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4524270 tn?1355881950
How to tell is this is correct armour dose.
I'm new here, so here's a little history: I'm 48 years old. I was hypo years ago, but decided to go off Synthroid. Without treatment, I had no symptoms for ten years, and a 'normal' TSH (4.5.) which we tested every six months. However, a year ago I felt withdrawn and mildly hypo, so we tested TSH: 4.98. We did not do an antibody or T3 test.

I've been taking Synthroid ever since, but in the past 5 months, I've became very symptomatic. TSH was 46. We doubled Synthroid (100mcg) for two months, and now TSH is 2.5, but I feel exhausted, withdrawn, depressed, scattered, dull, voice is gravelly, strong cravings for carbs/sweets and hot/spicy, gained 20 lbs, fingers and face are puffy. I don't recall if I have any short term memory. :-) And now my hair is thinning.

So it's Hashimotos. My TPO antibodies are 6771.

Because Synthroid is clearly not relieving the symptoms, my Dr is supporting me to try Armour, but he knows little about it. Because my antibodies are so high I decided to start on one grain. I felt more energy after I took it, but not noticeably better, so after a week I decided to up to 1 and a 1/2 grains. No shakes or other issues and I'm sleeping better, so I think it's helping. After another week, I went up to 2 grains, which I split between 3 doses. I plan to stay on 2 grains for two or three weeks. My morning temp was averaging 97.3, but now hitting 97.8 almost every day.

How --or when-- can I tell if this is the correct dose? How will I know if it's too much or too little?
I would really appreciate advice.
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649848 tn?1484935765
All vitamin/mineral supplements should always be separated from any thyroid medication by at least 4 hours to prevent them from inhibiting absorption of the thyroid med.

Quick search and I see that the tests you're having done today are adrenal tests and are often done when there's a possible dehydration issue, which could be caused by a number of things.

Wishing you luck with them.  Keep us posted.
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4524270 tn?1355881950
Thanks, Barb!

I will have to try to separate the vitamins a little more from the Armour. I really appreciate your replies! And I will let you know how it's going.

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4524270 tn?1355881950
Update on Aldosterone, Renin and Vitamin D:

my labs:
Aldosterone 10.4    range 0-30
Renin   .30   upright range 1.31-3.95
Vitamin D  32.3   30-100

I was upright, and on the fifth day of my cycle, when I took this test. I ate normally the day before but did not add salt.  

I was going to raise Armour, but wonder, if I treat adrenals in a few weeks if I will need to lower my dose at that time? I'm hoping my new endo will know how to treat this. Also, I started Vitamin D supplements yesterday. I would appreciate your opinion on the Armour dose and on the labs if you can tell me anything. Thanks
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i don't know what that one person is talking about it being 'dangerous game' to up your dose. I have been on 2 grains for years and it keeps my TSH suppressed and I feel better than ever. I was a total wreck on T4 only treatment (Synthroid).  PLease go to stop the thyroid madness . com (remove the spaces) The TSH only test and T4 treatment is outdated.  If your body is not converting T4 to T3 (like mine) you need the higher dose Armour.  
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i think if you read the comment again, you will see that the poster referred to "upping your dose every week" as a "dangerous game".  Upping your dose without giving the previous dose a chance to level out in your blood is a dangerous game.  It's a sure-fire way to end up hyper.  

While some people definitely need T3 with their T4 meds, not everyone does.  What works for one doesn't necessarily work for another.  I do very well on T4-only meds.  Anyone recommending one med to the exclusion of others is doing the thyroid community an injustice.  We all have to find what's best for us...  
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Back before there was synthetic T4, all they prescribed at the time was natural dessicated thyroid. There are many books and studies on why T4 only treatment just doesn't work.  You say you "do very well' on T4 only treatment, I would like to know if you still have brain fog, weight gain, lethargy, water retention, fibromyalgia and any other symptoms of hypothyroidism and/or Adrenal Fatigue or pituitary atrophy.  Just because your numbers are in the normal range, doesn't mean a thing if you don't feel better. The true injustice is that people are unaware of the benefits of dessicated thyroid because doctors get kickbacks from drug companies that make synthetic drugs like synthroid. It has been ingrained in the medical community psyche that synthetic is better, but the reality is that it is not. t4 only treatment has just that, only T4, synthroid or levoxyl doesn't contain T3, Calcitonin and other hormones that the thyroid naturally makes.  

1953 PHYSICIAN’S DESK REFERENCE TO PHARMACEUTICAL SPECIALTIES AND BIOLOGICALS 1954, Eighth Edition, Copyright 1953 by Medical Economics, Inc., Rutherford, New Jersey. (thanks to Mary32 for submitting this entry)

page 417, under “Thyroid U.S.P” Dosage: “1/10 to 5 GRAINS DAILY, AS REQUIRED BY THE CLINICAL CONDITION OF THE PATIENT. Uses: “Useful in patients who are on long term therapy with ACTH or cortisone to offset any thyroid depression.”

