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How to tell is this is correct armour dose.
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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 However, a year ago I felt withdrawn and mildly hypo, so we tested TSH: 4.98.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 We doubled Synthroid (100mcg) for two months, and now TSH is 2.5, but I feel exhausted, withdrawn, depressed, scattered, dull, voice is gravelly, strong cravings for carbs/sweets and hot/spicy, gained 20 lbs, fingers and face are puffy.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.
80 Comments Post a Comment
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Avatar_m_tn
For one thing you are moving too fast, it takes a minimum of at least three to 6 weeks for a replacement hormone to become fully active in your system, and Armour is a Combination T4/T3 Hormone replacement, most MD's wait 6 weeks between dosage adjustments and lab work, your playing a dangerous game upping dosages every week, you are taking a risk of getting slammed when all that medication catches up to you. If you over do the medication you take the risk of going Hyper instead of being Hypo, I would go back to 60mg/1grain, split the dose and take 1/2 in the am, and the same in the afternoon. You have to give thyroid replacement hormone time to work, it just does not react that quick, like you have a headache and take an advil. You need to have your MD do blood work after the first six weeks and then adjust the dosage, in addition you need to have your MD do a Free T3 and  Free T4 Tests, do not adjust meds by TSH , it is not accurate to adjust dosage. He/She should base dosage by those results and your symptoms, and only do small increment increases. Regards FTB4
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Avatar_m_tn
To explain why you or your MD should not rely on TSH, TSH is "Thyroid Stimulating Hormone" it is not a thyroid hormone, it is a hormone sent to the thyroid by the Pituitary gland located in the brain, when the T3 is low, the pituitary send a hormone to "Bump or Stimulate the thyroid into secreting more T4 into your system, then your system converts the T4 to T3, after your system absorbs all the T3 that it needs, what remains is called Free T3, this is the most important level to test for and how you feel with symptoms, Free T4 is done also, they can compare the percentages of each to determine if your body is converting from T4 to T3. So if your MD is not sure, Insist on The Free T3, Free T4 and the TSH, then when the lab results come back, get a copy, post the results here, include the test level, and the reference ranges provided for each. Then we can advise and comment on wheere you are  at regarding thyroid and dosage
Best Regards FTB4    (And stop raising that Dosage!) lol
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4524270_tn?1355881950
Thank you for your response! I will reduce to 1 and 1/2 grains and see how it goes with the next lab. The next blood test is in late January or early Feb. My Dr is not comfortable prescribing Armour. I wanted to get on it before seeing a new endo, because my new endo is also reluctant to prescribe it. He has patients on it though.

For some reason, my temp was 97.2. this morning. Lower than it has been in a week.

I'm aware that TSH is unreliable as an indicator of my thyroid and I've been frustrated that my Dr uses only that test. I had to ask him for the antibodies tests! But he listens to how I feel generally and he is open to trying this. I went in to him armed with research and told him the next time we do tests I will need to have the frees done.

And yes, I have raised the dose quickly, risking that will catch up to me. I really hope it doesn't. If I don't feel hyper by late January, I can see how I'm feeling. I'll post results and ranges when I have them. I really appreciate the help here.

Again, thanks!

Alittleblues
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Avatar_m_tn
When did all these increases occur?, also taking Armour gives you a little more energy because of the T3 in the medication, it raises you metabolism,
Do not let your MD talk you out of taking Armour for some stupid reasons that they come up with, like it is not FDA approved or it is dangerous, these are all "Old Doctors Tales" that when they have tunnel vision come up with.  I too have Hashi's and I am taking Armour, I have been through Levo, and Synthroid also. Could you Post your last Thyroid blood work, including reference ranges for each level. Also, Has he done Vitamin D and Vitamin B12 levels, please include them also, if he did not do those tests, you should request them in addition to the Free T3 and Free T4, and as long as you are at, have him throw in Iron. Many thyroid sufferers have issues absorbing nutrients from the food we eat, Deficiency symptoms can occur along with thyroid symptoms,ie: muscle pain/cramps, fatigue and lowered immune system.  Take Care and please post those labs. Regards FTB4
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Avatar_m_tn
in my opinion, any Dr who is prescribing a medication with T3 in it and not testing for Free T3 is bordering on malpractice.

