Thyroid Disorders Community
New Patient: Armour Thyroid
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New Patient: Armour Thyroid

Hello! Started having Hypo issues at 19 yrs old, and now 24, W/ no success...been on syn and levo, no results. I am brand new to Armour Thyroid just got my scrpt yesterday, at 30mg. Took my first pill today, how long should I take to start seeing and feeling a difference? When should I consider switching to something else, if this does not work? I am Hypo, Hashimotos, w/goiter. very bad hair loss and weight gain, no energy, very forgetful, mental clarity is poor... all the symptoms of hypo. Have heard alot of mixed feedback from the new reform. of Armour, could I have the same problems? Please help, any advice will be appreciated!
17 Comments Post a Comment
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Avatar_m_tn
There is lots to discus, but first please post your thyroid related lab test results and their reference ranges, as shown on the lab report.  Also, what dosage of those T4 meds were you taking daily?  Have you been diagnosed for the cause of your hypothyroidism?
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Avatar_f_tn
I just moved and found a new doc, she seems she will work with me on testing, My first visit was last week and these are the lab results:
TSH: 6.14 (.49-4.67)
T3: 1.79 (.97-1.69)
T4: 5.2 (4.5-12.0)
I have never been told exactly why I have hypo or hash, enviromental factors, virus I may have came in contact with. I do have aunts and cousins with thyroid probs. My dosage for T4 starting out was .25, .50, ended w/ .75 and that was about 6-8 months ago. I have not been on any T4, or T3 meds since then. Went and saw a natural doc, moved and now cannot keep seeing him, too far away. Thank you for your response and time.
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Avatar_m_tn
There is no consensus on the cause of Hashi's.  It does seem to be somewhat hereditary.  With Hashi's your autoimmune system produces antibodies that attack the thyroid gland until, over an extended period, the gland is destroyed.  As the gland produces less and less thyroid hormone, you have to supplement with gradually increasing doses of thyroid meds.  

Apparently your T3 and T4 tests were for Total T3 and T4.  That is unfortunate because those tests don't reveal very much about your thyroid status, as compared to tests for Free T3 and Free T4.  The Totals tests represent the total amount of T4 and T3 in your blood.  Most of that is bound up with protein molecules and thereby inactive.  Only the small portion that is free of protein is biologically active.  In the future, you should always make sure that you are tested for Free T3 and T4, not the Totals.  

Your test results for Total T3 andT4 and TSH are somewhat ambiguous, because TT4 is low in its range, and FT3 is over range, while TSH is above range.  We really need to see new tests for Free T3 and Free T4 and Reverse T3.  

Free T3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have also shown Free T3 to correlate better with hypo symptoms, while Free T4 and TSH did not correlate.  So having hypo symptoms typically means that your Free T3 is too low in the reference range, or much less frequently, that you have excess amounts of Reverse T3 which offsets the effect of your Free T3 level.

A good thyroid doctor will treat a hypo patient clinically by tresting and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor.

http://hormonerestoration.com/files/ThyroidPMD.pdf

So I suggest that you should go back and request testing for Free T3 and Free T4 rather than the Totals.  If the doctor resists, then you need to insist on it and don't take no for an answer.  I would also suggest testing for Reverse T3, Vitamin D, B12, ferritin, and a full iron test panel.  While there, it would be a good idea to find out if the doctor is going to be willing to treat clinically, as described in the letter.  If not, then you will need to find a good thyroid doctor that will do so.

When new test results are available, please post results and reference ranges shown on the lab report and members will be glad to help interpret and advise further.
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Avatar_f_tn
I was unable to get Reverse T3 done, bc it was not available. I requested Vitamin D, but I dont see it on my lab.Here are the rest of the Test Results:
B12- 583, (180-914)
Iron-104, (37-140)
Ferritin-16.6, (11-306.8)
TIBC-333, (250-450)
UIBC-229,(238-265)
FT4-0.85,(0.71-1.85)
FT3-3.26,(2.77-5.27)
Also I noticed my white blood cell count is low 3.9 (5.0-10.0). I am assuming this is bc of my Hashimotos disease.
Thanks again,
Ginger
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Avatar_m_tn
Sorry for the delay in answering.  Among other things I have been doing some reading on iron deficiency.  From looking at your test results and symptoms, it's clear that your Free T3 and Free T4 levels are too low. That 30 mg of Armour is an adequate starting dose.  The T3 portion (4.5 mcg) will be fully reflected in your blood in less than a week.  The T4 portion takes longer, about 4 weeks.  You may notice some slight improvement in how you feel, but symptom changes tend to somewhat lag behind changes in thyroid levels in the blood.  

