Aa
Question about armour
Hi there, I am a 34 year old female and I have been diagnosed with Hashimotos 5 years ago. I was just wondering if any of you find that armour is better than levothyroxine. I am so sore and achy, especially in my shoulders, hips, hands and knees. I just had a whole bunch of blood work to check other autoimmune diseases and all of my blood work is normal. I just had my TSH and T4 test done this morning and suspect it is a little off. I was taking 150 mcg of synthroid and now 175 mcg as of this morning. I feel like I am 80 years old.
Even if she has no experience with T3, what was the reason for not testing free T3? It is the most important of the three tests. FT3 is the biologically active thyroid hormone that largely regulates metabolism and many other body functions. Frequently when patients are taking significant doses of thyroid meds, the conversion of T4 to T3 is affected such that regardless of the level of FT4, FT3 is found to be in the very low end of its reference range. This would be consistent with having hypothyroid symptoms.
Do you think there is any possibility of giving the doctor copies of info from scientific studies, and from good thyroid doctors, and getting the doctor to reconsider? To at least do the testing for FT3. I say this because I think you are going to need T3 meds to relieve your symptoms. The other option would be the good thyroid doctor I described. What do you think?
Do you think there is any possibility of giving the doctor copies of info from scientific studies, and from good thyroid doctors, and getting the doctor to reconsider? To at least do the testing for FT3. I say this because I think you are going to need T3 meds to relieve your symptoms. The other option would be the good thyroid doctor I described. What do you think?
Today I got back my test results, from my TSH and Free T4, my dr. did not do the Free t3. TSH, as I mentioned before was 1.2, and Free T4 was 0.15. She said I was right in the middle so she wasnt sure what to do, to leave it at the increase of 175 mcg or go back to 150 mcg. I told her what you had wrote me and she said she wouldnt do anything with the T3 because she is not trained in it. She told me to try 2000 ui per day of vitamin D and take Vitamin B Complex daily, so I picked those up.
Thanks so much for you info!! I have a good understanding of what I need to be finding out now!
Based on my own experience, plus what I have learned from Forum members, combined with the extensive reading that I have done, I have become absolutely convinced that the only effective way to treat a hypo patient is clinically. A good thyroid doctor will treat a patient clinically by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH. I have multiple links on articles and scientific studies that back this up.
So, for your next appt. with the doctor, I think you need to find out if she is going to be willing to treat you clinically, as I described. I think you should copy this link on hypo symptoms, and check the ones that you have, and give it to the doctor and discuss your intent to be treated clinically, for symptoms.
http://thyroid.about.com/cs/basics_starthere/a/hypochecklist.htm
Toward that end, you will need to be tested for free T3 and free T4. If the doctor resists you can tell her that many patients taking significant doses of T4 meds frequently do not convert T4 to T3 adequately. Since scientific studies have also shown that FT3 correlated best with hypo symptoms, and TSH and FT4 did not correlate well at all, you need to know the level of FT3. FT3 is the most active thyroid hormone, and it largely regulates metabolism and many other body functions, so it is very important to be sure of the level.
Just getting FT3 somewhere within the so-called normal range is not adequate either. FT3 should be a tracking device to monitor the level of meds increases while being treated clinically. If the doctor clings to the belief that test ranges are accurate and important, just show her a copy of this and point out the insignificant difference between suspect groups and "normal" groups of patients. I think this makes it very clear that targeting a reference range is futile.
http://sz0102.ev.mail.comcast.net/service/home/~/KratzschNewRefRange.pdf?auth=co&loc=en_US&id=135360&part=2&disp=a
I think I would also give your doctor a copy of the letter I pasted in my prior post. That letter was written by a good thyroid doctor.
I don't know what options you have for doctors, but if your current doctor is unwilling to consider all this and treat you clinically, then you are going to have to find a good thyroid doctor that will do so.
So, for your next appt. with the doctor, I think you need to find out if she is going to be willing to treat you clinically, as I described. I think you should copy this link on hypo symptoms, and check the ones that you have, and give it to the doctor and discuss your intent to be treated clinically, for symptoms.
http://thyroid.about.com/cs/basics_starthere/a/hypochecklist.htm
Toward that end, you will need to be tested for free T3 and free T4. If the doctor resists you can tell her that many patients taking significant doses of T4 meds frequently do not convert T4 to T3 adequately. Since scientific studies have also shown that FT3 correlated best with hypo symptoms, and TSH and FT4 did not correlate well at all, you need to know the level of FT3. FT3 is the most active thyroid hormone, and it largely regulates metabolism and many other body functions, so it is very important to be sure of the level.
