Do I need a higher dose of Armour?

[trish061]

I started taking 90mg of Armour 6 weeks ago after being on Unithroid 125mcg for 5 years.  On Unithyroid my last test results were TSH .556, FT4 1.48 and FT3 2.8.  Now my test done last Tues. is TSH 1.63, FT4 .77 and FT3 2.5.  The reason I ask is that I have gained 5# in the last month, but overall I feel better than I ever felt on the Unithroid.  But I do have moments of feeling hyper.  Heart Palpitations and shaky hands.  I think I need to up my dose.  I don't understand why my FT4 fell from 1.48 to .77.  Should I take a higher dose?  

[trish061]

I started taking 105mg Armour about 3 weeks ago and I am now experiencing periods of rapid heart rate (100) that last for an hour or so.  Also intensive night sweats, and nervousness.  I am assuming my dose is a little too high?  I haven't had a blood test since May so I am going to try to get one done this week and see where my numbers are.  I am still taking my meds twice a day, 7am and 3pm and that seems to work for me.  I still worry about my low FT4(.77).  Doesn't that mean once the T3 dissipates there is not enough Ft4 in my system?  Any comments you can give me would be appreciated.  

[trish061]

I will give that a try.  After all I have to take all the pill in a day, if one side is a little uneven it won't really matter. Thanks for your comments.  

[grantj]

Well here is my scientific way of getting half of my pill without it breaking up in the pill splitter; I bite it with one of my eye teeth.  It works every time and I can get it very close to the center thanks to practice.  
This may not be the greatest method, but it works for me.  I had the same problem with the pill cutter; even bought several of them, but no go.

[gimel]

I don't worry about it myself, when splitting any of my pills.  The amount lost is very small, and shouldn't have any noticeable effect.  Later, when you get your dose optimized and stable, then you can probably get the prescription revised to give you the right amount for each dose, without having to split.  

[trish061]

Hi.  I took your advice and started cutting my pills in half and taking half in the morning and the second half at about 1pm.  The shakes and palpitations have disappeared, but the problem I am having now is that the pills kind of disinergrate when I cut them in half and leave behind a lot of dust and small particles.  Too small to ingest, so now I am wondering if I am getting the full amount?  I use a pill cutter, but no matter how careful I am they still don't cut cleanly in half.  Am I just worrying too much?  Trish

[trish061]

Thank you so much for all of your input.  It has helped a lot.  Even though my doctor finally prescribed the Armour, she is so paranoid about it that some of it has rubbed off on me.
I am sure, like you said, once my body acclimates to the new drug, I will feel even better and I will not be so anal about it.  Trish

[gimel]

Yes that makes sense.  Even though a pain right now, it might be best to go by the book for a while until your levels are adequate and you achieve the FT3 and FT4 levels that work best for you.  After that, you can probably make things a bit more convenient by not being so rigid about when you eat and when you take your meds.  If that affects absorption and your levels go down a bit, then that can be offset by a slight increase in meds.  But by that time you may be so acclimated to your current plan that it no longer is an issue.  

[trish061]

I am having difficulty juggling my medicines and eating times. I take my thyroid med at 7am and eat at 8am.  Then I have to wait at least another hour before taking my other meds.  Can't take them with the thyroid med.  Then I eat lunch around noon.  And will have to wait another hour of so before taking the second dose of Armour.  This will work if I am at home, but if I am out, it becomes a pain.  I have read to wait at least an hour after taking Armour to eat and at least 2-3 hours before taking other meds.  Does this make sense?

[gimel]

I think I'd add the small increase to the morning dose.  It might also be a good idea to take the afternoon dose a bit sooner than 5 pm, just to guard against it affecting your sleep.  I like to take mine around 1-2 pm.  Everyone is a little different.

[trish061]

Thanks so much for your input.  I am taking a 90mg tablet.  I can cut that in half and take it at 7am and 5pm?  I usually go to bed around 11pm.  I read the pdf you sent and plan to send it to my doctor.  When and if I add in the 15mg of Armour, do you think I should add it to my morning or afternoon dose?  I appreciate any input you can give me.  Trish

[gimel]

Just a couple of thoughts for you.  One is that I expect that your FT4 and FT3 are in the lower end of their ranges, which is frequently associated with being hypo.  The reason for this is that the ranges are far too broad.  They have never been corrected like was done for TSH over 8 years ago.  Many members report that relief of symptoms such as low metabolism required that FT3 was adjusted into the upper part of the range and FT4 adjusted to midpoint of its range.  

The second thing is that the T3 portion of your meds acts much faster than T4, so most times for meds with T3 it is recommended that the daily dose be split and taken in the a.m. and the rest in the afternoon, early enough that it won't interfere with going to sleep.  I don't understand why your doctor wold want you to take it all at once.  This may be a contributor to your palps and shaky hands.  

A good thyroid doctor will treat a hypo patient clinically, by testing and adjusting FT3 and FT4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important to you not just test results.  Test results are valuable mainly as indicators during diagnosis and then afterward to track FT3 and FT4 levels as meds are revised to relieve symptoms.

You can get some good info from this link.  It is a letter written by a good thyroid doctor for patients he consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.

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

[trish061]

My doctor wants me to take it once a day.  She did say I could up it 15mg if I would like to 105mg, but I think you are right.  I should wait at least a few more weeks and see how I feel.

The weight gain worries me though because I do think it is an indication that my metabolism has slowed.  Over the past 5 years I have gained 50 lbs and find it very hard to take it off.

The strange thing is I feel pretty good.  Not cold all the time or constipated.  I am sleeping better and have more energy, so I thinkl Armour was a good change.  It took me a year to convince my doctor to let me take it.  There are very few doctors (one or two) in Greenville that will prescribe it.  Thanks for the comments.  Trish

[gimel]

The rule of thumb is that one grain (60mg) of Armour is the equivalent of about 75 mcg of a T4 med like Unithroid.  So 125 mcg of Unithroid would be about the same as 100 mg of Armour.  Your 90 mg is close enough to the 100 I calculated that I would go with it for a while and see how you feel, including the possibility of the change having decreased your metabolism.

As far as the palps and shaky hands, it could well be the way you transitioned to the Armour.  If you just switched totally, then you would be affected short term by the faster effect of the T3 in the Armour, while your T4 levels would be going down much more slowly.  Also, how are you taking the Armour?  One dose, or two per day?