armour and synthroid taken together

[lashes123]

I have been taking synthroid for many years. Last week I was prescribed Armour thyroid to be taken 3 times per day, with the first dose to be taken in the morning together with a low dose of synthroid. Has anyone heard of this? I spoke to two pharmacists and they both report they have never seen it prescribed that way.

Please help!!!

[gimel]

Prednisone is bad stuff, especially if you have to take it for extended periods.  Someone I know was on it for a year plus, with the doctor's direction to wean off it slowly.  Almost immediately afterward the symptoms returned.  Another doctor  had previously mentioned the  possibility of the symptoms actually being due to low cortisol.  After starting on a prescription for hydrocortisone, along with DHEA adequate to offset the bad effects of cortisol, symptoms were 95% improved in just two days, and the good results continue.

When you say you had adrenal insufficiency, what was the basis for that?  What tests were done?

[TheEasy1]

What is the name of your Doctor in St. Louis. I need thyroid help and can't find a good doc in St. Louis. I live in OFallon, but am willing to travel a little. Thanks! - JM

[Barb135]

You've attached your (rude) comments to a very old thread; most of the previous posters are no longer active on the forum, so it's unlikely that they will respond.

Because people on Armour often have lower FT4, we do have some on the forum who are/have been on, both, Armour (or other desiccated), along with Synthroid (or generic levo).

[stuffedpolarbear]

I am 54 year old male that suffered a hypoxic brain injury 5 ½ years ago, do to lack of oxygen during a surgery. Right after that they said I had hypothyroid, but they kept changing my meds ever couple of months. I have never felt good post brain injury.
A year ago they finally diagnosed me as hypopituitarism. I replace my testosterone, HGH, thyroid. Having problems with adrenals as well, along with insipidus diabetes.
I have been wanting to use synthroid and armor together and just started this therapy.
I know I have a different set of problems, but I wonder about any others here that use both synthroid and Armor.
Are you feeling better on both?
Labs good?
Feel good?
Etc.
Thanks
Stuffed Bear!

[stuffedpolarbear]

The dosages you are taking is the same as me. I can’t help but wonder your age, size, sex and weight.
Are you open to letting me know these things?
I have a damaged pituitary gland. My docs have been trying to regulate my thyroid for the past five years. When they think they have me on the correct dosage, my pituitary gland throws a curve ball so to speak, then all labs go out the window and i feel sick, no energy, depressed, and ready to give up. I just got my doc to try using both Synthroid and Armor.
Are you still taking these? I think your post is an old one.

[tstrong]

I'm actually going to ask my doctor to take one grain of my naturethroid and convert it to levoxyl.  I hope to be on one grain of Naturethroid, 75 mcg of levoxyl (synthetic T4).  2 grains of Naturethroid gives me too high a T3 lab, and low T4  (below 1). If I try to take less than 2 grains of naturethroid, I become hypo.

[stuffedpolarbear]

What difference does it make as to what their dosage of synthroid is?
You don’t ask the correct questions because you don’t know what to ask or why!
So why are you trying to give advice?

You need to stop playing a no it all!

[tstrong]

Know it all

[tpre]

Just thought I would mention regarding food intake and exercise/ I have absolutely no appetite and make myself eat. Mostly meat, eggs, and veggies with maybe 2 or 3 treats a week. Very dry mouth and no desire to eat at all.

[tstrong]

Are you taking an active/co-enzyme b complex?  

[gimel]

There is lots of info on areas that I know very little about; however, among those results I saw nothing that stood out as a concern.   Focusing on the thyroid test results, your Free T3 was way too high when taking the Armour, due to the dosage.  

Now you have switched to 200 mcg of Levoxyl, and your Free T3 went down from 5.7 to 3.9.  Free T3 needs to be adjusted as necessary to relieve hypo symptoms.  A level of 3.9 is adequate for many people unless Reverse T3 is too high.  Your RT3 was 20.4, which gives a FT3 to RT3 ratio that is also adequate.  The issue I see in your thyroid test results is the high level of Free T4, at 1.74.  FT4 does not need to be that high.  Middle of the range is adequate.  