Just getting FT3 somewhere within the so-called normal range is not adequate either. FT3 should be a tracking device to monitor the level of meds increases while being treated clinically. If the doctor clings to the belief that test ranges are accurate and important, just show her a copy of this and point out the insignificant difference between suspect groups and "normal" groups of patients. I think this makes it very clear that targeting a reference range is futile.
http://sz0102.ev.mail.comcast.net/service/home/~/KratzschNewRefRange.pdf?auth=co&loc=en_US&id=135360&part=2&disp=a
I think I would also give your doctor a copy of the letter I pasted in my prior post. That letter was written by a good thyroid doctor.
I don't know what options you have for doctors, but if your current doctor is unwilling to consider all this and treat you clinically, then you are going to have to find a good thyroid doctor that will do so.
Well today I got my TSH back today which is right on at 1.2, that bloodwork was done while taking 150 mcg of synthroid, so my dr. at the next appointment will put me back on that rather than the 175 mcg she had me taking for the last few weeks. Your posts really got me wondering of what my free t3 is at, they did not test it. I am still achy but not as bad. I also read somewhere, maybe on here, is that if your thyroid antibodies are high, mine are over 1000, this can lessen the amount of t3 that is converted from the t4. My next dr appt is on the 13th, could a person suggest to try armour or adding in cytomel without knowing the values of the free t3... I am currently about 30 lbs overweight. I have always been thin up until about 2 years ago and cannot lose anything no matter what I do. For example last February I had the norwalk virus for 2 weeks and was in the hospital for 5 days, basically didnt eat during that time and didnt lose a pound. Just before Christmas I ordered 8mg tablets of ephedrine to see if I could lose a couple of pounds and gain some energy, I have lost about 2 pounds and could sleep while I have taken the ephederine. I just dont get it... And Im sure when I go back to the dr. she will think I am a nut job hypochondriac.
Keep in mind that when you are looking for the motivation for doctors and medical organizations to promote a given med so highly, just follow the money and think Big Pharmaceutical Companies.
Here's another link that I use a lot, because it covers this subject area very well. I think you can use this to your benefit in discussions with a doctor.
http://www.hormonerestoration.com/Thyroid.html
Sounds like you need to find a good thyroid doctor. If you will identify where you are located, perhaps members could give a recommendation based on their personal experience with a doctor.
Here's another link that I use a lot, because it covers this subject area very well. I think you can use this to your benefit in discussions with a doctor.
http://www.hormonerestoration.com/Thyroid.html
Sounds like you need to find a good thyroid doctor. If you will identify where you are located, perhaps members could give a recommendation based on their personal experience with a doctor.
shan82823, I felt horrible on levo and was being treated with anti-anxiety and anti-depressants. I took myself off the medication (137 mcg) as I was very concerned I was dying and only related my symptoms to levo after reading other patients experiences with Synthroid at askapatient.com. I should not have taken myself off, but I did feel wonderful for a few weeks. Then my thyroid crashed & burned. I asked my dr for natural and she refused. A few months later I found a dr willing to prescribe Nature-Throid. It has now been a very slow process getting my levels corrected. I still don't feel great, but I do not have as many horrific symptoms as I did on the levo (I am still TSH 10 and my T4 levels are low after nearly 6 months of increasing the NT dose).
gimel - I so wish I had your wonderful description of the problem before I went to my first endo appointment Monday! He treated me like I was insane when I said the T4 only meds did not work well for me. I am going to copy and print your comments to bring to my next dr appt (the endo refused to see me again unless I would go on Synthroid)!
gimel - I so wish I had your wonderful description of the problem before I went to my first endo appointment Monday! He treated me like I was insane when I said the T4 only meds did not work well for me. I am going to copy and print your comments to bring to my next dr appt (the endo refused to see me again unless I would go on Synthroid)!
The difference in residual symptoms between taking Armour or Synthroid is most frequently due to resultant levels of FT3. FT3 is the most important thyroid hormone, since it largely regulates metabolism and many other body functions. Studies have also shown that it correlated best with hypo symptoms, while FT4 and TSH did not correlate very well at all.
From your test results, it appears that your body is not adequately converting the available T4 to T3. This occurs frequently when taking significant dosages of T4 meds. for you it has resulted in your FT3 being much lower in the range than FT4. This suggests that you need to add a source of T3 to your meds.
I think you will benefit from reading this info from a good thyroid doctor. It is a form letter that he sends to the PCP's of patients that he consults with by phone.
