Thank you so much, Gimel.
Is there an iron supplement you recommend? and what dose?
She was not doing well..gaining weight, depression...I didn't want to raise her dose yet again and had heard good things about Armour so thought we would try it...So you feel she should be raised back to 90 and just roll with the occasional shortness of breath for now? I have started her on an iron and vit c supplement and also a d3 to get her level back up. Its about 30 right now after supplementing..
When your daughter was taking the dose of 100/12 of T4 and T3, that was the equivalent of 140 mvg of T4 ( 100 plus 3.3 times 12 ). After switching to the Armour her new dosage of 90 was the equivalent of 103 mcg of T4 (90 mg equals one and a half grains so 1 1/2 times 39 mcg of T4 per grain, plus 9 mcg per grain of T4 times 1 1/2 times 3.3= 103 equivalent mcg of T4).
So the reason she started having new symptoms was because of the reduction in meds, not the med itself. That is why she noticed no relief when you reduced the dosage.
In addition, her low ferritin can be a contributor to the following symptoms.
Minor aches
Fatigue
Weakness
Heart palpitations
Increased pulse
Loss of energy
Loss of libido
Confusion
Irritability
Shortness of breath
So it appears to me that she needs to go back to the 90 mg of Armour and even increase from there. And she needs to supplement as needed to get her ferritin up to about 70 minimum. Also need to test for Vitamin d and supplement as needed to get it up to about 55-60.
One other thing, if she was doing well on the Levo and Cytomel combination, why was she switched to Armour?
her reg t3 was 107 (71-180). t4 wa 5.7 (4.5-12.0)..t3 uptake 25%..free thyroxine index 1.4 (1.2-4.9)..not sure what those last are..I asked for rt3 and they gave me this other junk...
the issues only cropped up after she switched....wish I had good labs to report but my doctor only does tsh and no frees..her antibodies are both sky high but have been that way for a while her ferritin is 26 (15-150 range). it has been low for a long time. Her other iron has always been ok..although they haven't checked it recently..She has a high b12 but has never supplemented...we have an apt with a new endo that prescribes armour the end of the month..Her dose prior was 100 levo and 12.5 cytomel. The doctor started her at 90 armour but when she was checked at two months her tsh was 6. after she complained of the shortness of breath I reduced the armour to half, two times a day. when she continued to complain I lowered it to half that finally tried acella yesterday half a 90 pill..don't know how that's affecting her yet...
What was her dosages of Levo and Cytomel? I want to be sure that the switch to Armour Thyroid was an equivalent dose. What were the last lab results you have, along with reference ranges shown on the lab report.? What was the ferritin level?
I doubt that the swollen ankles and breathing issues are a direct result from the Armour. If they were, I think it would have showed sooner than two months. I suspect that her med switch is the culprit. We will see.
And yes, based on all the info, I think the problem of shortness of breath started from the reduction in total dosage as she switched to Armour. Be aware that if you talk to the doctor about that he will probably claim that one grain of Armour is the same as 100 mcg of T4 med, but that is not true. There is a scientific study that concluded that one mcg of T3 was the equivalent of about 3.3 mcg of T4, so that is what I used in the calculation.