1940-41 G.P. ETHICAL SPECIALTY PRODUCTS a catalog produced by G.P. Pty Ltd., Manufacturers of Standardized Biological and Pharmaceutical Products. Laboratories and Head Office: 65 Macquarie Street, Sydney, Australia.

One of their products, called G.P. Thyroid (Standardized), is listed on pages 38-39. Composition: A specially prepared extract of selected whole thyroid gland, containing 0.1 per cent of iodine in combination. Indications: Myxoedema and other thyroid deficiency disorders; obesity; oedema. Properties: Increases basal metabolism and stimulates diuresis. G.P. THYROID is chemically assayed and each batch, before issue, is BIOLOGICALLY STANDARDIZED BY THE OBSERVATION OF CHANGES IN THE METABOLIC RATE OF MYXOEDEMATOUS PATIENTS OVER A PERIOD OF AT LEAST ONE MONTH.
Dosage and Administration: 1 or more, according to the amount of fresh substance the physician desires to prescribe. N.B. Each 1 gr. fresh of G.P. THYROID is equivalent in total iodine content to 3/10 gr Thyroideum Siccum B.P. 1932. Original Packages: Bottles of 100 tablets in the following strengths: 1/4 grain fresh gland, 1/2 grain fresh gland, 1 grain fresh gland, 1 1/2 grain fresh gland, 2 grain fresh gland, 2 1/2 grain fresh gland, 5 grain fresh gland.

1909/1935 A System of Clinical Medicine (for Students and Practitioners) by Thomas Dixon Savill. Printed in Great Britain by Butler and Tanner, Ltd.

Page 239: For cretinism aka when an infant is born with hypothyroidism, Thyroid extract, beginning with 1/2 grain doses, causes a rapid and remarkable change. The skin become soft, the general conformation normal, and if the treatment has not been too long delayed, the mind assumes its natural vigour.   For full blown hypothyroidism, called Complete Myxodema, The treatment is started with thyroid extract in very small doses–1/8 to 1/4 grain three times daily, and the dose is increased until the go and the basal metabolism becomes normal.

(it goes on)

It is well known that T4 only treatment leads to Adrenal Fatigue.
Because unlike T4-only meds (Synthroid, Levoxyl, generic levothyroxine, Eltroxin, Oroxine, Levothyroid, Levaxin or Euthyrox,etc)…desiccated thyroid gives you exactly what your own thyroid would be giving you: T4, T3, T2, T1 and calcitonin.  Patients around the world have found it to be a far better treatment, removes lingering symptoms, improves your immune system, gives you your life back, stops the attack of Hashimotos disease if you dose it high enough, stops adrenal fatigue (which SO many patients end up with because of the inadequacy of T4-only) and is also far better for your immune system if you’ve ever had thyroid cancer.

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I'm not arguing that desiccated doesn't work.  I'm saying it's not for everyone.

Let me rephrase my comment:  I am completely asymptomatic and have been for years on T4.  I probably feel better than about 99% of people on this forum.  

I'm very well aware of what each of the different thyroid meds contains and the history of each.  I'm also very well aware of the symptoms of hypothyroidism.  

Yes, desiccated contains T3 as well as T4.  However, human thyroids (when working properly) produce very little T3 (a ratio of about 20:1 of T4:T3).  Most of our T3 comes from conversion.  Desiccated contains a ratio of about 4:1.  So, there's much more T3 in desiccated than our thyroids would produce, which makes it good for some, but not for others.  So, no, your statement is not correct "desiccated thyroid gives you exactly what your own thyroid would be giving you".

Over the years, there have been many discussions here on the relative merits of each therapy.  You can check the archives if you're interested.  Each has plusses and minuses, and we all have to find what works best for us.

Let me quote from one study.  It was conducted right here on this forum over the past 4+ years.  I have "met" thousands of people suffering from thyroid disease.  Some were helped by T4 only monotherapy, some by synthetic combinations of T3 and T4, and some by desiccated.  There is no one size fits all therapy.  

You found what works for you, and I respect that.  I've found what works for me.  I am in no way, shape or manner against any therapy that works.  We have pitifully few choices:  T4, synthetic T3/T4 combos, and desiccated.  With only three real options, we can't afford to take any off the table.

