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Trouble raising from 1 grain to 1 and a 1/4 grains - any advice please?...
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Trouble raising from 1 grain to 1 and a 1/4 grains - any advice please?

Hi - I am on a trial of Armour and have just gone up from 1 grain to 1 a 1/4 grains and am getting some very unpleasant symptoms.  I was wondering if anyone else has had this and could advise me please?

My most recent blood tests on the 1 grain after 6 weeks were:

TSH 8.1
FT4 10.7 (12-22)
FT3 3.9 (3.1-6.8)

| am taking 3/4 of a grain at 6.30am and the other 1/2 a grain at 3pm.  I am getting a weird spaced out feeling about 3 hours after taking the morning dose which I wasn't getting before.  I imagine this must be the very small amoutn of addtional T3.  I have tried taking the extra 1/4 at 11am and just felt weird a bit later.  When I increased from 1/2 a grain to 1 grain I didn't get this feeling but did experience bad anxiety and fastish pulse (80s), which I'm not getting this time.  I am taking ferrous fumerate for low ferritin and Nutri Adrenal for adrenal support (bovine OTC glandular).

If anyone has experienced this and got through it or has any advice, I would be really, really grateful.

Thanks.
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798555_tn?1292791151
Cant take iron supps withing three hrs of thyroid meds if there both mixing in the stomach.

Old Armour and current ERFA, and maybe the new Acella NP can be taken sublingualy to avoid absorbion probs all together. New Armour must be chewed to disolve in the mouth and then it still takes a long time.

Dont count on Nutri Adrenal to be precise amounts every time. I would look for adrenal or thyroid support with out actual animal thyoid in it once your on thyroid med.

Other than that, your still hypo per your labs, part of your anxiety could be from hypo.  Drs dont seem to understand that being hypo stresses the brain causing anziety. They seem to thing on hyper causes that - so wrong.

Try taking that 1/4 graineven farther away from the other doses.
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1139187_tn?1355710247
Who told you or suggested the bovine for adrenal support?   Are your adrenals low as a result of a test?
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Avatar_f_tn
Thankyou both for your advice.  I am taking my iron at least 4 hours after the second dose of armour - so hopefully no problems there.  I am chewing the armour up as I had read that was best.

I'm in the UK so am very lucky to be trying Armour.  My endo doesn't believe in Adrenal Fatigue but I did a 24 hour saliva test which showed a mixture of cortisol highs and lows.  My naturapath suggested the Nutri Adrenal to help with this as I'm unlikely to find anyone to prescribe steroids.  Do you think I would be better off trying Isocort, which I believe is plant based and can be ordered without a prescription?

I seem to have got used to the extra 1/4 of a grain now thank goodness.  Do you think I should increase to 1 and 1/2 grains on Friday - which will be 2 weeks since the last increase, or wait a bit longer?  I think I need to realise that increasing the dose makes me feel much worse initially but that is settles down in about a week.  Do you find this?

Thanks very much for your help!
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1139187_tn?1355710247
Why are you chewing your armour???  Who is telling you to do this stuff?
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Avatar_f_tn
I've read it on here - LazyMoose mentions it above!  I think I've read it in several other places too though.  Thanks for you help - what do you think about raising the dose after 2 weeks?  Thanks.
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1139187_tn?1355710247
My personal opinion may not be the opinion of others on here however,  if you feel bad and your labs are close to being in range, i personally would only raise by 1/4 grain.

If your labs are bad AND you feel horrible, I personally suggest raising by 1/2 grain.

Make sure you are waiting at least 5 weeks to test your labs, make sure you don't take your meds before your test OR take your meds very early and test at the very very end of the day.

I also believe the new isocort is not very good, you will be popping those damn things all the time.    If you had a blood cortisol or 24 hour urine that showed low cortisol,  can you find a dr. to give you a very low dose of HC?

I think there are a couple other products out there that are like the old isocort if you look on amazon.com  some people mention it in their reviews.

