HELP! Overmedicated, hyper?hypo? new armour...

[Jackie419]

I had been on 120mg. of the OLD armour for two years with great results. I moved to a different state in '08 and couldn't get armour here, so my old pharmacy in Ohio was sending it to me until 6/10. That was when I could finally get it here in LA. I had been under alot of stress for the past year and very busy working so when I started to lose weight, i attributed it to the stress. I went from 150 lbs to 130lbs in a short time. I realized I was easily aggravated and kind of wound up, so thought I may be on too much so tried to lower my dosage and would get migraines, so stayed at 120mgs. Months went by, people told me I was too thin...again, I attributed it to stress. I seemed to be managing to work and live life and be fine but then at the end of Nov '10, I lost my job and some other pretty heavy personal things and spiraled down into a severe depression. I had hypo symptoms AND hyper symptoms. Went to my doctor mid Dec '10 and realized how little I actually weighed (didn't own a scale!) and freaked out!  I immediately lowered my Armour to 105mg and had my TSH checked one month later-of course he only ordered the TSH...that came back at .049 after having been on 105mg. for one month. I then lowered my dosage to 90mg and had to beg him to order a free T3 and free T4, so a week after the TSH here are results:
TSH .049
FT3  2.8
FT4 .98
The day I got my TSH is the day I found out that Armour had been reformulated, the freaky thing is, everyone I have read about went HYPO on it, most gained weight and their TSH went up not down-- and they had to take more not less like I have had to. I have been on 90mg for almost a month and finally able to put some weight back on but having extreme depression and emotional difficulties which are not good to have when one needs to find a new job!  I realized that my weight loss and mental changes started to occur when I started getting my Armour where I currently live in June '10.
I saw a new doctor yesterday, as my GP told me my tests were in normal range except for TSH so he just told me to lower my dosage. My new doctor is holistic and only deals with natural thyroid so he has ordered a new prescription from a compounding pharmacy. I am concerned there is so much more here at play, like adrenals etc and wondering how much being on birth control pills have to do with this as I am in my 40's and still on them. New dr. has advised he will take me off of them soon but he said I am hypo, having bad reaction to new armour, birth control pills playing a part---start new compounding med and we'll test you in a month with no mention of dealing with adrenals etc. It seems that I was overmedicated for some time after having been on the same dosage for 2 years, so I am kind of lost on how to deal with this.
I have researched and researched and it is almost impossible to find anyone with a similar situation to mine. Sorry if my story is all over the place, but if you can make sense of it and have any advice, I am thankful for it!

[Jackie419]

Update....I did go to 120mg. of the compounded I have and it's gone very well! I split the dosage to avoid too much at once. It's only just over a week since I stopped taking the devil Armour and I already feel better.....my mind is coming into focus and I feel more like myself. I will be going to efra soon, but glad I tried the compounded--I will let you know what I think of efra.
Thanks again for your input, it is appreciated!

[Jackie419]

Sorry if I made that confusing, but it has been confusing! Thanks for your reply---here is where I am coming from,

My old doctor had me going down in dose due to my symptoms and then the the TSH test he ordered, it was almost another two weeks until I got my free T's tested---and he couldn't read the results right and told me to go down further. He is a joke.
Just saw my new doctor for 1st time last week and didn't mind he wanted me on compounded thyroid, was actually happy and had forgotten to ask him about efra, my bad. Didn't find out until the next day when the compounding pharmacy called, that the pills come in capsule form, which made me wonder how I would be able to dose back up slowly. Their filler is olive oil, by the way!
So a mere two months ago I was on 120mg armour and now on a 60mg dose of compounded thyroid (for 4 days)---that has to be shipped to me--I know they can make it any strength, but all I have on hand is 60mg. and I really just want to up my dosage at this point because I have been sending my poor body all over the place.
I was in massive brain fog when I saw the new doc last week so forgot about efra or asking about it- then, I couldn't reach the doctor until yesterday and he said I could try efra, so this compounded stuff is to tide me over until I can get that at this point.

My big question was if it might be ok for me to just go to 120mg, maybe splitting the dose, because being on 60mg is only going to confuse my body further and I feel like hell.

What a mess this is....I blame Armour Thyroid, Forest Labs 1st, but really, my 1st doctor here really did a number on me with his lack of knowledge. I just wanted to make sure i don't do something stupid, but will probably take another 60mg today and see how it goes. Thanks for all of your input, Stella!

