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Tammy Kveene
Been stable on thyroid meds for the past 15 years. I just got my TSH back and it is at 11.1. Why would this elevate so much? I was under 2 a year ago. I am 58 and went through radioactive therapy many many years ago. I take Armour Thyroid 90mg.
I am not personally familiar with NP Thyroid; however, they both contain the same amount of T4/T3 so the only difference would be in the fillers/binders used to manufacture the pills, and also how they are absorbed by your body. If you Google Armour versus NP Thyroid you will find there are conflicting reports of one working better than the other. So you will just have to see how it works for you by monitoring your symptoms and also your Free T4 and Free T3 levels.
Can I ask you one more thing. Due to the cost of Armour Thyroid they just switched me to NP Thyroid. Do the compare well? I will work at getting in a non RX treatment as soon. As I locate a provider
I just sent you a PM. To access, just click on your name and then from your personal page, click on messages.
Click on my name. That takes you to my personal page. Scroll down to bottom left area and you will see Journal. Click on that.
I am checking on several doctor prospects. To give you the best recommendations I need to know if you want to use health insurance or pay cash, because some doctors on the list don't accept insurance.
I am checking on several doctor prospects. To give you the best recommendations I need to know if you want to use health insurance or pay cash, because some doctors on the list don't accept insurance.
I am having a hard time finding your answers when I go back. How did you tell me I could see the responses on the website?
I would not recommend a nutritionist that gives you something not requiring a prescription. You need thyroid med, and more of it than current. It is difficult to find a good thyroid doctor. If you will tell us your location, perhaps we can suggest one that has been recommended by other thyroid patients.
This Dr I just saw is brand new. He seems open and more understanding of Armour Thyroid. It has been almond st a week and he has not even reviewed my labs so don’t think I will stay with him. Probably going to go to a Nutritionist who is going to start something that does not require prescription. We will see but certainly it is time to get my healt more on track.
Is your current doctor the one that charges you $250 per visit? If so, is that because you don't have insurance, or he doesn't accept insurance? Is this the office where you have trouble getting calls returned?
Many people split their dose of desiccated med or T3 med, in order to try and even out the T3 over a longer period of time. I think it is a personal decision: Whichever works best for you. If you are okay with taking it all at once, fine. When your doctor gets your dosage optimized, you could try and see if it helps in maintaining energy through the latter part of the day.
If you want to give this info to your doctor, click on my name and then on my personal page, go to the "Journal" section. There you will find a condensed (one page) overview of the full paper, which includes a link to the full paper. The one pager will be easier to give to the doctor and get him to read and consider the need for clinical treatment, as described.
Many people split their dose of desiccated med or T3 med, in order to try and even out the T3 over a longer period of time. I think it is a personal decision: Whichever works best for you. If you are okay with taking it all at once, fine. When your doctor gets your dosage optimized, you could try and see if it helps in maintaining energy through the latter part of the day.
If you want to give this info to your doctor, click on my name and then on my personal page, go to the "Journal" section. There you will find a condensed (one page) overview of the full paper, which includes a link to the full paper. The one pager will be easier to give to the doctor and get him to read and consider the need for clinical treatment, as described.
Each grain (60 mg) of Armour Thyroid contains about 39 mcg of T4 and 9 mcg of T3. This ratio is higher in T3 than natural thyroid, so when taking Armour it is quite normal for Free T3 to be higher in its range than Free T4; however, the reason I asked about when you took your dose and when blood was drawn is that it is recommended even in the ATA/AACE Guidelines for Hypothyroidism that the morning dose should be deferred until after the blood draw to prevent false high readings. The reason is that T3 has a half-life of less than a day and reaches full effect on serum levels in about 4 hours. A Free T3 test would be more affected that a Free T4 since T4 has a half-life of about one week. So we really cannot be sure of your real Free T3 level from that test. In the future you should make sure to defer your thyroid med until after the blood draw. In addition, you should insist that you are tested for Free T4, not Total T4. Free T4 and Free T3 are the biologically active thyroid hormones.
As for your higher TSH level, it is important to understand that TSH is affected by so many things that at best it is only an indicator of the thyroid status of an UNTREATED patient. TSH can be considered along with more important indicators such as symptoms, and then Free T4, Free T3, and sometimes Reverse T3. When a person has already been confirmed as hypothyroid, and is being treated with thyroid medication, most doctors don't understand that TSH is usually suppressed below range when the med dosage is adequate to relieve hypo symptoms. Instead the doctor will prescribe only enough thyroid med to bring TSH within its reference range. If the med dosage is increased and TSH becomes suppressed below range, most doctor get concerned about hyperthyroidism and reduce the med dosage. This is incorrect. Hyperthyroidism occurs only when having hyper symptoms due to excessive levels of Free T4 and Free T3. So TSH is basically a waste of test money when already taking thyroid med
I am relating all this just to explain that your doctor has been under-medicating you for all those years, by dosing you based on TSH. Instead a good thyroid doctor will treat a hypothyroid patient clinically, by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being influenced by resultant TSH levels. Symptom relief is all important, not just test results and especially not TSH results. Many of us have found that Free T4 needed to be at mid-range and Free T3 in the upper third of its range, and adjusted from there as needed to relieve symptoms. Your 90 mg of Armour is not enough to be a full daily replacement dosage adequate to relieve your hypo sympotms.
