Please Help w/Pre-and Post-Armour labs

[NightOwlz]

Hello.  Any advice is greatly appreciated:

Age 40 female; dxed w/Hashis in 2006; have been on Levoxyl since then; currently nursing an 8-month old (dd#3).

Results while taking 88mcg of levoxyl:

Free t4: 1.3 (range .8 - 1.8)
free t3: 1.9 (range 2.3 - 4.2)
Thyroid peroxidase antibodies: 664 (range < 35)
Ferritin:  35 (range 10 - 232
Vitamin D:  42 (range 30 - 100)
TSH:  1.05 (range .4 - 4.5)

Results after switching to 90g Armour for 6 weeks:
Free t4: .8 (rnge .8 - 1.8)
free t3:  3.5 (range 2.3 - 4.2)
Thyroid peroxidase antibodies: 822 (range < 35)
TSH: .55 (range .4 - 4.5)

While on levoxyl, I was irritable, had a knot/headache in the front of my head, constipation, brain fog, was a bit sluggish., had high LDL in spite of whole foods diet, exercise.  

At first on armour, I felt great.  After 6 weeks, I had insomnia, racing heart, tight/sore chest, extremely thin hair, had lost a lot of weight very quickly, swollen neck, general anxiety.  I hadn't had these symptoms before -- especially the insomnia.  It scared me.

I then (after 6 weeks on armour) did an adrenal saliva test which showed that my cortisol was elevated in the afternoon and at night (but fine in the morning).  I didn't do this test pre-armour (wish I had, to see whether/how it changed).

Because these symptoms were sudden and severe, I backed off the armour completely and haven't taken either armour or levoxyl for around 6 weeks now.  I feel better than I did 6 weeks ago, but am beginning to notice dry skin, am waking up every day at 3:30 or 4:00 am and can't fall back to sleep, so I'm tired during the day, and still have chest tightness,  anxiety, hair is still thin, and so am I -- and not in a good way.

I went for more lab work today to see where my levels are after  backing off of everything these 6 weeks; will post when results come in.

Any thoughts/comments on levels, symptoms, etc. very much appreciated.  Thank you!

[NightOwlz]

Please, just a few more questions:

My doc says that armour or levoxyl should not be split, but t3 or cytomel should be.  Does that make sense to you?????

Also, should Armour be taken on an empty stomach, or after a meal?  Should it be chewed?

Thank you!!!!

[NightOwlz]

Thank you so much!  I will do just that, and will let you know how it goes.  Have a wonderful holiday, and berst wishes for peace and health in the new year.

[Barb135]

As I said before, I'm not really convinced that you have an adrenal issue, but if you don't get back on thyroid medication, you very could develop one.

Both your FT3 and FT4 are below range, so yes, that clearly screams hypo.

I would suggest trying the Armour again at a lower dose.  You could talk to your doctor about starting at around 30 mg/day, split into 2 - 15 mg doses.  When increasing Armour, I believe increases should be at about 2 week intervals, but again, talk to your doctor.  You have to give your body time to get used to each dosage increase, before moving up.  Too often people get impatient, because they want to "feel better now", but it doesn't work that way.  It does take the T4 in the Armour, some time to build to therapeutic levels in the blood.  The T3 should help keep you going until you have more FT4 to convert.
So

[NightOwlz]

OK got some, but not all results after having stopped all thyroid meds for 6 weeks.
TSH is off the charts high; doc didn't send TPO level (and my lab copy hasn't yet arrived).  Strange thing is, I don't feel sluggish at all, but I am having trouble falling back to sleep when I wake at night, the skin on my knees is dry, hands are slightly dry, chest is tight and almost hurts (that's my biggest complaint), hair is thin, I am thin, and I feel anxious.

Free t4: .6 (range .8 - 1.8)
free t3: 1.8  (range 2.3 - 4.2)  
Ferritin:  26 (range 10 - 232  
TSH:  57.36 (range .4 - 4.5)

Do these numbers/symptooms scream HYPO, or do they suggest something else?

I clearly need to do something, but I'm not sure what would be best for me.

While taking 88 mcg of Levoxyl, my t3 was low.  Should I go back yo lexoxyl and try adding cytomel, or should I  try Armour again, but start out with a much smaller dose, say 30g per day, taken in 2 doses of 15, and then slowly increase over 2 or 3 weeks at a time to see if I can find a comfortable spot for me?  

If I do either, do I need to first sort out any underlying adrenal issues first?

Again, I appreciate any and all help/input/suggestions.  Thank you!

[NightOwlz]

Thank you, too, for your comment.  You've all been very helpful.

[artms]

I was in the same boat as you on 90mg. I wound up happy at 75 mg by taking a 60 and a 1/4 of another or 15mg. I divide into three times in the morning by splitting the 60 so I have two 30 mg and a 15mg .  This is working well for me.  i really think splitting Armour works well.

[NightOwlz]

Thanks, Barb. You had responded to a previous (vague and frantic) post of mine a few weeks ago, too. Thank you again for your help and input.

'm still trying to figure out what I should do.  After years of living with the mediocre results that I experienced with Levoxyl, I was eager to try armour.  But what happened really scared me, as I mentioned above.  Insomnia, losing so much weight so quickly, the racing heart/chest tightness, swollen neck, thin hair, all of a sudden and all at once --  it was hard for me to keep taking the armour and hope it would all just go away. I went for 2 weeks without getting more than an hour or so of sleep.  That has never happened to me in my life -- not even when I was pregnant.