[stella5349]

Its silly to go one way for a few months and then try another thing. Lets say the compound is working???

why then in God's name would you want to try something else...

That's quite frankly a very stupid train of thought this doctor had...

Its your choice. I gave you the ins - and - outs of compounding above. It can be a headache to do this avenue side of "investagating" too when if this doctor really "approved" ERFA as a thought... then that should be what you do first.

I may be bias on this route but too many patients play the flopping game with thyroid meds and my strong thought on everything on this post with you saying Old Armour helped you then the closest thing to go back to that would be the ERFA route now/

[stella5349]

I'm popular making things even more complicated and no simple answer to a question usually comes from me..... lol

OK - to go with the compound these would be my first warnings...

First, define the word compound for me.... Compound of prescriptions are made "specifically" and no massed dosed formulas

so in essence the 90 mg capsule CAN be made/ There is no reason why it can't... Heck!! - hypothetically, a 85.999 capsule is more effective on measurement if you needed that using compound formulas then using even ERFA - so I don't know why a jump of 120 HAS to be the next move if you aren't there now.


The other unique thing about compounding is fillers... Compounds can add different fillers - some extremely helpful and some binding to thyroid hormone that aren't good. We found that out when the whole Armour fiesco happened and people were scrambling to get their meds. In a nutshell we found the majority of thyroid patients backfired on the reformulated Armour because of adding in a huge amount of Microcellulose crystal and depleting the dextrose. MCC is a direct binder of thyroid hormone and won't release as well with this amount in the meds in the body.

Guess what major compounders use for filling capsules with the USP thyroid powder?

Yep! - Microcellulose crystals............. so in some cases its NO better than Armour thyroid is.

Here's where YOU have to do your homework with getting thyroid compounded....

Call the compounder pharmacist and ask about the fillers used. You may feel staying away from any MCC and ask if other fillers can be utilized. Most NDT compound patients find that eliminating MCC and using others like acidophillus, ginger, olive oil are better constantcies to release the USP thyroid hormones and get better results.

[Jackie419]

forgot to put that to you above!

[Jackie419]

Finally spoke to the new doctor today about Efra, he said he'd be glad to prescribe it but wants me on compounded for a couple of months to be sure I tolerate it--guessing he didn't have my chart there because I have been on armour for years----the compounded pill I have is 60mg in CAPSULE form so the only way to go up is to go from 60mg straight to 120mg. i am disgusted at this point. Here is my progression of dosages over past couple of months.

120mg Armour for 2 years and then:
Dec 15, 2010-  105mg. Armour    (the amount my above tests reflect)
Jan 15, 2011-      90mg. Armour    (old doc wrong about labs, so went down)
Feb 14, 2011-     60mg. Compounded Thyroid    (new med low dose)

I am going in the wrong direction! I guess my question is this: I am wondering if it is safe to just go for it and go back to 120mg dosage on the new compounded in a day or two, I feel that this downward progression is only going to put me into a worse tailspin. New doc will prescribe efra in the future but for now, I just want to maintain....get my lfe back. I should be finding a job for Mardi Gras and can barely leave the house! Thoughts? Thanks!

[stella5349]

If you need proper information on this med see the erfa website. A print out is available that you can take to your doctor.

Also it wouldn't hurt to offer the doctor the web information on the change with Armour and also the recent FDA warning on the script errors.

The doctor may see the light that Armour isn't what it was just a short time ago.

[Jackie419]

Stella, thanks you so much for your input, I value it very much. You help people every day here and it means alot!

[stella5349]

I think I am following you right and if we are looking at meds ( armour ) only - nothing else but meds and labs - seriously my thought would be the formula change that happen with Armour.

So many as you read - really went backwards after it happened. It took me 3 days on it to feel sideways and I knew I needed to make changes fast to maintain wellness as I was.

Weight gain/loss with thyroid disease generally is hyper/loss - hypo/gain. I don't believe sticking to it 100% or even as low as 50% for everyone. Thyroid is a beast to control and is a major component for alot of things in the body. Its common theme is metobolic control - however other things play into that too. Renal, DNA cell, adrenals, insulin - many others.

You have to go back to square one when you felt OK and now what kept you well. If you can say nothing else changed for you then losing the Old Armour - I would lean to the dextrose change being something to really look at.

You may if you go to ERFA have some weight upset - but it seems you know how to control your system better and could gain some back after you found a stable dose again that works right for you.

