Aa
T3 and T4 not improving on Armour
My NP is working on finding the right dosage of Armour for me. I personally think she's being too conservative, upping it slowly. After several months, I'm up to 75 mg. While my TSH has been steadily decreasing, my T3 and T4 don't seem to be budging. Actually, all numbers actually got worse during the latest lab test. Why is this and what can I do about it?
When test results don't reflect med dosage like that, the usual thing we consider is poor absorption. If that is the case, then I recall a good thyroid doctor's words that dosage doesn't matter, only the physiological effect. So increased dosage is one alternative.
Another possibility is having a low ratio of progesterone to estrogen. In that case the body produces excessive thyroxine binding globulin and even though Total T4 and Total T3 may reflect the higher dosages, most of that is bound with the TBG and the Free T4 and Free T3 do not increase.
So it might be worthwhile to get tested for the totals along with the Frees and also progesterone and estrogen.
Another possibility is having a low ratio of progesterone to estrogen. In that case the body produces excessive thyroxine binding globulin and even though Total T4 and Total T3 may reflect the higher dosages, most of that is bound with the TBG and the Free T4 and Free T3 do not increase.
So it might be worthwhile to get tested for the totals along with the Frees and also progesterone and estrogen.
I wanted to ask after reading through this thread what would cause someone not to absorb meds I'm on np thyroid ntd 3 grains I take it sublingually and my t3 and t4 have not changed since my initial dose of 60 mg
I'm still at the bottom of the range
I'm still at the bottom of the range
I'm having the same exact issue as you numbers and med increases are pretty much the same! I've made my way up to 3 grains and still t3 and t4 are the same as original dose. I've searched high and low for answers how are you doing now ?
Just curious to know if you ever reached a dosage that worked for you. I am having similar numbers and issues, zero change in free T3 and T4 after slowly increasing to 1.25 grains over 9 months. I have read that many people don't see change until they reach 3-5 grains.
Hashimoto's is far and away the most common cause of hypothyroidism in industrialized nations. Iodine deficiency is a possibility if both TgAb and TPOAb come back negative, but without that information we can't know. However, since Hashimoto's has not been ruled out and you are feeling poorly, I would continue to pursue the correct dose of thyroid meds.
Hmmm. I asked for antibodies but I don't see them on my lab results. I only see a sex horm BG - is that one of the tests? My level was 67 (19-125 ref. range)
I don't think cortisol issues have resolved. My test was done several months ago and I need to retest but just can't spend the $175 to do it right now. I feel like I wasted tons of money already.
I don't think cortisol issues have resolved. My test was done several months ago and I need to retest but just can't spend the $175 to do it right now. I feel like I wasted tons of money already.
You mentioned in the other thread that you do not have Hashimoto's. It's best if you can post your TgAb and TPOAb test results pertaining to that; but assuming no Hashimoto's, have you had your iodine levels tested?
Given all of that, I am inclined to think your body is not absorbing the medicine well for whatever reason. Some people need a very large dose of thyroid meds because they do not absorb much of it, and in that case you would want to consider upping the dose further until your numbers start to move a bit. Did your doctor say anything about your numbers not moving up at all? Hopefully she will see the problem. One option is to try another brand of thyroid, perhaps one that can be taken sublingually, or one with fewer fillers like Westhroid-P. I haven't taken desiccated sublingually, and there is some controvery over whether or not the body can actually take up thyroid hormone that way, but there are people who claim it works with certain brands, so it may be worth a try. This way you would bypass any absorption problems that may be happening in the digestive tract.
Do you feel the cortisol issue has been resolved? I am not particularly well-versed in cortisol and adrenal issues, though it may be having a big impact in your case.
I agree that ferritin is very important, especially where fatigue is concerned, though personally I was able to feel great relief of thyroid symptoms even when my ferritin was as low as yours. But not a whole lot you can do except keep taking the iron and add some vitamin C for better absorption.
Do you feel the cortisol issue has been resolved? I am not particularly well-versed in cortisol and adrenal issues, though it may be having a big impact in your case.
I agree that ferritin is very important, especially where fatigue is concerned, though personally I was able to feel great relief of thyroid symptoms even when my ferritin was as low as yours. But not a whole lot you can do except keep taking the iron and add some vitamin C for better absorption.
thanks. I've been supplementing w/iron for a while and my levels are slowly rising. My Vit. D is 54 which I think is pretty good.