"Just because your numbers are in the normal range, doesn't mean a thing if you don't feel better."  You hit the nail on the head.  Treatment for this disease has to be symptom driven, and when it is, we see people benefitting by all options.  Too many doctors believe in the infallibility of TSH, and too many practice "reference range" endocrinology, and therein is where treatment fails.  
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"Let me quote from one study.  It was conducted right here on this forum over the past 4+ years.  I have "met" thousands of people suffering from thyroid disease.  Some were helped by T4 only monotherapy, some by synthetic combinations of T3 and T4, and some by desiccated.  There is no one size fits all therapy."

I wholeheartedly agree with this, and i am glad that you found a treatment that works for you.  So many people with thyroid disease are not so lucky.  I believe the way that thyroid disease is treated by Endo's and other specialist needs to fundamentally change.  An overwhelming number of Endo's prescribe T4 only treatment, if you find an Endo that will even prescribe dessicated thyroid in this country, you are lucky. What i am saying is that the fundamental change needs to come from the medical community and the AMA on the approach to treating thryoid disease.  I was not so lucky and i suffered for years on T4 only treatment. It got so bad I  had to pay out of pocket to see a naturopath who prescribed armour because my Endo never bothered to check my T3 levels.  My former endo never bothered to even do a sonogram of my thyroid , if we would , he would have seen the terrible result of years of Hashimoto's assault.  Never once did he mention adrenal fatigue, never bothered to check my iron levels or D3 levels or anything.  Just blindly prescribed the synthroid and called that being a doctor.  The end result is that people are still sick on T4 only treatment.  And it has become very common for people do self medication, self dose and find alternate ways of treating themselves, which is a shame to the medical community.

"Too many doctors believe in the infallibility of TSH, and too many practice "reference range" endocrinology, and therein is where treatment fails.   "

Couldn't have said it better myself.  It is quite sickening if you think about it.  The large drug companies (Pfizer, Merck, Johnson & Johnson, etc) practically control the AMA now. Doctors have abandoned naturopathic care. I would recommend a documentary called "The Corporation". It is very eye opening.
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"What i am saying is that the fundamental change needs to come from the medical community and the AMA on the approach to treating thryoid disease."  Yes, I agree, but good luck with that...have you read the joint ATA/AACE position paper published last year on the treatment of thyroid disease?  It's at least ten steps back...  They flat out say that FT3 is useless for hypo patients.  Ugh...

"The end result is that people are still sick on T4 only treatment."  Yes, but they are also still sick on T3/T4 combos and desiccated.  I think desiccated has gotten a reputation as "the forbidden fruit" because so many people tout it as the be-all and end-all of thyroid treatment.  People are brainwashed into thinking that they HAVE to get desiccated to feel well.  Once on it, even if it doesn't work out to be the panacea they'd thought it was, they still often stubbornly stick to the notion that what they are on is "best".  That's why I think keeping all options open is so vital.  Most of the time, it's an inept practitioner dosing the meds that's at fault, not the meds themselves.

I'm no fan of Big Pharma.  If you want a real eye opener, read "Our Daily Meds" by Melody Peterson.  She's a NYT reporter, and this is an expose of the pharmaceutical industry.

Another great book (not new) is "The Lost Art of Healing" by Theodore Lown about the art of healing vs. the science of medicine.  Oh, and while you're adding to your reading list (LOL), write down "How We Do Harm" by Otis Brawley.  He's an oncologist, so a lot of the examples are from cancer treatment, but it could equally apply to thyroid treatment.

Happy reading!  

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"Yes, but they are also still sick on T3/T4 combos and desiccated.  I think desiccated has gotten a reputation as "the forbidden fruit" because so many people tout it as the be-all and end-all of thyroid treatment.  People are brainwashed into thinking that they HAVE to get desiccated to feel well.  Once on it, even if it doesn't work out to be the panacea they'd thought it was, they still often stubbornly stick to the notion that what they are on is "best"."

I don't agree. I don't think the wider population is even aware that dessicated thryoid is an actual form of treatment, If anything, people are brainwashed and conditioned by the endo's and so-called doctors  into believing that Synthroid is the best and only option.  If  NDT it has become a panacea, it's only because it actually did work for a large number of people.

Interesting on the books, I will check them out. It's a real misnomer to me when I hear people say that America has the best health care system in the world.  I don't believe it anymore.  
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649848 tn?1484935765
"If  NDT it has become a panacea, it's only because it actually did work for a large number of people."  Works for a large number of people, but not for everyone and not everyone needs it.

Sounds like you're lumping all doctors and endos into the same category that your first endo was in. Not all are like that.  My endo happens to test FT3 every time I have labs, he's willing to prescribe T3 and he's willing to let my TSH live in the basement, at < 0.01 where it's been since beginning on thyroid med.  

