Moving onto Levothyroxine again

[Rachel2033]

Saw my doctor this morning. I am on Armour 90mg now. My doctor agreed with me that my blood pressure was high for me and we both agreed we didn't like where my FT3 is at now. I did ask him about lowering my Armour to 75mg but we both knew my FT4 would suffer and he didn't like the idea of mixing Armour and a T4 med. He suggested I go on Levothyroxine to see how I do and to see if my FT3 & FT4 would go up normally. I expressed concern about switching to Levothyroxine because the last time I switched I experienced bad heart palpitations. He figured since I am already on the 90mg of Armour switching to a lower form of T4 won't cause heart palpitations. He is totally against cytomel though so I know that's not an option. If this doesn't work out I will go back to Armour.
Do I need to half the dose to wean myself on the T4 or just take it whole tomorrow? Also on the day of my labs, do I need to hold off on taking the T4 till after my labs or does it not matter?
Here are my last labs:
On 90mg Armour (7/26/2014)
TSH 0.010 (0.36-3.74)
FT3 4.0 (2.18-3.98)
FT4 1.0 (0.76-1.46)

Previous labs (60 mg Armour)
TSH 0.06 (0.36-3.74)
FT3 3.0 (2.18-3.98)
FT4 0.9 (0.76-1.46)

[Rachel2033]

Thank you to you two. I will keep all this in mind. I'm hoping to stick this out in hopes that if it doesn't work out then the doctor will be open to combining Armour with Levo. If not then I will look for another doctor. I have a list of in-network doctors to choose from now that aren't too far from our home.

[Barb135]

You didn't need to wait, med free, to make the switch from Armour to levo.  What gimel was pointing out is that the T3 in Armour is fast acting, and short lived, so without that, you will notice a difference in the way you feel until the levo kicks in at the 4-6 week mark... if you don't convert FT4 to FT3 adequately, you might not feel right at all.  It will take weeks to tell, but you'll feel the lack of the T3 in the Armour very quickly.

[Rachel2033]

I'm experiencing an anxiety feeling right now. My pulse is at 92 bpm, it was 72 bpm yesterday prior to my visit. I took my last 90mg of Armour yesterday and took my first 88mcg of Levothyroxine this morning. Should I have waited (med free) a few days (like 3-4 days) to start the Levothyroxine?

[Rachel2033]

It's Levothyroxine 88 mcg.
How long will it take to compensate? This is all new to me. :(

[gimel]

Before changing to the new med and dosage, you need to be aware that dropping the T3 from your meds will have a pretty quick effect, while adding the additional T4 will take longer to compensate.  This is due to the difference in half-life of T3 and T4.  

So, what is the new dosage the doctor wants you to switch to?

[Rachel2033]

I know, I thought the same thing. :(
I will be on 88 mcg so it'll be the equivalent of the 75mg Armour I hope. I figured I'll try it and see what happens and what he says. He seems very open so I'm sure if it doesn't show the results he wants he will be open to mixing T4 and T3. If not, I will be searching for another doctor.

[Barb135]

What dose of levo has your doctor put you on?

I know you have several other threads going and I've been traveling so haven't had a chance to follow them all, but just from this thread, I really don't trust your doctor.  

There's no reason not to add a T4 med to Armour in order to increase FT4 levels, nor is there any reason not to add cytomel to a T4 med to increase FT3 levels, if needed.

There's a good chance that being hypo is what caused your palpitations before, not simply being on a T4 medication...

My advice is find a doctor who better understands the use of thyroid hormones, including combining T4/T3 meds.

T4 meds take 4-6 weeks to build in your blood, so it really doesn't matter that much rather you take the med prior to your blood draw or not. What's in your blood is what you took a couple weeks ago, not what you took this morning.  What's important is that you be consistent...If you take it once before the draw, always take it before the draw or if you don't take it once before the draw, never take it before the draw.   I take my T4 med before my blood draw and my T3 med, immediately after.