Just wanted to emphasize the importance of ferritin. Your ferritin level is a long way from recommended levels. Please have a look at this info.
http://articles.submityourarticle.com/symptoms-of-low-ferritin-levels-230015
Since it is so late for me, I did not take time to read this entire thread, so I wondered if you have been tested for Vitamin D.
http://articles.submityourarticle.com/symptoms-of-low-ferritin-levels-230015
Since it is so late for me, I did not take time to read this entire thread, so I wondered if you have been tested for Vitamin D.
Yes, I'm up to 3 grain (180 mg). I was at 90, then raised to 105. Still nothing. I was tired of messing around and urged my NP to raise it higher so we went from 105 to 180. That was about a month ago.
I take 1/2 dose in the morning and 1/2 in the afternoon. Magnesium is at bedtime and iron is at dinner. I make sure there's at least 3 hrs between the iron and the Armour (per Stop the Thyroid Madness book - excellent read).
If it helps, I just received additional results. Reverse T3 is 7.9 (reference range 10-24). My Ferritin is up to 31.
I do feel slightly better - the fatigue isn't as crushing (though I still need my power naps) and sleep is better although I'm still up at 3:00 a.m. regardless of when I go to bed or if I nap or not during the day. Then again, the fatigue might be better since I'm back to drinking coffee. I know I shouldn't but I was just so sick of feeling so fatigued.
I take 1/2 dose in the morning and 1/2 in the afternoon. Magnesium is at bedtime and iron is at dinner. I make sure there's at least 3 hrs between the iron and the Armour (per Stop the Thyroid Madness book - excellent read).
If it helps, I just received additional results. Reverse T3 is 7.9 (reference range 10-24). My Ferritin is up to 31.
I do feel slightly better - the fatigue isn't as crushing (though I still need my power naps) and sleep is better although I'm still up at 3:00 a.m. regardless of when I go to bed or if I nap or not during the day. Then again, the fatigue might be better since I'm back to drinking coffee. I know I shouldn't but I was just so sick of feeling so fatigued.
As far as the TSH if too low could cause bone loss, ridiculouse. I was hyper thyroid for over 28 years with an extrememly low TSH like 0.007 I had bone density tests and they were always normal. i'm 59 years old, last test was in 2011 and normal. I worry more now about it not being normal, because of being hypo. This TSH testing is so irritating. Good Luck
Sorry, just reread your last post. So the final question should be amended to say, "What time of day are you taking the magnesium and iron?"
It's possible you may have a problem absorbing the medicine. I tried to absorb all of the info in your posts above, but just to recap, can you please confirm:
- What is your current dose? Are you really at 3 grains (180 mg)? I only ask because you posted 2 months ago saying you were on 1.5 grains (90 mg). Did you quickly raise the additional 1.5 grains in that time period, and if so, how long has it been that you are on the 3 grain dose?
- What time do you take your Armour? Do you split the dose in half, or take it all at once?
- Have you had any symptom relief at all since starting the Armour?
- Are you still taking the following supplements? If so, what time of day do you take them?
adrenal cortex, adapt, adaptamax, seriphos, chromium GTF, "liver support", selenium, magnesium
- What is your current dose? Are you really at 3 grains (180 mg)? I only ask because you posted 2 months ago saying you were on 1.5 grains (90 mg). Did you quickly raise the additional 1.5 grains in that time period, and if so, how long has it been that you are on the 3 grain dose?
- What time do you take your Armour? Do you split the dose in half, or take it all at once?
- Have you had any symptom relief at all since starting the Armour?
- Are you still taking the following supplements? If so, what time of day do you take them?
adrenal cortex, adapt, adaptamax, seriphos, chromium GTF, "liver support", selenium, magnesium
Wow, just reading back over my old posts. I just got my most recent test results back. I'm now on 3 grains of Armour and my free T3 and free T4 are EXACTLY the same. Other than magnesium and iron, I am not taking any other supplements.
I just don't know what else to do at this point.
I just don't know what else to do at this point.
