New here...would really appreciate advice! :-)

[lizpeters]

Hi everyone, I've used the site to gain some really valuable insights into being Hypo, so thank you firstly!

Ok, I'll be as brief as possible. Female, 39. Diagnosed 'borderline underactive' 5/6 years ago. Dr wouldn't do anything at the time. My mum (74) was diagnosed shortly after me, with Hashimotos. She was really, really sick, but thankfully is much better, and on 150 of Levothyroxine which seems to suit her.

So - I was finally 'allowed' to have some meds from the Dr at the start of this year.

TSH was 5.2,

Free T4 11.9,

Free T3 4.6.

Given 25mcg of Levo. Was on this for a few months, initially felt better. After 3 months they upped it to 50mcg.

Had another blood test, TSH was 2.8, and 'Haematocrit' was LOW, at 0.36 (range 0.37-0.47). Don't know T3 etc, as they didn't do them in this test.

3 months ago, test came back with low iron, and I then had a in-depth bloods done with an endo privately. Results as:

TOTAL THYROXINE(T4): 106nmol/L59 - 154

TSH: 1.83mIU/L0.27 - 4.2

FREE THYROXINE: 15.1pmol/l12.0 - 22.0

FREE T3: 3.6pmol/L3.1 - 6.8

THYROID ANTIBODIES.

Thyroglobulin Antibody<10.0IU/mL0-115

Thyroid Peroxidase Antibodies6.9IU/mL0 - 34

He switched me to Armour, and I take 1 grain a day. Honestly, I don't feel that much better at all, even a little worse. Been on Armour now for around 3 months.

Had bloods done again a couple of weeks ago, as I was feeling cold all the time, itchy skin etc, all the usual things. Results were:

THYROID STIMULATING HORMONE 1.24 mIU/L

FREE THYROXINE 13.6 pmol/L

TOTAL THYROXINE(T4) 91.0 nmol/L

FREE T3 6.36 pmol/L

THYROGLOBULIN ANTIBODY <10 IU/mL

THYROID PEROXIDASE ANTIBODIES <9.0 IU/mL

Now, unless I'm reading this wrong, it indicates that I potentially have TOO much Free T3, and am now verging on Hyper instead of Hypo?! But - I feel like I used to feel, tired, fatigued, dry skin, cold....you know the drill!

So, what's going on!? What am I doing wrong? I wonder whether I should switch back to the Levo, and ditch Armour. I really don't feel any better on it at all, even if the bloods indicate something different!

Hope that's easy to understand, I'd really appreciate opinions, thank so much!

[shaws]

Once we are diagnosed as hypo we cannot become hyper. We can become overdosed which can give similar symptoms to hypo.

When you have blood tests for thyroid hormones, do you get the earliest possible test, fasting (you can drink water) and leave a 24 hour gap between your last dose of Armour and the test and take afterwards?

[lizpeters in reply to shaws]

Hi Shaw, thank you for replying!

Ok, so good to know I can't be hyper!

I'm trying to think back to my last test. Hmmm.

I *believe* that I didn't take the dose of Armour before the test, I know I hadn't fasted though.

Am just very confused as to why 1 grain of Armour could be pushing me up to overmedicated? Do you think based on my results previously, that 1 grain is too much - and would you say I was overmedicated? The endo told me I'd need to be down to around 1 for TSH, as I'm TTC.

I definitely felt better on the Levo, in terms of the coldness, itchiness and also weight gain. It's crept back on again while being on Armour. Not sure what to do at this point?

Maybe naively, I thought Armour would be the 'miracle' drug over Levo, but on reflection, it might not be for me!

Sorry for SO many questions!!

[SlowDragon Administrator]

Suggest you get vitamin D, folate ferritin and B12 tested

Even though you appear to not have high antibodies, the fact your Mum does and you seem to have low iron, this suggests you may have gut malabsorption.

Low stomach acid is very common issue, causes low vitamins as result

drmyhill.co.uk/wiki/hypochl...

Once you get vitamins tested and improve if necessary, I would then also try strictly gluten free diet for 4-6 weeks to see if you notice any improvements

Is your Mum on gluten free diet?

Armour tends to have too much T3 in relation to T4.

But with any T3 it's essential to get vitamins correct first.

If you can't get full thyroid and vitamin testing from GP

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers. DIY finger prick test or option to pay extra for private blood draw or

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

[lizpeters in reply to SlowDragon]

Hi,

Yes my Mum has pernicious anemia. My iron is low, been on tablets for a few weeks now.

B12 is good, it was low, been on injections for 1 year and it's above average. Last reading was: 469 ng/L

Serum folate: 6.2; ferritin low at 14.

Literally always had stomach problems. Chronically constipated, with flare ups of upset tummy.

I've tried being 80/90% gluten free, didn't seem to help much to be honest.

Going to do a medichecks blood test this week, and check levels again.

