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The difference between taking Synthroid & Cytomel vs. Armour Thyroi...
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The difference between taking Synthroid & Cytomel vs. Armour Thyroid or Nature Thyroid

I am very curious to know what the difference is between taking a T3 and T4 Med vs a Dominately T3 med that has T4, for a person who does not convert well??? Some of you may know my history and bottom line i am struggling with being healthy again. I have many health issues steming from removing of my Thyroid. My endo isn't helping me as I pour out my heart to him, explaining my symptoms (all hypo and then some), while on Synthroid (alone). I have received many comments and advice from people on this site and I have done research (via books and online) as well in order to educate myself on my condition. I understand that Armour Thyroid is basically obselete but there are lots of people who do well on it verses just a T4 med (Synthroid). My levels (FT3) are always low in range, indicating a conversion issue, no matter what strength of Synthroid I am on. I am currently on 88mcg and my hypo symptoms are crazy although my TSH (The Swearby Hormone...lol) is in range but depending on my dosage, it ranges. My FT3 is always low in range whereas my FT4 is upper range.

Would love comments in regard to the difference and always side effects of Armour Thyroid...Thanks in advance.
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39 Comments Post a Comment
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1202943_tn?1347844252
I don't know too much about armour, but I believe it has T1, T2, T3 & T4. Many people say they feel better on it. But I've also heard that you can adjust & tweek the dosages with synthetics a bit more.

I was having the same problem when on Synthroid alone.  We kept raising the dose all the way to 150mcg and was still feeling hypo until I added Cytomel.  You should ask your dr if you can reduce your synthroid and add cytomel 2.5mcg twice a day.  After 2 weeks if you still feel hypo, you could increase to 5mcg twice a day.  I am now on 125mcg synthroid & 7.5mcg twice a day.  I have felt better with every increase of T3 and decrease of  T4.

Also, your FT3 should be higher than FT4, so I'm sure this might help you. If you do add T3 make sure you start slowly.
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798555_tn?1292791151
Like the comment above, I'd also think it makes more sense to first add cytomel (synthetic T3) to your daily synthetic T4. If your body likes a synthetic combination, the advantages are ease of availability and ease of adjusting T3 and T4 independently vs natural thyroid.

Most people  that have started natural thyroid in the last decade tried  a synthetic combination in the past and weren't satisfied with the results.  

I wish a synthetic combo worked for me, but it doesn't do the job as well as Canadian natural thyroid by Erfa. Were all different.
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1139187_tn?1355710247
Agree with moosey and erica.

I could not tolerate t4.  The synthetic did not make me feel well.  SO i tried the NTH which seems to be a little bit gentler.

As Moose says, it is easier if you can do t4, and then add/subtract the t3 if you need to.  But if you can't there is always the NTH.

t4/t3  is synthetic.  It is made in a lab from chemicals.

NTH is derived from a pig.  Its pig thyroid.  It has different components than the synthetic.  It also has t1, t2, in it as erica has stated.  

You will see different labs depending on what you take.  also if you ask 10 people which is better, 5 will tell you one thing, the other 5 something else.  Its just a matter of what you can feel better on.

bruce
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Avatar_m_tn
Everyone is different. Some people who can't feel well on T4 med alone oftent feel great when they switch to Natural dissected Thyroid (NDT).  Mainly because they needed the T3 compoenent and they were able to find the right dosage to make them feel well.  Those people think that NDT is the only way to go.  Also some can seem to tolerate the natural drug vs synthetic.

THen you have the other people who have the exact opposite effects and response.

SOme people with NDT also have to supplement with additional T4 or even additional T3 in order to get the proper dose they need.  As a natural product can only have a certain ratio of T4 & T3 so if a person needs a little bit more of one or the other they still need additional supplementation.

So in the end it is a matter of personal preference and what each person's body can take and tolerate.  Some also has to do with DR's as there are some who would NEVER give a NDT prescription, others who would NEVER give a T3 med but would prescribe NDT.  So some people just happen to hit on what works based on what limits the Dr will prescribe to the.  Others stay sick because the Drs never are willing to give what is needed.

You have to try something. If it doesn't work or your body wont tolerate it,  Try a different route.  The key is you have to be patient and also have a Dr who is willing to work with you.  Or you may have to find a Dr who will.
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649848_tn?1357751184
I know you've posted your thyroid levels on other threads, but could you post them here again, so we can see what they are.  

