How long does Armour Thyroid take to work?

[Charlie3055]

Having been suffering from an underactive thyroid for over 5 years (and suspected overactive for about 5 years before that), I finally found an Endocrinologist who did extensive tests and found that my thyroid levels are slightly under at tissue level. He prescribed me a 1/4 grain (15mg) Armour and I've been taking it for 6 weeks but feel worse than I did before! My tiredness, constipation, muscle aches, hair loss and other symptoms are all worse and I've started feeling a bit depressed. Is this normal and will I start feeling better or is Armour not for me? Any advice greatly appreciated as I can't find the info I'm looking for anywhere!

[gimel]

T3 hormone has a half life of only about a day, so it only takes about a week for the levels to build up close to the max you will see from that dose.  The effect on symptoms tends to lag behind the med levels; however, I am surprised that you feel no effect after 6 weeks.   This prompts me to wonder if you are getting enough med to really have any significant effect, so we really need to see what your thyroid hormone levels look like.  Please post test results and their reference ranges, for whatever thyroid testing has been done for you.

[Charlie3055]

Thanks for the reply to my post Gimel! I'll get hold of the results and post them on here. I'm due to have more blood tests in a month and go back to the Endo so it will be interesting to see what the score is.

[gimel]

If you are going back for testing, insist that they check for the actual, biologically active thyroid hormones, which are free T3 and free T4 (not to be confused with total T3 and total T4).  FT3 is the most important as it is four times as potent as FT4, and FT3 levels correlate best with hypo symptoms.  Symptom relief is what it is all about, not just getting test results to a level that the doctor thinks is okay.  In my opinion the very best way to treat a thyroid patient is to test and adjust FT3 and FT4 levels with whatever meds are required to alleviate symptoms.   The most difficult part is to find a doctor that is willing to treat your symptoms like this, instead of just going by TSH.  You might find this article interesting.

http://www.hormonerestoration.com/Thyroid.html

[Charlie3055]

I've just found some paperwork from my Endo which states that I have 'low serum free thyroxine and free tri-iodothyronine concentrations' - having looked these up on the net I see that these relate to the free T3 and T4 which is good news. I also found the blood test form for the blood work he wants me to have before going back to see him in about a month when my Armour is beginning to run out. It says nothing (as far as I'm aware) about thyroid tests but to test CRP, LPOA, APOA, APOB - all cholesterol from what I can gather (mine's high) and HOMO and MK6. /not sure what these are? It also doesn't state that I should fast which I know from much experience that if they're testing my cholesterol then I need to fast. Strange. Thanks for the info and web link - I'll have a good look at that.

[gimel]

Just a couple of thoughts.  For most accurate results when taking a T3 type med, don't take your thyroid med on the morning of the blood draw.  It's good that you have been tested for FT3 and FRT4.  Those tests really show where you are with thyroid.  Suggest that you get a copy of the test results and reference ranges and post them here for member comment.

Additionally,the amount of medication you are on is quite small, but that is fine if the doctor plans to continue to increase enough to alleviate symptoms.  This is something you will need to find out about.  If he plans to medicate you based on TSH, or to just get your FT3 and FT4 up into the bottom end of their ranges, that may not do it for you.  After hearing of so many patients that had FT3 and FT4 levels within the low end of the ranges and being told nothing further was required, even though they continued to suffer from hypo symptoms, I did a whole lot of thinking about it and this is what I concluded.


The reason the reference range for TSH is called "normal", is that it's based on a large population of patients' test results.  From that data base the decision was made that about 2.5 % of people would  fall out of this "normal" range because they were possibly hypo or hyper.  From this decision limits were placed at plus and minus two standard deviations from the overall average and that was called the "normal" range, supposedly representing people who had no thyroid problems.  

After many years of bad experience with this "normal" range for TSH, they finally acknowledged 6 years ago that there were a lot more patients out there with hypo  and hyper problems than previously accepted when they originally used their data base to established the range.  
After excluding from the data base those patients who were suspect for hypo and hyper, they again analyzed the remaining data base and established limits that included 95% of the total data base and called these new limits "normal".  This changed the reference range from .5-5.0  down to .3-3.0, which is a huge change.  Unfortunately this change hasn't yet been accepted or acknowledged by most labs and doctors, even though the change was recommended by the AACE over 6 years ago.

Also, realize that the reference ranges for the "Frees" were established the same basic way.  These ranges have never been reexamined and modified like the range for TSH.  I am absolutely convinced that this is the reason why so many hypo people fall into the lower end of the ranges for FT3 and FT4 and are still told they are "normal", and nothing further is done.

