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Hypo or Hyper?
Hi All - I am thyroidless, on 2 grains Armour Thyroid for the past 2 years. Current labs: TSH .06 (.3-5)
FT4 .9 (.8-1.77) FT3 3.5 (2.0-3.5) These labs were done around 10 a.m., having taken the full 2 grains at 8 a.m. the previous day.
The first year on Armour I felt good, this past year not so much, with occassional symptoms such as mild brief heart palps, mild brief internal shaking, high pulse (90-100), numbness in legs when sitting and in hands upon waking. Nothing major anymore, but enough to bug me.
I have eliminated 1.5 grains, 2.25 grains, and 2.5 grains completely at this point. My only options seem to be 2 1/8 grains (yes, I am going there) or slightly below 2 grains. Most recently I tired reducing by 30 mg a week, by going to 105 on Thursday on Sundays. This did not seem to change things for me, and after about 4 weeks of that, I started to feel tightness in the lungs, so stopped the 105 reduction.
Currently I start feeling off at around 6 pm every night, mild palps, a slight feeling that my body is running funny internally, and a weird ear pressure. Having a hard time sleeping, but by morning I feel fine. I take my two grains around 8 a.m. and am fine again until 6ish.
I have tried multidosing every which way, does not work for me, I feel better taking the 2 grains at once.
My first thought is I must be going hypo in the evening time, so far away from my meds, that's why I tried raising at first, but I only became super hyper.
Now I am thinking could I possibly be making too much T3 later in the day, creating the heart palps then? I thought the T3 peaked way earlier, but now starting to wonder if even a teeny bit more converted may be too much for me.
My drs only answer is to get off 'that extract' and get on Synthroid, the standard of care.
He says I am hyper hyper hyper.
I have tried 100, 150 and 200 synthroid before, 100 made me hypo, chest felt crushed in, 150 I was shaking, 200 I was hyper, with FT4 above range. So my dose could either be 125 or 175 Synthroid, not sure which. So scared to try and switch since I was so very ill on Synthroid, but willing to try one more time if I knew the correct dosage.
Any advice on which dosage would be closer to right for me if I do fairly well on 2 grains Armour or slightly less??? And on Synthroid, where do I want my Ft4 levels to be - mid range, or higher? On Armour I am used to them being rock bottom.
Any input would be appreciated - thanks!
FT4 .9 (.8-1.77) FT3 3.5 (2.0-3.5) These labs were done around 10 a.m., having taken the full 2 grains at 8 a.m. the previous day.
The first year on Armour I felt good, this past year not so much, with occassional symptoms such as mild brief heart palps, mild brief internal shaking, high pulse (90-100), numbness in legs when sitting and in hands upon waking. Nothing major anymore, but enough to bug me.
I have eliminated 1.5 grains, 2.25 grains, and 2.5 grains completely at this point. My only options seem to be 2 1/8 grains (yes, I am going there) or slightly below 2 grains. Most recently I tired reducing by 30 mg a week, by going to 105 on Thursday on Sundays. This did not seem to change things for me, and after about 4 weeks of that, I started to feel tightness in the lungs, so stopped the 105 reduction.
Currently I start feeling off at around 6 pm every night, mild palps, a slight feeling that my body is running funny internally, and a weird ear pressure. Having a hard time sleeping, but by morning I feel fine. I take my two grains around 8 a.m. and am fine again until 6ish.
I have tried multidosing every which way, does not work for me, I feel better taking the 2 grains at once.
My first thought is I must be going hypo in the evening time, so far away from my meds, that's why I tried raising at first, but I only became super hyper.
Now I am thinking could I possibly be making too much T3 later in the day, creating the heart palps then? I thought the T3 peaked way earlier, but now starting to wonder if even a teeny bit more converted may be too much for me.
My drs only answer is to get off 'that extract' and get on Synthroid, the standard of care.
He says I am hyper hyper hyper.
I have tried 100, 150 and 200 synthroid before, 100 made me hypo, chest felt crushed in, 150 I was shaking, 200 I was hyper, with FT4 above range. So my dose could either be 125 or 175 Synthroid, not sure which. So scared to try and switch since I was so very ill on Synthroid, but willing to try one more time if I knew the correct dosage.
Any advice on which dosage would be closer to right for me if I do fairly well on 2 grains Armour or slightly less??? And on Synthroid, where do I want my Ft4 levels to be - mid range, or higher? On Armour I am used to them being rock bottom.
Any input would be appreciated - thanks!
I wonder if you could reduce your Armour and add a T4 med? I saw this on the website tiredthyroid.
