super-hyper on Armour

[Tracy615]

Hi all-
I had a partial thryoidectomy in 2001, and RAI in 2003 (due to 'thyroid storm'). I am experiencing major hyper symptoms, heart racing, breathing difficult, trembling, emotional symptoms, major trouble sleeping, yet exhaustion.  I just got my TSH back, .03, very low.  Don't have my other numbers yet.  I am experiencing severe tinnitus as well.  My endo called and took me off my meds for 6 days, on the 7th day I took 1/2 my dose, 1 and 1/2 grains.  W/in 2 hours, wow-back fully hyper.  During the 6 days off my symptoms had almost disappeared!  So, she told me to go off 4 more days.  I guess since I don't have a thyroid, it's hard to know what to do.  I have to take the meds to stay alive, but on them, I just go insane.  I was taking 2.5 grains daily (150mgs).  I wonder if anyone else was ever taken off their meds and how to start back?  I am pretty much a wreck, but seem to regain my sanity off the meds.  How long is it safe to be off w/out going hypo?  W/out a thyroid, what tests should I have done?  Thank you anyone for listening and responding, I am just about at my wit's end.

[Mark Lupo, M.D.]

Hmmmm.  You are likely dependent on thyroid meds based on the history of I-131 treatment.  Stopping a med for 6 days seems like a long time, esp given that you are on combo t4/t3 (armour) and the t3 clears the system in about 1.5 days.  The problem is more likely that you are sensitive to the T3 and that is causing your symptoms.  If you stay on armour, would take 1/2 in am 1/2 in pm.  Else, consider switching to a levothyroxine brand T4 only) and see if things smooth out.  

Your TSH of 0.03 was too low and the dose did need lowering -- in these cases (ie low TSH and symptoms) I hold the dose for 1-3 days (depending on med/severity) then restart at a lower dose.

[Tracy615]

Thanks for your quick response, it's nice to know someone is out there listening!  My T3 uptake was 33.3 (25.0-35.0) and my T4 (thyroxine) # was 7.9 (4.5-12.0).  I even had a T7 done, that was 2.6 (1.3-3.4), I have never even heard of that one!  So, thanks, I appreciate your response.  Having gone thru a 'storm' I know I am totally hyper, that happened when I was on Synthroid, for the past couple of years I have had such wonderful luck w/ the Armour before this.