Thyroid Disorders Community
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Avatar universal

Need help figuring this out....getting frustrated

Hi all. I'm new here and confused.

I have been hypo for over twenty years due to RAI (Grave's), and lately things are getting messed up. Actually, since the 2009 reformulation of Armour have I started feeling so damn awful. I bounced around with Westhroid, back to Armour, then Synthroid for awhile, then back. A year ago when I was pregnant my TSH was 38 - so I had swung very hypo.

Now I'm on Acella (another NDT), and after being on Acella for 8 weeks, here are my latest labs:

FT3 3.1 (2-4.4)
FT4 .96 (.82-1.77)
TSH .01
RT3 159 (90-350)
Vit D 61.8 (32-100)
B12 1000 (211-946)
Ferritin 46 (13-150)
Cholesterol 185
Folic Acid 19

So my FT3 is at barely 46%, my FT4 is at less than 20%, and my Ferritin isn't optimal.

Would the best course of action be to
1. Increase from 3 grains Acella to 3.25 and retest later?
2. Take iron supplements and retest later? or
3. Wait it out and see if I adjust to the new meds. ALTHOUGH when I was on the reformulated Armour, my labs were very, very similar, and I felt bad then, too.

I just need some help figuring out how to proceed. I've been told my ratio of T3 to T4 is off, too.

5 Responses
Avatar universal
Someone also mentioned to me that perhaps 3 grains of Acella PLUS 25 mcg Synthroid might be the way to go.


1569091 tn?1295808551
I cannot stand anything when my TSH is high. Actually, your FT3 is suppose to be at the top of the range, if not slightly over. Your FT4 is supposed to be mid range. The lower my TSH is, the better I feel. Since the reformulation of armour, it is horse crap. It actually makes you feel worse. Synthroid was an absolutely NO, NO. Made me feel like I was dying or wanted to die. I am now on NT. First year TT anniversary is this month. I am still searching for my sweet spot. If I were in your shoes, I would increase by 1/2 grain Acella, stay on it for a week. If you do not feel better, I would increase another 1/2 grain. In other words dose slowly, but, dose by elimination of symptoms. Good health to you.
Avatar universal
i think your test look ok . my experience I have been taking both synthorid and Armour. i would stay where you are. are you taking any supplements? selenium 200-400mg helps convert T4 into it's active form T3.
Avatar universal
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  To better understand clinical treatment, this is a good link.  The letter was written by a good thyroid doctor for patients that he consults with from a distance.  The letter is sent to the PCP of the patient to help guide treatment.  Note that in the letter he states, "I have prescribed natural dessicated thyroid for your patient (Armour, Nature-Throid) because it contains both T4 and T3 (40mcg and 9mcg respectively per 60mg). This assures sufficient T3 levels and thyroid effects in the body. Since NDT has more T3 than the human thyroid gland produces, the well- replaced patient’s FT4 will be below the middle of its range, and the FT3 will be high “normal” or slightly high before the next AM dose."

Avatar universal
Thanks for the help thus far.
I'm going to see about raising it just a quarter so far....I don't want to overshoot.

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