Has anyone tried Armour thyroid post total thyroidectomy?

[JemimahR]

I was wondering if anyone had any experience of Armour thyroid. I had a total thyroidectomy in 2010. Since then my Endo has struggled to get my levels right. He's tried T4 solely up to 150mcg and T4 / T3 in combination at varying doses most recently 75mcg Levothyroxine and 30 mcg Liothyronine. I have asked to trial T3 only at a higher dosage but he has been against this as he thinks I'm over medicated. My most recent test results are T4 - 11, T3 - 3.7, TSH 0.01. My T4 and T3 levels have only recently fallen within the 'normal' range, however my TSH has always been suppressed. I am still symptomatic - breathless, palpitations, insomnia, cold, excess sweating, exhaustion, difficulty losing weight, foggy head, labile mood, etc etc...He has suggested I come off T4 and T3 and try Armour thyroid instead - 1.5 tabs daily (1 grain tabs). I am concerned that I'm going to feel wretched without the T3. My body doesn't convert T4 to T3 due to the severity of the Graves thus the requirement for T3 supplementation. Does anyone have any experience with this? Thanks Jem

[vajra]

Hi JR. Your mention of TT caught my eye as I had one in 2005. (but not for Graves - for a cancer and auto immune disease, with never diagnosed but long term severe hypothyroidism)

I don't convert well either, take a similarly moderate total replacement dose (50mcg T4 with 40mcg of T3) and have found that i too need T3 to function - and that the ratio of T3/T4 makes quite a big difference. I need some T4 too (the present 50mcg may be a whisker low), but too much triggers fatigue. It seems that it only comes right when my total dose is run close to the maximum that feels right for me. That's a TSH of around 0.1, but not any lower or my pulse rate starts to climb.

These days i'm doing pretty well.

Some thoughts that might be relevant, but would need a bit more digging to bottom out:

1. Doesn't the functioning of the already not very reliable indicator of correct replacement TSH get messed up with Graves disease? (something about the blocking of receptors?) No idea about the details, or if it recovers post TT - but might it be misleading your endo re. your replacement dose?

2. Many say that free T3 and free T4 may be the best predictors of the replacement dose required to get rid of symptoms. thyroid-info.com/articles/d...

3. It may not be a factor, but might it be worth checking your 24hr cortisol levels using the saliva based adrenal stress test? I've recently become aware and have been banging on to the effect that high cortisol from chronic stress (might Graves/hyperthyroidism have had that effect even before life situation etc are factored in?) can produce symptoms not dissimilar to hypothyroidism - because it can set the adrenal 'thermostat' artifically high, and beacause it can mess with digestion, absorbtion and the use of thyroid hormone. medicinegarden.com/2011/02/...

The low cortisol that follows adrenal exhaustion messes with thyroid and other functions too - this can arise if eventually the adrenals can't keep up.

Treating my high cortisol has helped me a lot. (i've described the approach several times) We can it seems end up with chronically elevated cortisol levels as a result of prolonged stress - physical, mental, disease, post traumatic whatever.

If testing maybe check the usual list of vits and minerals that sometimes end up off when there's hormonal problems about too - D, B12, ferritin etc?

I've not used Armour, but from reading suspect (as it seems you do) that one important point may be to end up with a T4 to T3 ratio that suits you. The T3 content in Armour is quite high by some standards. Synthetic T4 and T3 can it seems be used with it to adjust this. There's also the view that some of the naturally occurring more minor ingredients in natural hormone and/or easier absorbtion can be important for some....

Sorry not to be able to be more specific....

ian

[JemimahR in reply to vajra]

Ian thanks so much that's really helpful! I'm going to spend some time digesting (brain fog-insert smiley face). How do you go about arranging a saliva cortisol test? Thanks so much x

[debjs]

I had a TT in 2011 and take Armour. You are lucky to find an endo to suggest it! My endo will not prescribe it but thankfully my GP does. I am still a long way from being totally well with many of the symptoms you mention but suffer with calcium problems too. I am unable to tolerate synthetic T4 or T3 due to side effects but am making fairly steady progress on Armour albeit extremely slowly. However I was very badly managed in the first year and became seriously ill so am not a straightforward example. I have done a lot of reading about Armour and seen Dr S and both suggest most people with no thyroid function need in excess of 3 grains per day. I am currently on 3 grains.

Some people on this site have suggested trying the CT3M (I think that is right) method with Armour as a way of helping adrenals and I have found improvement since splitting my dose (I take 2 grains at 5 am and 1 grain at lunchtime). I think some people split it even more but I have to fit it around my calcium supplements.

You give no ranges with your results but your T4 and T3 seem low compared to mine so is your endo thinking you are over replaced by TSH alone? Dr S said any T3 will supress TSH. Mine last results on 2 & 3/4 grains were TSH 0.03 T4 15 (range 9-21) and T3 5.6 (range 3.5-6.0) and endo was happy for me to increase back to 3 grains as my symptoms were so much worse on low dose. Sorry this is a lot about me but perhaps my experience can help you to decide.

