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THYROID DISEASE
Sept 30, 2010, I had my thyroid removed. I am now trying to learn the numbers that are thrown out with TSH. Could someone please help me to understand these numbers. I am hypothyroid. I am on Synthroid 88 mcg. I have bought several books, but, I am still unable to understand the different TSH numbers that thyroid patients in the know throw around.
All good right now, thanks. The only way I can think of that your ankles swelling might be related to thyroid , would be if you are still a bit hypo. But since I think that the swelling just started, I think I'd monitor it for a bit and if it continues, then maybe good to talk with your doctor. Also, maybe other members can provide the benefit of any similar experience they have had.
Hello,
Hope all is well with you. I am finally at 3 grams, Armour, and on my fourth week of holding. My problem that I am having right now is that my ankles are starting to swell. I have never had this problem before. Could it be from the Armour? What is your opinion on this?
Paris
Hope all is well with you. I am finally at 3 grams, Armour, and on my fourth week of holding. My problem that I am having right now is that my ankles are starting to swell. I have never had this problem before. Could it be from the Armour? What is your opinion on this?
Paris
Been doing some reading of old posts on this subject and based on those the answer is yes, it would be best to wait.
Hi Gimel,
I have found out that my ferritin is low. So, I am starting iron tablets. I crush my Armour and take it sublingually in the morning and afternoon. Do I still have to wait three hours before taking iron and calcium.
I have found out that my ferritin is low. So, I am starting iron tablets. I crush my Armour and take it sublingually in the morning and afternoon. Do I still have to wait three hours before taking iron and calcium.
One and a half grains sounds about right considering your previous dosage of Levo. You don't have to chew, just swallow. To get 90 mg just split one of the one grain tablets in half and take along with an additional one grain tablet. I split my total dose in half and take half in a.m. and half in early afternoon. You could try splitting your tablets so that you take 3/4 grain in a.m. and rest later in day. Or you could just take one grain in the a.m. and 1/2 grain in the afternoon. I don't think you will notice a big difference in the two approaches.
Many members are very diligent about not eating or drinking for an hour or so after taking meds I don't want to wait that long so I just take my meds and do whatever I normally would do. The main thing is to just do the same way fairly consistently. Personally I think I would wait for 4 weeks before getting new bloodwork done and then re-consider the dosage at that time, based on symptoms and test results.
Many members are very diligent about not eating or drinking for an hour or so after taking meds I don't want to wait that long so I just take my meds and do whatever I normally would do. The main thing is to just do the same way fairly consistently. Personally I think I would wait for 4 weeks before getting new bloodwork done and then re-consider the dosage at that time, based on symptoms and test results.
Some questions that I need help with;
Do you have to chew Armour in order to get the most benefit.
Must the mg be raised after two weeks automatically, without bloodwork.
I read that the typical Armour tablet comes as 60mg or 65mg which is called one grain. So, a 1/2 grain tablet is 30/32mg. A 2 grain tablet is 120mg/130. A 3 grain tablet is 180/195mgs. A 4 grain tablet is 240/260mg.....So where does a 90mg tablet come in at, which I am on. I am confused. Also, do you break yours up during the day, to get the benefit of T3 throughout the day. Please help.
Do you have to chew Armour in order to get the most benefit.
Must the mg be raised after two weeks automatically, without bloodwork.
I read that the typical Armour tablet comes as 60mg or 65mg which is called one grain. So, a 1/2 grain tablet is 30/32mg. A 2 grain tablet is 120mg/130. A 3 grain tablet is 180/195mgs. A 4 grain tablet is 240/260mg.....So where does a 90mg tablet come in at, which I am on. I am confused. Also, do you break yours up during the day, to get the benefit of T3 throughout the day. Please help.
He started me on 90mg. I believe that he was using 88 to100mcq of Levothyroxine that I was taking on and off as an indicator. Do you think that 90 is too much? Please let me know. Also, are there any everyday foods that I should stay away from.
My understanding was that they changed the filler material. then the FDA decided that they needed to do a lot of re-testing. This ultimately depleted Armour from Pharmacies.
