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Armour 60+ years
I was diagnosed with a toxic goiter/hyperthyroidism in 1952 and had a total thyroidectomy. I have been taking Armour thyroid since then, except for 3 different years and 3 different Drs. who insisted I take synthetic thyroid. Currently seeing ENT who seems to have knowledge and willingness to prescribe Armour. Has anyone in this community had a toxic goiter? Is it called something else now?
These are results of my last labs. I did not take Armour thyroid that day until after the blood draw.
TSH 0.006 0.450 -4.50
Vitamin D, 25-Hydroxy 78.6 30.0 - 100.0
Thyroxine (T4) 9.5 4.5 - 12.0
Vitamin B12 971 211 - 946
Triidothyronine, Free, Serum 3.7 2.0 - 4.4
Are these numbers acceptable? I feel good.
TSH 0.006 0.450 -4.50
Vitamin D, 25-Hydroxy 78.6 30.0 - 100.0
Thyroxine (T4) 9.5 4.5 - 12.0
Vitamin B12 971 211 - 946
Triidothyronine, Free, Serum 3.7 2.0 - 4.4
Are these numbers acceptable? I feel good.
COMMUNITY LEADER
You should insist on having Free T4, not Total T4, as total T4 tells you the total amount of the T4 in your blood. The majority of that is bound by protein and isn't available for use/conversion to T3. Only the Free T4 is available for conversion, which is why we test the Free T4, not total T4.
Your FT3 is twice as high as it should be... Did you again, take your medication prior to the blood draw?
Your vitamin D looks good and so does your B-12, even though it's above the range used by your lab. Vitamin B-12 isn't toxic and many labs use a higher range than yours...
Your FT3 is twice as high as it should be... Did you again, take your medication prior to the blood draw?
Your vitamin D looks good and so does your B-12, even though it's above the range used by your lab. Vitamin B-12 isn't toxic and many labs use a higher range than yours...
TSH 0.014 0,450 - 4.500
Vitamin D 76.4 30.0 - 100.0
T4 10.1 (Thyroxine) 4.5 - 12.0
Vitamin B12 1001 211 - 946
Free T3 8.4 2.0 - 4.4
Vitamin D 76.4 30.0 - 100.0
T4 10.1 (Thyroxine) 4.5 - 12.0
Vitamin B12 1001 211 - 946
Free T3 8.4 2.0 - 4.4
COMMUNITY LEADER
What's the reference range for the FT3 and the T4? Ranges vary lab to lab and have to come from your own report. Is the T4, Free T4 or Total T4? Total T4 is considered obsolete so if that's what your ENT is ordering, he might not be the best for you after all.
Visit today with ENT. Lab results now are:
TSH 0.014
Vitamin D 76.4
T4 10.1
Vitamin B12 1001
Free T3 8.4
One he was concerned about, I think the Free T3, but said he thought it would level out by the next time he sees me in 6 weeks. He told me to continue same meds. He added some nasal sprays for my allergies. I will see my new oncologist and my ENT again in July.
TSH 0.014
Vitamin D 76.4
T4 10.1
Vitamin B12 1001
Free T3 8.4
One he was concerned about, I think the Free T3, but said he thought it would level out by the next time he sees me in 6 weeks. He told me to continue same meds. He added some nasal sprays for my allergies. I will see my new oncologist and my ENT again in July.
COMMUNITY LEADER
Be sure to tell your ENT this, because your FT3 is falsely high, since the T3 in the Armour is so fast acting, it would have increased your level higher than it would otherwise have been... we call this a "false high"... You should never take thyroid med prior to a blood draw. Have your blood draw first thing in the morning, then take your med afterwards...
From our experience here on the forum nearly everyone taking a T3 med, whether it be desiccated or synthetic finds that splitting the dosage in half, taking half in the morning when you first get up and the other half around lunch time, keeps the FT3 levels more stable, so you don't get a "slug" of it in the morning, causing a rush, then an afternoon crash, when the T3 wears off. You might try this - 60 mg in the morning and 60 mg around noon and see if that helps you keep going all day... play with the timing of the second dosage depending on your schedule - just don't take it after 3:00 pm or it may interfere with sleep...
From our experience here on the forum nearly everyone taking a T3 med, whether it be desiccated or synthetic finds that splitting the dosage in half, taking half in the morning when you first get up and the other half around lunch time, keeps the FT3 levels more stable, so you don't get a "slug" of it in the morning, causing a rush, then an afternoon crash, when the T3 wears off. You might try this - 60 mg in the morning and 60 mg around noon and see if that helps you keep going all day... play with the timing of the second dosage depending on your schedule - just don't take it after 3:00 pm or it may interfere with sleep...
