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How is dosage determined?
I had a quick question. How is the dosage determined? Is it by body weight or what your labs reveal?
I was on 60mg of Armour for a few weeks then was increased to 90mg because my labs hadn't changed nor my symptoms. While on the 90mg my labs showed I was in hyper mode and also had hypo symptoms as well as hyper symptoms. My doctor and I agreed that I'd be better off staying in the middle by going with 75mg instead. But before leaving the office he asked if I'd be willing to try a T4 med just to see if it would help but if not he would put me right back on Armour. I agreed to try it out so he told me he would prescribe Synthroid that would be Equivalent to the 75mg of Armour. He ended up prescribing 88mcg of Levothyroxine which is equivalent to less than 60mg of Armour and not the 75mg, I didn't know his at the time, I just put two-&-two together last night.
True, I feel a whole lot better than when I was on Armour but still struggle with some things which my doctor told me was normal since I have Hashimoto's. My levels are all within optimal level, I would just like to see if these other issues would resolve themselves if my dose was increased slightly. I made an appt for next week to discuss this with my doctor I figure I should be on either 100-112mcg of Levothyroxine. I don't know, I don't understand why he gave me a lower dose.
I was on 60mg of Armour for a few weeks then was increased to 90mg because my labs hadn't changed nor my symptoms. While on the 90mg my labs showed I was in hyper mode and also had hypo symptoms as well as hyper symptoms. My doctor and I agreed that I'd be better off staying in the middle by going with 75mg instead. But before leaving the office he asked if I'd be willing to try a T4 med just to see if it would help but if not he would put me right back on Armour. I agreed to try it out so he told me he would prescribe Synthroid that would be Equivalent to the 75mg of Armour. He ended up prescribing 88mcg of Levothyroxine which is equivalent to less than 60mg of Armour and not the 75mg, I didn't know his at the time, I just put two-&-two together last night.
True, I feel a whole lot better than when I was on Armour but still struggle with some things which my doctor told me was normal since I have Hashimoto's. My levels are all within optimal level, I would just like to see if these other issues would resolve themselves if my dose was increased slightly. I made an appt for next week to discuss this with my doctor I figure I should be on either 100-112mcg of Levothyroxine. I don't know, I don't understand why he gave me a lower dose.
I took (still take) my med after any labs, I know with Levo I don't have to do this but I don't want anything to mess with the labs.
Hypo symptoms were:
Low sex drive
Low heart rate
Low blood pressure
Freezing all the time
Major brain fog
Hair loss
Frequent headaches
Palpitations
Muscle strength was weak
Eye brows thinning
Anxiety
Depression
PMS
Gaining weight
Unable to lose weight
Hyper symptoms were:
heaviness on my chest
Shortness of breath if I did any type of housework
Migranes
My metabolism is still shot, I was on a very low calorie juicing diet and only lost 2 lbs in 2 months but as soon as I added oatmeal to my diet I gained those 2 lbs.
all my hypo symptoms went away except for the memory loss, unable to lose weight, and can't think of the others now.
Don't have results of the others.
Hypo symptoms were:
Low sex drive
Low heart rate
Low blood pressure
Freezing all the time
Major brain fog
Hair loss
Frequent headaches
Palpitations
Muscle strength was weak
Eye brows thinning
Anxiety
Depression
PMS
Gaining weight
Unable to lose weight
Hyper symptoms were:
heaviness on my chest
Shortness of breath if I did any type of housework
Migranes
My metabolism is still shot, I was on a very low calorie juicing diet and only lost 2 lbs in 2 months but as soon as I added oatmeal to my diet I gained those 2 lbs.
all my hypo symptoms went away except for the memory loss, unable to lose weight, and can't think of the others now.
Don't have results of the others.
Sorry to keep asking for more info, but it is important to not overlook anything. So, what lab results made you think you were n the hyper mode? What were the hyper symptoms you mentioned? What were the hypo symptoms that you thought went away when started on Levo?
Please post the Vitamin D, B12 and ferritin results that your doctor thought were optimal.
Also, you said, "Only things I'm dealing with are very low metabolism, tiredness every now and then and memory issues, and cold hands and feet, all of which my doctor told me were normal...its normal to have Hashimoto ups and downs." I totally disagree with your doctor.
