Dosage is irrelevant. Only the physiological effects matter. That mean your dosage needs to be high enough to relieve hypothyroid symptoms. If 90% of your Endo's patients are taking 90 mg of Armour, then I expect that the Endo is medicating them just enough to get TSH to a level satisfactory to the Endo. That doesn't work. Taking thyroid med once or twice a day is quite different than the continuous low flow of thyroid hormone in the untreated state. This changes the equilibrium among TSH, FT4 and FT3. The result is that most hypo patients taking thyroid med adequate to relieve hypo symptoms have suppressed TSH levels. That does not mean hyperthyroidism, unless there are attendant hyper symptoms due to excessive levels of Free T4 and Free T3.
Another way of looking at it is that the average thyroid gland output in a full day, results in 100 mcg of T4 and 10 mcg of T3. Since T3 is approx. 3 times as potent as T4, that would be equivalent to 130 mcg of T4. Since 60 mg of Armour is equivalent to only 66 mcg of T4 (not 100 mcg like shown in most conversion tables), that means the average daily requirement would be approx. 120 mg of Armour. Since thyroid med is not absorbed 100% the dose would need to be over 120 mg. That is why people taking a full daily replacement of Armour typically need somewhere between 150 and 300 mg of Armour (2 1/2 - 5 grainsz
Is the Endo testing you for Free T4, and Free T3 along with TSH? Have you been tested for cortisol, Vitamin D, B12 and ferritin? If so please post results and reference ranges.
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I take 90 mg of Armour. I started at 60. The doc didn’t want to adjusr dosage unless it had been 8 weeks. My endo told me 90% of his patients who take Armour, take 90mg.
I am on armour and it took about 8 months to get my dosage correct, but i have had some new struggles showing that the dosage i have been on is still not enough. i started on 30mg of armour, then uped to 60mg then uped to 120mg, which is my current dosage. But my tsh has gone from 3.11 to 4.5 in a month, and i know that isn't extremelt high ( my tsh was 23 when they uped my meds from 60 to 120) but i still dont feel well. I can tell you that my tsh was going crazy while on the smaller doses but i was on generic armour, then when they gave me my perscription for 120mg they put "brand medically necessary" and my tsh went from 23 to 3.11. so i would recommend asking for the brand name instead of generic. i take mine on an empty stomach and i wait thirty minutes before eating or drinking anything, but if i dont i usually get very bad stomach pains....i hope this helps.!
One thing. To get around the additional dosages with the empty stomach - most patients do consider as I do - taking the Armour sublingual.
There is really not much more to add here. mudkme83 hit everything perfectly on the head.
It takes time.
Depending of how high your labs are is based on your testing is a good way of judging how much armour you might need. Everyone is different.And it can be a long process to figure it out. With armour you need to make sure your doctor is testing the free T-4,T-3.In order to regulate your dosages.Also your adrenals need to be in good work order to have the armour work correctly.This is usually tested by a 24 hour cortisol saliva test.Most everyone does not mix Synthroid and armour. Although I think I have heard that before.This is just a basic rundown of a few things I have incountered myself. Their are lots of people on this site who take armour and have alot more experince than I do with it and im sure you will hear from them as well. Good luck.