I have never been told to split the dosage. Yes, I took all my meds before the blood draw. That was the first time I had ever had a thyroid US.
COMMUNITY LEADER
Will look forward to hearing what your ENT has to say and also results to your new labs...
COMMUNITY LEADER
I'm glad your ENT does not concerned about TSH... that's one hurdle you don't have to worry about...
Not sure if you saw gimel's question above... did you take your thyroid hormone dose prior to having your blood draw? If so, that could account for the high FT3, since FT3 is fast acting.
Also - gimel's other question about splitting your dosage in half - part in the morning and part around noon? Most of us on a T3 med find that it works best if we split the total dosage into 2 doses in order to keep the FT3 levels more stable throughout the day... if you aren't doing this you might want to discuss it with your ENT when you see him.
I certainly agree that it's time for a new oncologist -- I don't understand how your oncologist thought she could tell that your thyroid had regrown and was producing T4 when you take thyroid replacement med... but that explains the antibody tests. There's nothing wrong with a periodic ultrasound.
Not sure if you saw gimel's question above... did you take your thyroid hormone dose prior to having your blood draw? If so, that could account for the high FT3, since FT3 is fast acting.
Also - gimel's other question about splitting your dosage in half - part in the morning and part around noon? Most of us on a T3 med find that it works best if we split the total dosage into 2 doses in order to keep the FT3 levels more stable throughout the day... if you aren't doing this you might want to discuss it with your ENT when you see him.
I certainly agree that it's time for a new oncologist -- I don't understand how your oncologist thought she could tell that your thyroid had regrown and was producing T4 when you take thyroid replacement med... but that explains the antibody tests. There's nothing wrong with a periodic ultrasound.
New doctor (ENT) is not concerned about TSH. He checked antibodies and ordered a thyroid US because my oncologist told me my thyroid had regrown and was producing T4. The US showed no thyroid or suspicious masses. My surgeon that removed my thyroid told my parents (in front of me) that he thought my thyroid was malignant and if that proved to be true, I would have cobalt treatments. It was not cancer.
I am anxious to hear what the ENT says next week after more labs were done for him today.
Thanks for your input, Barb.
I am anxious to hear what the ENT says next week after more labs were done for him today.
Thanks for your input, Barb.
Just quickly went through this thread, and maybe you already answered this. Do you split your dose of Armour and take half in the morning and half in the afternoon? Also, did you take your Armour dose before the blood draw for tests?
COMMUNITY LEADER
As I suspected, your FT3 is over range, and your FT4 is only at 24% of its range... Rule of thumb (where most of us feel best) is for FT4 to be about mid range and FT3 to be in the upper half to upper third of its range... As you see your FT3 is actually quite a bit over range and I'm surprised you don't have some hyper (over medicated) symptoms.
It's not unusual to see higher than normal FT3 on desiccated thyroid hormones. As I noted above, many have to decrease the desiccate hormones and add some synthetic T4 only, in order to bring the Free T4 up where it needs to be in order to help alleviate symptoms.
I'm not surprised to see suppressed TSH with due to the high content of T3 in the desiccated hormones... any doctor who knows what they're doing will ignore that; if they don't you need to get away from them as fast as possible - make sure your family knows this, as well.
Since you don't have a thyroid, I wouldn't expect thyroid antibodies to be elevated; I'm surprised your doctor is even still checking them... The only thing I'd expect him to check, periodically, would be thyroglobulin (not antibodies), if your thyroid was removed due to cancer, because thyroglobulin is a cancer marker and elevated levels could indicate cancer recurrence.
It's not unusual to see higher than normal FT3 on desiccated thyroid hormones. As I noted above, many have to decrease the desiccate hormones and add some synthetic T4 only, in order to bring the Free T4 up where it needs to be in order to help alleviate symptoms.
I'm not surprised to see suppressed TSH with due to the high content of T3 in the desiccated hormones... any doctor who knows what they're doing will ignore that; if they don't you need to get away from them as fast as possible - make sure your family knows this, as well.
Since you don't have a thyroid, I wouldn't expect thyroid antibodies to be elevated; I'm surprised your doctor is even still checking them... The only thing I'd expect him to check, periodically, would be thyroglobulin (not antibodies), if your thyroid was removed due to cancer, because thyroglobulin is a cancer marker and elevated levels could indicate cancer recurrence.