How much are you planning to start with? One grain of Armour is roughly equal to about 75 mcg of Synthroid, so might be a good idea to start on a moderate dose and get acclimated to it and then increase slowly.
How much are you planning to start with? One grain of Armour is roughly equal to about 75 mcg of Synthroid, so might be a good idea to start on a moderate dose and get acclimated to it and then increase slowly.
Will be starting on Armour tomorrow. Feeling a little anxious, and excited. Certain everything will be ok though. I am more worried about the inactive ingredients than the active. My stomach was so sensitive to Synthroid. L-thyroxine has not given me a problem though, so I may be just fine with it.
From what I read concerning the shutdown, was that it was a problem with labelling, and not the product itself. Are you saying that they made changes to the product? I would not know the difference since this is my first time on it. And, you are not having any problems, so that is a plus. Yes, I will be sure to get my free T's done. I will be getting a report of the labs from him. I want to keep records for myself. Will keep you updated.
From what I read concerning the shutdown, was that it was a problem with labelling, and not the product itself. Are you saying that they made changes to the product? I would not know the difference since this is my first time on it. And, you are not having any problems, so that is a plus. Yes, I will be sure to get my free T's done. I will be getting a report of the labs from him. I want to keep records for myself. Will keep you updated.
Great news that you are getting the kind of treatment you should have gotten long ago. I do suggest that you ask the doctor to test for free T3 and free T4 next time, rather than total T3 and total T4. The frees are the portion of thyroid hormone that is not bound up with protein, which renders it inactive. If he resists, you should press him to do the frees.
As far as Armour. Armour was the thyroid med that I finally go to that relieved my symptoms by raising my free T3 level. Some members are somewhat dubious of Armour now, since the changes made a year ago that ultimately caused a shutdown of production for a while. I am back on it again and can't say that I have any problem Feeling great.
As far as Armour. Armour was the thyroid med that I finally go to that relieved my symptoms by raising my free T3 level. Some members are somewhat dubious of Armour now, since the changes made a year ago that ultimately caused a shutdown of production for a while. I am back on it again and can't say that I have any problem Feeling great.
Hello,
My new Endocrinologist, Dr. Jennings called me last night to report the results of my blood labs. He did studies from A to Z. Everything seemed to be great, except for my T3. We spoke about which therapy could possibly be beneficial in eliminating my residual hypo symptoms. We decided on Armour, which I will begin tomorrow. My pharmacy did not have it on hand, so it had to be ordered from the warehouse. I will be taking 90 mg for six weeks, at which time I will return to Dr. Jennings for new bloodwork.
LABS;
TSH .07
T4 10.7
T3 81
Has anyone ever been on Armour. And, if so would you please give me your opinion of this thyroid medication. Thanks.
My new Endocrinologist, Dr. Jennings called me last night to report the results of my blood labs. He did studies from A to Z. Everything seemed to be great, except for my T3. We spoke about which therapy could possibly be beneficial in eliminating my residual hypo symptoms. We decided on Armour, which I will begin tomorrow. My pharmacy did not have it on hand, so it had to be ordered from the warehouse. I will be taking 90 mg for six weeks, at which time I will return to Dr. Jennings for new bloodwork.
LABS;
TSH .07
T4 10.7
T3 81
Has anyone ever been on Armour. And, if so would you please give me your opinion of this thyroid medication. Thanks.
I finally met with my new Endocrinologist, Dr. Jennings on February 17th. I must say that I do feel new hope concerning my thyroid condition. He was very warm, attentive, and knowledgeable. We discussed my feelings, symptoms and concerns. I had prepared questions that needed answers, but doing our meeting my mind went blank. He was patient while I recaptured my memory lapse lol. After our discussion, he examined me, and did blood work for labs. He assured me that he did not think it would be too difficult getting me on the correct therapy. He also said me that we would plan my therapy TOGETHER. I am now waiting for my labs to come back, so that we can see where to go from here. I will be happy. Today is a not so good day for me.
