Armour for Hashi's not working

[karen2070]

I have been hypo for 20 years and on synthroid and now levothyroxine.  I wanted to try the Armour brand because I read so much good about it and had lingering hypo symptoms.  I switched doctors to someone who used this and did a full thyroid panel.  My TSH was.9, Free T4 1.5, Free T3 2.8, Thyroid peroxidase 61.1, Anti-thyroglobulin 2.1.  She diagnosed me with Hashimoto's for the first time.  She put me on 60 mg Amour to start and sent me home.  From the first day I took it I felt terrible, like I had taken pure caffeine.  Several nights I haven't slept at all with the best being 4 hours since starting 5 days ago.  My heart is racing and I am so anxious and jittery that I can't sit still.  I was so excited to try this and was not expecting this at all.  Have others responded like this?  What did you do? How can I stop this?

[karen2070]

That sounds like a good idea.  I had left my Dr. a message Mon. morning and she did call me Tues. and said it was right for me to stop the Armour and seemed surprised that this happened.  

She said, "Actually, when I look at your recent labs while on the levothyroxine, they look pretty good.  Your body seems to convert T4 well to T3 and maybe that is best for you."  I told her that I had come to her because I couldn't remember things very well, had constant brain fog, wasn't sleeping the best, and was lacking energy.  I have been on a gluten free, sugar free diet for over a year and exercise regularly.  

She said that for now I should do the 24 hour saliva test and we will see what that looks like.  I don't have insurance and spent a lot for that one Dr. visit, and I don't want it to be a waste, but after my first experience with Armour, I do want a break before I try again. So I think this sounds good and hope something in the test results will give some direction.

[LazyMoose]

Unfortunatly, most Drs will not know the best way to change meds. That has been my experience as well as others here. Drs cant measure how someone feels.

I would suggest going the the Armour website (think it was Forrest pharma), find the PDF and print the "15mg ramp up" instructions and bring it to the appt.

Then with the knowledge you now have , present some suggestions to your Dr.

[karen2070]

I was wondering if something like that would work.  For now I had to stop taking the Armour.  I went back to the levothyroxine and slept great last night. I couldn't function for 5 days so I am going to take a little break.  I felt like I was taking pure caffeine on the Armour.  Even 1/2 dose felt bad so I can't imagine 1/4 dose being that much better.  Maybe after a few days of feeling normal, I will be ready to try again. I do really want to feel better and have a working brain again, and staying on the levothyroxine isn't going to get me there.  I left a message with my new doctor yesterday morning that I needed to talk to her about what to do.  I'm still waiting to hear from her.  It was so nice to hear from several of you when I was desperate and wanted to know what was going on.  Thanks for your input.

[LazyMoose]

Some people seem to be more sensitive than others when changing from Levothyroxin to a T3/T4 combination med.

Changing back and forth also confuses your body to some degree.

The best way is to gradually taper the Levo daily dose by splitting a few days and gradually introducing the Armour 15mg at a time. If you feel hyper, just skip a day. By doing this you deliberately go a little hypo, which is better than going hyper. Its best to do this at a lower stress time with no big events going on for a couple weeks- you wont feel well and stress obviously wont help matters.

After 5 weeks on Armour, get another FT3 and FT4 test. You might slowly increase the Armour after that to find your sweet spot dose.

Also once on Armour I'd suggest lab testing at least three times per year, if your constantly upping the dose then test more often. The standard testing once or twice a year doesn't work so well for optimal thyroid health.

[karen2070]

Thank you so much.  That is just what she did. I would have thought my new doctor should have know that.  I am going back to my levothyroxine until I feel able to cope with any changes and try again.  I also have an adrenal saliva test that I will do when things settle down and start over.

I don't want to give up yet, but 5 hours sleep over 4 days is overwhelming. I can't believe how quick you responded.  I feel the anxiety lessening already.

This site is great!

[LazyMoose]

Cant start Armour on your full dose - you'll go hyper for a week or two.

Was the 60mg (1 gain) of Armour the rough equivalant to your levothyroxine dose. If so, thats the problem. When starting dessicated you cant start at your full dose equivilant, even if its split several times to equal the dose.

Armour itself had a PDF on their website showing you start at a lower dose (better to be hypo for awhile) and increase 15mg per week up to your full "guesstamated" dose.

That is the rule of thumb with any dessicated thyroid med.

[karen2070]

My doctor did say to try splitting the dose, taking half in morning and half early afternoon.  I tried this and it didn't help.  I feel so wired I can't think or function or sleep.

The lab levels are
Free T4  1.5  range .8 - 1.6
Free T3  2.8  range 2.4 - 4.2

[goolarra]

What are the ranges on your FT3 and FT4?  They vary lab to lab so have to come from your own lab report.

Given "usual" FT3 range, I'm guessing yours is very low in the range, i.e. you haven't had a lot of T3 in your system for a while.  Armour contains a fairly high amount of T3, and it can take some getting used to.  You might ask your doctor if you can start out at a lower dose until you get more used to it.  Are you splitting the dose into morning and afternoon halves?

[Barb135]

Armour has about 4 times as much T3 in it, as what the body would normally produce on its own.  The T3 can make you have those symptoms.

It's usually best to start out at a very low dose and work up.  You could try splitting that 60 in 1/2 for a few days to let your body get used to it.  Another thing is that most people who take medication with a T3 component, split the total dosage into multiple dosages; say 1/2 in the morning, and 1/2 at noon or shortly after.  This prevents a heavy shot of T3 in the morning, then nothing the rest of the day, so FT3 levels stay more stable throughout the day. It does, also take some time to get used to the medication.

There basically is no treatment for Hashimoto's, itself.  The resulting hypothyroidism is what's treated, with the replacement medication.

What are reference ranges for the FT3 and FT4?  Ranges vary lab to lab, so must come from your own report.  Your FT4 looks to be on the high side and FT3 looks to be low (depending on ranges); that would indicate that you have an issue converting FT4 into the usable FT3.