Reference Intervals:
TS Immunoglobulins 0 - 139
TPO 0 -34
Thyroglobulin Antibody 0.0 - 0.9
Free T4 0.82 - 1.77
TSH 0.450 - 4.50
Reverse T3 9.2 - 24.1
Vitamin D 30.0 - 100.0
T 4 4.5 - 12.0
Vitamin B12 211 - 946
Triiodothyronine, Free Serum 2.2 - 4.4
TS Immunoglobulins 0 - 139
TPO 0 -34
Thyroglobulin Antibody 0.0 - 0.9
Free T4 0.82 - 1.77
TSH 0.450 - 4.50
Reverse T3 9.2 - 24.1
Vitamin D 30.0 - 100.0
T 4 4.5 - 12.0
Vitamin B12 211 - 946
Triiodothyronine, Free Serum 2.2 - 4.4
COMMUNITY LEADER
We also need the reference ranges for labs posted, since reference ranges vary from lab to lab and we compare your results with ranges used by your own lab to see where your results fall within those ranges.
Your FT4 looks to be on the low side, but your FT3 looks high, though, of course, that will depend on the ranges used by your lab. It's not unusual for those on desiccate hormones to have high FT3 and very low FT4, due to the high content of the T3 in the desiccated hormones. Many have to decrease the amount of the desiccated hormones and add a small amount out T4 only medication in order to maintain the proper T4:T3 ratio.
Your vitamin D and B-12 look good; have you had a ferritin test recently? Ferritin is the iron storage hormone and iron is necessary for proper thyroid hormone metabolism, also.
Your FT4 looks to be on the low side, but your FT3 looks high, though, of course, that will depend on the ranges used by your lab. It's not unusual for those on desiccate hormones to have high FT3 and very low FT4, due to the high content of the T3 in the desiccated hormones. Many have to decrease the amount of the desiccated hormones and add a small amount out T4 only medication in order to maintain the proper T4:T3 ratio.
Your vitamin D and B-12 look good; have you had a ferritin test recently? Ferritin is the iron storage hormone and iron is necessary for proper thyroid hormone metabolism, also.
My last thyroid labs, ordered by new doc and drawn mid April, are:
Thyroid Stimulating Immunoglobulin 27
Thyroid Antibodies
TPO 21
Thyroglobulin Antibody <1.0
T4, Free 1.05
TSH 0.140
Reverse T3, Serum 10.8
Vitamin D, 25 Hydroxy 60.8
ANA Direct Negative
Thyroxine (T4) 6.8
Vitamin B 12 956
Triiodothyronine, Free, Serum 5.2
I will go tomorrow to have lab work done again for this doctor.
I had been taking 90 mg. Armour for a long time. In April, this new doc increased that to 120 mg. He said he might lower it at the next appointment in June.
I am making a list of things to ask about at my June appointment. I'm still gathering diagnostic reports to FAX to new oncologist.
Thyroid Stimulating Immunoglobulin 27
Thyroid Antibodies
TPO 21
Thyroglobulin Antibody <1.0
T4, Free 1.05
TSH 0.140
Reverse T3, Serum 10.8
Vitamin D, 25 Hydroxy 60.8
ANA Direct Negative
Thyroxine (T4) 6.8
Vitamin B 12 956
Triiodothyronine, Free, Serum 5.2
I will go tomorrow to have lab work done again for this doctor.
I had been taking 90 mg. Armour for a long time. In April, this new doc increased that to 120 mg. He said he might lower it at the next appointment in June.
I am making a list of things to ask about at my June appointment. I'm still gathering diagnostic reports to FAX to new oncologist.
COMMUNITY LEADER
Well, I certainly agree with the psychiatrist that if you don't want to take anti-depressants and pain med, you shouldn't do so... the oncologist can't force you to take anything you don't want to take.
I'm not sure when your hospitalizations occurred, or how long they lasted, but one can not live for extended periods without thyroid hormones.
It is totally against the rules of any hospital I've been in, in the past several years, for any family member to bring medications from home and had anyone in the hospital found out about this, I've no doubt your Armour would have been taken away from you and your family would have been barred from the hospital.