Thank you my friends. Without you, I would not be this far along in understanding and treatment. Will keep you posted. Have a well day.
The people on this forum have been so helpful, that I cannot thank you enough. But, know in my heart that I will always remember the help that you have been. It is because of you, that I now know how to listen to my body, and have the courage to seek further knowledge, and help. I am stronger because of you.
I have a new endo who I will meet with on the 17th. Hopefully, together, we will be able to make me feel better. The hardest thing for me to grasp is that there are doctors out here who do not really know, and are so closed down that they are not trying to learn. But, now I get it. Will keep you updated on my progress every now and then. Bless you, thank you, and continue to do well.
I have a new endo who I will meet with on the 17th. Hopefully, together, we will be able to make me feel better. The hardest thing for me to grasp is that there are doctors out here who do not really know, and are so closed down that they are not trying to learn. But, now I get it. Will keep you updated on my progress every now and then. Bless you, thank you, and continue to do well.
Just to throw this in; The TSH is made by the pituitary gland and it lags weeks behind treatment. If you are ok in the Free T4 levels, you might still have a low TSH. the feedback loop is delicate and the numbers are not indicative of symptoms.
In other words, the Free T4 shows you are taking your medication, and the Free T3 shows how well it is being utilised. The pituitary gland will get the message that there is not enough or too much Free T4 and will send out the message to the thyroid (in your case not there) to adjust the Free T4. TSH is the hormone it sends out to do that. It takes weeks for the balance to adjust. So assuming the TSH on its own is going to give a true indication of your thyroid condition is not correct.
We people without a thyroid will continually struggle. ALL the information on dosing is done as if we are automatically hypo. There is no consideration for the fact the feedback loop is broken. Hence why it would be wise to opt to take some T3 supplement. If you can convince a doctor of that, I am sure you will be fine in no time!
Soon you will learn not to rely on the pathology levels and just learn to feel your own symptoms and what your body needs. Many people no longer get blood tests and just go by the fact when winter comes they need to slightly up their meds till summer time, then go back to the normal dose. Some people know when highly stressed they need to up their dose for a time, as well.
Good luck!
In other words, the Free T4 shows you are taking your medication, and the Free T3 shows how well it is being utilised. The pituitary gland will get the message that there is not enough or too much Free T4 and will send out the message to the thyroid (in your case not there) to adjust the Free T4. TSH is the hormone it sends out to do that. It takes weeks for the balance to adjust. So assuming the TSH on its own is going to give a true indication of your thyroid condition is not correct.
We people without a thyroid will continually struggle. ALL the information on dosing is done as if we are automatically hypo. There is no consideration for the fact the feedback loop is broken. Hence why it would be wise to opt to take some T3 supplement. If you can convince a doctor of that, I am sure you will be fine in no time!
Soon you will learn not to rely on the pathology levels and just learn to feel your own symptoms and what your body needs. Many people no longer get blood tests and just go by the fact when winter comes they need to slightly up their meds till summer time, then go back to the normal dose. Some people know when highly stressed they need to up their dose for a time, as well.
Good luck!
When someone says that TSH is suppressed, they mean that it is below the ref range. Occasionally there are reasons that TSH suppression is advisable. Most of the time TSH becomes suppressed when taking significant dosages of thyroid meds. For example my TSH hs been about .05 for over 25 years, while taking a full daily replacement dose of Synthroid at that time. Even with this, I still had lingering hypo symptoms, which I later found out here was due to FT3 being low in its range. For all those years I had never been tested for total T3 or FT3 because they said it was "not necessary". After my meds were changed to Armour, and my FT3 increased, I have felt best ever.
Many times doctors will scare patients by saying that a suppressed TSH will cause bone loss or heart problems. These are only concerns when FT3 and FT4 are excessive. but they use that concern to justify their lack of further action to relieve symptoms by adjusting FT3 and FT4 adequately. A suppressed TSH does not automatically make you hyper. You are hyper only if you have hyper symptoms due to excessive FT3 and FT4.
