Transferred from Levothyroxine to NDT (Armour) Have big TSH changes and other symptoms seeing Endocrinologist tomorrow

[Crwbin1]

Hi all

My Endocrinologist let me go on a three month trial of Armour (NDT. )(he wasn’t keen at all!)

I have Hashimoto, severe diverticulitis , and have had history of: 2 sets of pulmonary embolisms, pre eclamptic toxima , Eclampsia, surgery for gangrenous intestine, and two bouts chest pains -suspected heart attack (latest one was November 2016) plus a few other not so serious things!

I just got my blood results back prior to seeing him tomorrow-he has only asked for TSH and free T4 bloods to be done.

Results are:

TSH 4.22 mU/L H 0.27-4.20

Free T4. 7.7 pmol/L L11.0-25.0

Before converting to NDT I was on 125 levothyroxine .

My TSH and other levels seemed to be fine while on Levo, TSH was surpressed at 0.02 MU/L 0.27-4.20 , Free T4 22.6 pmol/L 11.0-25.0 although I didn’t feel well whilst on it. I was put on 75mg of Armour and told do a straight swop.

I had crippling headaches and felt awful for over a week so went down to 60mg and felt a lot better. I have tried a couple of times to take the extra 15 mg (in the afternoon) both times I had awful headaches so stopped the higher dose. I thought maybe I was being over medicated.

As said, seeing my Endo tomorrow-I feel so much more clearer headed and hardly any brain fog but do feel very tired and no energy. Plus suffering from very bad anxiety late afternoon onwards-I feel ok during the day but by evening I am feeling very anxious . My stomach problems have also restarted the last few days. Just for completeness of information I also had the flu jab last Wednesday.

Can anyone advise What’s the best course of action for me- I don’t want to go back to Levo as felt awful in that but with the things described above he might take the opportunity to tell me to come off Armour. But that doesn’t seem to right at the moment either.

Many thanks for taking the time to read this message.

[Clutter]

Crwbin1,

You are undermedicated to have TSH so high. FT4 is often low when taking NDT which is why it is important to check FT3 as that is the guide to adequate dosing on NDT. Your FT3 is almost certainly low with TSH 4.22.

125mcg Levothyroxine is equivalent to 120mg (2 grains) Armour. If you can't raise Armour dose without adverse effects add in 50mcg-75mcg Levothyroxine in 12.5-25mcg dose increments and see how you feel.

It may be worth checking your ferritin, vitamin d, B12 and folate levels as low/deficient levels are common in hypothyroid patients and can be mistaken for hypothyroid symptoms.

[Crwbin1 in reply to Clutter]

Hi Clutter, thank you for your quick response.

I forgot to mention that I had taken my morning dose of60mg Armour (I was on automatic pilot ) on the day of testing -kicked myself when got back in the car and realised what I had done but thought that it would make my TSH lower and not higher as it has done.

I was surprised that he didn’t ask for any other blood tests to be done-as I mentioned he really doesn’t want me to be on NDT and wanted me to be on the “gold standard “ of Levo.

So what do I ask now as the results are a bit screwed or still ask as per your previous response. Sorry to ask again.

[Clutter in reply to Crwbin1]

Crwbin1,

Results aren't skewed. Taking NDT before your blood test has not made TSH higher. TSH doesn't respond that quickly to taking a dose. FT4 may have been lower if you had not taken it.

[Crwbin1 in reply to Clutter]

Thanks for the reply Clutter. See what he has to say tomorrow!

[Crwbin1 in reply to Clutter]

Hi Clutter-quick update.

Result, thought he wanted me to come off Armour but is letting me stay on it! Endo said, as did you, that I was under-medicated, he has increased my Armour to 1.5 grains and then to see him in 6 weeks, I asked for full blood panel of vitamin and thyroid function which he has agreed to do. Thank you so much for the help you have given.

[Clutter in reply to Crwbin1]

Crwbin1,

Excellent. I suspect you will need another dose increase in 6 weeks.