___________________________________
For Physicians of
Patients Taking
Thyroid Hormones
I have prescribed thyroid hormones for your patient because his/her symptoms, physical signs, and/or blood tests suggested that he/she had inadequate levels for optimal quality of life and long- term health. If there were clear improvements, I maintained the thyroid supplementation. Mild-to- moderate thyroid insufficiency is common and an unrecognized cause of depression, fatigue, weight gain, high cholesterol, cold intolerance, atherosclerosis, and fibromyalgia. Thyroid supplementation to produce higher FT3 and FT4 levels within the reference ranges can improve mood, energy, and alertness; help with weight control, and lower cholesterol levels.
Your patient’s TSH may be low or undetectable, even though their free T3 and free T4 are within the reference ranges. Why? We are taught that the TSH always perfectly reflects a person’s thyroid hormone status, supplemented or unsupplemented. In fact, we have abundant evidence and every reason to believe that the hypothalamic-pituitary axis is NOT always perfect. In clinical studies, the TSH was found not useful for determining T4 dose requirement.i The diagnosis of thyroid insufficiency, and the determination of replacement dosing, must be based upon the patient’s symptoms first, and on the free T4 and free T3 levels second. The TSH test helps only
to determine the cause. Even here, “normal” may not be good enough. The labs’ reference ranges for free T4 and free T3 are not optimal ranges; but only 95%-inclusive statistical population ranges. The lower limits are below those seen in studies of healthy adults. They define only 2.5% of the population as “low”, but hypothyroidism is more prevalent than that.
T4-only therapy (Synthroid, Levoxyl), to merely “normalize” the TSH is typically inadequate as the H-P axis is often under-active to begin with, is more sensitive to T4, and is over-suppressed by the once-daily oral thyroid hormone peaks. TSH-normalizing T4 therapy often leaves both FT4 and FT3 levels relatively low, and the patient symptomatic. Recognizing this, NACB guidelines call for dosing T4 to keep the TSH near the bottom of its RR (<1) and the FT4 in the upper third of its RR; but even this may not be sufficient. The ultimate criterion for dose adjustment must always be the clinical response. I have prescribed natural dessicated thyroid for your patient (Armour or Nature-Throid). These contain T4 and T3 (40mcg and 9mcg respectively
per 60mg). They are more effective than T4 therapy for most patients. Since they provide more T3 than the thyroid gland produces, the well-replaced patient’s free T4 will be around the middle of its range or lower, and the FT3 will be high-“normal” or slightly high before the AM dose.
Excessive thyroid dosing causes many negative symptoms, and overdosed patients do not feel well. I suggest lowering the dose in any patient who has developed insomnia, shakiness, irritability, palpitations, overheating, excessive sweating, etc. The most serious problem that can occur is atrial fibrillation. It can occur in susceptible patients with any increase in their thyroid levels, and is more likely with higher doses. It should not recur if the dose is kept lower than their threshold. Thyroid hormone does not cause bone loss, it simply increases metabolic rate and therefore the rate of the current bone formation or loss. Most older people are losing bone due to their combined sex steroid, DHEA, Vitamin D, and growth hormone deficiencies. The solution is not life-long hypothyroidism or bisphosphonates; one should correct the hormone deficiencies.
i
Fraser WD et al., Are biochemical tests of thyroid function of any value in monitoring patients
From your test results, it appears that your body is not adequately converting the available T4 to T3. This occurs frequently when taking significant dosages of T4 meds. for you it has resulted in your FT3 being much lower in the range than FT4. This suggests that you need to add a source of T3 to your meds.
I think you will benefit from reading this info from a good thyroid doctor. It is a form letter that he sends to the PCP's of patients that he consults with by phone.
___________________________________
For Physicians of
Patients Taking
Thyroid Hormones
I have prescribed thyroid hormones for your patient because his/her symptoms, physical signs, and/or blood tests suggested that he/she had inadequate levels for optimal quality of life and long- term health. If there were clear improvements, I maintained the thyroid supplementation. Mild-to- moderate thyroid insufficiency is common and an unrecognized cause of depression, fatigue, weight gain, high cholesterol, cold intolerance, atherosclerosis, and fibromyalgia. Thyroid supplementation to produce higher FT3 and FT4 levels within the reference ranges can improve mood, energy, and alertness; help with weight control, and lower cholesterol levels.