While desiccated meds certainly have a place in thyroid treatment, I agree with goolarra that they aren't for everyone. We've had several members who have been on desiccated and had to get off because they didn't need/couldn't handle that much T3.  
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4524270 tn?1355881950
I can appreciate how passionate you all are! And those articles from the 1953 Physicans are excellent! You have strong opinions and different views and it's good for each of us to get exposure to the things that are working here.

Before I see my new endo in April, I plan to send him a letter to let him know how I'm doing, including copies of my labs and my temp charts. I can slide in there that my TSH is suppressed but this is not unusual with Armour and I'm looking at relieving symptoms over a lab result. I can ask him to consider adrenal dysfunction from the aldosterone/renin tests and how we can take care of that too.

I hope to continue treatment based on my symptoms and that he will respect me and not try to TSH me back to the starting gate.

One issue I have had for years that hasn't seemed to improve on --or after-- Synthroid has been short-term memory issues and memory issues in general. But a few times in recent weeks I have remembered something clearly and I'm thinking that's because Armour is starting to help me.

I've been at 3 1/4 grains for a month and raising to 3 and 1/2 tomorrow, for the next month.
Thank you all for your posts!




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I don't think we fundamentally disagree.  I just have as much trouble hearing that desiccated is the ONLY treatment for hypo as I have hearing that T4 is the ONLY treatment.

Both are viable alternatives, as are synthetic combos.  

However, many people either have a hard time getting desiccated or simply can't get it for financial reasons or because of where they live.  I think it's terribly unfair, and depressing, to give them the impression that they will never be well on T4.  Some people just don't need T3, and some people don't need desiccated.  Why discourage them from the beginning if this is a bridge they may never have to cross?  (A synopsis of a recent thread here.)

I also see many people on desiccated still struggling, but since they've been convinced that desiccated is the ultimate in thyroid treatment, they stubbornly stick to "making it work".  After all, it's the "best", so they have to live with it.  Do they?  Did they give T4 a chance to work (I know some have), did they ever try a synthetic combo?  But, they seldom go "back" and revisit other options.  

So, I just don't think we should apply "only" or "best" to any treatment, except as it applies to the individual using it.  
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4524270 tn?1355881950
I agree. I hope desiccated works for me,  but I'm open to trying other options if needed. I think some of the intensity about desiccated or synthetic is because there were long-endured disappointments and frustrations dealing with this disorder until the "right" drug was found.

I get excited with each raise. I'm happy to be trying this in spite of a pervasive ignorance in the medical world. And I appreciate being able to post here and get help from all of you.
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4524270 tn?1355881950
I posted these weeks ago, but no one actually commented on them as far as I can tell in the above posts. I've been on 3 and 1/2 grains Armour for a month and would like to know if it's safe to raise by a half grain or would 1/4 grains be better? I see a new Dr. on April 30th. If there is an adrenal issue, it will probably change how I'm doing this, but I'd like to try raise to see if it helps.

Aldosterone, Renin and Vitamin D from a month ago.

Aldosterone 10.4    range 0-30
Renin   .30   upright range 1.31-3.95
Vitamin D  32.3   30-100

I was upright, and on the fifth day of my cycle, when I took this test. I ate normally the day before but did not add salt.  

Also, I started Vitamin D supplements right after the test.

I would appreciate your opinion on the labs and also, raising Armour, if you can tell me anything. Thanks
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Hey there...

I just wanted to let you know that I follow this thread to see how you're doing,  Without seeing current thyroid labs, I don't know what to tell you on the increase, except that you can't go terribly wrong with a more conservative approach.  Last thing you want is to blow it when you're getting close!

Good that you're supplementing D.  The other two tests, I know nothing about (which is why I haven't commented).
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4524270 tn?1355881950
Thanks. I really appreciate that!

I took four grains today--divided into three doses--  to see if I felt hyper at all and I didn't. I know it has to build but at least it didn't bother me.

Is it possible to develop a RT3 problem when I didn't have one a couple months ago? I hope I don't but I wont know for a couple weeks. I have been supplementing iron for a month now too. I may have an adrenal issue, but my current dr doesn't know how to treat.

What alerts me is that my basal temps took a dive the past 10 days, and now running lower,at 97.4 the past three days. This is what makes me think I do need more Armour or else have adrenal issues.

Agh! I hope my new Dr. knows how to treat.

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4524270 tn?1355881950
I think due to ovulation, my temp went up today. Maybe it will increase over the second half of the month.

I would offer suggestions to my dr about adrenal issues but I haven't confirmed what they might be. All the dosing options from STTM are a lot to take in right now.

I hope to get a new blood test before I see my endo at the end of the month.
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It's possible to develop an RT3 issue at any time.  Our bodies produce more RT3 than FT3 for a number of reasons, all of which have to do with survival through bad times.  More RT3 is produced in times of stress, famine (including extreme dieting), some illnesses, etc.  The only way the body can keep FT3 levels in check is to produce more RT3 instead of FT3.  This should be self-correcting, but it's when excess RT3 production outlives what triggers it and becomes chronic that it's a problem.