You have Hashimoto's Thyroiditis, so you cannot stop taking replacement thyroid med.  You also do not want to reduce by 50%, as you mentioned.  I would suggest that you discuss with your doctor that you need to reduce your T4 med by about 25 mcg and re-test after 4 or 5 weeks.  This may also reduce the RT3 level, which would be good.

The weight gain you mentioned after changing your meds is likely due to the fact that you went from being over medicated on the 4 grains of Armour, with a FT3 of 5.7, down to a more normal level of 3.9.  Even if you increased your FT3 a bit, within the range,  I doubt that is going to get your metabolism back to the supercharged level from before.  You may have to take a hard look at your diet and exercise levels, and make sure they are in line with your desired weight.

Since you also mentioned TSH, I should point out that when taking thyroid meds, TSH frequently becomes suppressed.  That does not mean you are hyperthyroid, unless you do have hyper symptoms, due to excessive levels of FT3 and FT4.  So TSH is basically useless as a diagnostic when taking thyroid meds.  

[tpre]

Ok Im not going to try to take anything out. You should see the different dates and maybe understand it. 04/12/2013 below was while on Armour

Lab Receipt: 4/12/2013 1:04:00 PM          Collection: 4/12/2013 8:10:00 AM          Results: 4/16/2013 2:22:00 PM







Patient is Fasting
303756 - Lipid Panel
      Cholesterol, Total  144 mg/dL 100-199 F
      Triglycerides  106 mg/dL 0-149 F
      HDL Cholesterol  41 mg/dL >39 F
According to ATP-III Guidelines, HDL-C >59 mg/dL is considered a
negative risk factor for CHD.
      VLDL Cholesterol Cal  21 mg/dL 5-40 F
      LDL Cholesterol Calc  82 mg/dL 0-99 F
      Comment:     X

001321 - Iron and TIBC
      Iron Bind.Cap.(TIBC)  367 ug/dL 250-450 F
      UIBC  247 ug/dL 150-375 F
      Iron, Serum  120 ug/dL 35-155 F
      Iron Saturation  33 % 15-55 F

000810 - Vitamin B12 and Folate
      Vitamin B12  739 pg/mL 211-946 F
      Folate (Folic Acid), Serum  18.6 ng/mL >3.0 F
A serum folate concentration of less than 3.1 ng/mL is
considered to represent clinical deficiency.

102525 - Hgb A1c with eAG Estimation
      Hemoglobin A1c  5.4 % 4.8-5.6 F
.
Increased risk for diabetes: 5.7 - 6.4
Diabetes: >6.4
Glycemic control for adults with diabetes: <7.0
      Estim. Avg Glu (eAG)  108 mg/dL  F

140103 - Testosterone,Free and Total
      Testosterone, Serum  28 ng/dL 8-48 F
      Free Testosterone(Direct)  0.4 pg/mL 0.0-2.2 F

001974 - Thyroxine (T4) Free, Direct, S
      T4,Free(Direct)  1.39 ng/dL 0.82-1.77 F

004020 - DHEA-Sulfate
      DHEA-Sulfate  52.0 ug/dL 35.4-256.0 F

004051 - Cortisol
      Cortisol 22.7  ug/dL 2.3-19.4 F
Cortisol AM 6.2 - 19.4
Cortisol PM 2.3 - 11.9

004259 - TSH
      TSH <0.005  uIU/mL 0.450-4.500 F

004515 - Estradiol
      Estradiol  26.5 pg/mL  F
Adult Female:
Follicular phase 12.5 - 166.0
Ovulation phase 85.8 - 498.0
Luteal phase 43.8 - 211.0
Postmenopausal 4300.0
Girls (1-10 years) 6.0 - 27.0
Roche ECLIA methodology

070104 - Reverse T3, Serum
      Reverse T3, Serum  21.5 ng/dL 9.2-24.1 F

081950 - Vitamin D, 25-Hydroxy
      Vitamin D, 25-Hydroxy  50.6 ng/mL 30.0-100.0 F
Vitamin D deficiency has been defined by the Institute of
Medicine and an Endocrine Society practice guideline as a
level of serum 25-OH vitamin D less than 20 ng/mL (1,2).
The Endocrine Society went on to further define vitamin D
insufficiency as a level between 21 and 29 ng/mL (2).
1. IOM (Institute of Medicine). 2010. Dietary reference
intakes for calcium and D. Washington DC: The
National Academies Press.
2. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al.
Evaluation, treatment, and prevention of vitamin D
deficiency: an Endocrine Society clinical practice
guideline. JCEM. 2011 Jul; 96(7):1911-30.

