Synthroid vs Armour

[sarah0413]

Hello all,

I know there are a ton of these types of discussions, but I could really use your help.

I am a 31 year old female and am suffering from all sorts of problems which seem to indicate a thyroid issue. (Horrible weight gain, always cold, dry skin and hair, fatigue, headaches, etc etc.) My blood test results always came back "borderline" when my doctor checked my levels over the past few years, but my symptoms kept progressively getting worse. I started having vertigo and a constant ringing in my ears along with swelling in my ankles and feet, so my doctor finally prescribed 50 mcg Synthroid. I haven't noticed any real changes, but after doing some reading, I'm wondering if I am on the right medication? A friend suggested that perhaps my T3 was low and I wouldn't be feeling much different when on Synthroid which is T4 treatment. Is that correct?

My doctor seems to think Synthroid and Armour are interchangeable and I would hate to say that I know better, but I really am tired of feeling this way and would like to take charge of my health if possible! (Easier said than done, right?)

My test results are as follows:

First test:

TSH - 5.63

T4 Free - 1.61

Second test:

TSH - 4.53

T3 Free - 2.5

T4 Free - 1.2

Third test:

TSH - 3.9

(T3 and T4 weren't run)

Any advice you could give me would be so appreciated!

Thanks!

[sarah0413]

Thank you so much for your in-depth response!  I feel like I have a lot of research to do but I want to know as much as I can so I can be better informed to get myself the help I need. The doctor who prescribed the Synthroid is the 4th doctor I've seen in 2 years - after so many tests (sleep apnea, Cortisol, Vit D, and a whole bunch of CMPs) I was glad to find one that would at least be willing to try treatment instead of just blaming it on weight gain.
And thank you for the information on the Free T3. That makes a lot of sense and I will definitely bring that up with my doctor and see about getting on T3 treatment as well. :)

[gimel]

A number of important things to bring up.  First TSH is a pituitary hormone that is totally inadequate as a sole diagnostic for thyroid.  At best it is only an indicator to be considered along with more important indicators such as symptoms, and also levels of the biologically active thyroid hormones, Free T3 and Free T4.  When already taking thyroid meds, TSH becomes even less useful as a test because many patients find that in order to achieve symptom relief thyroid med needs to be increased enough to relieve symptoms and that will frequently suppress TSH.  That does not mean you have become hyper, unless you have hyper symptoms, due to excessive levels of Free T3 and Free T4.  So, keep that in mind that as meds are increased to relieve symptoms, if your TSH continues to be tested and it goes below range, don't accept from your doctor that you need to reduce meds.  

I know that is getting a bit ahead of where you are now, but just wanted to alert you to that possibility.  For now, the reason you are experiencing some hypo symptoms is that your Free T3 is too low in the range.  So, you need to increase your thyroid med.  Your Free T4 is not too bad, but your Free T3 is way too low to relieve symptoms for many hypo patients.  Many of us say that symptom relief required Free T3 in the upper third of its range and Free T4 around the middle of its range.  You can approach this by taking additional T4, but there is already an indication that you are not adequately converting the T4  to T3.  So you may likely need to add some T3 to your meds, or switch to a combo T4/T3 med.

Free T3 needs to be increased because it largely regulates metabolism and many other body functions.  Scientific studies have shown that Free T3 correlated best with hypo symptoms while Free T4 and TSH did not correlate at all.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

So you need to request from your doctor an increase in meds, including a source of T3.  You also need to find out if the doctor is going to be willing to treat clinically as described.  If not then you will need to find a doctor that will do so.  

Any time you go in for tests, you should insist on Free T3 and Free T4 and don't take no for an answer.  Since the most common cause for diagnosed hypothyroidism is Hasimoto's Thyroiditis, you should ask for tests to confirm/rule out that possibility.  Those tests are for the antithyroid antibodies, TPO ab and TG ab.  Also, since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, I would highly  recommend those tests as well.

[sarah0413]

Jacqles -  Interesting you say that about freezing to death... I have been much colder than usual but attributed it to the change in the weather. Maybe not? I hope you are feeling better as well!

The range for the results are:
TSH  5.63 (0.35-4.00)
T4 Free 1.61 (0.71-1.63)

TSH 4.53 (0.40-4.50)
T4 Free 1.2 (0.8-1.8)
T3 Free 2.5 (2.3-4.2)

TSH 3.9 (0.40-4.50)

Thank you!

[ignitecivic]

what are the range for the test results?

[jacqles]

I am new to this as well, but I know I feel a big difference from levo to Armour...being on levo for 5 days almost froze me to death..Armour at least makes me warm...my levels have really changed in 3 weeks. I just posted a new post also with my levels and my story.
hope you feel better soon...this is a crazy thing to deal with.
Jacqles