Yes, I hope you get a new blood test, too.  It's been a while and several meds increases, am I right?
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4524270 tn?1355881950
Yes, it has been about six weeks since my last labs. I'm calling my dr next week.

I don't know what are hypo symptoms and what are just life or my age. I expend energy at work and then have little at home, which wasn't my normal a year or two ago. The puffy fingers and sore legs are ongoing symptoms that concern me. If I sit for 30 minutes, my legs ache when I walk. I'm drinking water and have been supplementing so hopefully my adrenals are improving if there is trouble there.

I don't think the increases are hurting me unless an Rt3 issue develops. If my new doc knows his stuff, we could go either  way, decreasing to treat adrenals or increasing. I might get my antibodies checked again to see if there is any change.

It's great to be able to share ideas and concerns here. Thanks.
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What's your menopause status?  Could that be contributing?  Does it help if you put your legs up when you sit?

I wasn't suggesting that the increases were hurting you.  I just think it's important to have blood work frequently when you're increasing fairly rapidly.  

Antibody levels really don't mean much.  The test is usually viewed as either positive or negative.  Some people with super high antibody counts don't seem to feel as bad as others that are just barely elevated.  

Look forward to seeing your blood work when you get it...
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4524270 tn?1355881950
Thanks! Did you have similar questions in the beginning?

I get what you're saying about checking levels regularly. I've been raising every four weeks, knowing that it could change in a heartbeat if something else is happening. And looking at it, it is closer to eight weeks since my last labs. It's time.

At this point, my periods are still regular as clockwork so I'm not sure if that is a factor yet.

To answer your question about putting my legs up, my legs hurt after I sit for a while or drive in the car, but then after the first few painful steps they feel better. My feet ache too. I definitely feel less pain as I walk around. At night I lay with them up as much as I can.

I started a wheat-free diet yesterday. I have had trouble with easy weight gain with wheat products for a long time, and reading Wheat Belly confirmed that it is problematic.
Getting rid of it has helped many people reduce inflammation and pain, so here's hoping it works for me!

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Am I repeating myself?  Sorry, this thread has gotten too long to go back and check for senior moments!  LOL

I don't know...I think I was in perimenopause for about 10 years, starting in my early 40s.  My only symptom was a slight shortening of my cycle.  It was still clockwork, but at around 26 days as opposed to my usual 29.

Good luck on the wheat free diet.  I went gluten free a few years back, and it caused nothing but trouble, but we're all different.  Hope it helps you.  Keep us posted.
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4524270 tn?1355881950
Well, for me wheat has been trouble, so I 'm going to try to abstain. I'm taking it a day at a time because I can't envision life without brownies, cake or cookies. This is the truth: I have had edema for months and have hardly been peeing, but I lost four pounds today of water weight. I was in the bathroom every 30 minutes all day. Maybe that's TMI, but it has really concerned me that I've been so puffy! I'm hoping this is a good sign for giving up wheat.

No, you didn't repeat yourself, I just wondered if you went through something similar with raises and questions and wondering.

I really appreciate your replies. I'll let you now how it's all going. I'm hoping my new dr is a good one.
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Oh, good, I HATE it when I repeat myself...makes me feel old!  LOL

Oh, yes, I questioned and agonized.  Every increase for me was torture because I have a congenital heart defect that gives me tachycardia, and every increase came with more tachy.  It takes time and patience...

Puffy isn't fun...I lost 25 lbs after starting thyroid meds, I think mostly water.  I'd had terrible swollen legs, ankles and feet while hypo.

Good luck with your new doctor.
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4524270 tn?1355881950
I can see why figuring the optimum dose would have been a difficult process! Scary.

I haven't lost the puffiness while on Armour, which has been worrisome. I'm shocked that I lost so much water weight yesterday. Needed to lose that. Still puffy today though. If it's an adrenal issue I hope my new Dr knows how to treat. Or maybe it will clear completely being wheat -free.

"Time and patience" Yes.
Thanks

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4524270 tn?1355881950
I left my labs at my specialist's office so I can't recall numbers, but what I have is this: The Feb lab showed my TSH is suppressed  and my Ft3 on this lab is over the top of the range. My Ft4 is 1.53 with a range of .78 - 2.19 ng/dl (I have that one on paper)

My endo suggests I scale back to 3 and 1/2 grains for eight more weeks. He says I am hyper without outward symptoms. He said I may be feeling better from the last dose of 3 and 1/2 grains rather than the current dose of 3 and 3/4 grains, he also said fatigue can be caused from hyper as well as hypo. I actually liked him. He said we got all the tests he wanted and he also said if my cortisol test in a couple weeks shows a problem he will know how to treat.