Many members, myself included report that symptom relief for them required that Free T3 was adjusted into the upper third of its range and Free T4 adjusted to around the middle of its range.  Symptom relief should be all important not just test results.  Hopefully your doctor is on board with treating you clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You should be ready for an increase in 5-6 weeks.  Some doctors like to wait longer.  You will have to discuss and reach agreement on that.  

As for Armour, I believe that a major part of the concern was that the new version could not be taken sublingually.  Some say that you should chew it up before swallowing.  I take Armour and don't have any concerns with it.  I just swallow with water.  

Just for info, some report that they feel best with B12 in the high end of the range.  You also need to test and verify the level of your Vitamin D.  It needs to be above middle of the range.  Your iron and TIBC and UIBC and %  transferrin saturation (which is calculated by Serum iron divided by TIBC multiplied by 100)  appear to be adequate.  Accordingly, I was somewhat puzzled by the relatively low ferritin result.  In doing some reading on that, I ran across info that looked like this.

"I  frequent another board where the role of iron in the metabolism of thyroid hormone is discussed. Along with selenium, iodine, L-tyrosine, zinc and other vitamins/minerals/amino acids, iron plays an important role in the conversion of the less inactive T4 form of thyroid hormone to the more bio-active T3 form.

I've seen iron discussed a bit on this board but not so much about ferritin . I thought you might be interested in what I found. Ferritin levels often begin dropping before serum iron levels become critically low or before full-blown anemia becomes apparent.

Many hypothyroid patients find that having good ferritin levels improves their use of thyroid hormone (their own body's or supplemented). The range of 70-90 is quoted as optimal for hypothyroid patients. Someone on another board asked me if I knew of any research she could show her doctor to support this. He wanted her to stop supplementing iron when she raised her ferritin from 17 to 44.

Here's some of the research I found that suggests a minimal ferritin
range of 50-70 and an optimal range for hypothyroid treatment of 70-90. I have read that in Dr. Gillespie's book, "You're Not Crazy, It's Your Hormones", she advises a ferritin level of around 100. I haven't read her book, so I can't confirm the research basis for her recommendation, but the experience of many hypothyroid patient certainly bear her out.

Improving ferritin levels can be beneficial for both reducing or eliminating hair loss & unexplained fatigue. Both of those are also frequently associated with hypothyroidism."

So ferritin level is something further to be discussed with your doctor.
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Avatar_f_tn
Sorry for the delay!! I responded to you and noticed it never went through!  Wow,anyways...I jus recently had blood work done and my results are as follows
Free t4 .74 (.71-1.85) results prior .85 lower this time?
Free t3 3.82 (2.77-5.27) results prior 3.26
Ferritin 18.6 (11.0-306.8) results prior 16.6 moving very slowly
I'm currently on 30mg armour,asked to have it increased
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Avatar_m_tn
Glad to see that you are making progress with those test results.  You should ask to keep increasing gradually toward symptom relief.   Is there anything the doctor can suggest to speed up increasing the ferritin level?
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Avatar_f_tn
We are talking about an iron infusion but my doc  suggest not doing that unless there is no other option. I am seeing a specialist tomorrow to see if I am not absorbing iron and then start doing shots of iron or higher dosage on my script.
My concern right now is my blood work..It is not making sense to me. My Ft4 levels keep dropping, and my Ft3 is getting higher. my dosage went from 30,60, and now my doc wants to raise it to 90. I feel VERY tired and can barely get out of bed, with 8-9 hrs of sleep. I dont understand why my Ft4 keeps lowering, it was actually higher when I wasnt on any thyroid meds. here is my latest bloodwork:
Ft3- 6.2  (2.77-5.27) now out of range??
Ft4 .64   (.71-1.85) now very low??
My Ft4 started at .85 no medication. every 6wks of bloodwork it has dropped about 10pts.
To my knowledge Armour has both T3 and T4 hormone which is why I wanted to take this medication, Seems that the more T4 hormone I take the lower it gets??
Thanks again for any advice you have
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Avatar_m_tn
I am so sorry to hear that you are still very tired and need lots of sleep.  That suggests to me that you may have a high level of Reverse T3, which tends to offset some of the effects of your Free T3 level.  That was why I originally suggested including Reverse T3 in your tests, and it is still a good idea.  