Yes those changes are WAY too fast.  I think it is a good idea to cut back. I completely understand your desire for quick results. Trust me. But that is NOT the best approach. And if you by self medicating like this have a bad reaction, it will only taint your Dr even further from every wanting to prescribe Armour every again.  You don't want to mess this up  for yourself, but also for others.

If on the other hand you take this slowly and it all works out. The Dr is likely to gain confidence with it and hopefully be able to help a future patient out.

Basal body temp in my opinion is probably more accurate than a TSH test.  However that's not saying much.  Also basal body temperature for a female who is still of child bearing years and not post menopausal can really only test for their basal body temperature for a short time during their menstrual cycle.  I can't remember when it is but if I recall I think it is only a few days to a week after her last period.  Ovulation etc have an effect on body temp.  So you have to be careful about using body temperature as such a precise gauge.

Testng for Free T4 and Free T3 every 6 weeks is the way to go.

Hashi's as you probably know is a progressive disease where your immune system slowly decreases your thyroid gland to produce thyroid hormone.  So you will likely have to have increased dosages of medication over time to make up for that loss of thyroid.  This is why it is good to know you have this situation so that you can keep getting tested enough to "catch" when a small bump in medication dosage is needed.

Many people here have found that they need to have BOTH of the following to feel well:

1) The Free T4 (FT4)  to be in the MIDDLE of the range (50%) or slightly higher

and - that means in addition to

2) Free T3 (FT3) to be in the UPPER 1/3 of the range (66.7%)

Notice that these are WELL up into the reference range!  Simply being somewhere within the reference range is NOT sufficient for many if not most people!

Everyone is different and they feel well at different levels. But the above target seems much more accurate to shoot for than simply the wide reference range.

Do NOT let any Dr tell you that you are "fine" simply because your TSH is at a certain level or that your FT4 and FT3 are "somewhere" within range.  If that is the case, they you will have to start searching for another Dr.

"immaculate TSH belief" and "reference range endocrinology" are two of the things Dr's will do that will keep you from feeling well.  And the only choice you have is to educate your Dr providing reams of medical studies and hope the Dr changes his mind or find another Dr.  Both have worked but both take a tremendous amount of patience and persistence.

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4524270_tn?1355881950
Thanks to everyone who has replied. My increases occured over a month but I decreased to 1 and 1/2 grains a couple days ago. I have considered how my Dr will have more against Armour if it doesn't go well, so when I went in, I told him we will need to check adrenals and do other tests if it Isn't going well. To me, Armour shows problems that already exist because it does help the metabolism. If the body can't handle it, there is probably something else going on.

My Dr doesnt like to prescribe it because he knows little about it. He talked me out of it before and this time I went in armed with information, determined to try it, and he agreed. We will have the appropriate tests in January. He does have a few other patients on Armour.

I bought the whole "TSH only" sell for a long time but not any more.  I'm concerned I may have had Hashimotos for years but had no idea because the TSH was "normal," (For me, optimum is about 1.5 anyway.) Because the antibodies are so high I probably will end up needing more than I'm taking currently. Right now, on the lower dose, I definitely feel more tired.

I take my temp before waking every morning. It has dropped the last two days. I just took it now, after being up for hours also, and it's 97.8.
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Avatar_m_tn
Stick to your guns and demand The Free T3 and Free T4, since he does not seem to treat thyroid very much you can win him over being armed with more facts on Thyroid! And don't forget to post rthe results. Good Luck FTB4
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4524270_tn?1355881950
Thanks for the encouragement! I will post the results and already told him we will need to do those tests next time.

After only a couple days on a lower dose, my voice is becoming gravelly again, where I was seeing improvement on 2 grains, and I'm super scattered. Should that improve if I give it enough time to build up in my body? I'm feeling less focused and energetic on the current dose of 1 and 1/2 grains. Hearing my gravelly voice is depressing, plus I work in a job environment where I deal with people all day.

I didn't mention this before, but what the heck: I'm super puffy and practically stopped urinating the last two months I was on Synthroid. When I hit the 2 grain dose, I started to pee again. That might be too much information, but I hoped I was starting to lose some of the water retention.

My initial question was how will I know if I'm the correct dose? I'm feeling so scattered.
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4524270_tn?1355881950
Can you help me understand the conversion table for dosing between Armour and Synthroid? I saw a few conversion charts online but what I want to know is, how does the T3 in Armour effect how potent it is or how efficiently is works?

