Symptomatic Despite TSH Results

[rls444]

Unable to metabolize synthetic medications, I am taking Armour Thyroid, but have had to steadily increase the dose (currently 105mg) as I continue to be symptomatic, even though my TSH is far below the lower limit of normal, and my basal temperature remains in the 97.1F-97.7F range (today, 97.3F). However, at testing my FT4 was only slightly above the LLN, and T3 in the middle of normal range. It is almost as if I am not absorbing the medication at the cellular level, certainly not sufficently to control the condition. My question is, do I increase to 120mg, or try swtiching to Nature-throid?

[rls444]

Got the FT3& FT4 results today, as follows:

FT4 = 0.95 (RR 0.76-1.46 ng/dL)
FT3 = 3.21 (RR 2.18-3.98 ng/dL)

The doctor agreed to raise my dose to 120mg, so I'm hoping that this will be sufficient for me to begin to feeling like a human being again.

Thanks to all for your help.

[LazyMoose]

Just in case Nature Throid does not work for you either (it did not for me, and some otheres, new Armour was better for me), there is always Erfa.
.
-I pay $19 per month for Erfa , thats without insurance too. Its way better than Nature Throid or Armour. I can PM you where to buy it in FLA.

[rls444]

Thanks for your comments. Can't say where I am with the FT3 because I don't yet have the results, and the Free T4 was only done once, and that was 3 months ago. I just had it done again, so it will be interesting to see if it's gone up or down since last tested. Even though the Nature-throid is using almost the same formulation as the new Armour, according to many who have switched, they have not had the same issues and instead responded better to it. I have talked with a compounding pharmacist about getting just the dessicated thyroid, but it's very expenseive, at almost $1 per pill, so it's too much for my budget. My insurance pays for Armour, but not for Nature-throid or compounding, so I have few options. At least Nature-t is relatively cheap. Will post my results of the FT3 and FT4 when I get them. Thanks again.

[LazyMoose]

How long has your FT4 been at the low end of range and FT3 been in the middle?    I ask this because the low FT4 ratio to higher FT3 ratio is very common on all current dessicated meds available in the US. And lower TSH is common with dessicated, but not as low as yours.

If you started on Armour last December, it was already the reformulated version.

Nature Throid  was also reformulated early this year with microcrystaline cellulose as a filler just like the new Armour.

That is why I switched to Canadian Erfa dessicated, its very similar to 'old' Armour. There is an import pharmacy that has this in FLA, close to you.

[rls444]

Thanks Barb. I've actually had both the FT3 and FT4 done (at my request - doctors don't understand the value of these tests:-), the former was the most recent, but I won't get the results until Monday. Last tested the FT4 about 3 months ago, and it was at the lower end of normal. I go by how I'm feeling, and right now it's not good....not terrible, but not good, so it's either time to increase the dose, or switch.

[Barb135]

Many people who are taking a T3 med, whether it's dessicated or synthetic have very low TSH.  As Sally said - you need to be looking at the Free T3 and Free T4 to see where you are.

Hopefully, your new doctor will test for those - btw -- do make sure they are FREE T3 and FREE T4 and not total T3 or total T4, as those are considered obsolete of little value.  

[rls444]

Thanks for the input. I heartily agree with what you are saying, but unfortunately so many doctors get bent out of shape by a TSH of 0.009:-) That said, I've just started with a new doctor; one who is a bit more amendable to new ideas, so when he sees that if anything my weight has gone up since seeing him a month ago, he might be more inclined to write me a script for 120mgs. I also asked him to read up on Nature-throid, so might get a script for that too, if he did his due diligence. It certainly does seem as if the reformulation of Armour is to blame for the lack of cellular absorbtion (although there is plenty of thyroid hormones flying around in my bloodstream), so switching brands may be the only answer. Having only started on AT last December, just when the changes were taking place, so perhaps this is why I've only had marginal improvement on the medication, despite the increase from 15mg to 105mg. Thanks again.

[Super_sally888]

Btw TSH is not a good indicator of thyroid levels for people taking dessicated thyroid.  you need to rely on and adjust on the basis of FT3/FT4 only, without paying too much attention to TSH.

I would be increasing the med to 120 to see how you feel on that after a few weeks.

[Super_sally888]

Hello,

Armour has a new formulation and may not be working for you.

Some people do better on other brands of dessicated.

However there is no problem to increase your Armour and see if that does the job.  

I am currently on a 155 mcg/day dose of ERFA thryoid, plus 100 mcg of T4.  THis is a pretty whopping dose - but the dose you take doesn't matter - only how you feel and what your levels end up at.