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Can anyone help with feedback on Lab Results taking Armour & T3 please?

I had papillary cancer and had 1/2 my thyroid removed in 2006. The doctors did not follow up and I slowly became more and more hypothyroid experiencing symptoms I associated with getting older or other issues.
Finally in 2013 I began medication after pushing the issue.
I have been on synthroid (allergic reaction) and the best I've felt was on Armour. It's been a battle with various doctors, most of the newbies (it is the area I live in, no choice).

Over the last year, I was dosed gradually up to 3 grains of Armour. Unfortunately I still had some symptoms (couldn't lose weight despite strict athletic diet), high blood pressure (I had been on meds for high blood pressure since my nodule was discovered but it was never linked), fatigue.

I added on the advice of a naturopath T3. I began taking 20 mcg of T3 with the 3 grains of Armour and feeling great. My blood pressure dropped lower than it ever had before and I felt great in all levels. I had never seen my BP so low and I even went off my meds.

Then after everything stable for about 6 months, suddenly I felt jittery and anxious.

I got my thryoid tested and my results are as follows:

23 Oct 15 @ 1031 (Coll) SERUM
FT4 . . . . . . . . . . 0.7 L (0.81-1.58) NG/DL

23 Oct 15 @ 1031 (Coll) SERUM
TSH ULTRA . . . . . . . <0.015 L (0.465-4.68) uIU/mL

23 Oct 15 @ 1031 (Coll) SERUM
+ T3 FREE . . . . . . . . . 2.9 (2.0-4.4) pg/mL

I'm not sure if my anxiety and jittery feeling is from the thyroid now b/c my Free T3 is not high and my Free T4 is low.

Also can anyone tell why my Free T4 is always so low on Armour?

I understand why the TSH is suppressed due to the T3 so that is understandable. I have done plenty of research and read a lot on forums, research papers, websites but am a little confused why on so much T3 my Free T3 is still not high and why my Free T4 is low (and why suddenly I feel like I'm a little hyper?)

Thank you to anyone who can give feedback.
2 Responses
Avatar universal
Before getting into a needed discussion of your status, please tell us why you think you might be a little hyper, even with those relatively low Free T4 and Free T3 results.
1 Comments
Thank you. AM/PM headaches (severe) over last couple weeks, racing HR, higher HR when I take my BP (which I do often as I have a history of high BP). Mostly the headache and the HR. Nothing extreme just at 80 instead of my normal 70 when I take it walking around or not doing a lot of physical activity. And yes the doctor wanted me off the T3 but when I saw my levels I was thinking that may not be necessary.
Avatar universal
Your Free T4 is below range, and your Free T3 is too low in the range, consistent with being hypothyroid.  Although a higher heart rate and headaches are frequently thought to be hyper symptoms, as you mentioned, they also can be due to being hypo.  From a very long list of symptoms that can be related to hypothyroidism, note these sections.

Heart
    High blood pressure
    Low blood pressure
    Slow/weak pulse (under 60 bpm)
    Fast pulse (over 90 bpm at rest)
    Arrhythmia (irregular heartbeat)
    Skipped beats
    Heart flutters
    Heart palpitations
    Chest pain
    High cholesterol
    High triglycerides
    High LDL (“bad”) cholesterol
    Mitral Valve Prolapse
    Atherosclerosis
    Coronary Artery Disease
    Elevated C-Reactive Protein
    Fibrillations
    Plaque buildup
    Fluid retention
    Poor circulation
    Enlarged heart
    Congestive Heart Failure
    Stroke
    Heart Attack

Emotional:

    Tension
    Irritability
    Wanting to be solitary
    Mood swings
    Anxiety
    Personality changes
    Feelings of resentment
    Jumpy
    Easily startled
    Lack of confidence
    Nervousness

So the big question is why your Free T4 and Free T3 levels are so low with the relatively high doses of Armour and T3.  There are three possibilities that come to mind.  One is poor absorption of the meds.  The second would be excessive Reverse T3.  The other is the possibility of high levels of Thyroxine Binding Globulin that can result in low amounts of FT4 and FT3 in spite of having high levels of Total T4 and Total T3.  The excess TBG can be a result of a low ratio of progesterone to estradiol.  So I think it would be a good idea to test again for Free T4, Free T3, Reverse T3, Total T4 and Total T3, along with progesterone and estradiol.  From those tests the cause should be apparent.

Regarding your question about low Free T4, it is always lower relative to Free T3 because the ratio of T4 to T3 in Armour and other desiccated type thyroid meds is only 4.  Also, just for info, be aware that when taking desiccated thyroid meds like Armour Thyroid it is best to split the dose and take half in the morning and half in the early afternoon, to even out the effect over the day.  Also it is best to defer the morning dose until after the blood draw for thyroid tests.  This avoids false high readings for Free T3.  

Can you get those tests done?
2 Comments
Thank you for the info, I will ask my doctor about this, but I'm dealing with only an Internal Med person, as there are no endocrinologists where I'm located. They also switch doctors regularly so there is no consistency and every doctor wants to do something different (with very little experience). The doctor I have now seems to think I should go off the T3. Its been the normal story of frustration on my end, like many thyroid patients. :( I appreciate your response, I will send over this info to my doctor and see if they are willing to help. It's been a non-stop back and forth for a number of years. And I am in a remote location so getting regular endo help is not an option, as well my insurance does not cover online doctor consultants...already checked. I appreciate your assistance, sincerely!
p.s. I also take my armour in 2 doses, and did not take before blood work as advised (had it taken first thing in am) :)
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