or that a bridge will help restore HPTA....."

Couldn't have said that better myself.

Endos used to give 200 mg a week of TE for the "kick start theory" years ago, was called suppression/rebound. Even listed it in the PDR. That was back in the day when they said AAS didn't enhance athletic performance as well. Didn't work then, doesn't work now, and won't work with thyroid either.

W6

 

[nikkita]

Some time ago I took Eutirox to treat simple goiter and at first it was a mess to find the adequate dose... because either I felt restless or too tired. On one hand one doctor told me to increase the dose in order to get my levels normal... however it just made me feel worse than in the beginning. Later, other doctor told me that I would know what the dose is when I feel normal and have no problems with my stomach (cause Eutirox has effect primarily on the stomach)... if the dose is not enough she may be constipated and presenting other signs of hypothyroid. However if the dose is too much the reverse happens.

I think that your girl should tell specifically to her doctor anything that she might be feeling, it may be important.

Meanwhile, here is a link so that you have more info about the medication:

http://mountzion.ucsfmedicalcenter.org/endocrinology/thycare/thycare/empharma/outsert.htm

 

[b fold the truth]

Thanks so much everyone. She entered a soccer camp (for girls age 10-16, she is 25) and just finished 5 days straigt of 2 and 3 a days (2-3 hours each). Between the meds and the exercise she has lost probably 5-8 pounds (not water). Her sleeping is better also...

She also recently spent 23 hours on a plane coming back to me...maybe the flight threw her off a lot too. She does need to talk with her doctor...but her doctor is back in Cyprus. I need to find her one here as well as a prescription (doesn't need a script in Cyprus).

B True

 

[AGP]

Hmm.. I work at Merck and I've been at the company for 6 years.. can't say I knew we make Euthyrox.. could have sworn it was manufactured by EM pharma. If we did make it, I'd be able to get the real deal on the drug for you!

We may distrubute it overseas however, since we've got a plant site in the med. If I get a chance tomorrow I'll see if I can't get you the stat sheets on it.

TP

 

[b fold the truth]

Hmm.. I work at Merck and I've been at the company for 6 years.. can't say I knew we make Euthyrox.. could have sworn it was manufactured by EM pharma. If we did make it, I'd be able to get the real deal on the drug for you!

We may distrubute it overseas however, since we've got a plant site in the med. If I get a chance tomorrow I'll see if I can't get you the stat sheets on it.

TP

Thanks for your time...so very much.

B True

 

[AGP]

B Fold:
I asked one of my boys in research, and he said we don't manufacture this particular drug, so he couldn't give me any specifics.

I did a quick google search and came up with some interesting fact sheets.. but I'm sure you've already exhausted that avenue.. sorry I couldn't be of more help

-T

 

[b fold the truth]

B Fold:
I asked one of my boys in research, and he said we don't manufacture this particular drug, so he couldn't give me any specifics.

I did a quick google search and came up with some interesting fact sheets.. but I'm sure you've already exhausted that avenue.. sorry I couldn't be of more help

-T

Thanks.

I am sitting here with the box in my hand now...and it says Merck on it.

B True

 

[AGP]

Most likely she might have gotten it from Merck Medco which handles some of the drugs overseas...

 

[b fold the truth]

Most likely she might have gotten it from Merck Medco which handles some of the drugs overseas...

They don't have to have a script for it in her country...but surely she could get one.

B True