004317 - Progesterone
      Progesterone  4.6 ng/mL  F
Follicular phase 0.2 - 1.5
Luteal phase 1.7 - 27.0
Ovulation phase 0.8 - 3.0
Pregnant
First trimester 8.8 - 48.6
Second trimester 12.4 - 75.8
Third trimester 58.5 - 222.3
Postmenopausal 0.1 - 0.8

004598 - Ferritin, Serum
      Ferritin, Serum  66 ng/mL 13-150 F

010389 - Triiodothyronine,Free,Serum
      Triiodothyronine,Free,Serum 5.7  pg/mL 2.0-4.4 F

[tpre]

Lab Receipt: 7/5/2013 12:38:00 PM          Collection: 7/5/2013 8:02:00 AM          Results: 7/9/2013 5:11:00 PM


Patient is Fasting
001974 - Thyroxine (T4) Free, Direct, S
      T4,Free(Direct)  1.74 ng/dL 0.82-1.77 F

004259 - TSH
      TSH <0.005  uIU/mL 0.450-4.500 F

070104 - Reverse T3, Serum
      Reverse T3, Serum  20.3 ng/dL 9.2-24.1 F

010389 - Triiodothyronine,Free,Serum
      Triiodothyronine,Free,Serum  3.9 pg/mL 2.0-4.4 F


Lab Receipt: 5/28/2013 1:47:00 PM          Collection: 5/28/2013 9:02:00 AM          Results: 6/3/2013 10:10:00 AM

Patient is Fasting
  .  
001974 - Thyroxine (T4) Free, Direct, S
      T4,Free(Direct)  1.58 ng/dL 0.82-1.77 F
  
004259 - TSH
      TSH 3.0 F
  
001974 - Thyroxine (T4) Free, Direct, S
      T4,Free(Direct)  1.39 ng/dL 0.82-1.77 F
  
004259 - TSH
      TSH <0.005  uIU/mL 0.450-4.500 F
  
070104 - Reverse T3, Serum
      Reverse T3, Serum  21.5 ng/dL 9.2-24.1 F

081950 - Vitamin D, 25-Hydroxy
      Vitamin D, 25-Hydroxy  50.6 ng/mL 30.0-100.0 F

004598 - Ferritin, Serum
      Ferritin, Serum  66 ng/mL 13-150 F

010389 - Triiodothyronine,Free,Serum
      Triiodothyronine,Free,Serum 5.7  pg/mL 2.0-4.4 F

[tpre]

Wow let me re-copy and past. I had the different dates of each test and some stuff is missing all together

[gimel]

Why are there two different results on Free T4?

[tpre]

Yes I have thyroid antibodies associated with Hashimoto's Thyroiditis and was diagnosed with Hashi's. It was not based on TSH, the Doc actually said he doesn't look at TSH once Armour is started. The reason I didn't go back to 4 grain is because my other Doc didn't just have me stop Celexa he changed it to Lexapro and things got worse from there. I Stopped taking the Lexapro.  I do know that if you are not converting FT3 then you most likely have high RT3.