It doesn't matter what you're doing - even "just laying there", your body requires thyroid hormones to keep your metabolism going. Your thyroid also controls, your heart rate, body temperature and other body functions, so if these were to go awry/begin to fail while you were hospitalized and/or unconscious, hospital personnel would have no way of knowing this was caused from a lack of thyroid hormones if you didn't tell them you take daily thyroid hormones, unless, hopefully, they would have the foresight to check your thyroid and find your levels low, at which point, you would be given thyroid hormones anyway and it wouldn't be your preferred Armour; it would be a synthetic...
Wow - you had breast cancer and have never had a PET scan? I cared for an elderly aunt who had breast cancer and she had a PET scan every 3 months to make sure the cancer didn't spread... of course, because of her age and other health concerns, she was unable to have a mastectomy; she could only do chemo drugs...
Yes, please do discuss all of this with your ENT; I'm hope he will advise you, as I am, to be up front with your new oncologist about all the medications you take. The older we get, the more important this becomes, so that whoever is charged with our care, under whatever circumstances, can do what's best for us. You can have the name and contact number of the ENT who manages your thyroid care, along with your med list, so that whoever cares for you in an emergency, would know to call him for particular information regarding the importance of your thyroid hormones.
I will look forward to seeing your labs as soon as you can post them.
I'm not sure when your hospitalizations occurred, or how long they lasted, but one can not live for extended periods without thyroid hormones.
It is totally against the rules of any hospital I've been in, in the past several years, for any family member to bring medications from home and had anyone in the hospital found out about this, I've no doubt your Armour would have been taken away from you and your family would have been barred from the hospital.
It doesn't matter what you're doing - even "just laying there", your body requires thyroid hormones to keep your metabolism going. Your thyroid also controls, your heart rate, body temperature and other body functions, so if these were to go awry/begin to fail while you were hospitalized and/or unconscious, hospital personnel would have no way of knowing this was caused from a lack of thyroid hormones if you didn't tell them you take daily thyroid hormones, unless, hopefully, they would have the foresight to check your thyroid and find your levels low, at which point, you would be given thyroid hormones anyway and it wouldn't be your preferred Armour; it would be a synthetic...
Wow - you had breast cancer and have never had a PET scan? I cared for an elderly aunt who had breast cancer and she had a PET scan every 3 months to make sure the cancer didn't spread... of course, because of her age and other health concerns, she was unable to have a mastectomy; she could only do chemo drugs...
Yes, please do discuss all of this with your ENT; I'm hope he will advise you, as I am, to be up front with your new oncologist about all the medications you take. The older we get, the more important this becomes, so that whoever is charged with our care, under whatever circumstances, can do what's best for us. You can have the name and contact number of the ENT who manages your thyroid care, along with your med list, so that whoever cares for you in an emergency, would know to call him for particular information regarding the importance of your thyroid hormones.
I will look forward to seeing your labs as soon as you can post them.
My oncologist sent me to a psychiatrist (one she chose) to prove to me that I needed pain and anxiety meds as well as anti-depressants. The psychiatrist spent an hour with me and told me any depression I was feeling was normal and if I did not want to take the anti-depressants, pain and anxiety meds my onc was prescribing, I should just not take them.
I have been hospitalized 3 times in the last 40 years - 1. surgery to remove toothpick broken off in bone joint in my foot; 2. surgery to remove and biopsy lymph nodes in my left groin. My family doctor had told me I had lymphoma. It turned out to be diagnosed a viral infection; 3. breast cancer/bilateral mastectomy. The last 2 times, I told my family to keep my Armour thyroid and just bring it to me. I didn't tell the doctors. During first of these hospitalizations, the doctor told me I didn't need thyroid medication because "all you're going to be doing is just lying there". I am concerned about being unconscious with a hospital admission.
I will post my lab numbers tonight. BTW, I have never had a PET scan. My onc tests for tumor markers. I had IDC < 1cm. I also had 10 lymph nodes removed - all negative.
Next week, I will see the ENT who is now managing my thyroid meds/testing. I will be sure to discuss these concerns with him.
Again, thank you for your reply
I have been hospitalized 3 times in the last 40 years - 1. surgery to remove toothpick broken off in bone joint in my foot; 2. surgery to remove and biopsy lymph nodes in my left groin. My family doctor had told me I had lymphoma. It turned out to be diagnosed a viral infection; 3. breast cancer/bilateral mastectomy. The last 2 times, I told my family to keep my Armour thyroid and just bring it to me. I didn't tell the doctors. During first of these hospitalizations, the doctor told me I didn't need thyroid medication because "all you're going to be doing is just lying there". I am concerned about being unconscious with a hospital admission.