Bruce
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1139187_tn?1355710247
Clare,  this may help you too:

http://thyroid.about.com/od/gettestedanddiagnosed/a/tshtests.htm
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Avatar_f_tn
Thanks for your help.  As I was feeling a bit better I decided to increase by 1/4 of a grain as you suggested, bringing my dose to 1 1/2 grains.  My next blood test will be in 5 weeks and I'm seeing the endo in 6 weeks.  I had a really good day yesteday and went for a lovely all day walk in the country with friends and my 2 children - but today feeling totally knackered.

Hope you are feeling OK?  I have read about your horrible tinnitus - I too have been suffering with this but not neary as bad as yours sounded.

Thanks again.  
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Avatar_f_tn
Just thought I'd provide an update in case anyone is interested.

I am now up to 2.5  grains and am feeling pretty much back to normal - hooray!  All of my symptoms have pretty much gone (anxiety, vertigo/dizziness, feeling spaced out, memory problems etc etc).

I am in the UK and my endo is amazed as he didn't expect the Armour to work.  My lovely GP is even prescribing it for me on the NHS now, as he can see how much better I am.  Only problem there is that they still think I'm taking 1.5 grains not 2.5.  I have had to raise a couple of times since my last appointment in July due to symptoms creeping back.

One of the biggest steps forward seems to have been when I started the CT3M for adrenals.  I have stopped the adrenal glandulars and am taking 0.75 grains at 5.30am which seems to be doing the trick on the adrenal front.

Thanks very much to everyone on here for all of your help in the past and hope you are all doing well too.

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Avatar_m_tn
Hi Clarebear. I'm working my way up on armour right now. Currently at 1 grain and still feel tired, foggy, and pretty crappy haha!

I'm curious how you were splitting up your dose during the day, times/amounts.

Also when did you start to feel a bit better? Around 2 grains or earlier?

Also how are things going now as it is a few months later?

Your scenario sounds similar to mine so I was just looking for some info. Also I think it's super cool that you did a follow up post. Usually you never find out what happened to the person haha! Thanks in advance.
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649848_tn?1357751184
Clarebear has not posted on the forum since her Sep 20 post; when people disappear, we generally assume that they got their issues worked out and no longer need our help.

Most people split their dosage, by taking 1/2 in the morning and 1/2 around noon, but that will also depend on the actual dosage. At one grain, you'd be fine doing that, but if you get to a much higher level, you may have to split into 3 doses.  It's all very individual and many of us have to experiment to see what works best for us.

As to what point you will begin feeling better -- that's even more individual because we are all so different.  A dosage that makes one feel great, may leave another hypo or even send them over to hyper.

It would help us considerably, if you would post your most recent labs, so we can see what your levels are...... be sure to include reference ranges, as ranges vary lab to lab and have to come from your own report.
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Avatar_f_tn
Hi Frank - thankyou for your lovely comments.

I am still feeling so much better but it has been a bit of a bumpy ride since I last posted on here in September.

I ended up feeling a bit over-medicated on 2.5 grains so gradually reduced back down to 1.75 grains.  Initially I felt ok on this level but then they hypo symptoms started creeping back and blood tests showed I was hypo.  I am now back up to 2.25 grains and much better again.

I split my dose as follows:

1 grain at 5.00am (CT3M dose)
0.5 grains at 11am
0.5 grains at 5pm
0.25 grains at 11pm or bedtime

I started to feel better at 1.5 grains when I started the CT3M (Circadian T3 Method) to support my adrenals.  At that time I couldn't tolerate 1 grain in a single dose - it made me feel hyper.  Now I seem to need 1 grain to get going in the morning.

I'm not sure how well the CT3M is known in America?  It was discovered by Paul Robinson, a British thyroid patient who is the author of "Recovering with T3, my journey from hypothyroidism to good health using the T3 hormone".  It involves taking a dose of T3 containing medicine during the "main cortisol production window" which is 3-4 hours before waking.  It really seemed to make a massive difference to me when i adopted this approach, and I feel that my dosage increases since then have been much easier to tolerate.  I didn't even get a headache when I increased by the last 1/4 of a grain!