Just feel like I should switch back to Levo.

[SlowDragon Administrator in reply to lizpeters]

Levo plus very small amount to T3 may be an alternative (works for me)

Gluten free has to be absolutely 100% to work

The other common intolerance is dairy

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

[lizpeters in reply to SlowDragon]

Thank you. How did you get your Doc to prescribe the T3? My GP won't put me over 50mcg of Levo! Thinks my numbers are low enough at 1.9.

Had to see a private endo to get Armour.

[SlowDragon Administrator in reply to lizpeters]

I have senior endo - more on my profile

Gluten intolerant, DIO2 gene too

Hashimoto's, low magnesium, vitamin D, B etc etc etc

[shaws]

When we take NDT (Armour/or others) we start on a dose equal to what we were taking on levothyroxine. After 2 weeks we increase by 1/4 tablet and continue every 2 weeks until we are symptom free/feel well.

Blood tests are not as important as NDT contains four hormones so it cannot compare with levo which is T4 alone. You should take temp/pulse before you begin and if either goes too high/fast you reduce to previous dose.

web.archive.org/web/2010103...

[lizpeters in reply to shaws]

Thanks Shaws.

I just switched - straight from 50 Levo to 1 grain Armour.

No side effects/issues on the switch, it's been nearly 3 months. I just don't feel quite right, cold, sluggish etc. Only felt like this the last month or so.

Pulse/temps are normal, was low temp particularly in the morning before I started Armour, around 35 most days. Endo had me check it for 2 weeks before switching to Armour.

I find it confusing that if I'm overmedicated, why I don't get hyper symptoms.

Spoke to Endo, he looked at bloods and said I definitely don't need to increase Armour based on results above - TSH down to 1.24, Free T3 6.36, Free Thyroxine 13.6.

So do I reduce? Would that improve things?

[shaws in reply to lizpeters]

The blood tests were introduced for levothyroxine alone. Therefore, if we add in T3 either taking some or taking NDT (contains T3) your T3 will show higher than being on levothyroxine alone.

As you've remained on the same dose of Armour for three months without increasing 1/4 tablet every two weeks until you have no clinical symptoms that is most probably reason for not feeling good i.e. not yet on an optimum dose.

I am not medically qualified but we cannot just take a 'dose' and expect that one dose to relieve all of our symptoms. Also you haven't given the ranges of your above tests and it is necessary to give the ranges. Labs differ in their ranges so we need the ranges.

I don't know why you state : "I find it confusing that if I'm overmedicated, why I don't get hyper symptoms" ." that it because you are not overmedicated.You are not sure either whether you took your dose of Armour before your blood test. You also ate before the test - both

can interfere with the results.

You say your "B12 is good, it was low, been on injections for 1 year and it's above average. Last reading was: 469 ng/L-"

The recommendations for us - even if we don't have P.A. is an optimum B12 of around 1,000 to try to prevent brain shrinkage and/or alzeimers etc. I don't think doctors are aware of the importance of B12.

[shaws in reply to lizpeters]

lizpeters, have you had all your other vitamins/minerals tested:-

Vit D, iron, ferritin and folate.

[lizpeters]

Thanks Shaws, I didn't realise that in regards to the B12? My doctor actually commented that it was high at that dose, and I should reduce the injections!

Iron is low. Currently on tablets, Folate was 6.2, Ferritin at 14.

Last Thyroid results:

THYROID STIMULATING HORMONE 1.24 mIU/L 0.27 - 4.20

FREE THYROXINE 13.6 pmol/L 12.00 - 22.00

TOTAL THYROXINE(T4) 91.0 nmol/L 59.00 - 154.00

FREE T3 6.36 pmol/L 3.10 - 6.80

THYROGLOBULIN ANTIBODY <10 IU/mL 0.00 - 115.00

THYROID PEROXIDASE ANTIBODIES <9.0 IU/mL 0.00 - 34.00

As you said, on instructions from the Dr, I just went straight to a grain of Armour.

So, is there anything I can be doing now? Sticking with it and decreasing/increasing?

My GP says go back on Levo, (traditional Dr who thinks Levo is the only 'real' medicine) and can't get hold of Endo, who said just jump onto 1 grain, and my results "look fine now".

[shaws in reply to lizpeters]

If you want to respond to a particular answer you have to press the 'Reply' button otherwise the person isn't notified.

Blood Results are really immaterial in a way as it is our symptoms which are disabling. I gave a link above on how we used to be treated before levothyroxine and blood tests were introduced. It is a more holistic way, i.e. concentrating on relief of symptoms.

Also the blood tests were introduced along with levo (T4) and you are now taking T4,T3, T2,T1 and calcitonin in the NDT .

If you want to try and continue on NDT, increase by 1/4 every 2 weeks. If pulse/temp goes too high you return to previous dose and that should be you 'optimum'.