Your patient’s TSH may be low or undetectable, even though their free T3 and free T4 are within the reference ranges. Why? We are taught that the TSH always perfectly reflects a person’s thyroid hormone status, supplemented or unsupplemented. In fact, we have abundant evidence and every reason to believe that the hypothalamic-pituitary axis is NOT always perfect. In clinical studies, the TSH was found not useful for determining T4 dose requirement.i The diagnosis of thyroid insufficiency, and the determination of replacement dosing, must be based upon the patient’s symptoms first, and on the free T4 and free T3 levels second. The TSH test helps only
to determine the cause. Even here, “normal” may not be good enough. The labs’ reference ranges for free T4 and free T3 are not optimal ranges; but only 95%-inclusive statistical population ranges. The lower limits are below those seen in studies of healthy adults. They define only 2.5% of the population as “low”, but hypothyroidism is more prevalent than that.
T4-only therapy (Synthroid, Levoxyl), to merely “normalize” the TSH is typically inadequate as the H-P axis is often under-active to begin with, is more sensitive to T4, and is over-suppressed by the once-daily oral thyroid hormone peaks. TSH-normalizing T4 therapy often leaves both FT4 and FT3 levels relatively low, and the patient symptomatic. Recognizing this, NACB guidelines call for dosing T4 to keep the TSH near the bottom of its RR (<1) and the FT4 in the upper third of its RR; but even this may not be sufficient. The ultimate criterion for dose adjustment must always be the clinical response. I have prescribed natural dessicated thyroid for your patient (Armour or Nature-Throid). These contain T4 and T3 (40mcg and 9mcg respectively
per 60mg). They are more effective than T4 therapy for most patients. Since they provide more T3 than the thyroid gland produces, the well-replaced patient’s free T4 will be around the middle of its range or lower, and the FT3 will be high-“normal” or slightly high before the AM dose.
Excessive thyroid dosing causes many negative symptoms, and overdosed patients do not feel well. I suggest lowering the dose in any patient who has developed insomnia, shakiness, irritability, palpitations, overheating, excessive sweating, etc. The most serious problem that can occur is atrial fibrillation. It can occur in susceptible patients with any increase in their thyroid levels, and is more likely with higher doses. It should not recur if the dose is kept lower than their threshold. Thyroid hormone does not cause bone loss, it simply increases metabolic rate and therefore the rate of the current bone formation or loss. Most older people are losing bone due to their combined sex steroid, DHEA, Vitamin D, and growth hormone deficiencies. The solution is not life-long hypothyroidism or bisphosphonates; one should correct the hormone deficiencies.
i
Fraser WD et al., Are biochemical tests of thyroid function of any value in monitoring patients
I was diagnosed with Hashimoto's two years ago,at that time I was only suffering from Insomnia, after starting on Synthroid I began having the same symptoms you mentioned plus a few more, I was tested for Vit. D and found to be lacking, although even now my D levels and Magnesium are within range,, I still have the muscle, hip and lower back pain on and off, I informed my MD and she upped the dosage to 137MCG, now after 2 and a half months, I have more hip and muscle pain than when I was on 75's, So I will ask the same question you did, "Do Hashi's sufferers have less symptoms with Armour than Synthroid?" My levels are all good as far as my MD is concerned and here is my latest blood work: TSH Value 0.146 Ref. Range 0.450-4.500 uIU/ml Free T4 1.58 REf. Range 0.82-1.77 ng/dl Free T3 2.9 Ref Range 2.0-4.4 pg/ml These results are fro 9/23/10 6 weeks after the increase in dosage.
Thank you for your help. No, my GP did not test my free T3. I did not know this until a couple of you told me this from the posts. I'm going to see if I could get this done too.
Body pain with Hashi is usually from inadequate T3 levels. Free T3 needs to be tested, I dont see that in your post.
Many need additional T3 med besides the standard T4 that you take. I was sore for years, thats what I needed, more T3.
Many need additional T3 med besides the standard T4 that you take. I was sore for years, thats what I needed, more T3.
Sent you a PM to try and make sure you see my message and hopefully can act on it right away.
I'd really like to have a look at your thyroid test results and reference ranges shown on the lab report. I took a quick look but didn't see any such info previously posted. Also, what are the symptoms you have, and also medication dosage?.
I am amazed at so many of us on the Levo are having the same issues. I just sent a note to another friend on here and we were both talking about how our hips hurt and we feel so dang old. We both have Hashi's too. I have been reading up on the naturethroid and Armour and I am just wondering if it would make us feel better. Seems that just meds with the T4 only isnt doing the job of relieving the symptoms. Sometimes my symptoms are so severe It can be the scariest times ive ever had. Sorry shan82823 you are having such a hard time too. God bless...
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