Anyway hopefully this is of some help to you.  I'm afraid I don't have time to come on this forum any more as I am a moderator/admin on a UK based forum and it is very time consuming!

I too would be interested to know what your latest blood test results are?  I tend to find that I feel best when my FT3 is in the top part of the range and by FT4 is mid range and TSH is supressed.  My last results were well below that so hence increase back up.  Also how are your cortisol, ron, ferritin, vitamin D and vitamin B12? If these are not optimal they can cause symptoms similar to hypothyroidism or hinder with the conversion/uptake of T4/T3.

Thanks,

Clare

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Avatar_m_tn
Here's my whole story...

I'm a newly diagnosed Hypo, went to the doc complaining of slight dizziness, brain fog, tinnitus, and tired all the time, anxiety, all the good things, I've been miserable most days. All of this came on fairly quickly over a couple of months time and previous to this I had been going to the gym regularly for about a year and always felt pretty healthy and energetic.

I had been to a few Docs before and none of them had an answer. Thyroid runs in my family and my Sister actually suggested I get the test done so I asked for the test.

My diagnosing lab was taken in October:

TSH 4.2 (.36 - 3.74)
FT4 1.05 (.76 - 1.46)

Went on Synthroid for about 6 weeks 25 mcg. Couldn't tolerate it and after about a week went down to 12.5 mcg for the remainder of the 6 weeks. Did not help any of my symptoms. Had another lab drawn in November, TSH and Morning Cortisol only:

TSH 6.27 (.36 - 3.74)
Cortisol 12.6

Doc switched me to Armour partly by request and also because he thought the added T3 would help with my symptoms. Titrated up from 1/2 grain every two weeks to 1 grain, after 2 weeks at 1 grain and a total of 6 weeks on Armour, I took another lab with FT3/FT4 and Antibodies (this was yesterday and the antibodies are not available yet, I will update later).

TSH .35 (.36 - 3.74)
FT4 .99 (.76 - 1.46)
FT3 4.0 (2.18 - 3.98)

I kept on hoping I would feel better when I got the FT3 high and the TSH below 1, but I still feel foggy and tired. Now the doc is saying to hold at 1 grain for 3 months. Is it possible that symptom relief is lagging a bit as I've only been at 1 grain for 2 weeks? Maybe it's wishful thinking haha! All I know is that I'm very frustrated and I don't feel anywhere near how I used to feel. I actually think I feel worse than I did when I was diagnosed. Any thought or ideas are welcome and thank you in advance.
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Avatar_m_tn
Barb135 Thank you for commenting. I think you are right about splitting the dose. That's how I have been doing it actually 1/2 grain in the morning and 1/2 grain 6 hours later. I was thinking about moving the second dose even later though maybe 7-9 hours later. Any advice is appreciated.
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Avatar_f_tn
Hi Frank - thanks for posting the labs.  Please can you confirm whether you took any Armour before the test and if so how much and how long before?  I usually try to leave about 22-24 hours before my last dose and a blood test, as other wise the serum fT3 can look artificially high.

Generally when feeling well on Armour it is common to have a supressed TSH e.g. 0.05.  FT4 is often mid-range and FT3 near the top of the range.  I am wondering if, as you only increased to 1 grain 2 weeks ago, you are not seeing the full effect of the increase on your bloods (and symptoms) yet (especially TSH)?  

I'm not sure what the ideal length of time after an increase is for a blood test with Armour.  My doctor makes me wait at least 8 weeks but he is not very familiar with Armour and I think I have read that it can be sooner.

I started on Armour nearly a year ago on half a grain, and although I felt better initially, I soon started feeling worse with very bad anxiety, headaches, tingling and vertigo.  When I increased things seemed to get better for a day or two and then symptoms came back with a vengeance.  Not sure why I didn't give up really (probably because I had felt awful on thyroxine too).  I think my problems were probably due to low cortisol (per a saliva test) and low ferritin.

Do you have a range for the cortisol please?  

Armour isn't the answer for everyone but fingers crossed that it will be for you.