I typically go to bed around 8:30 pm and have absolutely no trouble falling asleep. Quite the opposite. In the hour before bed, I watch a little tv and try to read (but usually fall asleep after a couple pages.) I am so used to getting up at 3:30 that I have learned to enjoy the quite time to myself. My sleep just hasn't been sound lately. I wake up without an alarm, don't drink coffee and have enough energy to go to the gym at 5:00. I've been having waves of fatigue around 9:00 and noon and sometimes 3:00. I usually take a 20 min. power nap on my lunch break. I've tried not napping, staying up later, etc. but my sleep is always interrupted and I always wake up at 3:30. The power nap helps me get through the rest of the day.
I know what each of the supplements are for but didn't independently research them. The herbalist chose and dosed the supplements based on my test results and symptoms so I deferred to her expertise. I did have good results but they were short-lived. Now, after having a taste of feeling better, it makes it that much worse to have this backward slide.
I know what each of the supplements are for but didn't independently research them. The herbalist chose and dosed the supplements based on my test results and symptoms so I deferred to her expertise. I did have good results but they were short-lived. Now, after having a taste of feeling better, it makes it that much worse to have this backward slide.
COMMUNITY LEADER
What time do you go to bed and what activities do you perform in the hour or so prior to bedtime?
Vitamin B12 isn't toxic, but I'd advise you to go easy on the yeast flakes, as they most likely contain other vitamins as well.
Did you research the ingredients of the herbs that were given you by the herbalist? Some of those could be responsible for increasing hormone levels.
Heavy exercise can cause increased levels of growth hormone, which could, in turn throw off all your other hormones.
The symptoms you've just listed above are those of hypothyroidism, and you probably do need an increase in your medication, though I'd advise you to continue going slow, until you're sure that the cortisol issue is resolved.
Vitamin B12 isn't toxic, but I'd advise you to go easy on the yeast flakes, as they most likely contain other vitamins as well.
Did you research the ingredients of the herbs that were given you by the herbalist? Some of those could be responsible for increasing hormone levels.
Heavy exercise can cause increased levels of growth hormone, which could, in turn throw off all your other hormones.
The symptoms you've just listed above are those of hypothyroidism, and you probably do need an increase in your medication, though I'd advise you to continue going slow, until you're sure that the cortisol issue is resolved.
No more excessive cardio. I still weight train for 1 1/2 each 5-6 days/week. That may seem like a lot but I lift heavy which means lots of rest time between sets = longer workouts. I have not done any cardio whatsoever in over a month.
Re: protein - in the early years before I learned about nutrition, I just didn't eat meat. I didn't supplement with anything. Lots of carbs by default. For the past 6 years, I've devoured everything I can about nutrition (didn't also follow the information but learned what I could - there's so much conflicting information out there). I began supplementing with protein powder, lots of egg whites, etc. I don't supplement w/vit. B but use lots of nutritional yeast flakes
Sorry I missed the question re: cortisol timing. I believe the nighttime test was taken at midnight but I'm not positive. I do remember setting an alarm to wake up to do it. My records don't indicate time. I was experiencing the same symptoms I am now: sick daytime fatigue, frequent waking at night/early a.m. wakening, bloated, water retentive, cold, low temp, lower blood pressure, bouts of anxiety (SO unlike the real me).
I don't have any symptoms of high testosterone so I'm starting to question the saliva results.
The herbalist was the one who suggested the supplements, dosage, etc. I would happily go back to her but I going thru a bit of a financial hardship right now and just can't afford it which is why I am trying to learn all I can on my own.
Re: protein - in the early years before I learned about nutrition, I just didn't eat meat. I didn't supplement with anything. Lots of carbs by default. For the past 6 years, I've devoured everything I can about nutrition (didn't also follow the information but learned what I could - there's so much conflicting information out there). I began supplementing with protein powder, lots of egg whites, etc. I don't supplement w/vit. B but use lots of nutritional yeast flakes
Sorry I missed the question re: cortisol timing. I believe the nighttime test was taken at midnight but I'm not positive. I do remember setting an alarm to wake up to do it. My records don't indicate time. I was experiencing the same symptoms I am now: sick daytime fatigue, frequent waking at night/early a.m. wakening, bloated, water retentive, cold, low temp, lower blood pressure, bouts of anxiety (SO unlike the real me).
I don't have any symptoms of high testosterone so I'm starting to question the saliva results.
