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Thyroid low and med change

So, to follow up. They refused to do the saliva test, only the morning cortisol.

10/23/2018:  
Cortisol:    8.5.     (2.5-25 Range)
Rt3, total:   6.3 L. (7.5-19 Range)

11/7/2018      
Cortisol:   17.5.      (4.0-22.0 Range)

September 2018 labs:  
TSH:   0.02.    (.40-4.50). L
T4,Free:  0.7. (0.8-1.8). L
FSH. 69.0
LH. 21.3
Iron, total:  54.  (45-160)
Ferritin:  38.        (10-232)

My out of network provider thought an adrenal supplement would help and cortex, a steroid.  I did not take either.  A new primary provider found my case "mystifying", but felt I was correct in not taking  the steroid.
I am quite tired, to be honest.  Now, with the Cytomel shortage, I am really freaked.  
So, it's time to switch to Armour.  
I am out of Florida,  
The out of network will write for Armour.  I am not sure how I will handle labs without insurance....

Big Question.  

How much Armour?
Suggested is: Armour 15 3x Mon-Fri
And 4 x Sat & Sun
Does this sound about right, for a boost from the current regime:  50 Levoxyl 5 days a week, 75 Levoxyl 2 days a week and 25 mcg Cytomel 7 days a week.
All answers appreciated.
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1756321 tn?1547095325
My endo gave me 1 grain (60 mg) of Armour to replace 50 mcg of eutroxsig (synthetic T4). I wasn't absorbing Armour though so I switched back to T4.
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3 Comments
I would prefer to stay on t4/t3 synthetic, but t4 alone is not going to work for me, now that Cytomel is unobtainable to possibly summer 2019!
I found this info on Drug Shortage Report for CYTOMEL. Last updated on 2018-06-12..."next stock availability to cover all customer demand is expected mid-February 2019."

But I found another forum (Inspire - Cytomel shortage?) mentioning this "The pharmacist said that we will be only getting the 5mcg tablets back in Feb, and the 25mcg tablets will not be back until summer of 2019." Hmmm. You could also consider taking compounded T3 with levoxyl.
Thank you for that suggestion. That may be a better option, as I am reading questionable formulation reviews on Armour.
Monday looks like a day of phone calla.
Avatar universal
I have no idea how to even begin to explain how your cortisol level could essentially double in two weeks unless something caused a false high result.
I think you should ask the doctor how that could have happened.  At any rate I am sure they seized on the latest result and said all was okay.  

Obviously, you have a number of issues that would contribute to  being tired.  First is that your Free T4 is even below range, when it should be around mid-range.  There was no Free T3 test shown so does that mean they did not test?  You always need to tet for both Free T4 and Free T3.  In addition your iron level is way too low.  Ferritin should be at least 100.  So you need to supplement with a good iron supplement.  A very good one is Vitron C, which contains 65 mg of iron plus some Vitamin C to help absorption and avoid stomach distress from the iron.  

Whoever suggested that replacement dosage for Armour is very wrong.   With T3 meds you don't want to alternate doses like with T4.  Also, your current dosage averages 57 mcg of T4 and 25 mcg of T3 daily.  Since T3 is 3 times as potent as T4 that is equivalent to about 132 mcg of T4 which is equivalent to two grains of Armour (120 mg).  The proposed new dosage of Armour that you listed would average only 50 mg per day, which would be a huge drop and would be far worse for you.   To switch to Armour from you current med/dosage you really need to start with two grains (120 mg) and then increase from there.  
Helpful - 0
1 Comments
I sent a message to them.  i remembered trying Armour before, and starting at that 120 mg.  
I am not happy at all, that I do not have a competent doctor. And now, no doctor at all, till February.  And yes, happy indeed were they to dismiss all was fine.  Except the new primary went on to add that my call, in NOT taking the steroid was spot on.  I will take the Iron and
I will try to resolve this dosage error over the phone Monday.  Once again, as always, thanks Gimel
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649848 tn?1534633700
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