In a nutshell, you need a good thyroid doctor that will treat you clinically by adjusting FT3 and FT4 adequately to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not test results. In fact I could give you a reference to a 15 year old study that concluded that trying to manage a patient by test results on the 5 major tests, TSH, TT3, FT3, TT4, and FT4 was basically useless. That it was better to treat clinically (by symptoms) and use test results only to monitor progress.
I think you might get some additional good insight from this link.
http://hormonerestoration.com/files/ThyroidPMD.pdf
Many times doctors will scare patients by saying that a suppressed TSH will cause bone loss or heart problems. These are only concerns when FT3 and FT4 are excessive. but they use that concern to justify their lack of further action to relieve symptoms by adjusting FT3 and FT4 adequately. A suppressed TSH does not automatically make you hyper. You are hyper only if you have hyper symptoms due to excessive FT3 and FT4.
In a nutshell, you need a good thyroid doctor that will treat you clinically by adjusting FT3 and FT4 adequately to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not test results. In fact I could give you a reference to a 15 year old study that concluded that trying to manage a patient by test results on the 5 major tests, TSH, TT3, FT3, TT4, and FT4 was basically useless. That it was better to treat clinically (by symptoms) and use test results only to monitor progress.
I think you might get some additional good insight from this link.
http://hormonerestoration.com/files/ThyroidPMD.pdf
Hello,
Could you please explain what suppression means, and how low the suppression numbers should be. Also, is TSH used to make certain that you are suppressed. From what I've read, they seem to be very low numbers. If that is so, that means that I have never been suppressed by my lab TSH numbers. My endo never mentioned this to me. I found this out through reading. Is this suppression very important? Thank you.
Could you please explain what suppression means, and how low the suppression numbers should be. Also, is TSH used to make certain that you are suppressed. From what I've read, they seem to be very low numbers. If that is so, that means that I have never been suppressed by my lab TSH numbers. My endo never mentioned this to me. I found this out through reading. Is this suppression very important? Thank you.
Feeling bad on my regimen of Levothoroxine 88 mcq. Having all kinds of symptoms. Spoke with my endocrinologist today to ask if she would consider adding T3 to my regimen. She does not EVER prescribe this. She kept saying that your labs are good, and that T3 causes heart problems. I explained that even though my labs look good on paper, my quality of life was not so good. I told her that I felt better on 100 mcq of Levo, but her response to that was "you have too much thyroid hormone when you are on l00 mcq, and I am afraid that you will become hyperthyroid, and develop arrythmia." I told her that I did not want to stay on Levo 88 and feel bad, when I do everything else in my life to feel good, i.e., exercise, diet........She could tell by my questions and answers that I was not feeling good with her. She suggested that I should get another opinion from another endocrinologist. I told her that I already planned to. She told me that I should not listen to what I read on the internet. My response was, I am trying to live the best life that I can with my disease, and I will listen, and read or whatever else it takes to get me to back to feeling and living well, and whole. She offeered a list of other endocrinologists. I asked did they practice intergrative medicine. She got quiet. The last thing that I need is to get another doctor that thinks as she does. I found it hard to believe that she could only go so far in helping me.
I have an endocrinologist and a PCP. Unfortunately, they think alike. They both think that I am in perfect range. He keeps telling me that I am not hypothyroid. I thought when they removed your thyroid, that made you hypothyroid.I had to get my PCP to refer me for T4/3 testing, because my endo did not think that I needed it. I have an appointment with another doctor, referred to my by someone from this forum. He is supposed to deal with T4/3 issues. I pray that this turns out ok. My appt. is on the 17th of Feb. No, I do not believe that I have had an antibodies test. I have had a complete blood workup for everything else in the body though. Would the test be called an antibodies test? The other thing that I am not up on is the suppression thing. Why are they keeping me suppressed. What does that mean? Could you please explain that to me. Sept 30, 2010, they removed my thyroid. They found two less than 1 cm cancers. I did not have to take any other medicines, because they did not extend outside the parameters. I remember before my endo put me back on 88 mcq Levo from 100 mcq, I felt better, and my TSH was 09 L while on the 100 mcq. She put me back on 88 because during our visit she asked me if I could hear my heart thump when I was laying prone. I said yes. Thank you so much for helping me sort through this. If it were not for the people here, I don't know where I would be.
