Itching with increase or decrease in Armour dosage

[Czechmate3]

I was diagnosed with Hashimotos in 2007. I have been on Armour for the majority of that time period . I would take 30 mg in am and 30 mg at 2pm. In late Nov I switched to NP because of the high cost of the Armour. Same dosage. From Nov to Feb I noticed my hypo symptoms starting to return so I called endo and she ordered labwork. I had switched back to the Armour on my own thinking it was the NP andthat it was not working. I got labwork one week after going back on the Armour.  Labwork came back as TSH 3.87 T4 .71 and T3 3.36. My TSH normally is around 1... So high!  Dr concluded that I was slightly under replaced and increased my morning dosage to 45. Well I didn't have any 15 mg so they told me to cut the 30 mg in half. That was not very successful as the pills were soft. Some days I got a little more than 45 and other days a little less. Then I slowly developed nocturnal itching that was becoming severe . Called and my Drs partner( she was on vk for a week) instructed me to stop 45mg in am and go back to original 30 am dose. I had an appt scheduled for March 31. As part of that appt she requests Labwork. So after returning to original dose of 30 for about a week I got repeat Labwork. TSH 3.49 T3 3.35 and T4 .75. Remember this is after being back on the original dose for only one week- I'm sure it was not truly reflective of what was going on.
Went to appt.  and described symptoms. She had no idea what was causing itching. Started me on Synthroid - 50 in am. Took one dosage and itching  did stop for one night. I still though wanted to stick with desiccated hormone so I called the next day for a new rx of Naturethroid. Dosage back to original 30 am and 30 at 2pm. After 3 doses itching returned. Went back to Synthroid 50 for one day - itching!
So ...itching with all of these ! It HAS to be the dosage! Itching with both synthetic and desiccated all within a few months???? Does itching occur with a slight increase in dose? Started when I went from 30 to 45 mg in am with the Armour? I was thinking it was the kind of hormone when I think now it is the increase in dose. Please help ...anyone

[gimel]

Yes it is.  Note also that there is only anecdotal evidence of any difference in Armour.  I personally called the company and asked questions about where it was produced and if it had changed and if anything in the product had changed.  I was assured that nothing had changed.  They stated they were aware of the allegations but had no idea where that came from.  I use Armour and I know I have not noticed any difference.  And my blood test results don't reflect any difference.  

[Czechmate3]

Thank you- one last question- I have made the decision to switch to Naturethroid based on the undisputed amount of comments regarding Armour questionable efficacy since fall of 2015. That is actually when my hypo symptoms started to return started to return. Is the dosing the same for both Armour and Naturethroid since they are both NDT ?

[gimel]

Very easy to split usually.  It is not vital that the split be a perfect 50/50.  If it is too hard to split with a pill splitter or with your fingers I have found that if you moisten the surface with water it is much easier.  

I wouldn't bother with 45 mg.  To me it is easier to just split the pills as needed until you get to the optimal dose and then perhaps you can get pill dosages  that can be combined as needed without splitting.  

[Czechmate3]

Again thank you - my endo did not inform me of any of this. Is it ok to cut a 30 mg of Naturethroud with a pill splicer to get the 45 mg or to get a second prescription for 15mg? Does Naturethroid come in 45mg?

[gimel]

No that is not too much of an increase, and your doctor previously had approved it.  It is common for thyroid hormone levels and symptoms to show no improvement, or slightly worsen when changing dosages.  That is because the med increase causes the TSH to go down and in turn that causes less output of natural thyroid hormone.  The resultant total serum thyroid hormone levels thus don't change much, if at all, until meds reach levels that cause the TSH to be suppressed to low end of the range or below.  

T3 builds up quickly and reaches peak effect in about 4-5 days.  T4 is much slower and requires about 4-5 weeks to reach 95% of its final effect on levels.  Symptoms sometimes lag somewhat behind changes in thyroid hormone levels.  In view of your thyroid levels I would push to re-test and increase dosage in 4-5 weeks until you get closer to optimal levels, and then you can extend to 7-8 weeks.  

[Czechmate3]

Thank you so much- with the Armour would increasing it to 45 mg in the am be advised? Is that too much of an increase at once? Is it common to have itching when you increase a dose until your body adjusts? And what time period is appropriate to adequately assess that the increase is working?? At least 4 weeks... 6 weeks ?

[gimel]

From your test results I'd say that you are very hypothyroid.  Your Free T4 is terribly low: actually below range.  .  Your Free T3 is at about 50 % of its range, which is lower than optimal for many people taking NDT type med.  IN addition, most frequently hypo patients taking adequate thyroid med will have TSH suppressed below range, yet your is well up in the range.  

Your symptoms, along with those test results, strongly indicate that you are hypothyroid and in need of an increase in your med dosage.  Also, since hypo patients are so frequently low in the ranges for Vitamin D, B12 and ferritin, I suggest that you should get tested for all 3 and supplement as needed to optimize.  D should be about 55 min., B12 in the upper end of its range, and ferritin should be 70 minimum.

[Czechmate3]

T3 is 2.8-3.9
T4 is 0.76-1.46
TSH is 0.358-3.740

[gimel]

Reference ranges for the FT4 and FT3 tests please.

[gimel]

Dry skin and itching are common symptoms of hypothyroidism.  

Please post the reference ranges shown on the lab report for those test results.  Do you have any other symptoms besides the itching?

[Czechmate3]

Intense hot flashes mostly at night along with a feeling like I want to crawl out of my own skin. Also sleep issues- insomnia and not being able to fall asleep once I wake up I middle of night

[zoe114]

I just started on medication today, I do not know your answer but I will suggest something that might help. There is a connection to Gluten and thyroid. Three years ago I developed a  rash on my lower legs. I had no idea it was related to thyroid till I got off of wheat and then my thyroid TSH went from 4.59 to 1.7, it did not solve my thyroid issue but the rash went away. So maybe give that a try?    

[Czechmate3]

Thanks for taking the time to respond- I have the intense itching but no rash at all