I think my dr is avoiding me!!!!!!!

[texas_grandma]

My new dr switched me to Armour about 6-7 weeks ago. At the time (of 50mcg levo) my TSH was 2.15 and all my T's were on the low end of the normal range.

After 4 weeks on 60 mg Armour I begged to have my labs run again because I KNEW I needed an increase, but she wouldn't let me do that until the labs. Well, The results came in last week. My TSH hit the basement at .05, but all of my T's were lower than they were before she switched me...except for my free T3 that went from 2.5 to 2.9 (2.0-4.4) but still near the bottom of the range.

I waited a day after I got the results (thinking they would call me) before I called in. It was the end of the day, so the girl on the phone got all my information and said someone would call me the next day (Friday). No one called. No one called Saturday (they are open). I am going to call them at lunch today, but I am super ticked off.

Are they about to ditch me because my TSH freaked them out?!

[texas_grandma]

I'll be patient as long as I can...lol. I was in bed by 8 last night because I couldn't fight it any longer. I was actually ready to go to sleep by 6:30.

I will hold off as long as it doesn't affect my job. Man, this thyroid stuff stinks :(

Thanks for your help though :)

[goolarra]

You're pretty close to what you were taking in the Armour.  Armour has about 7 mcg T3 in it.  Of course, you did want an increase, though.  On the other hand, you're taking about twice the T4 that was in 1 grain Armour, so as that builds, you should get some T3 from conversion.  Give it a little time.  Thyroid meds have to stabilize.  If you switch back and forth too rapidly, you usually just end up having it take more time in the long run.  Patience, if you possibly can...

[texas_grandma]

I'm getting better at speaking up for myself. I'll go to the mat for anyone I care about, but not so much for myself until this whole thyroid thing came about. I'm almost 45 and I still had my mom meet me there so that I was kinda forced to say what needed to be said...lol

On another note, yeah, I can already tell that 5 mcg of Cytomel isn't nearly enough. This is gonna be a long 3 weeks :/

If it looks like I'm not gonna be able to wait the whole 3 weeks I may call her. I just have to be able to function. My job (and insurance) depends on it.

[goolarra]

Good for you!  I'm so glad you made it happen and got some satisfaction.  It's good that she's trying something else.  We all have to find what works best for each of us.

Three weeks is long enough to check the FT3.  FT4 will still be building at that point, but at least you'll see how FT3 is going.  It is very encouraging that she likes frees high.  

I don't feel good about myself when I pitch a fit, either, but if that's the only way to get things done, then you have to console yourself with the fact that it's THEIR incompetence that forced you to do it.  I've gotten to the point where I'm very vocal when I see something being done improperly.  Amazingly, people just sometimes need direction to do the right thing.  No one's taught them or been a role model.  

[texas_grandma]

Well, I saw the actual dr and not the PA that had been seeing me. She took me off Armour and put me on 75mcg Synthroid and 5mcg generic Cytomel. She also adjusted the doses of my aspirin and methyl folate and I'm having a thyroid ultrasound this morning. At least I feel like we're moving forward, not backwards like I had been feeling.

She also said we could re-test me in 3 weeks instead of waiting 6, so if 5mcg of t3 isn't enough, at least I won't have to wait too long to adjust it. I also asked here how she interprets my labs and she said she likes to see my frees pretty high, so that was encouraging.

I hate that I had to pitch a little fit to get my answers, but I'm glad now that it's done :)

I'm sure I'll be back to ask about the results of my ultrasound

[texas_grandma]

Thanks, will do

[goolarra]

Good luck this afternoon...let me know how it goes...

[texas_grandma]

I called again this morning and the girl checked the msgs and said that they weren't going to do anything until my appt next month. I told her that that was unacceptable and that I need a dose increase now, so after putting me on hold again, she set an appt for me today at 2. Fingers crossed that I can be clear and firm without crying or something stupid like that...I'm not great about being assertive

[goolarra]

I guess they think we have nothing but time to wait on them...very frustrating.  

[texas_grandma]

Ok, thanks.

Btw, I just called again, was put on hold for a long time (again), the girl came back on and said that she would have someone call me back (again). We'll see :(

[goolarra]

To tell you the absolute truth, your TSH isn't as low as we often see it.  Less than 0.01, or even zero, isn't unusual at all.  Something else could be going on, but we see this all the time with people on Armour (or any meds with T3 in them).  

[texas_grandma]

Thanks, I'll do that. I'm just so disappointed by the runaround I'm getting. I'm obviously not hyper, and I heard that ndt's suppress the TSH, but this low? Could something else be going on as well? Pituitary or something?

[goolarra]

I don't know that they're about to ditch you, but the TSH might stop them from giving you your increase, which I agree you need.  In fact, it might just prompt them to want to DECREASE your meds.  

It's the T3 in Armour that's suppressing your TSH.  As you said, your FT3 and FT4 are both still too low in the ranges.  FT3 is at 25%, and FT4 is at 21%, so clearly an increase is in order.  Hopefully, if your doctor is used to working with Armour, she will recognize its effect on TSH and treat based on FT3 and FT4 and symptoms.

If they try to fob you off on the phone, make an appointment and have a heart-to-heart with your doctor.

[texas_grandma]

T4 - 7.6 down to 6.1     (4.5-11.7)
FT4 1.25 down to 1.09  (0.93-1.7)
T3 110 down to 107      (80-200)
FT3 2.5 up to 2.9         (2.4-4.4)