Clare
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Avatar_f_tn
I meant to add that it took about 6 months for me to really start feeling better.  By that time I was on 1.75 grains.  I was only able to increase by 1/4 of a grain at a time due to the horrible symptoms I got with each increase.  I increased by a 1/4 of a grain at the start of Decmeber and that gave me a headache for 2 weeks but my most recent increase 10 days ago of another 1/4 grain hasn't given me any problems this time.  
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Avatar_m_tn
Clarebear

No range for the cortisol. They may have one, but it is the only test they emailed me without a range. I've read that anything below 12 can be considered low so I am cutting it close by some standards. The office told me it was "normal range".

I did take my normal doses of Armour the day before the test which was 1/2 grain at noon and 1/2 grain at 6pm. The test was taken the following morning at about 8am. So at test time of 8am, it had been 20 hours since my noon dose, and 14 hours since my 6pm dose. I had been under the assumption that was enough time to not show an FT3 spike as I had read other people would leave as little as 4-5 hours between dose and test.

Yes, it wasn't ideal that I was tested after only 2 weeks at 1 grain, but I think my doc did it just to have some reference, and the fact that I was sort of eager to see where things were at. He would have preferred that we had waited a full 6 weeks at 1 grain.

I totally hear you on the anxiety and headaches. A couple of times I almost considered just stopping the treatment because with each increase I would lose a lot of sleep. Every time my head would hit the pillow and my eyes would close, my heart would pound really hard, not fast, just hard and heavy to the point I could almost feel it. I would also get these sort of moments that I call "the dizzy wake-ups" where I would be just on the edge of falling asleep and them bam! A dizzy wake-up, where I felt as though I was sort of falling and my head would feel extremely light for a second and I would wake up. It would usually accompany the heavy heart beat. And then about a week after the increase it seemed that stuff went away. But dang what a pain while it was happening.

Those episodes seemed worse for me on Synthroid which led to the Armour switch. I felt I was able to tolerate Armour better, but now looking back, maybe I should have just toughed it out on Synthroid, because honestly it seems like t4 treatment is easier to manage from the standpoint of you only have to take 1 pill a day and let your body do the converting on its own. So you leave a lot of the responsibility up to your body to a degree and you don't have to pay so much attention to the t3 levels and multi-dosing and all that. Not saying Armour isn't great in it's own way and good especially for those who aren't converting, but maybe someday I may end up trying Synthroid again. Who knows. Thanks for letting me rant haha!

Are you on any anxiety stuff? I've been discussing it with my doc and thinking it may be beneficial for me just in emergencies for those really tough days. So far I've been ok without it though but it seems that the anxiety is building inside of me lately and I just want to be prepared.
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Avatar_f_tn
Hi again - no I am not any anxiety stuff - fortunately it has settled down on it's own although I don't really know how I got through the worst of it as it was really horrible.  Hope it doesn't come back.  The other thing I used to get in bed at night was horrible surges of adrenaline, which meant I couldn't go to sleep - maybe this is what your dizzy wake-ups are?

I think this could be due to low cortisol - your test result sounds like it supports that.  Would your doctor give you anything for this or would you consider trying the CT3M? I'm not an expert on this but here is a link which explains a bit more about it (not sure if you can post links on here?)

http://recoveringwitht3.com/blog

Bearing in mind the timing of your doses before your blood test I think your FT3 looks fine.  You may just need to wait a bit longer on this dose to see if your symptoms improve.

Or as you say you may actually do better on thyroxine if you are able to convert.  I guess you don't have a fT3 test result from before the Armour?  My results seemed pretty conclusive - I started on 50mcg of thyroxine and my fT4 increased from 13.2 to 18.5 (12-22) but my fT3 fell slightly from 4.0 to 3.8 (3.1-6.8).  As you say thyroxine is so much easier as you only have to take it once a day - if it works for you then that would be great.

I really hope you start to feel better soon - I think I've read on here that symptoms can lag behind blood test results.

Where are you by the way - I assume you are in the USA?