His judgement that I scale back sounds reasonable, unless I become more symptomatic on the lower dose. Rt3 and Vitamin D won't be back for several days. I'm curious what you think, given this limited info? Thanks
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4524270 tn?1355881950
FYI; I had the test done 14 hours after my armour dose.
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Do I have this right:  Your FT3 on this current lab is over the top, or it was back in February?  Your FT4 is at 53% of range, which is right on target.

Fatigue can be caused by both hypo and hyper.  Do you think you feel tired despite a good night's sleep or because you have insomnia or don't sleep well/too lightly?  How are your other hypo symptoms doing?

It will be interesting to see what your RT3 is doing.  Don't forget that it's the ratio of FT3 to RT3 that's important and not the raw numbers.  With FT3 over the top, you can expect your RT3 to be quite high as well.
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4524270 tn?1355881950
Yes, I do understand that is the RT3 ratio that will be revealing. I called again today and they they told me they won't have it until Friday or even next Monday.

I am sleeping straight through six hours a night. That is an improvement after years of frequent waking. I feel ok during the day and have noticed some improved memory in certain moments but super-tired after work. My feet and legs are still aching but I think that may be improving also. Muscle loss and fat are both factors in not having much energy or strength.

I rode my bike eight miles today and was so beat I had to stop a couple times. But I kept going. Even now, I want to get back out there and ride.

The Current lab showed Ft3 over the top of the range. I forgot the paper so I don't have the number or range in front of me. Still waiting on the others.

I don't have any hyper symptoms. No racing heart or racing thoughts. I was trembling when I was due for Armour but that has not been happening the past few days. I feel so normal, I forget to take the Armour and I end up taking them an hour or two late.

My DR said the fact that my Armour dose was so many hours before shows that it is in reality, my FT3 much higher when I am taking it.
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4524270 tn?1355881950
For clarification: My legs only ache after I sit down for a bit. And my voice has improved and I am peeing normally again. I still have puffy fingers and am withdrawn.

I do feel normal a lot, but wonder if I will ever become outgoing and vibrant again. I went through some severe trials a few years back which may have caused a change in my personality unrelated to thyroid disorder. But maybe it is thryoid.

Thanks for writing today.When I have the full results, I will post them. One thing I am thrilled about is that my liver enzymes have been rising for the past year and on this last lab, my ALT is still slightly high, but saw a 40 point drop and AST was normal again! I have been eating a TBSP coconut oil every morning in my coffee for two months and I think it helped!
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Well, it all sounds positive.  It will take a while to heal after being hypo, so you will most likely keep seeing imrpovement even after you stop increasing.  The longer you were hypo, the longer that can take.

Since you hadn't taken your Armour before the draw, your doctor is right...there are definitely times during the day when your FT3 is even higher than it showed on your labs, which was already over the top.

You don't have hyper symptoms, and I always say that if you don't have them, you're not hyper.  I don't know what to tell you about the decrease.  It's very small.  Were you ever on 3.5 before, or did you skip that dose and go from 3.25 to 3.75, for example?
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4524270 tn?1355881950
Thanks so much! I was on 3 and 1/2 grains for four weeks without much improvement so I raised 1/4 grain. Now I am starting to see some improvement and if it's from 3 and 1/2 catching up, then I'm happy to drop a 1/2 grain.

I think I will try it and see if I continue to improve. I think I was hypo for years but didn't feel obvious symptoms. The inability to lose weight no matter how active I was, plus memory problems that never improved probably were pointing to hypo. But my TSH was "normal" at 4.5 so I didn't treat.

My employees are shocked lately that I've been remembering things in detail! That's a great sign. I have had memory issues for at least fifteen years. I thought it was permanent damage from being hypo years ago.

How are you doing? Are you feeling healthy and happy this Spring?

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I am feeling happy and healthy, thanks.  However, we seem to be going from spring right back into winter on alternating weeks.  The warmth and the light definitely help the psyche.  

I just had blood drawn this morning, so I will know tomorrow if my labs have caught up to my lack of symptoms or not.

Give it a try.  You can always increase again if you have to.
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4524270 tn?1355881950

I took 3 and a 1/2 grains yesterday and will try it for a few weeks. But today my basal temp was 97.5 where it had been 97.6 for three days before.

I was just getting up to 98.2 a week or so ago before my period. If my temp doesn't go up to around 98.2 for the second half of this cycle, then I will probably increase again. I'm in another thyroid group and several of the mods have had suppressed TSH for years now with no other problems.
But for me the Ft3 over range is a reason for reducing. I'm happy to get my Ft4 in mid range.