"Many on desiccated thyroid have lab results that show a low in range Total and Free T4 when their Free T3 gets into the optimal range (upper half). This is because desiccated thyroid (pig thyroid) is approximately 80% T4, and 20% T3, while a normal human’s thyroid output is closer to 94% T4 and 6% T3. [4] The simple remedy for people who test low on T4 is to just add some synthetic T4 to their desiccated thyroid. Studies show that both T4 and T3 need to be optimal for mental and physical well-being. The brain and body are in two different compartments, and they require both hormones"
"Many on desiccated thyroid have lab results that show a low in range Total and Free T4 when their Free T3 gets into the optimal range (upper half). This is because desiccated thyroid (pig thyroid) is approximately 80% T4, and 20% T3, while a normal human’s thyroid output is closer to 94% T4 and 6% T3. [4] The simple remedy for people who test low on T4 is to just add some synthetic T4 to their desiccated thyroid. Studies show that both T4 and T3 need to be optimal for mental and physical well-being. The brain and body are in two different compartments, and they require both hormones"
Also, these are the Mayo Clinic's thyroid ranges - extremely conservative and outdated - TSH upper limit is 5! At home, my Ft3 range is 4.4 upper limit. After taking my meds for the day, a few hours later, my FT3 will be 4.1, still within the range here at home. I did see it hit 5 once on paper, so I am thinking that occassionally it does get higher, so may explain the occassional evening symptoms I get.
Thanks Barb, I think I convert to T3 very very well, maybe too well, lol. I thought T4 only would be ideal for me, but I completely crashed on it. It took me 7 months to recover on a steady dose of Armour. Looking back, the supposed equivalents to what I was on on Armour probably didn't work because I eventually made so much T3 again it made me hyper. I was told I need to bridge over using Cytomel, but no endo, not even Mayo Clinic, could tell me the correct dosage equivalent, so I am on my own - the thought of guesswork with synthroid/cytomel, knowing how very ill I become, is overwhelming.
COMMUNITY LEADER
Let me make sure I understand your blood work -- you had not had medication for approximately 26 hours, before you got the blood draw?
If this is correct, your labs would indicate that you are hyper, with the high FT3. FT3 is the hormone that the body actually uses, so that's the one we need to look at. I have to wonder if you really need the extra T3 in the Armour, or if you'd convert adequately on your own.
It's impossible to tell you what dosage of synthroid you should be on, because everyone is different. You can't target an FT4 number, because we don't know how well you convert. As always, FT3 is the number to target, but even that depends on symptoms........ some people have FT levels that are either very low in the range or much higher, and still feel well.
"So my dose could either be 125 or 175 Synthroid, not sure which." Maybe neither --- maybe you only need 112 mcg or maybe you need 137 mcg or 162.5 mcg. You would simply have to try various dosages to see what works best for you. To get various dosages, you may have to split pills or alternate dosages......... for instance, I've alternated 50 mcg and 75 mcg to get a 2 day average of 62.5; I've alternated 75 mcg and 88 mcg to get a 2 day average of 81.5; I've done 88 mcg and 100 mcg to get a 2 day average of 94 mcg........... I've currently settled at 88 mcg T4 (Tirosint) and 7.5 mcg T3.
You could try alternating 100 mcg with 125 for an average of 112.5 and if that's not enough, move on up to 125, then try alternating 125 mcg with 150 mcg for 137.5 mcg......... Sometimes, all it takes is the tiniest tweak.
Increasing by the very smallest increments is usually the best, because when you make jumps, like from 125 to 175, it's quite likely that there's something between there that will do better for you. Alternating or splitting pills can be a real pain, but at least you can get the right dosage.
Maybe you don't need all the T3 that's present in the Armour, since your FT4 is on the floor of the range and your FT3 is at the roof. Maybe a dose of synthroid (or generic levo), with a very small dose of cytomel, would work best for you.
Once we get to a certain point, it actually becomes something of a balancing act to get the final "tweaks" and find what's really right for us.
If this is correct, your labs would indicate that you are hyper, with the high FT3. FT3 is the hormone that the body actually uses, so that's the one we need to look at. I have to wonder if you really need the extra T3 in the Armour, or if you'd convert adequately on your own.
It's impossible to tell you what dosage of synthroid you should be on, because everyone is different. You can't target an FT4 number, because we don't know how well you convert. As always, FT3 is the number to target, but even that depends on symptoms........ some people have FT levels that are either very low in the range or much higher, and still feel well.
"So my dose could either be 125 or 175 Synthroid, not sure which." Maybe neither --- maybe you only need 112 mcg or maybe you need 137 mcg or 162.5 mcg. You would simply have to try various dosages to see what works best for you. To get various dosages, you may have to split pills or alternate dosages......... for instance, I've alternated 50 mcg and 75 mcg to get a 2 day average of 62.5; I've alternated 75 mcg and 88 mcg to get a 2 day average of 81.5; I've done 88 mcg and 100 mcg to get a 2 day average of 94 mcg........... I've currently settled at 88 mcg T4 (Tirosint) and 7.5 mcg T3.
You could try alternating 100 mcg with 125 for an average of 112.5 and if that's not enough, move on up to 125, then try alternating 125 mcg with 150 mcg for 137.5 mcg......... Sometimes, all it takes is the tiniest tweak.
Increasing by the very smallest increments is usually the best, because when you make jumps, like from 125 to 175, it's quite likely that there's something between there that will do better for you. Alternating or splitting pills can be a real pain, but at least you can get the right dosage.
Maybe you don't need all the T3 that's present in the Armour, since your FT4 is on the floor of the range and your FT3 is at the roof. Maybe a dose of synthroid (or generic levo), with a very small dose of cytomel, would work best for you.
Once we get to a certain point, it actually becomes something of a balancing act to get the final "tweaks" and find what's really right for us.
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