7/15/2013      200mcg Levoxyl

Thyroxine (T4) Free, Direct, S
      T4,Free(Direct)  1.74 ng/dL   0.82-1.77 F

TSH
      TSH 39  

      VLDL Cholesterol Cal  21 mg/dL 5-40  
      LDL Cholesterol Calc  82 mg/dL 0-99  


Iron and TIBC
      Iron Bind.Cap.(TIBC)  367 ug/dL   250-450  
      UIBC  247 ug/dL 150-375 F
      Iron, Serum  120 ug/dL 35-155  
      Iron Saturation  33 % 15-55

Vitamin B12 and Folate
      Vitamin B12  739 pg/mL   211-946 F
      Folate (Folic Acid), Serum  18.6 ng/mL   >3.0  

Thyroxine (T4) Free, Direct, S
      T4,Free(Direct)  1.39 ng/dL 0.82-1.77  

TSH
      TSH <0.005  uIU/mL 0.450-4.500  

Reverse T3, Serum
      Reverse T3, Serum  21.5 ng/dL   9.2-24.1  

Vitamin D, 25-Hydroxy
      Vitamin D, 25-Hydroxy  50.6 ng/mL   30.0-100.0
  
Ferritin, Serum
      Ferritin, Serum  66 ng/mL   13-150  

Triiodothyronine,Free,Serum
      Triiodothyronine,Free,Serum 5.7  pg/mL   2.0-4.4

[gimel]

Sorry for all the questions but I don't want to just slough you off without pursuing some things.  First, on what tests/symptoms did the doctor base his decision to prescribe thyroid med originally?   I have never known of adrenal issues causing low thyroid hormone levels.  Were you tested for the possibility of having thyroid antibodies associated with Hashimoto's Thyroiditis?  Those tests are TPO ab and TG ab.  Also, what test was used to determine your dosage as you increased over the years?  Was it based on TSH levels?

If 4 grains of Armour was working fine, before Celexa, why didn't you just go back to that med and dosage when you stopped the Celexa?  

Just because your T3 level was apparently high enough did not mean that you were converting T4 adequately.  T3 is always higher when taking NDT meds because of the 4:1 ratio of T4 to T3, not because of conversion.  

When you decided that 200 mcg of Levoxyl was too much, what was the basis for that conclusion.  I ask because 200 mcg of Levoxyl is nowhere near an equivalent dose for 4 grains of Armour, even if you did adequately convert the T4 to T3.  I expect the weight gain is telling you that you are not converting the T4 med to T3 adequately.  You really need to have test results for both Free T4 and Free T3 to know this.

Also, just because TSH is low does not mean that you are hyper, unless you do have hyper symptoms, due to excessive levels of Free T3 and Free T4.  

At this point I sure don't know what to suggest other than for you to get a full set of tests done.  For that I would recommend that you ask for Free T3 and  Free T4 (not the same as Total T3 and T4), along with Reverse T3, Vitamin D, B12, ferritin and a full iron test panel.  Believe me, just reducing your Levoxyl by half is not going to work for you.  I can't imagine too much Levoxyl causing too much strain on your adrenals.  If I knew nothing more, now or in the future, I'd say that the best approach would be to go back to what worked for you in the past, and gradually switch over from the Levoxyl to Armour again, and increase as necessary to relieve symptoms.  But I strongly suggest that you get the above tests done and review with us and get members' comments and further advice before making any more changes.

[tpre]

Ok after a lot of Doctors that knew nothing regarding adrenals and thyroid connection I went to a specialist in St Louis, MO. He spent 4 hours with me and I was on the road to success. My adrenals, vitamin, hormone levels were depleted 4 yrs post hysterectomy. And in realizing via a lot of testing that I was in some serious trouble the Doctor started me on a low dose of Armour along with Cortisol and hormones. Over the next 5 yrs as my adrenals healed and all my levels looked great we continued testing and adjusting my Armour. I felt my best at 4 Grain and my levels were right on the money. But I got put on Celexa for my OCD and my T4 fell way below so this is why we raised. I went off the Celexa without lowering the Armour  and felt very hyper (of course). We could see that my FT3 was converting fine so we thought lets try a lower dose and T4 only. Well 200 mcg Levoxyl it way to much and my Doctor and myself are thinking that I did really good on Armour at 4 Grain that maybe we should go back to this. But Im questioning if maybe since the only thing making  me feel bad is to much lovexyl putting strain on the adrenals again (levels a little high) should I continue it at 100 mcg or try to go off all together. My TSH NEVER came back up after starting levoxyl telling me again I was taking to much. Since starting levoxyl 4 months ago I gained 17 lbs.