I was feeling symptomatic on 100mcg synthroid. I was feeling better on 2 grains of Armour, but is that way stronger because of the T3? Do Armour patients usually need higher or lower doses than they had on Synthroid?

If you or anyone else can help me understand this, or if you can point me to a reliable website, I'd appreciate it. Thanks
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Avatar_m_tn
Here you go:


          Armour       Synthroid
         1/4 grain      18-25mcg
          1/2               74-100
          1.5               111-150
          2 grain        148-200
    Ypu are taking too much @ 2 grains, you need 1/2 grain to equal 100mcg         FTB4
                                                                                
      
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4524270_tn?1355881950
Thanks. I wonder why I feel worse on 1 and 1/2 grains. I was very symptomatic after two months on 100mcg Synthroid, so that may not have been enough.

Does the T3 in Armour make less T4 mcg necessary?

My basal temp has dropped since I cut back, but I want to track it for the next weeks to see if it rises as the Armour builds.
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4524270_tn?1355881950
I mis-typed the TSH before at 2.5. Years ago, when my TSH lowered, I felt better, except for the depression. I haven't had hypo symptoms or depression for ten years, but now I think my withdrawal the last few years has been a symptom. That and a very slow weight gain, until two months ago where my cravings and sudden weight gain were alarming! I had some extreme stress to deal for some time, so withdrawing made sense, at least before everything else went askew a couple months ago.

Here are my last results as they appear on paper:

test:                                                  
Thyroid AB           77             reference:    < 40 IU/ML
Microsomal AB     6771              "                <= 60  u/ml
T4                         8.5                "           5.53 - 11.0 ug/dl
TSH                      2.05               "           .465 - 4.68  uIU/ml

I'm open to anything helpful you can surmise from this. Thanks



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4524270_tn?1355881950
Correction: My symptoms began months ago. I have had sleep disruption for a while, but that was worsening. I was alarmed when my hair started thinning and my voice suddenly became gravelly. That is my "wake up" symptom. "Wake up! You are definitely hypo!" And every time I stepped on the scale I was a pound heavier. I went to my Dr  and he prescribed double-dose Synthroid for two months, which wasn't relieving the symptoms. Which led me to start the Armour.

I felt like I needed to clarify the timing.
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Avatar_m_tn
The medication takes time as said above, you cannot expect miracles in a week or two, it takes at a minimum of 4-5 weeks to get a good idea where you are in regards to your thyroid. You have to stop self medicating, all these stops and starts or up and down dosages just cause delays in balancing out your system, decide on a little lower dose than 2 grains, 2 grains being equal to 200mcg of Synthroid is a high dose for someone just starting out on a T3/T4 mecication. The reason you feel so much better on the high dosage is due to the T3 cranking up your metabolism, but can have a negative effect if it is abused, you must take small steps, until you get to a stable, and consistant tested level. The more you go back and forth, the more you delay getting well.   Regards FTB4
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4524270_tn?1355881950
Thank you so much. I'm frustrated because I was feeling better on the higher dose, seeing some improvement in my voice and in sleeping for several hours straight. I figured out I have been at 11/2 grain dose for three weeks now, with the one week at the 2 grains.

What can I expect if I'm at too high a dose? I appreciate your patience with me. I have learned a lot about Armour but would like to know how I will know if this is too much or too little.
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Avatar_m_tn
Like we have stated, the reason you are feeling better is the T3 portion of a T3/T4 Hormone, the T3 gets used up quick, usual 5-7 hours, The T4 portion stays in your system longer and takes time to convert to T3. Until you get that T4 up, you are not going to be consistant. The higher dose you speak of is the T3, look at it like taking amphetamines, they were prescribed to be taken in small doses, at those doses they remaim fairly safe, but once you abuse them, because they make you feel good and give you a burst of energy, but what damage are they doing to your internal organs and heart, one of the most severe symptoms of Hyperthyroid is the heavy load that is placed on the heart due to an overworked metabolism. If you stack up all this T4 in a short period of time, it could make you hyper, and give you a whole new set of symptoms to deal with. At least four members here have warned against rushing and self medicating, why would we be making these statements? Because what you are doing is taking a risk with your health, You ask, "How will I know how much is too much or too little?" You do it the way we have advised "Small Steps" You raise the dosage a little bit, you wait 6 weeks and have a blood draw,wait for your Free T3 and Free T4 then if you are still low you increase a little again, its not rocket science, you have patience and take your time. If not then your body pays for it in a negative way. FTB4
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Avatar_f_tn
I was diagnosed with hypothyroidsm in May, 2009. I took the generic(I can't spell it) for synthroid and was retested after 6 weeks. My doctor also checked the free T3 and T4. She made adjustments and my tsh went from 6.1 to 4.6. she felt I should be super  now. But the truth was, I only felt a bit better. One Monday, I did...I felt so good it was almost like I used to feel. but by Tuesday, it was wearing off and by Wednesday it was gone.