My next appt with my new doc is in Nov.

Hope all is well with your labs. Are you hoping for a certain result?

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Well, suppressed TSH definitely has no ill effects.  I know several people who have had undetectable TSH for years.  Even high FT3 has no ill effects, IF you are not hyper.  It's being hyper that's the problem.

My FT3 had tanked last time I had labs...I'm talking below range.  The amazing part of that was that it totally blindsided me because I felt fine, so much so that I was sure the lab had made an error and had the test repeated.  No error, but no symptoms, either.  Anyway, I increased just slightly mostly to assuage my endo's conscience.  So, I'm curious to see what FT3 is doing now.

Unfortunately, getting my labs out of the doctor's office is enough to raise anyone's BP.  HE'S great about it, but the ladies in the office guard those results like junyyard dogs!  Grrrrrr.....  Got to start bothering them again this morning when the office opens.
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4524270 tn?1355881950
I posted a new question called "Rt3 rears its ugly head! Please advise!" I think that's what I called it anyway. It has all my new labs listed. From the title you can see there is an RT3 problem. I do not feel hyper in any way, shape or form. I don't feel great either, but improving. Rt3 is daunting to me.  

So you aren't feeling the drop in FT3? That's good! Hopefully the small increase will get it back up there before it takes any toll on your energy levels.

re: lab results: My Dr's office staff know I call for the results and they always give them to me over the phone, time permitting, until I can pick up the paper copy. I'm always matter-of-fact when I go to a new Dr so we just start out with that expectation, that I will get the labs and research them before my next visit. I catch things my Dr misses sometimes.

Well, if you get a chance to read my other post, please let me know what you think.
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Already have!
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TSH testing doesn't work for me because I have pituitary issues
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Your advice is "right on!". I have just completed 2 1/2 years of a TSH/T4 doc who kept showing me that everything was within range - and yet I felt as if I was going to die!. It wasn't until I did my own private tests (through True Health Labs, via the Internet) of complete Thyroid panels that I was able to see that although I was within range, every one of the measurements was about one unit above the minimum range bar. I calculated the T3/T4, T3 to reverse T3 ratios and saw for myself that things were way out of whack and therefore why I was feeling so ill. With that knowledge I got very angry, I finally flipped and went to the insurance office of my HMO and demanded that I get a "sensible" Endo. She called another hospital, got me a different Endo and here I am with almost no symptoms, a clear head, no headache, no muscle pain, no joint pain, wide awake and back into life on Armour Thyroid. Why on earth we are up against this wall of obstinance from the medical profession I would truly like to know. Anyway, keep talking and keep this outrageous nonsense in the limelight.
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Your advice is "right on!". I have just completed 2 1/2 years of a TSH/T4 doc who kept showing me that everything was within range - and yet I felt as if I was going to die!. It wasn't until I did my own private tests (through True Health Labs, via the Internet) of complete Thyroid panels that I was able to see that although I was within range, every one of the measurements was about one unit above the minimum range bar. I calculated the T3/T4, T3 to reverse T3 ratios and saw for myself that things were way out of whack and therefore why I was feeling so ill. With that knowledge I got very angry, I finally flipped and went to the insurance office of my HMO and demanded that I get a "sensible" Endo. She called another hospital, got me a different Endo and here I am with almost no symptoms, a clear head, no headache, no muscle pain, no joint pain, wide awake and back into life on Armour Thyroid. Why on earth we are up against this wall of obstinance from the medical profession I would truly like to know. Anyway, keep talking and keep this outrageous nonsense in the limelight.
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Thanks for telling us your experience.  Information like that is good for new members to read about.  

I also was just curious about what your thyroid test results looked like from the time you were feeling so bad, and then when you were feeling good.  It is always interesting to see what levels work best for members.  
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I'm new to this "taking charge of my health" thing and I'm battling my doctor over dosing with Armour.  I just went to the American Board of Endocrinologists website and I can't find where they state that TSH should be .2-3.0 or 3.5.  Can you help me with something I can show my doctor?  
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If you take a look at this link to the 2012 issue of Clinical Practice Guidelines for Hypothyroidism, by the AACE and ATA associations, you will note on page one that,  "The guidelines are not inclusive of all proper approaches or methods, or exclusive of others, The Guidelines do not establish a standard of  care, and specific outcomes are not guaranteed.  Treatment must be made based on the independent judgment of health care providers and each patient's individual circumstances.  A guideline is not intended to take the place of physician judgment in diagnosing and treatment of particular patients."

http://online.liebertpub.com/doi/pdfplus/10.1089/thy.2012.0205

All this is generally ignored by many doctors who lock in on TSH as the predominant diagnostic they need, and if it is above range, then they will also test for Free T4.  If Free T4 is within its range, then many will not treat, regardless of symptoms.  The guidelines do mention some of the symptoms that can be related to hypothyroidism, but then go on to say that, "While the exercise of calculating clinical scores has been largely superseded by sensitive thyroid function tests, it is useful to have objective clinical measures to gauge the severity of hypothyroidism."