The herbalist was the one who suggested the supplements, dosage, etc. I would happily go back to her but I going thru a bit of a financial hardship right now and just can't afford it which is why I am trying to learn all I can on my own.
COMMUNITY LEADER
Okay, your background info gives a good reason why you might have gone menopausal at such a young age, since your female hormones are high. Excess exercise can cause the menstrual cycle to go awry. It can also cause the adrenals to stress out.
How often/how long do you work out? You're not doing yourself any favors with your excess exercise.
I have to wonder what you were eating for protein if you're on a vegetarian diet? And where is all your vitamin B12 coming from? Do you supplement that?
If you can go back to my original post and answer some the questions about the time of the nighttime adrenal test, as well as others that I've asked here, we might be able to see what's going on.
I'd also have to question the supplements you're on; did you research the ingredients of each one? I've found that many supplements have ingredients that are just as harmful as the other ingredients are beneficial.
I'm far from an expert on testosterone, but from my research, blood testosterone is much more reliable than saliva... Do you have symptoms of high testosterone, such as abnormal aggressiveness (be objective), excess body hair, etc?
How often/how long do you work out? You're not doing yourself any favors with your excess exercise.
I have to wonder what you were eating for protein if you're on a vegetarian diet? And where is all your vitamin B12 coming from? Do you supplement that?
If you can go back to my original post and answer some the questions about the time of the nighttime adrenal test, as well as others that I've asked here, we might be able to see what's going on.
I'd also have to question the supplements you're on; did you research the ingredients of each one? I've found that many supplements have ingredients that are just as harmful as the other ingredients are beneficial.
I'm far from an expert on testosterone, but from my research, blood testosterone is much more reliable than saliva... Do you have symptoms of high testosterone, such as abnormal aggressiveness (be objective), excess body hair, etc?
Wow. I am so thankful for all this information!! Let's see...
- Little background. I'm a pretty high level athlete. I was heavy into triathlon training around the time my periods stopped at age 42. They never came back. I've since learned the dangers of endurance training while under fueling on a vegetarian diet. Not a good combination, I've learned. I backed off that but took up bodybuilding. I'm sure my hormones took another big hit with the competition dieting.
I give this background because I'm sure it is why my body became overstressed. There is no stress in my personal life - good job, good family, etc.
Looking back at my thyroid tests over the years (they only tested TSH, never T3 or T3 until 2012) my TSH was always on the very low end of the reference range. I was always told everything was normal.
Oh, my Ferritin has been rather low also - 28 (14-350 ref range) and as low as 16 in the past couple years.
B12 tested high at 1359 (160-1000) in Aug. of 2012.
Blood testosterone level - free testosterone was actually low at .2 (.2 - 1) in Feb. 2013. It was the saliva test that came back high.
In April of this year, I started adrenal cortex, adapt, adaptamax, seriphos, chromium GTF, "liver support", selenium, magnesium.... I think that's it. By August, I was feeling really good. I stupidly started exercising more (couldn't help myself - it felt great). By mid-Sept., I was back to square one. Lesson learned !
Any information/suggestions would be greatly appreciated!!!
- Little background. I'm a pretty high level athlete. I was heavy into triathlon training around the time my periods stopped at age 42. They never came back. I've since learned the dangers of endurance training while under fueling on a vegetarian diet. Not a good combination, I've learned. I backed off that but took up bodybuilding. I'm sure my hormones took another big hit with the competition dieting.
I give this background because I'm sure it is why my body became overstressed. There is no stress in my personal life - good job, good family, etc.
Looking back at my thyroid tests over the years (they only tested TSH, never T3 or T3 until 2012) my TSH was always on the very low end of the reference range. I was always told everything was normal.
Oh, my Ferritin has been rather low also - 28 (14-350 ref range) and as low as 16 in the past couple years.
B12 tested high at 1359 (160-1000) in Aug. of 2012.
Blood testosterone level - free testosterone was actually low at .2 (.2 - 1) in Feb. 2013. It was the saliva test that came back high.
In April of this year, I started adrenal cortex, adapt, adaptamax, seriphos, chromium GTF, "liver support", selenium, magnesium.... I think that's it. By August, I was feeling really good. I stupidly started exercising more (couldn't help myself - it felt great). By mid-Sept., I was back to square one. Lesson learned !