I was doing a lot of research on the Internet and asked her if she was going by the old window or the newer one. She was using the older one and didn't want to get my level lower than 4.1. She scheduled me for a visit with a local encrinologist who explained everything she had already told me. He was going by the old window too. So since I was doing a bit better I just stayed with her.

After about a year I noticed I was developing a lump in the upper center of my breastbone. I've been watching it for a couple years now. this week I checked online for info on what is located in this area. The Thymus gland is in the same location. It is supposed to hold white blood cells and fat and shrink after puberty. But mine has grown enough to puch the breasbone up.

A year ago I moved to the norht Georgia area and looked for a new doctor,. My doctor in Ohio was Chinese and always open to listen to my concerns and read the info I copied from the Interet. This doctor is from  India and the info on them said they treated geriatic patients and used some holinistic treatments. I'm not sure what that is but I hoped it meant they stay up to date on medicine and treatments.

Not so, she is not as open to discussion, did not check the amount of dosage my Ohio doctor prescribed and gave me the feeling we 'elderly' don't know what we''re talking about. At 79 years old I'm 'older' not elderly. As a result in May 2012 she gave me 50 mcg of Synthroid instead of the 100 mcg. I think that's right, I don't have it here in front of me. My TSH test in September 2012 was 4.6. I said that was higher than my test in Ohio, should she raise the dosage...she said it's in the range and is okay.

I have an appointment January 4, 2013 and plan to take some info I found on the Internet that suggest there is a connection between the thymus and the thyroid glands. It was on www.ehow.com and states "According to the Womens' Guide toThyroid Heath, low thyroid function can cause a reduction in the production of hormons by the thymus galnd."

So my question is, if that statement is true can the Synthroid I'm taking to raise my low thyroid also cause the thymus to grow????

Has anyone else had this experience with their thymus?
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Avatar_m_tn
Hello, First of all, 4.6 TSH is on the high side of an old range, the new range recomended by the American Board of Endocrinologists advise 0.2-3.0 or 3.5  so your THS would be a little high, indicating Hypothyroid or underactive thyroid condition. Also, if you wish to get as many responses and information regarding your questions and issues, that you post a question on the main page rather than in response to someone elses as yo have acidentally done, I hate to have you retype your whole post, unless you can copy and paste it on a new page. If you go to the main forum page, which lists all questions and post at that location. Also, Did they do a Free T4 and a Free T3 in addition to the TSH? If they did, please include those and the references that were provided for each. We will help in responding to any questions you may have. Best Regards FTB4  
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4524270_tn?1355881950
" At least four members here have warned against rushing and self medicating, why would we be making these statements? "

That's what I needed to know: Why you are making these statements.

I wanted to know if Symptoms would tell me if it's too much or if I must wait for labs. I am symptomatic, with little or no relief after being at this dose for a few weeks. I haven't had shaking or any other hyper symptoms and my blood pressure is consistently excellent so I would need to know why I should still not increase. Your last post helped me understand that by sharing a little about how the science works. That's what I need to make a good decision.

Thank you for the information and also sharing about your own experience.

