Latest Lab test results after being off Armour for a year or so.

[Crunchieeagle]

Hello All. Newbie here!

TSH a year ago was 1.98 Free T4 of 10.2 (range 9-28)

TSH 3 months later 2.28 Fr ee T4 of 11.7 (range 9-28)

My new doctor will only do TSH so 2 months ago 4.45 and a few weeks ago 3.36

My TSH is going up and down and my Free T4 is low in the range. I was lucky and able to see the late great Dr Skinner, who put me on ARmour, but I was always between 2-3 grains. Felt better on 3 grains but my TSH went to loew for my GP's liking so went back to 2 to keep her happy. Maybe 2.5 is the right dose I don't know.

I think I am hypothyroid, and have many physical symptoms. Feeling muscular pain, joints swelling up, Fatigue, Tiredness, Over sleeping (and not feeling refreshed), but have very broken sleep, Feel foggy headed and depressed (my depressive symptoms are more than just thyroid related but thyroid does help), Puffy face, dull eyes, blurred vision, Eczema, thinning of hair (no hair loss), chronic constipation ( i will leave it there ) poor libido, very Hoarse voice which gets worse during the day (no one can hear what I am saying after 4pm), high blood pressure and pulse, and heat intolerance and cramping.

As I say I believe I am hypothyroid, and went to see a pharmacologist and neurologist yesterday, as have a focal secondary dystonia, which is unwanted muscle involuntary movements, which was caused by an SSRI and have even had an operation called Deep Brain Stimulation which has dramatically improved the condition.

Upon seeing him I described these symptoms to him, and said to him apart from the depression, which I have just been given medication for, (Lamictal which has helped in the past), and said that my thyroid could be struggling, and only prescribes T3 for it (as he does it for depressive patients who respond better to T3 treatment than T4).

He did say however wait for a month (which I dont want to do) and see how my symptoms are then, I assume because he wants to see how the other drug is working, and not changing too many parameters at once.

I do have 2 grains of NDT at home (RLC labs), but don't want to start as I was hoping to work with a doctor through this if I could.

Firstly as I say, am I hypothyroid? If so, what doses of T3 is equivalent to say 2.5 grains of NDT? and how quickly do I raise each dose. (I assume it is 1/2 a tablet a time but not sure how long before increasing it?)

I think longer term I would go 1/2 T4 and 1/2 T3 as my T4 is low in the range, but maybe T3 is a good idea to begin with, as I doubt I will have much Reverse T3 (guesswork here?).

But living in devon, UK it is difficult to see someone here or is it a good idea to try and get a better set of lab tests done?

Many Thanks

[Clutter]

Crunchieeagle, Your symptoms are consistent with being hypothyroid and TSH >2.0 indicates the thyroid is struggling. TSH alone doesn't indicate how good or poor FT4 and FT3 are. I would recommend you order a private thyroid panel including antibodies. You can order private tests from Blue Horizon and Genova via thyroiduk.org.uk/tuk/testin...

TSH fluctuates according to circadian rhythms so it is recommended patients arrange early morning blood draws when TSH is highest, and fast (water only) as TSH drops post-prandially. TSH may also fluctuate if you have positive autoimmune antibodies (Hashimoto's).

If you do resume NDT you should start at 1/2 grain and increase in 1/2 grain increments no sooner than every 2 weeks. 1/2 grain NDT is equivalent to 12.5mcg T3.

It may be wise to wait and see how you do on the new med you are taking otherwise you may not be able to tell whether that med or NDT is causing any adverse effects you may experience.

_______________________________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[Crunchieeagle in reply to Clutter]

Thank you Clutter.

If I do wait and go under a doctors instruction for T3 treatment only I assume a target of 60 Grams of T3 (each tablet is 20mg of T3 in the UK isn't it?) would be equivalent of around 2.5 grains of NDT.

Again how quickly (or slowly ) would you increase the dosages?

and again, probably jumping ahead here a bit, but interested to know, if I did swap some T3 for T4 would 150mg of T4 and 20mg T3 be about right?

Many thanks for your continued support.

[galathea in reply to Crunchieeagle]

1 grain of ndt contains about 9 mg of t3 and 35 of t4, so 2.5 grains would give you about 90 of t4 and 22 of t3.

The 90 of t4, may. Or may not be converting into t3. If you wanted to take t3 only, then it might be best to take 20 to start with and increase by 5 mg lots. 90 of t4 must be about equivalent to 20 of t3, assuming you absorb and convert it all.....

So, it would seem your aim of 60 mg is a bit over ambitious.

g

[Clutter in reply to Crunchieeagle]

Crunchieeagle, Don't assume you will be prescribed the equivalent of 2.5 grains. You're likely to be prescribed 10-20mcg T3 to start with and dose will be titrated according to thyroid levels. Titration is likely to be in 10mcg increments every 6-8 weeks.

10mcg T3 is equivalent to 30mcg Levothyroxine.

It's extremely unlikely you will be prescribed anything like 150mcg Levothyroxine or 60mcg T3. That level dosing is prescribed for patients post thyroidectomy.

_______________________________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[Crunchieeagle in reply to Clutter]

Thank you.

I will get the blood work done then and come back to you what the best way forward is. T3 or (back to NDT and self medicate)

Thanks

[rosetrees]

Have you been tested for Lyme Disease?

[Crunchieeagle in reply to rosetrees]

No I have not rosetrees, should I?

[rosetrees in reply to Crunchieeagle]

Yes. I believe that Lyme (and/or co-infections) are responsible for a large number of cases of difficult to control thyroid problems. Joint swelling is a classic Lyme symptom.

Take a look at lymtestinguk.com - which is run by my practitioner in Philadelphia using MDL in New Jersey. Other tests are available (as they say!). Mine was done by Igenex, as I wasn't seeing my practitioner then. Also Armin in Germany does testing.

[Muffy]

A low TSH is normal with NDT or T3 only because the T3 goes directly to the tissues. Such a shame so many doctors don't realise this and carry on with the 'gold standard' TSH test. The pituitary gland doesn't respond when the T3 is already in the system.

[Crunchieeagle]

Yes, it seems quite simple Muffy doesn't it?