[birdie51]

TPRE-
What were all the meds for the adrenals that worked? I've been on prednisone for years and still have adrenal insuffciency and no one knows why. I too am in St. Louis and go to Barnes endocrinology. Who was your dr?

[gimel]

The info you have given sets off some alarm bells regarding your doctor.  First, 5 grains of Armour is a very large dosage.  I'd really like to see your actual Free T3, Reverse T3 and Free T4 from that time, along with their reference ranges shown on the lab report.   Second, on switching from 5 grains of Armour, the 200 mcg of Levoxyl is nowhere near an equivalent dose.  I also don't understand the idea of going off thyroid med altogether because supposedly your Free T3 level was affected by your adrenal problem.  If that were the case, what was done to fix the adrenal issue,  and why did you also need to take all the thyroid med?  This just doesn't compute.

[tpre]

OK... when all of this began it was due to the adrenals and my FT3 was low. It has been 5 yrs and the adrenals are doing great but in the mean time through all of that I was slowly raised to 5 grain Armour. 4 months ago I got switched to 200 mcg Levoxyl. and in 4 months I gained back 17 lbs among other symptoms mainly extreme headaches and hot all the time. To answer your question regarding levels while on Armour ...My FT3 and Rev T3 are right where they need to be on Armour but T4 never gets any higher 1.38 Ref range 0.84 - 1.77. I admit I do great on Armour so I am going back but just wondered if maybe a little levoxyl with it would be a good thing to do. My doctor and I even discussed going off all together because my original problem was only my FT3 due to my adrenals years ago.

[gimel]

What are your Free T4 and Free T3 levels, and reference ranges?  Are you having any symptoms?

[tpre]

I have been reading and I see about the combo you take. My levels are good on Armour except my T4 level is low. The more I raise the Armour my T4 only comes up very little. I wonder if I should add 25 mcg of Levoxyl or if it is even heard of.

[1961bill]

question the reason for this? I take .175mg levothyroxine daily. To get my numbers adjusted endo suggested I take extra pill at night once a week. When i do I feel great, sleep well and its down hill till the next weeks dose. I m crashing and dosing is not working or allowing me ot feel good all day and night. This mixed does 3 times a day could be something to help me sto pthe crash.

[anca77]

I finally got my blood results. After 7 weeks of taking 75 mcg of Synthroid and 60mg of Armour my TSH is 0.47, free T4 is 1.2 and free T3 is 1.32.

My vitamin D is 26; I do not know what this mean. The doctor advised me to start taking  1000 units of vit D.

[laura1967]

Let us know how your labs turn out....get a copy so you can post them here. So glad you are feeling better....hope this was your answer.

Stella- Neat protocol huh? I discussed this protocol with my doctor who said huh?! She hadn't heard of it. It's a great book....you should get it and read it. The same book series also has a"what your doctors may not tell you about menopause" is good too! Yes all the free's are tested with the tsh for bloodwork. Dr Ken treats by symptoms and the free's, not by the tsh. He even works with patients long distance.
C- I completely believe you, because my pms diminished when I was optimum for that short period of time before hashi's dumped my thyroid again. Yes everyone's optimum level is different. If only most drs understood this.

[stella5349]

WOW

I really thought this was an odd treatment.

Who knew........???

With the lab ranges being so different taking them seperately I wonder how the Free T3 and Free T4 tests come out?

Do they test them too? I would think they would have to. Curious on the TSH test too??

Synthroid usually is about 1.0 for well being - but Armour is lower - in the .5 ( sometimes lower)

I wonder what protacol is????

[anca77]

I take Synthroid 75 mcg and Armour 60 mg, daily. I take the Synthroid in the morning then at 11 AM I take 30 mg of Armour and around 4 PM I take another 30 mg of Armour. I feel the best on this combination. I used to take only Levothyroxine then only Armour but combining the two works best for me. I am on this combination for over 6 weeks, I just had my blood test yesterday so I will see the results of this treatment soon

[Marath0ner]

How did this work for you?

[sherrygaither]

Yes, I'm wondering how this worked for you as well.  Please update.  Thank you.