I agree with Erica and LazyMoose.  At this point, try adding cytomel and see if it helps alleviate your symptoms.  Meds are easier to adjust when taken separately.  You can increase/decrease each component individually, whereas with dessicated, if you raise/lower your dosage, you increase/decrease both.  

Synthetic thyroid medications are identical to what your body produces.
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1139187_tn?1355710247
Barb135,

Have you ever tried NTH?  I know you are doing well on tyrosint, but I'm just curious.   Also even though Synthetic thyroid is identical to what your body produces, some people still have a hard time ingesting this form.
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798555_tn?1292791151
What works best for you is what you need, but cost per month is not all the same either.

Any T4 med is cheap for one months supply with or without insurance. Cytomel three years ago was in the $45 month co-pay range for me with decent insurance. But with out insurance it was around $100 per month! I have no idea what the generic cytomel (it does exist) is priced at.

Armour was priced around $45 at the same time with ins., because it was not on their prefered list of meds. So I went to a different pharmacy, said I had no insurance and then it was $17 per month cash! Sometimes insurance jacks up the price of certain meds and rips us off.

Insurance does not cover Erfa at all, but its currently only $22 to $24 per month with shipping from Canada, its cheap.
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649848_tn?1357751184
Bruce - no, I have never tried NTH.  The doctor who dx'd me hypo refused to consider anything with a T3 component, even refused to test FT3 and refused to prescribe anything but synthroid. He's no longer my doctor.  Because I was able to alleviate symptoms with the Tirosint and T3 med, I haven't really felt a need to switch.  Additionally, I do have leaky heart valves and high blood pressure plus, sometimes an issue with racing heart and palps, and am on a beta blocker.  High doses of T3 are contraindicated for someone with possible heart issues.  I'm on only 5 mcg generic T3, with 88 mcg Tirosint; needing an increase right now, which  my endo has refused because of my low TSH (< 0.01).

I know some people have trouble with Synthroid or generic T4, but it's not the active ingredient (T4) that causes the trouble, it's the fillers/binders and/or being over or under medicated.

My 88 mcg Tirosint costs $58.95 for a 3 month supply ($19.65/mo), with insurance; without insurance, it would be $71.95 ($23.98/mo.  It's more expensive because there's no generic and it's not a preferred medication.  My 5 mcg generic T3 med costs me $11.81 for a 3 month supply ($3.93/mo); without insurance, it would be $74.95 ($24.98/mo).  I've never priced Armour or NTH.
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798555_tn?1292791151
That's a real savings with the generic T3 vs the actual Cytomel price in the past.

Does the generic just say liothyronine on the lable? Very little is mentioned about generic T3 on the forum.

Just found my old leftover Cyto 5 made by Monarch, it was spendy stuff.

When I was on Nature Throid after the Armour shortage (boy was that fun), it was also cheaper without insurance and similarly priced with Armour under $20 per month.

I imagine the newer natural thyroid Acella NP Thyroid (or PN?) offered by walgreens and Target is cheaper - but I have yet to see someone praise its results on this forum.
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Avatar_f_tn
The T3 I take (UK based) just says liothyronine on the label.

I have just started a not dissimilar thread about the difficulties I am having with it.

Maybe the fact that is appears to be generic is significant....
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1139187_tn?1355710247
To put the prescription costs in perspective, i think that I would pay $50 a month for something that would make me feel much better considering the thousands i have spent in deductibles just trying to figure this crap out.

Barb-  and I wasn't harping on you, it was more of a curiosity thing.  I know you are doing good on tirosint.  I tried the stuff too, and to be honest, i felt much better on tirosint then i did on synthroid or the generic.

I don't particularly like taking NT and frankly after seeing what armour did to people like lazy moose.   I honestly wish i could just take tirosint like you.  

here are my costs with my insurance -

tirosint - any size dose $12.99 month
Naturethroid -  qty 60   1 grain $4.88
synthroid qty 30  10.50

clonzepam (which i take to help me wind down at night for bed) $46 a month!
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929504_tn?1332589534
As requested, these are my comparison labs.


I am posting labs from july, end of sep, and end of dec of 2011. Please comment.