The strange thing is it's been almost 8 weeks since I've taken any thyroid meds, and I have no headache, no constipation, no cold hads or feet or that overall cold feeling that I used to have, no more brain fog or irritability.  Aside from the waking at night (actuallly my daughter wakes me up a few times at night, but when she wakes me  up any time after 3:30, I can't get back to sleep), slightly dry hands and knees, and chest tightness (which comes and goes, depending on how much/little I sleep and didn't exist prior to armour), I actually feel fine -- but I've traded some symptoms for some others.

I'm curious to see what the blood tests I took today will show, and I'm hesitant to take anything right now and risk through the insomnia, etc., again.

Maybe I picked the wrong time to make a switch -- I probably should have waited until I wasn't nursing anymore, but I finally found a doc who would "let" me try armour, and when I asked her if nursing might be a factor, she said "No"-- probably the answer I wanted to hear...

In any case, do the lab results that I posted and the corresponding symptoms I described suggest that I was taking the correct amount of armour?  FWIW, my doc said that the post-armor results showed that I was slightly over-medicated -- she was concernec about the low TSH, but, having read a bit about that and t3, it seems that she might be wrong -- but I don't know.  

FTB4 was so helpful, too, and noted that my "ratios" were almost spot on (with the caveat that the levels might be wrong b/c I took armour a few hours before I had my blood drawn).

FWIW, my doc said that the post-armor results showed that I was slightly over-medicated -- she was concerned about the low TSH, but, having read a bit about that and t3, it seems that she might be wrong -- but I don't know. ...  


Sorry for wandering

[Barb135]

When you are hypo for long periods of time, the adrenals try to take over for the thyroid, and after a while, they, too, can't produce proper amounts of hormones, or at the proper times.  

The Armour did not cause the elevated cortisol, but being hypo could.  I'm not really sure that you have an actual adrenal issue.

Vitamins/minerals should be separated from thyroid medications by about 4 hours, but iron is necessary for adequate use of the thyroid hormones.

It's not unusual for symptoms to worsen (or new ones to appear) when one changes medications/dosages.

The longer you stay off the medication the more hypo you will get.

[NightOwlz]

Thank you so much again!  It's so helpful to be able to bounce this off someone, and you're giving me great info..

Yes, I did take the 90 g of armour the morning of the blood draw.  (I take the thyroid meds at the same time every day. I won't do that again.)
If I do go back to armour, I will split the dose.

I'm afraid to take the armour again, for many reasons, but especially due to the elevated cortisol that showed up on my saliva test. Could the armour have caused that?  Do you think I should sort out the adrenal issue first before juming back on the armour?

I avoid all-things-soy like the plague -- even my kids help me read labels.  :)

I have been supplementing Vit D and added some iron after I got the results, but I don't think I'm taking enough.  Doesn't iron also interfere w/thyroid meds?

It's just hard for me to accept that my meds were "right" (or almost) when I felt worse than I can ever remember feeing.  And the insomnia is awful beyond words.  I have small kids and a baby -- I MUST sleep!

Thank you SO much.  I can't tell you how much I appreciate your help.

[FTB4]

Armour is a T3/T4 hormone med, it should have increased your Free T3, but you should try it again splitting the dose. Insomnia is one of those symptoms that can occur with both Hyper and Hypo, my levels are close to optimal and I cannot sleep at night either, and that is the first symptom I had prior to being diagnosed with Hashi's, I am also on Armour, a rule of thumb with Hypothyroid is to try and get your Free T4 around 1/2 in its range, the Free T3 at 2/3rds in its range and the TSH supressed below 1.0
And you are almost on the button with the exception of Free T4 being just a shade low, Did you take your medication the morning of your blood draw ? Sometimes your levels, especially Free T3 will show up high if you were medicated when the draw took place, you should skip the medication until after the draw, because your levels will give a false high or actually higher than it is. I would try the Armour for another six weeks and split the dose, I doubt that you are Hyper, sometimes thyroid sufferers can bounce back and forth. Your Vitamin D and your Iron are low also, You should take a supplement without soy as an ingredient, soy causes an absorption issue with thyroid medication.

[NightOwlz]

Thank you very much for your reply.  

No, I took the 90 all at once. I dind't feel and "ups and downs" while on the Armour.  It was only after taking it for around 6 weeks that I couldn't sleep at all (and I mean at all), had the neck swelling, chest tigntness, noticed that my hair had thinned a great deal, and that I was very thin.

Is it  possible that it took 6 weeks for my system to "react" as it did?

Based on my post-armour levels, my t4 went down.  Is this a "hyper" sign?  The free t3 went way up, but was "within range."

I'm stumped.

[FTB4]

Did you split your dose of Armour? It is possible your system was shocked by the sudden increase of T3 and could have made you a little hyper on the T3, T3 dies down after 5-7 hours after the dose is taken, this could have caused your up and down symptoms, it normally takes 4-6 weeks for your system to adjust to Thyroid replacement hormone medication, if you did not split your dose, try taking it again, it will not do you well to just stop taliking medication all together. Take half in am and the balance in the afternoon. Regards FTB4