Alittleblues
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Avatar_m_tn
The only reason we or I seemed to harp on being patient is so you don't flip to Hper. Lets say for example I say or advise you to go ahead and take some extra Armour since you don't feel good and it may help you. One of two things could occur 1, You get better, and your labs come out fine.
2, You take just enough T3 to make you feel better, but since T4 is like a stockpile in your system, all of a sudden your conversion kicks in and you start getting a huge dose of T3 that comes from this stock pile of T4 that you have built up over the last three weeks or so, because you were taking 2 grains of Armour a day, Now you are going Hyper, and when the six week period comes up and you do your labs, your levels are going to be so far out of whack, you have to go through another two six week periods before you straighten out. I would never advise you to increase your own dosage without knowing where your levels are at. In addition Armour is only about 9% T3, some buffers or binders and the rest is T4, T3 reacts right away, T4 builds up. I don't want you to get upset with me or any other members here, we are here to help you, not make you frustrated or streesed out. All we can do is offer the knowledge we have, and everyone reacts different to thyroid medications. Sometimes we have to just grit our teeth and accept a little misery to achieve a longer lasting goal. I hope this answers your question of why I think you should wait before increasing your dosage any further until you get your lab results. When you get them, you are welcome to post them for members to advise and comment. Best Wishes and Good Health FTB4
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4524270_tn?1355881950
I appreciate that you're trying to help and am not frustrated. I just needed more information. I needed to know why, not just because you told me so. :-)

As passionate as some responses were, I didn't feel my actual questions were answered. Thank you for the information in the last two posts especially. I may have to hit some bumps in the road--hopefully not many-- but I'll figure this out.

Hope you and others here have a very happy new year!


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Avatar_f_tn
I understand your concerns over dosing and here is how we do it in south Florida. You increase your Armour dose by 1/2 grain every two weeks until your symptoms abate. You keep a record of how you feel during this time. If you go hyper, you don't take your pill that day, and cut back by 1/2 a grain. Your body tells you what your optimal dose is, not the blood work. Your TSH will be on the low end at your optimal dose. We do not wait 6 to 8 weeks for lab results to increase the dose. Each morning, before you get out of bed, you place your hand on your heart. If it feels rapid-if it is, it will be obvious-skip your dose that day and cut back by 1/2 grain. It's that simple. I am a nurse practitioner, as well as, a hypothyroid patient.
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Avatar_f_tn
Please go to another doctor that speacialize in the thyroid, it seem to me your body is not accepting, every time they change your med it usually take 6 to 8 wks for my medicine to kick in, i have had graves disease and hypothyroid, and now my endroconoligist, i have low blood pressure and high cholesteral and fibromyalgia, i have never been on armour dose, i am currently
being tested for hashimoto due to this, there are more test that they need to do, get a second opinion, this doctor is messing with your body and throwing everything off, Get a second opinion
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Avatar_m_tn
How do you account for the build up of T4 without doing blood work?, The best procedure is using both Free T3, Free T4 results and symptoms, also skipping doses is not good practice. It takes longer than one day for your body to react then one day. And the waiting period is at least 4 to six weeks. On again off again everyday is not a good procedure. and we are all
Hypo and Hyper thyroid patients.   FTB4
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Avatar_f_tn
Sorry to come into this thread so late...someone asked me to read it over, and I'm going to try to clarify some things and hope I don't just confuse even more.  

First off, 1 grain of Armour is roughly equivalent to 100 mcg of Synthroid OR (not and) 25 mcg of Cytomel.  1 grain of Armour contains 9 mcg of T3 and 38 mcg of T4.  T3 is much more potent than T4, 4 to 5 times more potent.  So, 1 grain of Armour contains 38 mcg of T4 plus 36 (9X4)  to 45 (9X5) as the equivalent of the T3 in it.  So, total 74-86.  However, Armour contains both T3 and T4, so these "equivalents" are really just a suggestion for where to start when you switch from one to the other.  Even if the dose were EXACTLY the same, switching is a little like starting over...you are going to react differently to the combo med than to T4.  

T3 meds peak in your blood about 3 hours after taking them and are completely out of your system in just a few days.  T4 meds, on the other hand, take 4-6 weeks to peak (reach their full potential) in your blood.  As T4 levels are building, your body will convert more T4 to T3.  So, when you first start taking Armour, you are really living off the T3in the meds.  T4 is building, and your body starts to convert more T4 to T3 as the T4 builds.  On a consistent dose, that building of T4 stops after 4-6 weeks.  That's why testing at 4 week intervals is recommended.  (The vast majority has settled after 4 weeks.)  So, now, you are using both the T3 from the meds and the T3 your body has converted from T4.