July (on 100mcg synthroid)
TSH                          0.44                0.40-4.50
FT3                           2.5                  2.3-4.2
FT4                           1.1                  0.8-1.8            
T3 Total                      96                  76-181  

September  (decreased to 88mcg based on labs)  
TSH                          1.45                0.40-4.50
FT3                           2.6                  2.3-4.2
FT4                           1.2                  0.8-1.8            
T3 Total                      79                  76-181

December (88mcg) Labs requested by gp
TSH                          3.80                0.40-4.50
FT3                           NA (did not test, even when I requested)                          
FT4                           2.5                   1.4-3.8      
T3 uptake                   31                    22-35

My TSH is flip flopping and from the previous two tests, my FT3 is low in range, what about my FT4, is that at an optimal range, and how does T3 Total and Uptake play a part in how I feel??? Help. I'm trying to be a professor in this subject so that I won't feel helpless with my symptoms and actually do my part in doing something about it. Also, Does Selenim help with any hypo symptoms??? I understand that it does.

Barbara  



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929504_tn?1332589534
Thanks for the responses...i will talk to my TSH Endo on my next visit and i will leave with some results, even if it's to never see him again....
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929504_tn?1332589534
Also, Is Tirosint a T3 med alone??..Sorry but I don't have the energy to read the entire post, i'm about to fall asleep on the keyboard!  In desperate need of some engergy pronto!
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798555_tn?1292791151
I'm surprised that insurance Rx helps out with the cost of Nature Throid. Off brands of any med usually fall under the "not preferred" category, and they jack the price way up to make you think twice about it.

I was actually on two different manufactures of generic natural thyroid (made by Time Caps and Major) after Armour stopped shipping in '09 and before my trial with Nature Throid. They worked better than Nature Throid, but the FDA made both jump through so many hoops that it wasnt worth it for them to keep making the stuff.

Armour was bigger and was apparently able to still be profitable after the FDA messed with them, and made them reformulate - just my guess. Then the FDA made Nature Throid reformulate also in '10. None of them had micro cellulose filler before the FDA messed with all of those. They absorbed better with the old filler.

Erfa still uses dextrose for filler, like the US brands used to, that is the difference. And that is why it can be swallowed or taken sublingually and with the same effect (food doesn't seem to effect it sublingually) . You could probably snort the stuff too LOL!
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1139187_tn?1355710247
I did notice that there are 2 manufacturers on my bottles.  That spooked me a bit.  I'm taking a 1 grain from one mfg  and 1/4 grain pills (for dosing) from another.

its funny how a lot of the fillers that are in the meds are the same fillers in my kids candy.  
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Avatar_m_tn
Tirosint is a   pure T4 med.  It is in a liquid capsule form.  It has  no fillers or dyes.  So many people who are sensitive to the fillers and dyes in the powdered pills and can not tolerate those find that Tirosint works for them  better.

Also there seems to be better absorption with the liquid caps than the powdered pills.  Therefore for the same effect you may have to reduce the dose of Tirosint versus Levo or Synthroid.
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798555_tn?1292791151
[ "I'm taking a 1 grain from one mfg  and 1/4 grain pills (for dosing) from another." ]

- just remember there are differences in manufactures of natural thyroid.

So you're on Nature Throid, and the other must be Armour or Acella NP which sometimes just says "Thyroid" on the script bottle. These are the only three prescription natural thyroid meds available from US pharmacies at the moment.

You, your Dr, and the pharmacy will need to remember to not get these mixed up in the future as the strengths can very in effectiveness among brands of the same grain / size. Sometimes pharmacies will sub Armour for Nature Throid and Acella without telling you, as they assume its all the same - this can mess you up, watch out for this.

I remember NT and Armour did not split well (crumbled) after their reformulations.


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649848_tn?1357751184
Bruce - I know you weren't harping at me; I was merely explaining why I haven't tried dessicated med.

Strange - at my pharmacy, the cost of the Tirosint varies, depending on the dosage, and because it's not a generic, it's not on the list of preferred medications for my insurance.

LazyMoose - yes, my bottle simply says Liothyronine SOD.  The bottle I'm using from now was manufactured by Paddock Labs.  The new bottle that I'll start on in a couple of days is manufactured by Mylan.  I've never noticed a difference between the generic and cytomel; nor have I been able to tell a difference between manufacturers.

blsdnsvd  -- why was your dosage dropped from 100 mcg to 88 mcg, when your FT3 and FT4 were still so low in their ranges?  Also, please check the range for the Dec FT4 - it doesn't look right.