Did your take your Armour med on the morning before your blood draw for tests?
Please post the Vitamin D, B12 and ferritin results that your doctor thought were optimal.
Also, you said, "Only things I'm dealing with are very low metabolism, tiredness every now and then and memory issues, and cold hands and feet, all of which my doctor told me were normal...its normal to have Hashimoto ups and downs." I totally disagree with your doctor.
Did your take your Armour med on the morning before your blood draw for tests?
Forgot to mention my symptoms on the 90mg were all hypo symptoms along with migranes, a heaviness on my chest and shortness of breath.
I mean to add that dosing by body weight is only a very general guide. Each patient is different in many ways that affect their needs for thyroid hormone. The best approach is clinical treatment. As noted in this quote from a very good thyroid doctor.
"In the best tradition of clinical medicine, a physician should prescribe thyroid hormones as needed to eliminate the symptoms and signs of
hypothyroidism without producing any symptoms or signs of thyroid hormone excess."
When you think about it, we go to the doctor because of symptoms we have noticed, not because our TSH level is bothering us, or because our Free T4 and Free T3 levels are inadequate. We go to the doctor because we aren't feeling well. So why do doctors spend all their time trying to get our TSH, Free T3 and Free T4 to levels that the doctor believes are adequate. 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.
"In the best tradition of clinical medicine, a physician should prescribe thyroid hormones as needed to eliminate the symptoms and signs of
hypothyroidism without producing any symptoms or signs of thyroid hormone excess."
When you think about it, we go to the doctor because of symptoms we have noticed, not because our TSH level is bothering us, or because our Free T4 and Free T3 levels are inadequate. We go to the doctor because we aren't feeling well. So why do doctors spend all their time trying to get our TSH, Free T3 and Free T4 to levels that the doctor believes are adequate. 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.
Sept 2014 (88 mcg Levothyroxine)
TSH 0.020 (0.36-3.74)
FT3 3.6 (2.18-3.98)
FT4 1.2 (0.76-1.46)
July 2014 (Armour 90mg)
TSH 0.010 (0.36-3.74)
FT3 4.0 (2.18-3.98)
FT4 1.0 (0.76-1.46)
June 2014 (Armour 60mg)
TSH: 0.06 (0.36-3.98)
FT3: 3.0 (2.18-3.98)
FT4: 0.9 (0.76-1.4)
May 2014 (Armour 30mg)
TSH: 0.55 (0.36-3.74)
FT3: 2.9 (2.18-3.98)
FT4: 0.9 (0.76-1.46)
He had checked Vit D, B12, and ferritin and said they were all within optimal ranges. While on Armour I had every hypo symptom imaginable but they all pretty much went away when I went on Levo. Only things I'm dealing with are very low metabolism, tiredness every now and then and memory issues, and cold hands and feet, all of which my doctor told me were normal...its normal to have Hashimoto ups and downs.
Before getting into discussion of everything please post your thyroid related test results from the time you were taking 60 mg of Armour, then also results when taking the 90 mg and last, current results on the 88 mcg of T4. Please include reference ranges. Also please describe the symptoms you had at the beginning and then what you referred to as hyper symptoms. What symptoms do you have now?
If tested for Vitamin D, B12 and ferritin, please post those as well.
If tested for Vitamin D, B12 and ferritin, please post those as well.
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So, I question whether you really crossed over into hyper during that time. Also, if you and the doctor thought that a reduction might be best, why not reduce down to the 75 mcg of Armour level you discussed, rather than jumping to T4 med, especially at the 88 mcg level? Since you had improved so much, it seems to me it would have been far better to stay with the Armour, and just tweak it as necessary to be optimal for how you felt.
Now, you are back to having symptoms that are typically related to hypothyroidism. Usually that requires adjusting Free T3 into the upper part of its range, and Free T4 to the middle of its range, at minimum. Your last Free T4 is at an adequate level. Your Free T3 is higher than I would have expected since you are taking T4 med. So, at this point I am not quite sure how that could happen. I do think that we need to look at your Vitamin D, B12 and ferritin results. Also, have you ever been tested for cortisol?
Sorry your "quick question" is taking so much effort on your part. LOL