I expect that your current symptoms are more likely due to inadequate dosage rather than lack of just T4. You felt better right after the switch because your T4 med was still affecting you, until it became depleted over the next 4 or 5 weeks. It would be a good idea to be tested for Free T3 and Free T4 to determine your current levels, which appear inadequate..
I said your Armour dosage is insufficient. Depending on which conversion factor used, your previous T4 dosage is equivalent to somewhere between 1 3/4 to 2 1/3 grains of Armour. So, the dosage prescribed for Armour is less than previous dose, which was somewhat inadequate.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation. The letter is then sent to the participating doctor of the patient to help guide treatment. In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."
It is a good sign that your doctor was willing to switch you to Armour. Now you need to persuade him to increase your Free T3 and Free T4 levels as necessary to relieve symptoms, as described in the link.
Further, if not tested for Vitamin D, B12 and ferritin, you should request those. It is important that each of those is optimal as well, for a hypothyroid patient.
Whats your diet like? Do you have any food triggers? Have you tried doing an Auto immune Paleo diet?
As for myself I was diagnosed last october. I am dairy, soy and gluten free. Some people would disagree with this thought process but you need to find out what works for you! I feel incredibly better and on 3 grains of Armour a day.
You can check into Micky Trescott, Marc Ryan or the Paleo Nurse.
While some people may feel better with diet restrictions, there is no scientific evidence to back up the theory that people who are hypo or who have Hashimoto's should give up an certain foods. Of course, if one has intolerance or allergies, by all means, they should be eliminated from the diet.
Actually i think there is a pretty well documented link between autoimmune thyroid disease and celiac/gluten, and more thyroid experts are now recommending gluten free diet for autoimmune thyroid patients, including Hashimoto's. here is some info i found:
Celiac Disease and Thyroid Disease
A significant number of patients with autoimmune thyroid disease also have celiac disease. The link between celiac disease and autoimmune thyroid disease is well established. Celiac disease and autoimmune thyroid disorders share a common genetic predisposition. This genetic predisposition may explain the higher incidence of thyroid autoimmune disorders among celiacs than in the general population.
It has been shown in studies that the prevalence of celiac disease in patients with autoimmune thyroid disease is 4-15 times greater than that in the general population. Various findings for the prevalence of celiac disease in Hashimoto's thyroiditis have been reported, between 3.3% and 4.8% in adults. According to a 2007 study published in the World Journal of Gastroenterology, patients with Hashimoto's thyroiditis should be screened for celiac disease and patients with known celiac disease should be screened for Hashimoto's thyroiditis.
In a large study published earlier by a group in the UK, confirmed celiac disease was found in 4.5% of adults with Graves disease.
According to the University of Chicago Celiac Disease Program, introducing a gluten-free diet in patients with celiac disease, with subclinical thyroiditis (only increased autoantibodies but no disease yet) is effective in most cases in bringing autoantibodies down to normal within two years. According to the study, if a patient with celiac disease already has diagnosed thyroiditis, then the gluten-free diet might not be effective.
The link between celiac and Hashimoto's is that they are both autoimmune diseases and when one has one autoimmune, they are more likely to have/get another or more. I totally agree that anyone with Hashimoto's, should be screened for celiac (and visa versa), as well as some other common autoimmunes, including, but not limited to Pernicious Anemia, RA, Lupus.
Anyone with diagnosed celiac should be gluten free, whether or not they have autoimmune thyroid disease. Those with autoimmune thyroid disease, but not celiac or an intolerance to gluten, have no reason to go gluten free.
Not to ask the obvious question, but you are taking the medication away from any iron you may also be taking right?
Also, it is frequently noted that the consistency of dosage for Armour and similar products is far less than synthetic hormones so it could be the batch.
Lastly, off the top of my head, have you spoken to your doctor about Low Dose Naltrexone? if you have mild Hashimoto's LDN could clear it up since it affects the immune system.
Thank you for your replies and thoughts. I contacted my MD and requested an increase of Armour based on my symptoms and the fact that 90mcg of Armour is only 150 mcg of Levothyroxine (I was previously at 175 Levothyroxine). But he wants to see me before making a change so I have an appt. in a few days.
My last question is about the math. How many mcg of Armour would equal 175 of Levothyroxine? And, if we decide to do a mixture, how much Armour and how much Levothyroxine would be equivalent to the original 175 mcg Levo?
Is there a benefit of using a combo rather than straight Armour?
I know I need blood work eventually, but just to get to a level playing field and to get these irritating symptoms to subside.
Natural Dessicated Thyroid (NDT like Armour) has been used successfully for over 100 years and has a longer track record of success than Synthetics which have been invented more recently. NDT is a manufactured product and potency is controlled during this modern production of the medication. There actually have been more recalls for the synthetics due to production variation in potency than there have been for NDT.
I have absolutely no problem with synthetics. I just do not buy into the idea that NDT has this massive variation that is commonly used as a criticism of NDT. If in fact there was this large of variation and with the high amount of T3 within NDT which is felt and used in HOURS compared to synthetic, then the large numbers of people using NDT would be complaining unendingly and the FDA would likely take NDT off the market. Yet this is NOT the experience of people using NDT. In fact I read many more reports of just the opposite. That nothing worked for them except NDT, or NDT along with one or other of the synthetics. But NDT was the breakthrough. Just using emperical/anecdotal experience to base my opinion on.
NDT itself IS a combo drug because it has BOTH the T4 and T3 hormones (and also T1 & T2). But I think you might be comparing or meaning the use of synthetic T4 and T3 instead of NDT. I see nothing wrong with ANY combination of medicines as long as the result is that you feel well! This combination can be 1) both synthetics, 2) NDT and T4, 3) NDT and T3. or even 4) T4 alone. Different dosages of different combinations work for different people. That is why we are all called INDIVIDUALS. What works great for one person may not work for another. The trick or the "art" of medicine is to find the tailored combination of drugs that will work for the individual patient. Unfortunately we seem to have a medical industry that is heavily weighted towards the "science" side of things. And expect the blood lab or labs getting to within some specific majic range to be right for everyone. A one size fits all method, rather than an individual art side of things.
Just my opinions. Others are free to agree or disagree.