Total T3 is pretty much obsolete and doesn't tell diddly squat; that's why we ask for Free T3.  T3 uptake is also pretty useless.  You could actually save money by leaving off the Total T3 and the T3U, and get FT4 and FT3, which are the tests that tell exactly what's going on.

In my opinion, you're still hypo.

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1139187_tn?1355710247
i thought it was weird when i was on tirosint that i picked up my first box which was .13  and the cost was 12.99

then i went back 3 months later and picked up the larger dose and it was 12.99

then i picked up .75  and it was 12.99

I wish that i could take t4.  I wish.  

also i looked at my naturethroid.  The 1/4 grain bottle says "rlc labs"

the 1 grain says "western" on it, but the pills say "rlc"

bruce
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929504_tn?1332589534
The dosage was decreased based on my TSH level...it was low in range and also remember that my doc doesn't even look at the FT3 level, so that doesn't matter to him. That's why i need to find another doctor. Re: FT4.Those are the ranges on the labs (t4 free calculated), my gp requested these labs. Notice how my TSH is much higher than it was on 88mcg, either way, I feel crappy. I have extreme fatigue and many other hypo symptoms, feel like i'm not on any medication.

I went to my Cardiologist for follow up today and sat there for two hrs to find out that his assistant was covering and my mood changed drastically. I felt as if, why even speak, because he doesn't know anything about my history, but what's on my chart. I have a extra beat and it show on my ekg everytime and i've had every test under the sun, everything came back normal..so this assistant want me to do another stress test and I immediately told him no, not now...there is no way i can do that crazy test without passing out. I'm so frustrated about everything. Then, I tell him that the problem doesn't lye their, it's all due to my thyroid issues and once that is corrected, everything else will get better and he says: I believe you...so, why order the test!!!. Sorry for venting, but i feel better now... :))  
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929504_tn?1332589534
Sorry for all of the mispells ............
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1202943_tn?1347844252
Last time I went to pick up my liothyronine(7.5mcg twice a day),  it was too early and they said insurance wouldn't cover it yet.  It's usually $10, but would have been $89 without!  I  pay $21 for synthroid. I'm not sure how much it is without insurance.

blsdnvd-  I take 150mcg Selenium a day.  It has seemed to help a little bit with my hypo symptoms and my eyes.  Is your current dr going to let you add a T3 med?

I know how exhausting it is to find a dr who will listen to you.  I just had an appt with a new endo.  I waited a month to see her and I could tell in the first 5 mins that she was more narrow minded than my current dr.  I had articles printed off with a few important things highlighted. She told me the info was incorrect and that TSH is more important than FT3 & Ft4. She said  less than 1% of her patients are on a T3 med & she was surprised that I had seen so much improvement with the addition of T3.  She also said my symptoms could be from being hyper.  I know they aren't....I was hyper for years! I get so drained & frustrated dealing with all this.  Why should it be so hard to get proper thyroid treatment?!    I'm keeping my appt with my current endo,  but will keep looking for a new one.
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798555_tn?1292791151
[ "extreme fatigue and many other hypo symptoms, feel like i'm not on any medication" ]

- I recall those days. On T4 med for a decade, did nothing for my symptoms. Nothing, but moved my TSH down. Whoopie. Just got worse every year. Then I started to goggle all this and went to the library, book store ect. and created a new attitude. The new attitude was "look here doc, this is what we're going to do".

Now I can look back and say T3 was all I needed. Finding the right brand after the original Armour became obsolete was a tough one, since it worked better than Cytomel in my personal case. I still say to try Cytomel first though.

By adding T3, I subtracted:

many hypo symptoms, the Gastrointestinal Dr, the Ear Dr, the Sleep Dr, the Dizzy Dr, chiropractic visits, hourly need for caffeinated beverages, more stress tests for heart palpitations, unbalanced lipid panel results.

Yea, I like T3   :- )
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929504_tn?1332589534
Thanks for the inspiration and that is exactly what i will do.."look here doc, this is what we're going to do". I've never even heard of some of the specialist i'm seeing now, before the thyroid removal.

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1139187_tn?1355710247
moose,

what are you taking exactly?
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798555_tn?1292791151
Erfa from Canada. My comments above mention why.
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1139187_tn?1355710247
ok i was confused.  thought you were taking t3 as well.  I'm on NTH and i still feel horrible!
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Avatar_m_tn
Thanks for that fantastic description of what you subtracted by adding T3.  LOL     I just couldn't keep from wondering what branch of medicine you study to become a "dizzy doctor".  
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798555_tn?1292791151
The dizzy Dr was some type of neurologist. And of course there was another neurologist for the carpel tunnel feeling (numb hands), which I forgot to put on the list above.  