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Avatar_m_tn
I may definitely be interested in trying the CT3M. I'm sort of at that point where I'll try anything haha!

No I don't have an FT3 test from before unfortunately. I'm sort of new to all this and I didn't know enough to ask for that in the beginning. My Doc is ok but I seem to have to push for certain things sometimes.

I am in the USA. Out in Colorado. I can see the Rocky Mountains from my home. I noticed you said you won't have time for this forum anymore. Let me know what forum you will be hanging out at and I can check it out some time. I'm always looking for new sources of information on this stuff.

Also, jumping back for one second, when you finally got rid of your brain fog, was that just something that sort of happened slowly or how did that happen? Brain fog is my biggest complaint right now. I hate it. Did the CT3M help with that? Can I get that stuff out here?
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Avatar_f_tn
the Rocky Mountains sound lovely - I have never been to the USA but I love skiing - only skied in Europe so far.

I am not sure if I am allowed to name other forums on here so will send you a message.  In the UK though we face different challenges.  Most doctors won't treat patients until their TSH is over 10.  Most won't prescribe T3 as the British Thyroid Association have decreed that T4 is good for everyone.  I am exceptionally lucky to have got my endo to prescribe Armour as it is really frowned upon over here :-(

I found that the CT3M really allowed me to increase my Armour where as before I just couldn't seem to accept the increases.  The CT3M isn't a suppement you can take - it is a method of taking the Armour or T3 that helps support the adrenals - there is much more info on the link I put in previous post.  Basically it means taking the Armour (or T3) during the main cortisol production window which is during the last few hours of sleep.  You need to titrate the amount and time to get the best response.  Lots of people have managed to come off HC by adopting this approach, but it isn't for everyone.



I am still feeling a bit under-medicated and slightly foggy but loads better.  My last results on 1.75 grains were FT4 9.0 (12-22) and FT3 4.0 (3.1-6.8) and TSH 0.14.  

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Avatar_m_tn
That's insane that TSH has to get to 10 to be treated, I felt absolutely horrible at 4.2 and still feel pretty unwell.

I'd love to see the UK someday. I'm a fan of a lot of British humor. I love the original Office with Ricky Gervais. I thought that show was brilliant and had watched the entire series a couple times before The Office even hit America.

Anyway, I had one last thing to put up here for you guys to look at if you have time. My TPO came in today. Here are the lab results again with Doc's note:

TSH .35 (.36 - 3.74)
FT4 .99 (.76 - 1.46)
FT3 4.0 (2.18 - 3.98)
TPO 0.5 IU/ml (0.0 - 9.0)

Doctor's note with TPO result read: No antibodies to the thyroid suggesting possible temporary thyroid under activity. Will monitor going forward and taper as needed. This is likely hypothyroid due to viral thyroiditis, not autoimmune thyroiditis.

So basically I was wondering what that means to you, but also what should I do as far as my current dose. My FT3 looks high and my FT4 maybe under the 50% mark. Should I be concerned that I'm taking to much hormone right now, and maybe request a reduction, or should I ride it out for a few more weeks and try to get in for another test when I've been at 1 grain for a full 6 weeks? I guess my concern is all this talk about going hyper I read about. It sounds crappy to go hyper haha! Am I taking enough to go "hyper"?
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Avatar_f_tn
I loved "The Office"too!!  Ricky Gervais so reminded me of my old boss..and not in a good way.  I haven't seen any of the American Office but I can't imagine it without Ricky!  I live in Bristol which is a nice city in the west, about 1.5 hours from London.

It sounds like you don't have Hashimotos (autoimmune thyroid disease) although to be sure you would need the other antibody test Tg ab.  I had both of these done and both of mine were negative, so they are not sure why I am hypothyroid but I am.  In fact my endo said about 5% of people can have autoimmune hypothyroidism and not have detectable antibodies..

I think if I was you I would try and remain on the dose you are on for another 4 weeks - so 6 weeks in total, and then get anther test.  Obviously if you feel you are getting hyper symptoms then you should reduce slightly.
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