Thyroid Medication Converstion

[Applesan]

I was taking 88mcg of Levoxyl and because I felt unwell taking synthetic thyroid medications my doctor is having me try Armour.  She gave me 90mg of Armour in place of 88mcg of Levoxl.  Can anyone tell me if that is a correct converstion since now I feel extremely unwell, internal tremors, light headedness, etc.  Seems to me that 90mg is too high when I look at some of the conversion tables on the internet, but I'm not sure they are correct.  My TH prior to the change to Armour was .45.

[Applesan]

Thanks so much; I appreciate all of your comments.

[gimel]

Wow, that is a puzzle as to why your doctor did not agree with reducing your meds.  Usually with TSH that low in the range and palpitations, doctors would be anxious to reduce your meds.  Although palpitations can occur from both high and low thyroid hormones, in my opinion I would not go over one grain of Armour and make sure your body is okay with that dose first.  

Also, I suggest that you should test for Vitamin A, D, B12 and ferritin, to make sure those levels are well up in their ranges.

[Applesan]

Ranges:
TSH - .40 to 4.70
Free T3 -  2.8-5.3
Free T4 - 0.8 - 1.8

My regular doctor is the one who wouldn't reduce the Levoxyl to 75mcg when I asked and she also wouldn't prescribe Armour although the synthetics make me ill.  So I went to a Women's Clinic and they are the ones that prescribed the Armour; I did tell them that I thought the dosage was too high but I was told that it wasn't.  Makes me wonder how much you should or shouldn't trust a doctor.

[gimel]

Before commenting further, could you please provide the reference ranges for those tests, as shown on the lab report?   Also, why is the doctor resistant to you reducing your meds slightly?  If the heart palpitations are associated with the Free T3 and Free T4 levels being a bit on the high side, I don't understand her refusal to reduce.  I am also concerned that the Armour dosage she gave you may be the wrong direction.  

[Applesan]

My last blood test on Levoxyl was the following; all within normal ranges according to my doctor:
TSH .45
Free T3 3.8
Free T4 1.4
I had been having heart palpitations then and asked if I could have the Levoxyl reducted from 88 to 75, but she wouldn't do it.  I then went to a Women's Clinic and they offered Amour so though I would try it.  I'll see how this goes but I do think the doseage is too high to start with.

[gimel]

The conversion of T4 to an NDT med like Armour or Nature-Throid depends on an assumption of the activity of T3 to T4.  Assumptions are that T3 is somewhere between 4 to 8 times as active as T4.  Therefore, the conversion factors usually are one grain of NDT med is equivalent to somewhere between 75 and 100 mcg of T4.  So your doctor gave you too much Armour.  One grain would have been closer to your T4 dose.  

That said, it could well be that you ultimately need a larger dose than one grain to relieve hypo symptoms, but even if that is found correct, it would have been better to start with one grain and increase slowly, as needed.  

For the future, be aware that hypo patients taking thyroid meds adequate to relieve symptoms often find that their TSH becomes suppressed below the range.  In a case like that the doctors often declare you hyper and want to reduce your meds.  In reality, you are hyper only if having hyper symptoms, due to excessive levels of Free T3 and Free T4.