I have always used a combination of armour and thyroxine, which is what Dr Skinner always recommended for me. Is it unusual to be on both?

[JANJAN2]

Do all people tend to be on armour alone? I've managed with the combination for years-the only problem being that I am very tired in the evenings (but I'm no spring chicken!). I wonder why Dr Skinner put me on both, when other doctors prescribe armour on it's own.Does anyones else on here use a combination of both meds?

[Clutter]

Jan, Although NDT alone suits many people the proportions of T4 and T3 in NDT don't suit everyone so they add in T4 or T3 as required.

If you post your recent thyroid results with the lab ref ranges and say how much NDT and T4 you're taking members will comment/advise.

[JANJAN2 in reply to Clutter]

Thanks for that. I am in the very fortunate position that an endo has at last prescribed armour for me. My GP has now told me to stop taking thyroxine and only use armour....sounds wonderful, but as I reduce the thyroxine and add the extra armour, I don't feel right at all. I have come to the conclusion that we are all so completely different!!! I have tried so many different combinations over the years and suddenly changing my amount from the one I am used to, has really thrown me.

[Clutter in reply to JANJAN2]

Jan, it's hard to comment without knowing your bloods and what doses you were taking and the new dose and when it was changed. Any change can be unsettling but it doesn't sound as if you have felt any improvement in symptoms.

[JANJAN2 in reply to Clutter]

I have been on 1 1/2 grains armour plus 75 mcg thyroxine for several years. Initially I was on a lot more armour (2 1/2grains), but reduced over the years as I felt over medicated.I have undergone 7 ops,including a second knee replacement in february, while on this dose and my observations and bloods are always normal. I always have a suppressed TSH though.

My GP suggested that I change to 2 grains a day, which is what the endo suggested.I have reduced my thyroxine by 25mcg for the past 10 days and started adding a 1/4 grain but I feel dizzy and my legs feel like jelly and i couldn't sleep last night.My GP seems to think that people are on armour only-but that's obviously not true.

I was just beginning to feel better after my op-apart from feeling very exhausted in the evenings-which is probably due to the fact that I am walking more than I have done for years!!! I don't want to rock the boat right now but my GP is adamant that i change, due to the endo's letter.While I was Dr Skinner's patient I was left to my own devices!!!

[Clutter in reply to JANJAN2]

Jan, your doctor and the endo can recommend but they can't insist. 1/2 grain of Armour is roughly equivalent to 37.5mcg Levothyroxine (T4) but there was no need to taper off 25mcg for 10 days prior to increasing Armour. The evening fatigue suggests undermedication (I would need to see your results to be sure) which can be due to decreased absorption or even increased activity when you were previously inactive. Reducing 25mcg for 10 days will have made this worse. There's no need to taper off T4 before increasing Armour, the adjustment can be made the same day.

The nitrous oxide in general anaesthetic can deplete B12. B12 deficiency and vitamin D deficiency can cause fatigue, dizziness and muscle weakness. Ask for ferritin and folate to be tested too. Make sure to request a printout of all bloods results with the lab ref ranges as normal can be anywhere in a very broad range and is rarely optimal which is what we need.

[JANJAN2 in reply to Clutter]

Whenever I put up my armour by 1/4 grain I have loose bowels, which is why I decreased the thyroxine to see if it would help and so far that dept is OK. I think I have been undertreated for a while, but perhaps I am stuck on this lower metabolism. I have tried everything, including treating adrenals in the past.I think all these ops have utterly exhausted me and doctors just have no idea how long it takes to recover-especially with hashimotos as well.

Thank you for your replies, Clutter. I will persevere with raising the armour and ask for more tests.

[Hidden in reply to Clutter]

I'm getting confused with the dosages,having read your reply to Jan.

My bottle of Armour says 1 grain 60mgs = 38 mcgs

The Armour chart says 1/2 grain 30mgs =

19.0 mcgs. Am I misunderstanding this as I don't want to take the wrong amount?

What would I take to be the equivalent of 75mcg s Levo.please ?

[helvella Administrator Thyroid UK in reply to Hidden]

marfit,

What you have quoted is how much T4 is in one grain (or half a grain) of Armour.

What Clutter was saying is that one grain of Armour is about equivalent to 75 mcg of levothyroxine. That 75 comes from adding the 38 mcg of T4 you mention PLUS a rough approximation of the T3 content.

Yes - it is confusing.

Rod

[Hidden in reply to helvella]

The T3 content of 1grain ( 60 mcgs) Armour is 9mcgs.

Is that multiplied up ?

[helvella Administrator Thyroid UK in reply to Hidden]

Yes - it is.

In this case, it is taken to be about four times as potent as T4. So 9 times 4 = 36. Plus the 38 of T4 adds up to 74. Which is the one grain being about equivalent to 75 mcg (or half a grain being about 37.5 mcg) being talked about!

Of course, in the real world of real humans, it will not be quite this neat.

Rod

[Hidden in reply to helvella]

Thanks Rod .....I think that explains it to me......just wanted to try to get it right as I have switched my 75mcgs Levo for Armour,keeping my 10mcgs T3....... Have blood test in two week's time so want to be as accurate as I can......not sure if I come into the real human category these days!!!!!!

On that note I'll say good night.....I'm off to my bed.