COMMUNITY LEADER
Even though "in range", your FT3 is WAY too low........ this indicates that you aren't converting FT4 to T3........ I'd suggest that you try a small dose of a T3 med (cytomel or generic), to bring the FT3 up; also try taking a good quality selenium, which, studies have shown, "may" help with the conversion of FT4 to FT3.
You are right that muscular pains are common symptoms of hypothyroidism.... is it possible to get a referral to an endocrinologist? If not, you may have to look at finding a different pcp...........
Have you ever had tests for antibodies to confirm/rule out autoimmune thyroid disease?
You are right that muscular pains are common symptoms of hypothyroidism.... is it possible to get a referral to an endocrinologist? If not, you may have to look at finding a different pcp...........
Have you ever had tests for antibodies to confirm/rule out autoimmune thyroid disease?
NEW LABS - PLEASE TELL ME WHAT YOU THINK.
REFERENCE RANGE
TSH 3rd GENERATION 0.32 L 0.40-4.50 mIU/L
T4, FREE 1.6 0.8-1.8 ng.dL
T3, FREE 2.6 2.3-4.2 pg/mL
CBC (INCLUDES DIFF/PLT)
WHITE BLOOD CELL COUNT 4.0 3.8-10.8 Thousand/uL
CALCIUM 9.2
REFERENCE RANGE
TSH 3rd GENERATION 0.32 L 0.40-4.50 mIU/L
T4, FREE 1.6 0.8-1.8 ng.dL
T3, FREE 2.6 2.3-4.2 pg/mL
CBC (INCLUDES DIFF/PLT)
WHITE BLOOD CELL COUNT 4.0 3.8-10.8 Thousand/uL
CALCIUM 9.2
Thank you Barb.
I will post them as soon as I receive them in the mail. After speaking with my PCP yesterday, I am convinced that he is not up on what is really happening as far as the thyroid goes. I told him that I was having muscular aches to the point of not being able to walk on Sunday (better now). His response was we have too look for something else, its not coming from the thyroid condition)". He obviously does not know this is one of the many symptoms.
I will post them as soon as I receive them in the mail. After speaking with my PCP yesterday, I am convinced that he is not up on what is really happening as far as the thyroid goes. I told him that I was having muscular aches to the point of not being able to walk on Sunday (better now). His response was we have too look for something else, its not coming from the thyroid condition)". He obviously does not know this is one of the many symptoms.
COMMUNITY LEADER
I totally agree with gimel -- ignore the TSH and work off your symptoms and Free T3 and Free T4 levels. But to answer your question, TSH of 0.32 is much lower than 1.25, though still in range. Like gimel, my TSH stays very low (usually < 0.01), and we don't even look at it; we go by the FT3 and FT4. I'm trying to figure out why they keep testing it.
Since you don't have the ranges for the FT3 and FT4, I can only guess, but judging from what we usually see, your FT4 appears quite high and your FT3 appears very low ............ In my opinion, even though your levels may fall within so-called "normal ranges", they are probably not "ok" for you.
It would appear that you may not be converting the FT4 to T3, which is most likely what's keeping you feeling ill. You might benefit greatly from a small dose of T3 med (cytomel).
Of course, keep in mind that it depends on the ranges used by your own lab, I could be way off. Please post those ranges as soon as you get them, because without them, we can only guess.
Since you don't have the ranges for the FT3 and FT4, I can only guess, but judging from what we usually see, your FT4 appears quite high and your FT3 appears very low ............ In my opinion, even though your levels may fall within so-called "normal ranges", they are probably not "ok" for you.
It would appear that you may not be converting the FT4 to T3, which is most likely what's keeping you feeling ill. You might benefit greatly from a small dose of T3 med (cytomel).