In one my past lives I had a lot of training and experience in statistical analysis.  Based on that experience, if I had to estimate what a revised range for FT3 would be if the data base were purged of suspect hypo and hyper people, like was done for TSH, then I would say the FT3 range should change from 2.3-4.2 pg/dl up to about 3.2-4.3.  And FT4 probably would change from .60-1.50 ng/dl up to about 1.0-1.55. Quite a difference, huh?  Think maybe that is why we hear from so many people that have hypo symptoms, yet they are in the "normal" ranges for the "Frees"?  I'd bet my last dollar.    


Sorry to lay all this info on you, but I think you need to discuss all this with your doctor and determine if your doctor is willing to treat you by testing and adjusting FT3 and FT4 levels within their ranges,  as required to alleviate symptoms.   If the doctor has any problem with this, then you need to start looking for a good thyroid doctor that will do so.

[magpieannie]

It's probably the Armour brand not working well for you. They reformulated their product(changed the binders and fillers) Many people who had always done well on their product, suddenly began having hypo. symptoms and changes in blood work that were not for the better! Switch brands or have it compounded! We switched to Nature-throid (desiccated porcine) and doing so much better then we were on the "new Armour"  You also said that it was good that your free t3 and free t4 were in the low end. If my daughter' are in the low end of normal then she has sever hypo. symptoms, similar to those you've described. She does better when the freet3 and freet4 are kept on the high side of normal range with her TSH supressed to under 1. She is nine and born without a thyroid gland! Change your med and get that t3 and t4 up a bit and I bet you will feel better.

[Charlie3055]

Thank you both so much for your comments and help on this! I tried to post something yesterday but internet connection went! After reading the posts I decided enough was enough. I went for blood tests yesterday morning (having taken the last Armour the previous morning) and saw my Endo this afternoon. My results were as follows: (these are in different measurements to yours however and I can't figure out where on the web to convert them, sorry!)...

TSH - 1.21 mIU/L (normal range 0.27 - 4.20)
Free Thyroxine 13.3 pmol/L (normal range 12.0 - 22.0)
Free T3 -  3.8 pmol/L (normal range 4.0 - 6.8)

As you can see, the T3 is under and the T4 is only just above the 'normal' range. I told my Endo what you said about Armour's reformulation and he was really interested and said he wasn't aware of it - he was very glad I'd told him! Consequently he has switched me to a 1/4 grain of Nature Thyroid a day. He said it should start working within a few days and definitely within 2-3 weeks and if I'm not feeling better in this time then to increase it 1/2 a grain and to go back if there are any problems. If not, I am to just see him in the New Year having had my blood work done again so he can see how my levels are. I imagine I may need to go higher than 1/2 a grain judging from what I've read here and on other websites, so we'll have to see!

Already, having now missed two doses of Armour I feel loads better. Yesterday I really struggled and couldn't see how I was going to make it through the day, let alone the week but I'm feeling so much more positive about everything and I have you to thank gimel and magpieannie, thank you so much! I'm also so lucky to have found an Endo who really knows his stuff and listens. I can't believe how many Doctors I've visited and blood tests have been done for my thyroid function over the past 10 years and only now has this been discovered after years of feeling unwell. (Well, actually I can believe it because exactly the same happened to my Mum). I will report back once I've started taking the Nature Thyroid, fingers crossed!

[magpieannie]

Okay, this is great! You are very welcome for the help. Gimel's advice on the ranges is right on. She helped me lots when I was left in the dark, so a BIG THANKS also from me to Gimel. I say, we are all in this together and thank God for the computer and this site! Now, just so you'll know, it took a whole grain more of the Naturethroid then the Armour for my daughter to feel right.(the conversion chart seemed a little too modest) She was on 120 mg of Armour , but she is on 190 mg of Naturethroid to feel the same as she did on the good (old) Armour.. The chart says that 60mg Armour (1grain) = 65mg Naturethroid (1 grain) It also took her several months on this optimal dose to get rid of most of the hypo. symptoms that she developed on the reformulated Armour. We upped it every 10 to 14 days by 1/2 a grain until she came out of it.( The Hypo.Funk!). You need to really pay attention to how you are feeling (symptoms) and remember "gradual increases over time") On the blood work, test in 8 weeks when you feel like you have been on the right dose symptomatically for a while. You want that freet4 and freet3 to line up closely at mid to high normal.TSH is not a factor really, and it will and should be low normal. Also, I like to put my daughters ranges on their own bell shaped curve with the reference numbers at either end. Then chat the actual lab result on their bell. The freet4 and freet3 should both be on the right side of the bell with bthe TSH on the far left. This gives a good visual and helps with seeing where you are at. A good book for you to read now is "Overcoming Thyroid Disorders" Dr. David Brownstein on Amazon. com. It's an easy read and it helped me so much! Keep us updated on your progress!