[Jackie419]

Stella, thank you so much for the response. The scary thing is, those test results reflect the 105 mg dosage I was on and have been on 90mg for about a month now, so I must be super hypo now!
Here's the problem then, when on 120mg, my levels were probably good but I was cranked up, severely underweight and losing more weight and severely depressed/emotional problems. I have no way of knowing when I actually started the NEW Armour, I just know the changes in my psychical/mental state started when I was able to finally get Armour in Louisiana in June '10- it was then I went from being fine to being a mess.
One month ago, my GP told me those test results were normal except for the tsh and to lower med more, so here I am, even more hypo, problem is, I am still trying to put on another 10 lbs to get back to a normal, healthy weight. I have had a problem with my appetite so it's been hard to eat more to put the weight on, it's been like a job trying to eat more! I have nothing now to explain this weight loss and mental and other symptoms. All of this is leading me to think adrenals but my new doctor didn't address those at all, just prescribed a compounded thyroid which I will start next week....EFRA is looking good to me though, especially now that you've recommended it, stella.
Just wondering your thoughts on the fact that on 120mg I seemed like I was going hyper, with hypo and hyper symptoms, with severe weight loss and severe mental disturbances but my levels were more than likely right on. Because now I have to raise my dosage to get my levels right and am scared to death to lose the weight I have managed to gain and possibly go crazy.... none of this makes sense!
Hope you were able to follow that! Thanks!

[stella5349]

Yeah - tracking that with the 120mgs would be nice but I feel you went hypo after seeing the lab panels..

Your Free T3 level is suffering here bad. So is the FT4.. You're undermedicated here dear and shouldn't have been lowered.

Don't obsess over the TSH lab. When the FT3 is where is should be usually in the upper 1/3 part of the reference range and the FT4 is near mid or higher on its reference the TSH should suppress. Mine stays near 0.01 when I am optimal but my frees are stable in the upper ends when I feel good.

If you were really on the OLD Armour thyroid that recently ( changed and was weeding out that old formula last in May 09 actually) and did well my push to you would be to look at ERFA thyroid and see if you can get on that. With the Armour change the fillers changed to and many that did extremely well on the dextrose with the old formula did horrible on the new hike with MCC filler with it. ERFA thyroid is about as close to the Old processing as it comes on a distribution process. Compound pharmacies are getting close on some levels and one in upper Florida is about the closest to it - However on both of these options most likely it is a pay-out-of-pocket senerio for you.

Patients who can't go the payout option are looking for alternative ways to get the most out of this new formula by chewing it - not swollowing. Adding raw can sugar in with it to absorb again with dextrose and changing their diets to eliminate gluten so the MCC is better absorbed. There's too much bog on the system when too may fillers are involved for thyroid hormone to freely get through the body - so a stricked change in lifestyle can help for some.

[Jackie419]

PS.  
I really wish I had gotten my levels while on the 120mg, but didn't really have the money (no ins.) would be curious to see what they were. It almost seems as if my dosage wasn't too high, but had hyper and hypo symptoms on 120mg. aggitation, anger, brain fog, couldn't remember simple words, vision changes, weight loss, trouble putting any weight on even now, outer eyelashes thinning. I think it's the fact I lost weight that is throwing me off. I am 6 feet tall and was at my optimum weight for a year on 120mg which was 150. It even went up at times depending on my activity level, but losing weight being hypo has always been hard. I believe I have had a thyroid problem my whole life but it was only diagnosed 5 years ago.

[Jackie419]

Thanks for your response, stella! I should have thought to post those! also want to add my TPOab test too....

TSH .049    (.450 - 4.5)
FT3   2.8     (2.0 -4.4)
FT4   .98     (.82 -1.77)
T3     111    (71-180)
TPOab  9   (0-34)

I want to note that the TSH was done 1 month after going from 120mg armour to 105 mg
and the free t's and tpo were done a week and three days after going down to 90mg. I had a brief break in my depressive/obsessive thoughts after lowering my dosage btu am miserable again now. the thing i see in these results is that my free t3 is too low. I have been able to put on 10lbs in past month but this doesnt make any sense!!

[stella5349]

Jackie/

Can you post the reference ranges on those labs you have. I'd need that to comment more if you can

[Jackie419]

Thank you for the heads up, but believe thats the 1/2 grain pills, I was taking 120mg (or (2) 1 grain tablets) per day...thank you though!

[redheadaussie]

There is a recall on Armour at the moment.. Your tablets may well be one of the lots being recalled. See the post Stella has put up higher in the posts.