Again, This is me relating a correction--my Ferritin level was 250. The Reference Range tops out at 288. So, I was 38 below the Top of the Reference Range. Thanks for my being able to correct that.
Just so that we have all your info in one place, following is your prior post.
I have recently switched to Armour after having been on generic Synthroid for all of those 19 years. In January, I attempted to go off the Synthroid and treat myself with the bovine desiccated tissue, but apparently I did not take enough. On my next appointment with the doctor for labs, my TSH was 108.6. Right away, I went back to the synthetic Synthroid for three days, and then I started the Armour and at the same time discontinued Synthroid.
The doctor had prescribed two (60) mg tablets which would equate to approx. twice what I had been on of the Synthroid (112 mcg.) so I disregarded that and tried to go by the chart, starting out at first with a little under 60 mg, then after three days I took a whole 60mg tablet, then one week later I went to 90 mg. which I am presently on. This whole process began approximately three weeks ago. So, I am now on approx. 90 mg.
I am exhausted. I felt good after ramping up to the 90mg. for about two days, but it did not persist. I have a follow-up appointment to get labs done (he concentrates totally on TSH only in eighteen days. Should I now go to the full 120 mg, and if so, will the labs reflect this change by that time? "
When trying to assess a person's thyroid status, the most important is an evaluation for symptoms that occur more frequently with hypothyroidism. So as a start please tell us about any and all of your symptoms.
Next comes biochemical tests needed to confirm the symptoms. Your TSH was really low, but that is the usual case when taking significant doses of thyroid med. It means nothing as far as your treatment. The doctor should not adjust your dosage based on TSH. Instead the dosage should be adjusted to achieve the following, as concluded in a recent, excellent scientific study: "Hypothyroid symptom relief was associated with both a T4 dose giving TSH-suppression below the lower reference limit and FT3 elevated further into the upper half of its reference range." Frequently this requires the inclusion of T3 med to adequately raise the Free T3 level.
From your test results the Free T4 Index and T3 Uptake are outdated and not very useful. Save your money on those and always make sure to test for Free T4 and Free T3. For your T4 and Free T3 test I need to know the reference range shown on the lab report.
The average daily amount of T4 and T3 produced by the thyroid gland is 100 mcg of T4 and 10 mcg of T3. This equates to 130 mcg of T4 and instead of what is shown in conversion tables, is approximately the same as 2 grains of NDT med. The amount of thyroid med required would be higher due to absorption of the med not being 100%. So taking the 2 grains should not be a problem and it will better prepare you for the doctor, as I see it. In 18 days you will get the full effect of the T3 in the Armour and probably about 80% of the full effect of the T4 on serum T4 levels.
A few other questions for you. Are you male or female? Do you take any iron related supplements that might account for your ferritin level?
Why do you think your feelings this morning were due to too much thyroid med? What are the reference ranges for your T4 and Free T3 tests?
There is not a lot of iron in a serving of either almond butter or almond milk. So that makes me wonder about your ferritin level. Also, what is the range shown for the iron binding? At 167 your SHBG is very high. Note the following info about that. It seems to indicate that you need a test for free Testosterone.
Maybe I overlooked it, but how long on the 90 mg of Armour when the blood was drawn for those latest tests. Also, did you take your morning dose of Armour before blood draw. If so, how long between taking the med and the blood draw? Have you ever been tested for Vitamin D?
Based on your lack of having any hyper symptoms and your test results, I think you you should continue on the 120 mg of Armour and stabilize there for a while. I will be interested to see your Reverse T3 result. Vitamin D should be at least 50 ng/mL. Is your's above that? I also expect that your B12 is not optimal. It should be in the upper part of its range. Taking your ferritin and TIBC together makes me wonder about possible iron related issues. It is strange to me that your ferritin is that high without taking a large amount of iron. Along with that your TIBC is low. I understand the problem with additional labs, but it would be a good idea to also test for serum iron and % saturation. Those, along with the ferritin and TIBC should identify any issue there.
As I reviewed your iron related test results I wondered if you have had a hemoglobin test? There is a lot to discuss, so please indulge me as I try to go through it all and more questions arise.
Were you originally diagnosed as having Hashimoto's Thyroiditis?
A hypothyroid patient should be medicated with thyroid hormone adequate to eliminate the signs/symptoms of hypothyroidism without creating any signs/symptoms of hyperthyroidism. That state between hypo and hyper is called euthyroidism. That should be your goal, rather than just going by your body temperature. To get there I expect that it will take the full 120 mg of Armour, but you can determine that by trial and error between 90 and 120 mg. In addition you need to make sure your Vitamin D is at least 50 and your B12 in the upper end of its range.
As for your osteoporosis, note the information on page 16 of the following link.
High levels of homocysteine are not good. Note that there is scsientific evidence that hypothyroidism can result in high homocysteine.