[vajra]

You probably end up clicking the happy smiley by accident or something J.

It sounds at least that you have a relatively responsive and open minded endo - there's quite a few that seem to just do their thing within an imagined set of techno-medico-legal set of constraints that leave all sorts of stones unturned and then send the patient on his/her way. The other bit of hopefully good news is that it's often reckoned to be much easier to optimise replacement after removal of the centre of autoimmune disturbance that is a thyroid like what either of us had.

Those are just some possibilities for exploration, but seem often to be the sort of angles that deliver results. (barring other disease process and/or abnormality) The thyroid side often gravitates down to the trustworthiness or otherwise of the stock thyroid blood and other tests and reference ranges - many of us went for years and years being told our thyroid was 'normal'.

There's no easy answers, as we seem so often to find that there's little option but to read a lot, trial those options that seem promising judging by our symptoms/others' experience, and to follow whatever makes us feel better. We're for some time often chasing a moving target anyway as the body recovers - especially if we've been hypo and/or suffering auto immune or hormonal issues for a long time so that we're badly out of whack.

Replacement tends to be much more straightforward if the thyroid problem is recent, and there's minimal autoimmune or other consequential imbalances about.

Paul Robinson's book and website on use of T3 is another very useful source of insight: recoveringwitht3.com

The adrenal stress test is by quoting that you are a Thyroid UK member available from Genova Diagnostics in the UK and costs about £90.

Depending on how new you are to the field you may find that you have a new career - that you are on the start of a never ending road of study and trialling of treatments and adjustments to your replacement. There tends to be little option but to take responsibility for ourselves, and often given the complexity of the bodily systems and especially hormonal interactions involved no substitute for lots of trial and error.

The first step is to start learining to walk between raindrops - to realise that while medicine can help in various ways (if nothing else we need prescriptions, and a supply of hormone) that the stock dogma/ideology that underpins mainstream handling of thryoid replacement (and much else) while OK for some simply doesn't deliver well being for many.

Apart from blind adherence to dogma, the other major barrier the system presents is that it tends not to be supportive of the sort of symptom and co-operation led repeated trials the above suggests and (in absence of medicine offering truly effective diagnostic procedures and treatment protocols) usually requires. Some few get lucky, strike gold early and wonder what all the fuss was about i guess!

This site and others like it are great repositries of real world experience - even if its mostly those experiencing problems that post. Discrimination is of course required, but there's leads to sources of information (especially in the areas raised), better docs, books, medical papers etc.

The sad part is that the more research that gets published that undermines the dogma the more dug in the practices of some defensively minded docs seem to become. There's meanwhile little sign that anybody is putting the sort of effort into chasing the sort of new paradigm that many of us feel is required - no doubt the return on investment isn't big enough.

Pardon the discursive answer and the length, but i'm trying to write for others that may look in too...

ian

[Heloise]

Just briefly and hope not repetitive but I took Armour for ten years or so. It is a natural product and the only product used for hypothyroidism (for the most part) for decades and decades until the drug companies began making thyroxine in the laboratory which was T4 only. But Armour is roughly three quarters T4 and one quarter T3, so you will still be getting T3.

Your own gland produces T4 and the liver converts it to T3 so GP's feel they only need to give you T4 but as we can see for quite a few people, this is not adequate. T3 is always manmade as there is no natural T3 excepting what you derive from a natural desiccated thyroid which I prefer over T4.

[shaws Administrator]

Natural Dessicated Thyroid hormones were the only ones prescribed before TSH blood tests plus levothyroxine were introduced. There are several dessicated thyroid hormones and sometimes you have to try one or two to find the ones that suit. These are more synergistic with our human body as they are from cows or pigs thyroid hormones. There are also a couple which are hypoallergenic.

This is a link re Armour and cursor to about the third question and also read the others on the page.

web.archive.org/web/2010112...

[SR119]

I had half my thyroid out in 2014 due to a very large mass ( benign) . For about the first year I was prescribed the synthroid . I literally felt like death. I was so horribly fatigued I was sleeping all day. I began reading the book by Gena Lee Nolan thyroid sexy. It of course talked about NDT but my doctor refused to even let me try it. I asked my primary and he said sure. I had plumped up significantly on the synthroid . Within the first day of taking my armou 120 grains I stayed awake all day! Within the first month I was down 5 lbs . It's been over a year and I lost 27 lbs and although I'm not asymptotic I have felt better. Well just last month the renaming half of my thyroid out due to yet another mass. My doctor had increased my armour awhile back because I told him I felt like I needed more as once again fatigue was an issue. He increased it to 180 grains. I can tell I'll need more I'm very lethargic and deoressed and I've noticed I've put back on a few pounds since my surgery . I have hashimotos , and RA. Not sure what amount I'll be on but of course they want me to " level out " then get new lab work to determine . This is a horrible surgery and disease . I wish everyone on here to feel better.