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Need help transitioning from Levothyroxine to Armour

I have been on synthethics for 40 years, having a subtotal thyroidectomy for goiter.  Have been on 150 mcgs. a day alternating with 175 mcgs.  I've finally found an intergrative NP who has agreed to switch me to Armour, knowing how I hated my PCP only doing TSH tests, but was floored when she switched me to Armour l  1/2 gr. a day alternating with 2 gr. a day.  From the research I've done I think that is too high a dose, I'll be flooded with T3.  Here are my recent labs and I hope someone has some guidance for me:
TIBC 315 (250-450)
Iron 103 (30-150)
Reverse T3 10.4 (16-20) Ratio 0.201 should be greater than 2.0
T4 Free 1.4 (0.8-1.8)
Total T3 87.5 (71-180)
TSH 0.50 (0.350-5.500)
Homocysteine 8.8 (4-8)
Ferritin 18.6 (40-100)
Vitamin D 48.2 (60-80)
24 hr. saliva corisol was stage 2 wired/tired
DHEA 8.4 (300-400)

So I think I need to start much lower than what she said....What does anyone recommend.  I was shocked when she called and said what I was to take and then said she would watch it, get blood work in 2 months and when my TSH came up would lower my dose.  When I questioned lower?  her comment was yes because my blood work....my TSH....showed I was hyper.  I'm so confused now because we had a conversation about not medicating by my TSH.  Do any of my labs indicate hyper?  I've never had any of these other tests before, only TSH, so I'm not familiar with them   And I thought she knew what she was doing.  Oh My....what trouble did I get myself into?  Please help!!!!!
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Avatar universal
Thank you again for all your help
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Avatar universal
FT3, FT4, RT3 and TSH definitely.  Ordinarily, I'd say TT3 is pretty much a waste as long as FT3 is being tested, but in this case, it might be useful to have it to compare to this set of labs.  You have no FT3 in this set, so there's nothing to compare.  I think I'd add TT3 this next time and then drop it in favor of FT3.
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Avatar universal
Thank you for all your answers....I'm going to be getting more tests done in 2 months.  She only wanted a few tests, but I'm going to check a few more off on the lab slip.  Do you suggest a FT3, FT4, Rt3, TSH and anything else?  Should I get a TT3?  This would be the first lab after starting my Armour.  
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Avatar universal
So, your TT3:RT3 ratio is actually 8.4, and when using TT3, this should be 10 or more.  It's confusing at times because some people would say your ratio is 0.84 and should be 1.0 or higher; this is just off by a factor of 10 and means the same thing.  So, your ratio is a little bit low, but It really doesn't concern me because your RT3 is very low, below range.  I'd like to see it done with FT3.

Even if she is basing her "diagnosis" on TSH, TSH is in range!  If she's going to fixate on TSH, she should at least do it to the letter.  LOL
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Avatar universal
Wow....you're fantastic! I have some of the reports:  The TT3 87.5 (71.0-180.0 ng/dl.  The Reverse T3 I don't have the copy of the report...I will get it.  She filled it out on a form as she did most of my results and stated it was 10.4  (16-20 ng/dl) and then she computed the ratio herself.  My husband was with me and commented later how disorganized she was, constantly flipping her papers back and forth, constantly looking for reports, so she may have done it wrong.  

I assume she was basing her statement that I was hyper purely on the fact of my TSH range, as so many medicaly personnel do, who rely solely on that figure.  

Thank you again for your responding.  I've been on her dosage of Armour (appears to be generic) since Thursday and seem to be doing fine with no problems or changes....good or bad.  
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Avatar universal
Do you have the lab report?  What are the units on your RT3 and TT3?  They should be something like pmol/L or pg/mL ng/dL, etc.  I think she's miscalculated your FT3:RT3 ratio.  Also, since there's no FT3 there, I have to assume she's calculating the ratio of TT3:RT3, and when you use TT3, it should be greater than 1.0, not 2.0.

If you don't feel hyper, you're not hyper.  Both TSH and FT4 are in range.  Did she say what she was basing hyper on?

It is too soon to know.  You're going to have to be on desiccated for several weeks before you can make any determinations.  It will take 4-6 weeks for the synthetic to be out of your system.  
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Avatar universal
Thank you so much for responding to me.  The calculation was what she gave me.  I don't feel hyper, in fact feel more hypo, but she said my tests indicate I'm hyper.  I've put 10 lbs. on the the past week!  I don't have readings for the cortisol....I need to get copies of my test.  She just told me I start out wired, go down, down, more and crash at 6 PM.  She put me on 7KetoDHEA,  I've been feeling so lousy for so long, achy, tired, brain fog, all the normal symptoms of hypo for so long and what goes on with people on synthetics that I'm so used to feeling lousy...it's my normal.  I took my first pill last night and another this morning, sublingual, and feel exactly the same.  From the STTM facebook site, some were saying I would be taking too much T3 at this dose and wouldn't feel well.  Don't know if it's too soon to know.  I think if anything, my legs are achy today.  Thank you for any advice.....this is such strange territory I'm entering
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Avatar universal
1.5 grains Armour is considered equivalent to 150 mcg of T4 meds.  2 grains is equivalent to 200 mcg.  So, it's a little more than you're taking now, but really not much.  Yes, you will be getting 13.5/18 mcg of T3 from the 1.5/2.0 doses, but remember that your T4 intake is going to plummet.  You'll only be getting 57/76 mcg of T4.  The equivalency charts just give you a logical place to start.  On desiccated, I think you will find that you have to run your FT3 considerably higher than you did on T4 meds, and your FT4 level will undoubtedly drop.

How are you calculating your FT3 to RT3 ratio?  I don't see an FT3 there.

Your TSH doesn't indicate hyper, nor do any of your other labs.  Do you feel hyper?

Your ferritin is dismal.  I've read it should be in the 90-110 range for cells to be able to use thyroid hormone properly.

What were the individual readings and ranges for 24-hour cortisol?

What is she saying about your DHEA level?

How are you feeling right now, before the transition?

  

    
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