None on them thought of thyroid as far as I know.

So all my money and insurance money was wasted when all these Docs scratch their heads - another repeated story that many can relate too, I would guess.

The art of diagnosing has been lost with technology, just like the new generation of car mechanics, I tell them what to do too, then pay them anyway. Hm.

  ;-0
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798555_tn?1292791151
I[ "I'm on NTH and i still feel horrible!" ]

But your not on Erfa.  Its different, like mentioned above - dextrose is the filler not micro-crystalline cellulose.



When you mention NTH (natural thyroid hormone), it sounds like you might be grouping all natural thyroid together.... in thought, like they're the same.....? Can't, as there are technical differences between the manufactures actual "recipes" of the stuff.

All the brands of natural thyroid can all feel different to one individual.

Having tried  Two formulations of Armour, and Two formulations of Nature Throid,  Two manufactures of generic natural thyroid (now obsolete), and now Erfa for almost a couple years - I've used seven (wow) different natural thyroid hormone "recipes".  They all felt a little different, and for me, Efra was the biggest difference and thus, wins the shootout. I saved the best for last. But other people might like another brand. It was one long dragged out, unintentional, scientific medical experiment on myself, and was not very enjoyable either. It all started when Armour stopped shipping the original formula a few years back.

Never tried "Thyroid S" from Thailand, I hear its actually good (not kidding).

I have also been on Cytomel in the past for a short time, that was before my first try with natural which was the Original Armour..

The specific brand and or type of T3 or combo T3/T4 can make a difference in some people.

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1139187_tn?1355710247
i have read about thyroid -s .  I have seen it as good too, but I have also seen warnings that it is unregulated so that is scary.

I have really only tried nature throid.  I am tempted to try something else.  This just isn't working for me.  Yes my labs are all in range etc.  but seriously i just feel horrible.  5 months now.  

Lazy,  on your lab tests, are your t4 free low range and t3 free high range?

Do you feel any physical effects after taking your thyroid?  Each dose i take about paralyzes me.  Its like groundhog day. Take meds, feel crappy.  As the day goes on, feel better.  Nausea wears off as day goes on.  I never just take the meds and think "hey i just took my meds".  I sort of take them in fear.
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1139187_tn?1355710247
what about a compound?
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798555_tn?1292791151

"on your lab tests, are your t4 free low range and t3 free high range"

- yes. . And that is normal for many people on pig thyroid, but they still feel good. But for me the "T's" are less spread apart on the Erfa brand. I feel only good effects from Erfa. Like a very small cup of coffee 20 minutes later, no jitters, only good, I like it. The longer someones body is messed up, I think it takes longer to feel good on thyroid med. Took me 1 1/2 years on Erfa to feel great, but 6 months was pretty good too, just not like now.

I never tried compounding, no reason for me. Its a person mixing it. People make mistakes. But some need it - after they tried everything else.

Don't want to get to far off topic for this thread. To refrain from making it an Erfa advertisement, and repeating myself, my Erfa comments have officially ended here.  : - )

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535882_tn?1396580285
it takes a while to heal after you get good numbers. especially if you were hypo for a long time it's not  instantaneous, it takes months of slow progress  and healing ,  in my opinion you need to stabilize and stay at the same dose for  at least 6 months to give yourself time to heal. bouncing around constantly changing doses won't let you do that. hang in there. Kevin
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535882_tn?1396580285
moose under my plan i can get the generic np accella thyoid for 3 months home delivery for 10 dollars. .. armour would be 35 dollars for 3 months and compound is 35 a month... thinking of trying the np after Feb endo app.
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1139187_tn?1355710247
What?????????   Why acella?
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798555_tn?1292791151
Great, we need a NP Acella experimental patient here.

Generic can be good, people can be leery of them at first. Never know till you try.

The obsolete natural thyroid generic by Time Caps had great results for some people (myself included). It was like the old Armour though, fillers and all. Smelled like it too - like frozen pork chops.
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1139187_tn?1355710247
i almost took it but it was hard to split.  I thought NT looked cool. Thats why i take it LOL
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