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What To Expect from Synthroid?

I’ve had high TSH for about a year and a half (well, since ive been getting CMP’s done at least), and after discussing with my doctor I may be getting prescribed Synthroid. Only waiting on a lab to come back.

  • What should I expect once I start?
  • What is a good dosing?
  • Should i try and push for Armour (or something for T3 too)? If so, what else?
  • Is there any recommendations from users or info I should know?


In order to select the appropriate thyroid medicine, you need rT3 testing because if it’s elevated, Synthroid which is T4 only is would increase rT3 negating any increases in fT3, the main active thyroid hormone.

Synthroid can work for some, but is obsolete and T3+T4 combinations are the best route to take unless of course rT3 is elevated, then T3 only medicine is appropriate. There are some doctors out there that have allowed themselves to fall behind and have become complacent.

There are studies out that clearly show people on T4 only treatment are more likely to be on antidepressants than without thyroid problems.

Hypothyroidism symptoms linger despite medication use, normal blood tests

Research conducted by Bianco and other Rush colleagues published Oct. 6 in the Journal of Clinical Endocrinology and Metabolism found that individuals on levothyroxine who had normal TSH levels were significantly more likely to be taking antidepressants than peers with normal thyroid function. The individuals taking thyroid medication were also less physically active, suggesting lower energy levels. They weighed about 10 pounds more than peers of the same height even though they consumed fewer calories, after adjustments for body weight. Plus, they were more likely to be using beta blockers, a drug frequently prescribed to lower blood pressure, and statins that reduce cholesterol levels.

“These findings correlate with what patients have been telling us,” Bianco said. “This study documents for the first time, in an unbiased fashion, that patients on levothyroxine feel worse and are much less active than controls, exhibiting objective cardiometabolic abnormalities despite having normal TSH levels.”

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Synthroid was very helpful for me. I had symptoms like severe chills and sensitivity to cold, low energy, etc, and my TSH was high, and my testosterone was lower than normal. I was prescribed a small dose of Synthroid every morning, my TSH is now normal and test is right where it should be.

Regarding a good dosing, you should be talking with your endo or specialist about what they recommend. Just my .02!

My doc was very quick to say Synthroid, and also told me it was replacing TSH, when I asked if it was Synthetic T3 or T4…

However, he is open to what I suggest. So I may pitch the idea of Armour as it has both. Are there any other alternatives to Armour that are a combo drug?

The .02 is appreciated. It’s my GP, and not a specialist. He is open to what I suggest. Also, not an expert in HRT and such. He recommended Synthroid after my labs come back. We didn’t discuss dosing. I’m just trying to get feedback before I commit to Synthroid or recommend Armour.

Armour Thyroid & Nature Thyroid are the go to drugs for T3/T4 combo.

Google stopthethyroidmadness and go to their website. It will tell you exactly what to tell your doc.

Thank you for the reference. Much appreciated.


I think you should find a specialist who is an expert in this stuff and not recommend medication for yourself based on reviews on a forum. Find a good endo who will listen to you and treat your symptoms, and provide the expertise to know how to do it.

I have hashimotos. I had a TSH well into the 20s, if I remember right, (range was 1-4ish). I was diagnosed around 15 years old (33 now).

Doc prescribed me synthroid, but quit before my blood ever got stabilized. I was young and didn’t think I needed to take meds for the rest of my life.

I went back on it for a while several years later, but didn’t feel any different. I then went to a naturopath, and we played with levothyroxine, Armour Thyroid, synthetic T3, Cortisol, etc.

All of that made me feel way worse. For me T3 was a bad idea. The half-life is so short (1 day) it makes you swing between hypo and hyper thyroid and my bloods were never stable. I tried different dosing for a good year before going back to just T4.

I’ve been on T4 now for several years at the same dose. I can say with certainty the only symptom it actually helped me with is my hair and nails. My hair used to be brittle, curly, and thin. Now it’s stronger and thicker. My toe nails used to split in half and now they don’t. I also had an orange tint to the skin of my toes which is gone now.

Unfortunately my energy, depression, sleep, and motivation have always been pretty bad and never improved with thyroid, Which is why I started looking into TRT.

I’ve been through it all with thyroid, so I would be happy to answer questions about it.

To add to my comment above, I wish I got my FT4 and TSH stable on just synthroid before messing with My T3. Right now my TSH sits at about 1.2, and both my FT3 and FT4 are on the higher end of normal. And that’s where I feel the best.

I will say that hyperthyroid symptoms are pure hell compared to hypo. Hot flashes, night sweats, anxiety, fidgety, extremely short fuse, irritable, and angers.

My advice: Get your levels stable on synthroid, stay there for 3 months minimum, then evaluate whether or not you need T3 as well.

What is your current dose? Going in tomorrow to speak to my doctor. What would your recommendation be? Armour or Levothroxine? What is an appropriate starting dose?

I take 125mcg. Thyroid is a whole different beast, your natural production doesn’t shut down when you take it, so the dose is very individual.

I would start with T4 only (levothyroxine or symthroid). Get leveled out on that. Doc will probably check your blood every 6 weeks until you’re at a normal level. Once your TSH is around 1.5 and your FT4 is mid or high range, then check your, FT3 and rT3.

Should I be concerned with its conversion to T3? Or other thyroid hormones.

I would not start on T4 only. I would start by googling stopthethyroidmadness and going to their site and reading about this very subject on why T4 only is usually a waste of time. I would then read why a combo of T4/T3 is usually a better decision. I would then be happy that I knew this info before wasting said time.

You should get a full thyroid panel done before taking any meds.

Go to stopthethyroidmadness and I promise you’ll feel like you have a much better understanding of all of this than you do now.

I read through it. I’m going to speak to my doctor about Armour tomorrow. I’ll update the post on the outcome.

Also, since you are taking it, how do you handle taking it first thing in the AM, an hour before you eat?

Just curious since I’m up usually 6AM and at work at 7:15AM, squeezing in a few eggs and fruit for breakfast. Do you just squeeze your macros in throughout the day? I love my breakfast :,( lol

I suspect you’ll love the way having a decent thyroid feels more than breakfast but surely there’s a way to have both. @enackers I believe it’s on Armour

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I’m curious what the doctor will say. I can tell you for certain I regret wasting my time trying to dial in T3 when my body converted it just fine. When I was on Armour I was hyper thyroid all the time even with normal T4 and TSH. Just be careful with it. I highly recommend going one variable at a time.

The half-life is way too short on T3 to have anywhere near repeatable blood tests. My thyroid levels (and symptoms) were all over the place on armour. If your body converts T4 efficiently, which most people do, then there is no reason to take anything with T3 in it unless you’re still experiencing hypo symptoms. Which is why I highly recommend getting a baseline first of how much T4 you need and how efficiently it gets converted once you’re T4 is stable.

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You want to take it first thing in the AM, and at least a couple hours before eating. Minerals like calcium will block the absorption of T4.

Intermittent fasting is the way to go.