I will post my lab numbers tonight. BTW, I have never had a PET scan. My onc tests for tumor markers. I had IDC < 1cm. I also had 10 lymph nodes removed - all negative.
Next week, I will see the ENT who is now managing my thyroid meds/testing. I will be sure to discuss these concerns with him.
Again, thank you for your reply
COMMUNITY LEADER
I also forgot to mention that if you are hospitalized for anything, for any period of time and do not have access to your Armour thyroid (you're not allowed to take your own medications with you), you will go hypo very quickly and will eventually, have to tell them... the fact that you have no thyroid will become known one way or another, no matter what, because you can't go very long without your med. If you're unconscious, you will not be able to tell anyone and this will only exacerbate any illness/injury you might be suffering.
You should carry a list of your medications with you and your thyroid medication should be at the top of that list.
You should carry a list of your medications with you and your thyroid medication should be at the top of that list.
COMMUNITY LEADER
I don't understand why you would not want to mention taking Armour or any other thyroid medication to a new oncologist. You had a thyroidectomy and since you are a cancer survivor, I'm assuming that you have regular PET or other scans to make sure cancer has not returned. It will be obvious (simple palpation could tell them that) that you are missing your thyroid gland (or any other organs you've had removed) and since we can't live without thyroid hormones, it will also be obvious that you must be on some sort of thyroid hormone replacement. Just because oncologists aren't thyroid doctors doesn't mean they can't put these things together... I'm not even a doctor and I put it together immediately...
I don't understand why your current oncologist would say the Armour is "doing nothing in your body"... since you have symptoms of depression, and possible pain and she wants to prescribe anti-depressants, Xanax and Tylenol 3, I might suggest that your dosage may need to be adjusted to help alleviate those symptoms, since they can be symptoms of hypothyroidism.
If you'll post your most recent thyroid related blood tests, I might be able to better assess your situation. Please be sure to include reference ranges with any lab results, since ranges vary lab to lab and we need to compare your results with the ranges used by your lab.
I might also suggest that when you start the survivorship program, you make clear that the ENT is managing your thyroid condition and the oncologist has nothing to say about the type/amount of thyroid hormones you take. I'd also suggest that you discuss this with the ENT.
It is imperative, however, that your oncologist know about your thyroid hormones, because some medications they might prescribe could interfere with metabolism of thyroid hormones and/or exacerbate your condition. If they know about your thyroid condition, they can possibly prescribe medications that will cause less interference than others.
I don't understand why your current oncologist would say the Armour is "doing nothing in your body"... since you have symptoms of depression, and possible pain and she wants to prescribe anti-depressants, Xanax and Tylenol 3, I might suggest that your dosage may need to be adjusted to help alleviate those symptoms, since they can be symptoms of hypothyroidism.
If you'll post your most recent thyroid related blood tests, I might be able to better assess your situation. Please be sure to include reference ranges with any lab results, since ranges vary lab to lab and we need to compare your results with the ranges used by your lab.
I might also suggest that when you start the survivorship program, you make clear that the ENT is managing your thyroid condition and the oncologist has nothing to say about the type/amount of thyroid hormones you take. I'd also suggest that you discuss this with the ENT.
It is imperative, however, that your oncologist know about your thyroid hormones, because some medications they might prescribe could interfere with metabolism of thyroid hormones and/or exacerbate your condition. If they know about your thyroid condition, they can possibly prescribe medications that will cause less interference than others.
Thank you for your answer. I have many questions. I am wondering if Armour thyroid can be detected in my body if I see another doctor or am hospitalized for an unrelated matter. I am 72 and a breast cancer survivor (at this time) for seven years. My oncologist has told me that Armour thyroid is doing nothing in my body. She has also been pushing me to take anti-depressants, Xanax, and Tylenol #3. I do not need any of these. I do not plan to see this doctor again. This summer I will be switching to a survivorship program at major cancer center. I really do not want to mention anything about thyroid to a new oncologist there. Meanwhile, I will continue to see the ENT doctor who is prescribing my Armour thyroid at this time.
COMMUNITY LEADER
We've had members with toxic goiter in the past, though I'm not sure we have any active members with that as a current diagnosis. It's often called a toxic nodular goiter, since it's often the nodules that produce hormones independently of the thyroid. Plummers Disease is a single hyperfunctioning nodule.
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