Basis and timing of Armour dosage increases?

Question

Hello--I was diagnosed with mild Hypo (TSH of 5, low T3 and T4, everything else okay) plus some considerable B-12, potassium, and ferretin deficiencies that are being addressed. I tried a couple of days of Synthroid, and it made me quite ill, so I asked the doctor to let my try Armour. She agreed, started me at 15 mcg, and said I could slowly adjust upward, but I would probably not need to exceed 60 mcg. Over a period of a little over two months, I have been gauging how I feel, following the instructions of "Stop The Thyroid Madness", and slowly increasing every couple of weeks or so. At 90 mcg I feel pretty good, but am still having "attacks" of pain, fatigue, mood swings, and swelling, plus painful, dry eyes and sinuses.

I called my doc to ask about a blood test, and told her my dosage, and her reaction was, "No, no, no! You're a small person, and you don't need that much! We agreed to 60 mg! I won't even test you until you go back to 60 mg for a month." I'm telling you, in the middle of a week-long yuck attack, I dropped down to 60 mg today and the swelling and pain are even worse! Before I even took the dose this morning, the soles of my feet hurt when I walked, so it just feels like the same attacks I had before I started treatment. She thinks that the reason I am still feeling off-and-on bad is because I am hyperthyroid. I don't feel that way, though...

Is Armour dosage typically corresponded to TSH levels or weight? Did I miss that? Do I need to look for a more knowledgeable doctor? I tend to feel worse later in the day, so is it a matter of breaking up my dose?I know she doesn't have much experience with Armour, so I think she's doing the best she can, but I don't want to go back to where I was for a month just to wait for a blood test.

Thanks!

gimel · Accepted Answer

Hard to tell where you are with thyroid levels without followup tests.  Obviously your last test results showed (I am making an assumption that your lab's reference ranges are similar to those we see so often) that your Free T3 and Free T4 were much too low for most people.  In addition, your Vitamin D needs to be more like 55-60, your B12 should be in the upper end of the range and your ferritin should be at least 60.  These low levels can all cause symptoms on their own, as well as add to problems with metabolizing thyroid hormone.  

Since you were feeling better on the 90 mg of Armour, it might be best for now to stay on the 90 mg and start supplementing for the other three, to raise those levels toward optimal, in order to determine the effect on your symptoms. Along with the effect on symptoms, you will also need to have new test results available to help determine any further changes in your med dosage.  If you have enough Armour Thyroid to see it through, this approach would also give you some time to make  arrangements with a new doctor if necessary.

lesinaustin · Answer

Thanks again...here are labs:

TSH: 5.1
Free T3: 2.9
Free T4: .99
Thyroglobulin: 10.8
Thyroglobulin AB <1

Ferritin: 19
B-12: 262
Vitamin D: 37

Also, from reading I know that Pernicious Anemia can be indicated by low B-12 and low CBC readings. My doctor didn't think my CBC was significant, but they were:

WBC: 6.5
RBC 3.86 out of a range 3.80-5.10
Hemoglobulin: 12.2 out of 11.5-15.5
Hemocrit: 36.2 out of 34.4 -45.0

I am also seeing  a biodentist this week about jaw reconstruction...I had a bone implant 2.5 years ago to prep for an implant, and that's when I became so ill that I couldn't get the implant. I think I may have a bone infection--either from the implant, or from bacteria that was already present--that triggered the immune response, My jaw has rapidly dissintegrated and my face is now quite lopsided. I'm only 46! Thanks.

gimel · Answer

Just sent you a PM with names.  To access, just click on your name and to to your personal page.  Then click on messages.  

Please don't forget to post the above requested test results.

lesinaustin · Answer

Hi Gimel--thanks so much for your insight! I did contact People's Pharmacy to get the names of some other docs who have more experience with Armour...but I would certainly welcome more names. I just have the feeling that Armour dosing is more "soft" than Synthroid dosing, but she only really knows Synthroid. Any names you can give would be awesome. If it has be offline, my address is ***@****. Cheers

gimel · Answer

Your doctor is better than most, in that she at least agreed to prescribe thyroid meds and allow gradual increases.  Unfortunately she seems to be medicating you based on your weight, in order to estimate the amount of med needed.  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.  Symptom relief should be the primary concern, not test results and especially not TSH results.  You can get some good insight from this link written by a good thyroid doctor.  In the link, note this statement, "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."

http://www.hormonerestoration.com/Thyroid.html

For reference, please post your thyroid related test results and reference ranges shown on the lab report.  Also, Vitamin D, B12 and ferritin.  

I expect that you may have some difficulty in getting your doctor to agree with clinical treatment.  In that case, your will need to find a good thyroid doctor that will do so.  If interested I may have some doctor prospects in the Austin area.

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