At any rate, as a start you need to add some T4 to your meds, maybe 25 mcg,  in order to bring up your Free T4 to a target around the midpoint of its range.  Along with that you will need to reduce  your Armour by 1/4 grain (15 mg).  

Also, you really need to do whatever is necessary to increase your ferritin level as previously discussed.  Since you haven't been tested for Vitamin D, you should also make that happen.  I suspect that Vitamin D that is low in the range may be part of your problem as well.

I suggest that you discuss all this with your doctor and get his approval.  Please let us know how it goes.
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Avatar_f_tn
I will for sure get the ferritin up, I was at the specialist last week. However my family doc does not have access to Reverse T3, so I will look into seeing a specialist. What kind of medication would you suggest for the additional t4? I do have some levo left from last year, will that work? I will start taking vitamin D supplements right away. Thanks for this insight this explains why I have been feeling so tired.
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Avatar_m_tn
Yes, the Levo should be fine.  Don't forget to discuss all this with your doctor and get his agreement, and maintain cooperation.  You never want to upstage a doctor.  LOL
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Avatar_f_tn
lol, Yes you are right. If my t4 rises and my symptoms get better. Will I have to continue to take an additional t4 from this point on? Or is there another medication option? I didnt do well on just t4 meds alone, Except for in the beginning of taking only t4 meds.I felt amazing tons of energy, my metabolism what so much better started to lose weight. Then I crashed never had that feeling again, kept rasing my dosage and no results. I started to feel somewhat normal when taking the Armour but then my levels of t4 kept dropping.
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Avatar_f_tn
My levels are stable now, t4 is in good range and my t3 has came down also. I really thank you for this info, it has really helped!
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Avatar_m_tn
Thanks for the update.  Glad you are doing better.  What, if any symptoms do you still have?  What is your current dosage of meds?  Latest test results for Free T3 and T4 and ferritin.  Were you able to get the Reverse T3 done?  Also, Vitamin D, and B12?

Sorry for all the questions, since you are doing better, but let's try and make sure that you continue to get better.  
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Avatar_f_tn
Hello again!
So back in Dec I was feeling well, now not so much my levels are off. To answer your questions from Dec (sorry! very busy time of yr for me I work retail) when I was feeling well, I still had hair loss issues..dry skin and nails(weak). Memory still bad..thats all I can really remember lol
My lab does not have reverse T3, what will this tell me? or what is reverse T3? I dont have any currnent B12 or D I will do that my next blood work.
3/28/13 lab results  My dosage was Armour 45mg(half of 90mg pill)  Levo 37.5mcg(half of 75 pill)              
ferritin 11.9  R(11.0-306.8)
Free T3 2.47 R(2.39-6.79)
Free T4 0.70 R(.58-1.64)
I dunno what dosage to take now? My doc usually just raises my dos.
I thought about going to a holistic doc, I found one in my area...

Thank you!
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Avatar_f_tn
Also, my goiter is bigger :( my throat is bigger/swollen. It is hard to swallow, I had a scan done a yr ago and they said it was very small not big enough to biopsy.
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Avatar_m_tn
Don't be concerned with Reverse T3 at this point, your other labs are so low in the range, it is no wonder you have hypo symptoms.  I say that because the ranges are so broad that many members, myself included,  say that symptom relief required Free T3 in the upper third of its range and Free T4 around the middle of its range.  In addition, you ferritin needs to be up around the 70-90 level.  

So you need to increase Free T3 and free T4 as necessary to relieve symptoms.  You also need to supplement with iron, to raise your ferritin level.  You also need to make sure to get the Vitamin D and B12 tests done, and make sure they are well up in the range or supplement as necessary to achieve that.

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

So, yes you should increase both your meds to sufficiently raise your Free T3 and Free T4 levels.  Also, supplement with iron, and find out your Vitamin D, and B12 to see if those need to be supplemented as well.



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