So, you can see how this could "catch up to you" and make you hyper.  You take more and more until your symptoms go away (on the T3 in the pill), then you start converting that T4 to T3, and suddenly, you are way overmedicated.  It's due to the very different half lives of the two hormones.  Also, once T4 levels rise, it can take conversion a while to ramp back up (FT3 keeps rising even after FT4 has stabilized), further increasing the gap in blood levels.  And lastly, even after both FT3 and FT4 have stabilized, it often takes even more time yet for hypo symptoms to disappear since our bodies have to heal.  

As for the hand on the heart test...not the way I'd want to go.  Yes, it's an excellent indication that you are hyper (overmedicated), but do you really want to have to have tachycardia to prove it???  Periodic blood work at 4 week intervals before each increase can give you a prediction of what's about to happen.  Personally, I'll do about anything to avoid hyper.  Hypo isn't fun, but I'll take it any day over feeling like I'm about to buzz off the planet.  

I hope that clarifies the "why".
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4524270_tn?1355881950
Thanks! Yes, all of these posts help me to understand how it works. I have an appointment with an endo in April, but I specifically asked if he prescribes Armour and his receptionist told me he usually does not. But he does have a few patients on it, like my family doctor does. I hope to have a good understanding on how this is going before I see him.

You all have been at this for awhile and can understand what I'm dealing with. My concern is not to become hyper, but also, I would have expected to see some improvement after five weeks, leading me to think this may not be enough.

I wrote above that I was just starting to feel relief when I went up to 2 grains. Lisaanne66's advice is similar to Stop The Thyroid Madness' advice to increase in two week increments to 2 and 1/2 grains, then hold that dose for 4-6 weeks. I want to try that. I'll be curious to see what the labs show when I get the proper tests done.

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4524270_tn?1355881950
It's been weeks since I posted. I increased my dose at two week intervals and I am now at 3 grains for three weeks for these lab results. I have had no hyper symptoms. I break the dose into three/one grain doses over the day. I think I am starting to feel better. I'm back to wanting to exercise, or at least walk, which has to be a good sign. I still get gravelly voiced when it's time for a dose and my legs continue to ache, but the weight gain can't be helping.

My basal temp is hitting around 97.7 the past few days, which is higher than it has been. I have also increased my water intake because I think I have been dehydrated. Hoping a gallon a day will help me lose the puffiness.

From these labs, I do not see a RT3 problem and my Dr agreed, but he said my iron is fine too; however, the saturation % is low and Ferritin is barely in the normal range. From researching this, they should both be higher. Should I consider supplementing? The FT4 looks look low to me and the Ft3 in upper range.

I would really appreciate your thoughts on my labs.

                Lab ref range
Rt3  10     9.2 - 24.1 ng/dL
Ft3  4       2.0 - 4.4 pg/mL
Ft4  .80    .78 - 2.19 ng/dL
TSH .02   .465 - 4.68 uIU/ml  (old range?)

ferritin      51.4      ng/mL
tot. iron    55       30-170 ug/dl
TIBC       284      265-497 ug/dL
% satur.    19        20-50%

glucose 90         70-110 mg/dL
bun 15             7-17 mg/dL
sodium 143       136-145 mmol/L
potassium 4.5      3.5-5.1 mmol/L
cloride 105         98-107 mmol.l
calcium 8.5         8.5 - 10.1 mg/dL

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Avatar_m_tn
There's a lot of improvement in your labs.  One quick question before commenting further.  Did you take thyroid med before the blood draw for those labs?
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Avatar_f_tn
Everything's looking very good.  I agree that RT3 is not a problem.  Your FT3 is right up there in the range, and your FT4 is low-ish, but that's not unusual on desiccated.  If you continue to feel that you're not 100%, you might try adding just a little synthetic T4 to your desiccated to get your FT4 up a bit.  Don't worry about your TSH...once on meds it often goes very low and becomes unreliable as an indicator.

A gallon of water is a lot.  Lately, they're even backing off the 8X8 rule (eight, eight-ounce glasses per day, which is a half gallon total) saying that is more than we really need.  Too much water can deplete your electrolytes.

I'm no expert on ferritin, and you didn't include the range (although you said barely normal), so you might want to consider supplementing.  Total iron is pretty low in the range, too.  

Have you tried supplementing magnesium for the leg aches?  
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To gimel: no, I didnt take my morning dose of Armour the day of the labs. I took it after.

My dr said it looked like I was on too much Armour from the TSH but I had already told him we could expect a suppressed TSH with Armour. I added that I still have a low basal temp, no Rt3 problem and still symptomatic so maybe it isnt enough.