Of course, keep in mind that it depends on the ranges used by your own lab, I could be way off. Please post those ranges as soon as you get them, because without them, we can only guess.
Today my PCP called with the results of my blood work. I was at the gym so I did not get a chance to speak with him. I will give you what he left on my phone. He promised to send the report to me in the mail.
He said that my thyroid actually came out ok". TSH was .32, which is an appropriate level of suppression, FT4 was 1.6 which is normal, FT3 was 2.6. which is right in the normal range. I do not have the actual lab form yet, so I do not know what the lab range is. Vitamin D very good. He said he was pleased, and that my thyroid levels looked good on this level. He also said my cholesterol was high. The sites which you sent me said that high cholesterol was one of the things that happened when you are hypo. Is this suppression thing because of my 2 small cancers (less than 1cm) that were found in my thyroid? I think my endo said that this will help to keep it from coming back.
Now, what I cannot understand is if everything is sooo normal, why do I still feel like crap. Why am I still having muscular pains and spasms. Why is my hair so brittle, and my hands so dry? And, why am I going from hot to cold, cold to hot, among other various off and on symptoms.
Also is .32 higher or lower than 1.25, which is where my endo is trying to get me back to.
I really do not know if I am doing right or wrong, but I started myself back on 100 mcq Levo, instead of staying on the 88 mcq hoping that I would feel better. Is it dangerous for me to do this? Really do not know what to do until I get to the new doctor. I keep reading everything hoping that a light bulb will come on, and I will understand all of this.
Thanks for your help.
He said that my thyroid actually came out ok". TSH was .32, which is an appropriate level of suppression, FT4 was 1.6 which is normal, FT3 was 2.6. which is right in the normal range. I do not have the actual lab form yet, so I do not know what the lab range is. Vitamin D very good. He said he was pleased, and that my thyroid levels looked good on this level. He also said my cholesterol was high. The sites which you sent me said that high cholesterol was one of the things that happened when you are hypo. Is this suppression thing because of my 2 small cancers (less than 1cm) that were found in my thyroid? I think my endo said that this will help to keep it from coming back.
Now, what I cannot understand is if everything is sooo normal, why do I still feel like crap. Why am I still having muscular pains and spasms. Why is my hair so brittle, and my hands so dry? And, why am I going from hot to cold, cold to hot, among other various off and on symptoms.
Also is .32 higher or lower than 1.25, which is where my endo is trying to get me back to.
I really do not know if I am doing right or wrong, but I started myself back on 100 mcq Levo, instead of staying on the 88 mcq hoping that I would feel better. Is it dangerous for me to do this? Really do not know what to do until I get to the new doctor. I keep reading everything hoping that a light bulb will come on, and I will understand all of this.
Thanks for your help.
Hi,
Tried to contact the doctor (Dr. Anthony Jenkins) you called. The operator keeps saying that the number has been disconnected. Could you please give me the number again.
Thank you
Tried to contact the doctor (Dr. Anthony Jenkins) you called. The operator keeps saying that the number has been disconnected. Could you please give me the number again.
Thank you
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A good thyroid doctor will treat a thyroid patient clinically, by testing and adjusting free T3 and free T4 with medication adequate to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not test results.
Leg cramps are one of the symptoms listed in this link. Do you have other symptoms as well?
http://www.endocrineweb.com/conditions/thyroid/hypothyroidism-too-little-thyroid-hormone
With you still having symptoms, you probably need to have your meds tweaked, but you first need to find out the levels of free T3 and free T4, to help guide med increases. For example if your FT3 is on the low end of the range, but FT4 is midpoint or higher, then just adding more T4 meds is not the best approach. In that case it would be better to add a source of T3 to your meds. Also, if you are not converting T4 to T3 very well, then that might indicate the need for testing of iron/ferritin and selenium. Also, if you haven't been tested for Vitamin D and B12, those are frequently found to be low for hypo patients.
So I suggest that you go back and get that testing done (insist if necessary) and then when available, get a copy of the lab report and post results and reference ranges here. Members will be glad to help interpret and advise further.