Switch to Armour

[wendaeh2892]

Hello - I wrote about my daughter a week ago (old post below this). Moved up to Levoxyl 50 mcg and she was having lots of muscle pains, carpal tunnel in left wrist, but less cold. Saw naturopathic doctor on Friday who ordered saliva testing as well as full hormone panel when she gets her cycle. Switched her thyroid meds to compounded Armour (sustained release) 45mg. Started it yesterday - all pains went away but low moodish. Today she woke up very tired, falling asleep with her head up in class, sad and anxious. Tried to call Dr but no office hours today. Any recommendations?  Thank you.

Old post from 11/2/14
Saw endo on 10/29/14. She will only do TSH and T4. TSH on 10/13 was 2.88 and she wants in under 3. Despite my daughter being cold all the time and exhausted, hot flashes, sore muscles, hair falling out and very dry, and trouble concentrating, she said it wasn't thyroid and she should come back in 6 months. My pediatrician ran extensive blood work, which was not back when we met with endo. She ordered another TSH which was drawn on 10/27 and the endo seemed angry it was done again and needless saying it would be the same. I did get her to switch from generic to Levoxyl 37.5. She would not do T3 test.

Got home and blood test results were back. Here is what I have (we are seeing an alternative Dr in Dec who is ordering the saliva test and a full hormone panel).
TSH 4 (.45-4.5)
T4 free 1.31 (.93-1.6)
Vit D 44.2 (30 -100)
Vit B12 1029 (211-946)
Ferritin 18 (15-77)
Hematocrit 37.6 (34-46.6)
Hemoglobin 12.8 (11.1-15.9)
Celiac - negative

I called endo and faxed results...I think she needs a higher dose of thyroid medicine??? Endo has not returned my phone call. Started iron supplements. Any ideas?

Thanks for your help!

[wendaeh2892]

Here's an update - any comments welcome: got blood test results back - this Dr insists on blood work 3-5 hrs after taking thyroid medication to see how it is working in the body; fasting otherwise. He is a holistic/MD doctor. The blood tests were from about 2 weeks ago and he also did saliva and urine testing. About 10 days before med increase my daughter began complaining of being cold again and her hair turned brittle. Positive benefits thus far are increased energy and concentration. Still low mood and lots of anxiety (typical for her but currently exacerbated by boyfriend breaking up with her and winter sport starting). She has lost about 6 lbs since starting thyroid tx (she works out a lot and also feels hungry a lot). She is losing a lot of hair :( - he increase compounded sustained release armour to 60mg starting Friday - hair is now shiny but falling out more! She has lost about 1/2 her volume in the past 4 months of treatment.

Results: CBC and metabolic panel all normal
Urinalysis and lipids normal
Vit B12 high 1003 (211-946) - said not to worry
Vit B6 - high 49.8 (2.0-32.8) - said not to worry
Sex hormones fine
Iron panel fine
Ferritin 49 (15-77) -- this was 18 before gluten free and supplementing
Vit C, copper, zinc, IGF-1 fine
DHEA  high 1153 (40-491) said this is stress as DHEAs is normal
DHEA-sulfate 227.7 (110-433.2)


Thyroid - 45mg compounded suspended release Armour taken 4 hrs earlier so it is "in her system"
TSH 2.01 (.45-4.5)
T3 164 (71-180)
Free T3 3.9 (2.3-5)
Total T4 7.5 (4.5-12)
Free T4 1.17 (.93-1.6)
Reverse T3 14.5 (9.2-24.1)
Antibodies - negative

Saliva test
cortisol
8am 28.5 (5.1-11.6) high
2pm 2.6 (2.3-5.3)
6pm 1.4 (1.0-2.4)
11:30pm .9 (.4-2.1)
DHEAS 8am 4.5 (1.0-3.0) high
DHEAS 6pm 1.5 (1.0-3.0)

Neurotransmitters
serotonin low - 71.8 (optimal 200-415)
GABA low 181.5 (600-1100)
dopamine low 100.6 (250-400)
nor-epinephrine low 23.4 (30-50)
epinepherine  low 6.0 (10-15)
Glutamate 10.2 (5-10) high

He increased thyroid meds from 45 to 60 mgs - with her weight loss, hair loss and anxiety I worry about overmedication, but I would assume that she even has room in free T3 since she took her medication before this test correct? Heart rate and blood pressure are fine. Does this plan below sound adequate? I am very nervous about so many supplements. Any suggestions on hair loss?

He said she could stop iron supplement except during her cycle; keep up with Vit D and C
To help with anxiety he gave her GABA (at a very large dose) and TravaCor (5-HTP, Taurine, L-theanine plus vitamins) to start for a few weeks as he wanted to calm her down, esp with the increase in thyroid meds before adding Adrenal support (ND), a dopamine supplement, and ExcitaPlus (for low epinephrine).

Thanks for any input.

[gimel]

Your daughter really needs to be tested for Free T3.  I am surprised that the doctor put her on the Armour without testing for Free T3.  I suggest that you go back and somehow get that done now, rather than waiting.  Without a Free T3 test it is really like flying blind.  The 50 mcg of Levoxyl is equivalent to somewhere between 1/2 and 2/3 of a grain of Armour, dependent on which conversion factor you choose to use.  So, no I don't think it is too much of a change.  

Switching meds and dosages frequently results in unexpected reactions for a while.  So for the interim I would just insist on the Free T3 test and a Reverse T3 test also, while she is there, just to check that out.  I am very surprised that her ferritin is still low since I think she has been supplementing with a good dose of iron.  That is also something to discuss with the doctor.  

[wendaeh2892]

Hello - it is compounded armour with an additive for sustained release to last through the day, so it can't be split and is supposed to be taken in the morning. I sent in the saliva/urine test by mail this morning; all the other tests are to be done the first day of her menstrual cycle (probably in about 10 days) - we see him again beginning of December to get results back. She is taking 106mg elemental iron (325mg ferrous fumarate with Vit C) and he added 5000iu D3. Said he thinks there's an adrenal problem as well, but waiting for test results. He didn't want her to have to continue to struggle on the Levoxyl for another month so he changed her thyroid medication.

She said she was tired all day but stopped falling asleep after the first few periods. Moodiness has been increasing over past month - she is not feeling hot, racing heartbeat/palpitations, no shaking hands. From what I have read the equivalent dose between Armour and Levoxyl (she was on 50 mcg) should have been 30mg? Maybe 45 is too much of a change with the added T3? I have a call into the Dr. Just wondering if this will pass in a few days and stay the course or try to get a lower compounded dose of Armour?  Thank you gimel.

[gimel]

How long before the ND will be able to test your daughter?  Was your daughter advised to split her Armour Thyroid and take 1/2 in morning and the other 1/2 in the early afternoon?  Was anything suggested for her low ferritin level?