To goolarra, I don't usually hit a gallon a day but I try. I weigh almost 200 lbs, so I'm following the "half your body weight in ozs" guideline. It's an effort but I've added a little more sea salt and apple cider vinegar to my diet, hoping to balance out a bit. My dr said iron was fine but I doubt it.  I think I'm going to go back to eating black strap molasses every day first and see how it looks in a month or so..

There was no range given on the ferritin lab. I think I read it should be well over 50, like 70 -90 for women, for optimum. Do you know how much I could safely supplement?

Thanks for responding. My doc ok'd a 1/4 grain raise of Armour in a couple weeks if I still feel symptomatic.
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To clarify re: ferritin range, I read online that 50 or above is 'normal' and mine is 51, which to me is just barely in normal. I think it should be higher. But there are so many warnings about supplementing, I'm not sure how to go about it.

I love blackstrap molasses, so I'll be happy to eat it every day. The one I have has 70% iron in every Tsp. I forgot all about it until this week.
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An observation re: the conversion table between Synthroid and Armour: I started at 1 grain Armour because that approx. matched what I was taking on Synthroid. However, Synthroid wasn't relieving symptoms at that dose. I think we have to keep that in mind when we look at the table, that matching the Synthroid dose may make sense initially, but we will likely need more if that dose of Synthroid wasn't working.

I'm hoping my new Dr wont try to cut me back because the TSH is low. It might get even lower. I really appreciate the help on this forum.
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Just a couple of thoughts.  First, scientific studies have shown that Free T3 is the hormone that correlates best with hypo symptoms, while Free T4 and TSH did not correlate at all.  So the Armour likely will have more effect than an equivalent amount of T4 med, unless your body really converts T4 to T3 well.  

Second, you could give the doctor a copy of this link, with this conclusion highlighted.

"We consider that biochemical tests of thyroid function are of
little, if any, value clinically in patients receiving thyroxine
replacement. Most patients are rendered euthyroid by a daily dose
of 100 or 150 ,mcg of thyroxine. Further adjustments to the dose
should be made according to the patient's clinical response.'     MY Note:  this assumes that the patient converts T4 adequately, which is frequently not the case.

http://www.bmj.com/content/293/6550/808
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In my opinion (humble or not so), that is way more water than you need.  The 8X8 rule is even in question these days.  Yes, we need 64 ounces of liquid, but that's from all sources... including other liquids and food.  Of course, drinking 128 ounces of water per day, I doubt that you'd be able to down any other liquid.  We get lots of liquid from our food.  More isn't necessarily better.  If all you do is drink/pee, drink/pee, the water is doing you absolutely no good.  

Re:  the conversion table from Synthroid to Armour.  This table is a suggestion on where to START.  If you've been on Synthroid, which is only T4, switching to Armour is a bit like starting over.  Different people react differently to the T3 in Armour.  I believe the table errs on the conservative side, the philosophy being that it's better to be slightly hypo (you can always increase) than it is to go hyper.

You're right...don't let your doctor cut your dose back based on TSH.  Once on meds, especially meds with T3 in them, TSH often becomes a totally unreliable diagnostic.  Symptoms, FT3, FT4 and TSH, in order of importance.
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I have used thyroid medication for six years, first Thyroxine, then Armour, then Thyroid (Erfa). My TSH decreased to below 0 as early as I was on thyroxine. It was not earlier than after three years' medication that my cognition improved ( I was then on Thyroid). At the same time I had many infections. I increased my dose as high as slightly above 3G, but dropped it back to 3. At the dose  of 3G I got atrial fibrillation. Since then I have used 2.5G, but sometimes tried to increase with 1/4G or decrease  1/4G. My TSH is abot 0.002. Free T3 is below the upper reference limit.

I have again got atrial fibrillation, I have many infections, eg. chronic sinusitis. I have also many other diseses, eg. mild hyperparathyroidism. An endo advised me to drop my Thyroid dose to 2G.

I have low basal temperature. On 2.5G my basal temperature was 36.3-36.4C (sublingual). It is the same as in my fertile years (now 65 years). I have now been for about a week on 2G. My sublingual basal temperature first decreased to 36.1-36.2C, but today was again 36.3. I think tthyroid supplement does not change the basal temperature. I have often been "poilkilothermic", at least during much of last year.