Unfortunately most doctors have interpreted the Guidelines as rules to follow and use that as an excuse to deny treatment for many hypo patients.  The only real value to TSH is to distinguish between primary (autoimmune system related ) and central ( hypothalamus/pituitary related) hypothyroidism.  Suffice to say we could talk all day about why this situation exists, but TSH cannot be shown to even correlate well with the biologically active thyroid hormones, Free T4 or Free T3 much less correlate with symptoms.  Yet, symptoms are why we go to the doctor, not our TSH levels.  

Even when the doctor tests for Free T4, the range for it (and also Free T3) are faulty, because of the erroneous assumptions used to establish them.  As a result a Free T4 or Free T3 in the lower half should be suspect for being hypo, and further evaluated.  

As for something you can show your doctor, this might be a good talking paper.  This link was written by a good thyroid doctor.

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

Since you mention dosing, you might also be interested to know the following, taken from a study by Fraser, et al.  "  “It is clear that serum thyroid hormone and thyroid stimulating hormone concentrations cannot be used with any degree of confidence to classify patients as receiving satisfactory, insufficient, or excessive amounts of thyroxine replacement…The poor diagnostic sensitivity and high false positive rates associated with such measurements render them virtually useless in clinical practice…Further adjustments to the dose should be made according to the patient’s clinical response.”

Also from a study in the British Medical Journal.   "In a study published in the British Medical Journal, Meir et al also investigated the correlation of TSH and tissue thyroid effect. It was shown that the TSH level had no correlation with tissue thyroid levels and could not be used to determine a proper or optimal thyroid replacement dose. The authors concluded that “TSH is a poor measure for estimating the clinical and metabolic severity of primary overt thyroid failure. … We found no correlations between the different parameters of target tissues and serum TSH.” They stated that signs and symptoms of thyroid effect and not the TSH should be used to determine the proper replacement dose."

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Best answer yet..... Watch your symptoms and increase gradually.  I had a thyroidectomy 20+ years ago.  Was on Synthroid for most of those years.  Found Armour 2 years ago.  I am now at 3.5 grains, but feel like I may need more.  What should I do?  I have been at this level for over 6 months.
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Best answer yet..... Watch your symptoms and increase gradually.  I had a thyroidectomy 20+ years ago.  Was on Synthroid for most of those years.  Found Armour 2 years ago.  I am now at 3.5 grains, but feel like I may need more.  What should I do?  I have been at this level for over 6 months.
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What symptoms do you have?  What are your thyroid related test results and reference ranges shown on the lab report?  If tested for Vitamin D, B12 and ferritin, please post those as well.  Ever been tested for cortisol?
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You are comparing taking too much Armour vs amphetamines... really... not even close....If you are ADHD or ADD, you do not get the rush that you are referring to. Every person is different when comes to  the thyroid disease & reacts differently to meds. For one thing, nobody should taking the advice from anyone on the internet about how much meds a person should take.Tell the person to see a doctor or two doctors or three doctors and get a medical diagnosis. Tell them to write in a dairy about their daily activities and give it to their doctors.
  I have Hashimoto onset 16 years ago, and my body does not react the same as it did when I was in my twenties. I only wrote this for anyone reads this article in the future. Go see a doctor instead of reading the what ifs on the internet because this disease varies from person to person even if your numbers are same, your symptoms are not exactly the same. It must be Rocket Science.Unfortunately, there is no cure or magical pill for it.
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If only getting adequately tested and treated for possible hypothyroidism were as easy as seeing a doctor or two.  Good thyroid doctors are very scarce because most have the "Immaculate TSH Belief" and use "Reference Range Endocrinology".  That doesn't work for the majority of hypothyroid patients, That is why there are so many people on thyroid Forums like this.  And why we spend so much of our personal time trying to help members understand what is really needed in the way of testing, diagnosis and treatment.  
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16428684 tn?1460088684
Your comment about amphetamines seems tangential to me.

It sounds like you have been fortunate enough to find doctors who listen to your symptoms, test Free T4 and T3 and work with you on getting the proper dose.  Even as your body has changed with time.  I am glad for you.  Perhaps you can share your story as to how you found your thyroid health.

For many others it has not been so easy.  This forum is for sharing success and challenges.  It has been invaluable for me in learning how to advocate for myself and find my way out of a dangerous hypo situation.
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How where you able to get Armour thyroid? Most Doctor's won't prescribe it.
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