In addition to getting your med dosage increased enough to relieve your hypo symptoms of weight gain, joint and muscle pain, and high cholesterol, you also need to test and supplement Vitamin D, B12 and ferritin to optimize. D should be at least 50 ng/mL, B12 n the upper end of its range and ferritin should be at least 100. All three are important for hypothyroid patients to feel their best.
If you want to confirm what I have told you please read at least the first two pages of the following link, and more, if you want to gt into the discussion and scientific evidence for all that is recommended. You might also find the info helpful by giving a copy to your doctor and asking to be treated clinically, a described, rather than based on TSH. If your doctor resists all this, then you will need to find a good thyroid doctor.
http://www.thyroiduk.org/tuk/TUK_PDFs/The%20Diagnosis%20and%20Treatment%20of%20Hypothyroidism%20%20August%202017%20%20Update.pdf
As for your higher TSH level, it is important to understand that TSH is affected by so many things that at best it is only an indicator of the thyroid status of an UNTREATED patient. TSH can be considered along with more important indicators such as symptoms, and then Free T4, Free T3, and sometimes Reverse T3. When a person has already been confirmed as hypothyroid, and is being treated with thyroid medication, most doctors don't understand that TSH is usually suppressed below range when the med dosage is adequate to relieve hypo symptoms. Instead the doctor will prescribe only enough thyroid med to bring TSH within its reference range. If the med dosage is increased and TSH becomes suppressed below range, most doctor get concerned about hyperthyroidism and reduce the med dosage. This is incorrect. Hyperthyroidism occurs only when having hyper symptoms due to excessive levels of Free T4 and Free T3. So TSH is basically a waste of test money when already taking thyroid med
I am relating all this just to explain that your doctor has been under-medicating you for all those years, by dosing you based on TSH. Instead a good thyroid doctor will treat a hypothyroid patient clinically, by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being influenced by resultant TSH levels. Symptom relief is all important, not just test results and especially not TSH results. Many of us have found that Free T4 needed to be at mid-range and Free T3 in the upper third of its range, and adjusted from there as needed to relieve symptoms. Your 90 mg of Armour is not enough to be a full daily replacement dosage adequate to relieve your hypo sympotms.
In addition to getting your med dosage increased enough to relieve your hypo symptoms of weight gain, joint and muscle pain, and high cholesterol, you also need to test and supplement Vitamin D, B12 and ferritin to optimize. D should be at least 50 ng/mL, B12 n the upper end of its range and ferritin should be at least 100. All three are important for hypothyroid patients to feel their best.
If you want to confirm what I have told you please read at least the first two pages of the following link, and more, if you want to gt into the discussion and scientific evidence for all that is recommended. You might also find the info helpful by giving a copy to your doctor and asking to be treated clinically, a described, rather than based on TSH. If your doctor resists all this, then you will need to find a good thyroid doctor.
http://www.thyroiduk.org/tuk/TUK_PDFs/The%20Diagnosis%20and%20Treatment%20of%20Hypothyroidism%20%20August%202017%20%20Update.pdf
1 Comments
Thank you sir you just explained so well for me what I wish my Dr would have told me. Good thing is I now have a doctor told me he’s willing to work with as well. I’ve spent years struggling in a community health center with the doctor he wouldn’t listen to any reason. I will take this information to my doctor. Do you suggest that I cut my dose in half and take it at two different times of the day?
I usually take full dose right away in the morning usually around seven. I had my blood drawn at about 1 o’clock in the afternoon.
Since you have confirmed the Free T3 result, that leads to a further question. Do you take your Armour Thyroid dose all at once? Also, what time did you take your morning dose of Armour Thyroid, and what time was the blood draw for those test results?
We whikIfeel pretty good with the exception of weight gain. I have had problems with high cholesterol for quite some time. I believe I can’t control the cholesterol well I’m fighting hypothyroidism. Seems I’ve had more problems being hypo in the last six years then I had the whole first 10 years of being on a thyroid replacement. They totally killed the thyroid. Yes both tests show 4.6. Reference values for T4 are 4.5-12.0 and for the free serum 2.0-4.4 and the TSH .0450-4.500.
Sorry, I should have also asked if you had symptoms in the past when your TSH was under 2? Also, did the RAI totally kill your thyroid gland, or was there some tissue left? Also, please double check the Free T3 result. You showed 4.6 for each. Is that correct? Also, since lab results and calculated reference ranges vary from lab to lab, please give me the reference ranges for the T4 and Free T3 results.
Thanks...weight gain and joint and muscle pain. T4 4.6, TSH 11.160, Triiodothyronine Free Serum 4.6, total cholesterol 301. New Dr that has not reviewed labs yet even after 4 days. When I call the office I don’t get a call back. $250 Dr visit and $200 lab work makes scheduling another appt difficult. Last year my TSH was 1.230. Only one other time in my history of being on thyroid meds have I been hypothyroid.
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