As to excess water drinking: I have to drink fairly much water, because I have polyuria (sometimes over 4L urine). OK, polyuria may result from being hyperthyroid. I am not diabetic, but may have partial diabetes insipidus (according to a water deprivation test, and low ADH). Because I have hyperparathyroidism, my ionized Ca is too high at least part of the time. In hyperparathyroidism the kidneys cannot conserve water, because of incorrect functioning of ADH, although it were present. Maybe hypercalcemia, caused  by any reason, can cause water loss. Those who are hyperthyroid may have slight hypercalcemia. Disorders of adrenal glands (eg. hyperladosteronism) can cause polydipsia and polyuria. I think that I am often dehydrated and at the same time my Na+ is high. ( I may have high sodium and high calcium at the same time). The electrolyte and water disturbances may cause me atrial fibrillation. The shortage of water causes too small blood volume.

Alittleblues, you should have the cause for your excess drinking studied. Was your temperature taken from the armpit of sublingual?

It may be that thyroid medication is not first working enough even for years. Then it begins to work better and can surprisingly liead to overmedication.

Sorry, I may only create confusuion. I am a complicated case!
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Thanks. Yes, I'm thankful my Dr has been allowing me to rasie regardless of the tsh. He really has been listening. I hope the endo I see in April will give me that much respect.
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It's hard to drink a gallon of water a day. For the last several months I wasn't peeing so I thought maybe the reason was that I was dehydrated. I have been going more, but I also drink coffee and green tea almost daily. I usually drink about 3/4 gal of water because I can never seem to reach a gallon. I'll take your advice to heart.
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Your case is complicated but I appreciate your story. It shows how you have to keep trying, adjusting, learning until you figure out the way to reach your best health.

I choose to drink more water because I think I may be dehydrated. If coffee and tea all count than I can cut back on water. But because I had decreased urination for several months, it concerned me that maybe my body didn't have enough fluids.I also had an unusually difficult time drawing blood a few months back and that had never happened before. She asked me if I could be dehydrated. I usually don't drink enough water.

Thanks for your post!
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I'm supposed to get Aldosterone and Renin tests tomorrow. Is there anything I should do differently in the morning?

Is it ok to take Armour or supplements before the test?
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I'm not sure about taking your Armour or any other supplements prior to your tests tomorrow; to be on the safe side, if your doctor didn't telly you, I probably would wait until after the tests, if possible.  Might mean you won't get in a full 3 doses of Armour for the day.

Reading over this thread, some of your comments bring up some questions, though.

Do you separate your thyroid medication from vitamin/mineral supplements by at least 4 hours every day?  Many supplements can interfere with the absorption of thyroid medication; they should never be taken at the same time.  You might try taking your vitamin/mineral supplements in the evening before bed, in order to get a 4 hour separation from any thyroid medications.

Reading over the thread, the amount of water you drink and the frequency of urination makes me wonder if you've ever had kidney/bladder tests.  For drinking that much water, you should be practically living on toilet. Do you have any swelling of the feet/legs/hands/face?  You said you weigh near 200 lbs; a lot of that could be excess water weight.  You might want to get kidney/bladder function tests to make sure there are no issues there.  
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Shoot. I took my thyroid without thinking this morning.

I do have puffy hands and have had edema of the legs once that scared me, but I only attempted a gallon of water for about a week. It was too much and I could never reach a gallon. I cut back on my water to about 50 oz. a day. I do go more frequently when I'm drinking more and lost a few pounds since I increased my intake. I'm urinating more frequently than I was a few months ago and I think it's from drinking more, and also because my metabolism is kicking into gear.

I take selenium, zinc and magnesium first thing in the morning. I usually take black strap molasses in the evening, but occasionally, a few hours after Armour. Other supplements in the evening before bed.

I gained 45 pounds over the last few years, which I thought it was stress eating, as I spent a lot of time alone mulling over issues.  The last twenty pounds  was gained quickly, over a few months, and most of the symptoms in my first post happened pretty suddenly too. But I think I'm starting to see the light at the end of the thyroid tunnel. I'm remembering some things that I usually don't remember, and wanting to walk and get out more. Both are good signs to me.

Thank you for writing. I'm hoping this these tests will be accurate.
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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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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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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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"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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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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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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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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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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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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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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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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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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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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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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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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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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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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