Any information/suggestions would be greatly appreciated!!!
COMMUNITY LEADER
Sorry to be late to this party, but gimel asked me to take a look and reading over the thread, there are a couple questions I have.. actually, more than a couple - sort of like "a lot"... LOL
48 yrs old and post menopausal? I don't mean to pry, but is that natural or surgical menopause? How long have you been post menopausal? I also notice that your Estradiol is slightly over range. Gimel's question regarding medications/supplements is a valid one. Are you taking any HRT, such as premarin, patches, etc?
As far as the cortisol levels, that is a concern and I agree with gimel that often adrenal issues must be resolved, before thyroid function can be addressed. What happens is that when the thyroid doesn't work right, the adrenals kick in to pick up the slack. If the adrenals get too overworked, they just sort of "poop out" and don't work right.
Questions about the adrenal tests - what time was the nighttime cortisol test? What had you been doing/feeling just prior to that? Had you been under a lot of stress, in the days, just prior to these tests? Do you make sure you start "settling in" for the evening, early enough to let your body/mind slow down for sleep?
Have you had vitamin B12 levels tested? If so, what were the results and reference ranges?
Sorry, I probably asked a lot more questions than you care to answer, but with more information, we might be able to point you in the right direction.
I don't think you need anymore liver flushes... the body is designed to flush itself, if everything is working properly... If you have doubt about liver function, you should ask the NP to do liver function tests. I'm sure the reason the herbalist had you do those flushes is because the majority of conversion of FT4 to FT3 is done in the liver. The problem is that it's up to the liver to metabolize a lot the meds/ supplements we take, so we do have to be careful not overtax it.
What supplements did the herbalist put you on to flush the liver and which ones to enhance adrenal function? How long have you been on these supplements? Some of them take months to work; some don't work at all.
Okay, I'll stop here and let you catch up... LOL
48 yrs old and post menopausal? I don't mean to pry, but is that natural or surgical menopause? How long have you been post menopausal? I also notice that your Estradiol is slightly over range. Gimel's question regarding medications/supplements is a valid one. Are you taking any HRT, such as premarin, patches, etc?
As far as the cortisol levels, that is a concern and I agree with gimel that often adrenal issues must be resolved, before thyroid function can be addressed. What happens is that when the thyroid doesn't work right, the adrenals kick in to pick up the slack. If the adrenals get too overworked, they just sort of "poop out" and don't work right.
Questions about the adrenal tests - what time was the nighttime cortisol test? What had you been doing/feeling just prior to that? Had you been under a lot of stress, in the days, just prior to these tests? Do you make sure you start "settling in" for the evening, early enough to let your body/mind slow down for sleep?
Have you had vitamin B12 levels tested? If so, what were the results and reference ranges?
Sorry, I probably asked a lot more questions than you care to answer, but with more information, we might be able to point you in the right direction.
I don't think you need anymore liver flushes... the body is designed to flush itself, if everything is working properly... If you have doubt about liver function, you should ask the NP to do liver function tests. I'm sure the reason the herbalist had you do those flushes is because the majority of conversion of FT4 to FT3 is done in the liver. The problem is that it's up to the liver to metabolize a lot the meds/ supplements we take, so we do have to be careful not overtax it.
What supplements did the herbalist put you on to flush the liver and which ones to enhance adrenal function? How long have you been on these supplements? Some of them take months to work; some don't work at all.
Okay, I'll stop here and let you catch up... LOL
Glad to try and answer anything I can, but you're getting into unknown territory for me with your questions about high progesterone and testosterone. I am going to ask another member to have a look at your questions. One thing that did occur to me is whether you are taking any supplements or meds that could affect those levels?
Not to keep picking your brain but..... What does the high testosterone and progesterone mean and what can be done to bring those levels down. I'm a 48 yr old postmenopausal woman, by the way. :)
I'm sure that if there are supplements available to address the problem, doctors will have numerous medical options available. Perhaps you should ask your NP if she can prescribe something. I know your Free T3 and Free T4 will need to be increased, but at this point it may be best to work on the cortisol issue, and stabilize that before pushing further with your thyroid meds. Especially since your biggest concern seems to be lack of sleep.
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
