Thyroid UK
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Switching from Levo to Armour

I've been on 50 mcg of Levo for 8 years. My TSH went from .887 mcIU/mL to 1.480, 0.350, 1.290, 2.930, 2.020 to 4.050. This was from 2013-December 2017). TSH doubled from 2015-2017, then doubled again in less than 1 month!! My antibodies are in normal range. My potassium has been low 3.30, (the highest being 3.7 only twice) for at least 4 years, I think from Indapamide, which I have stopped taking. My Vit D was low, I need to get that checked. I've asked for my hormones to be tested and the doctor said that info wouldn't be useful. My cholesterol has spiked in the last year. My magnesium is good. My iron has gone from 50. to 108 to 133 in 2 years. Iron binding capacity total 311,Iron Sat 34.7%, Ferritin 236.4 (from 146.9 in 2015). Free T3 is 3.3 pg/mL, Free T4 1.13 ng/dL, T4 8.20 mcg/dL, Reverse T3 15 ng/dL. I don't understand why I'm not feeling better and have no energy. Doctor tried to put me on 15 mg Armour, but I told him I probably need to start with one grain. So after 2 1/2 weeks on one grain, not feeling good yet. Sorry post is so long, but I don't know what to do from here. Thanks!

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Belle307,

Can you post your results with the lab ref ranges? It's not possible to interpret results without the ranges (figures in brackets after results). We only need your most recent thyroid results and ranges.

If TSH was 4.05 in Dec then you were undermedicated on 50mcg. 1 grain is equivalent to 65mcg Levothyroxine so you may still be undermedicated.

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T3 Free 3.3 (2.8-4.4) reference range

T4 Free 1.13 (0.89-1.76) reference range

T4 8.20 (4.80-13.90) reference range

TSH 4.050 (0.358-3.740 mclU/mL) reference range

Reverse T3 15 (10-24) reference range

Thank you, I appreciate your response!

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Belle307,

TSH is high and FT4 and FT3 are low in range so you are undermedicated and should request a dose increase. You will probably need an increase of 1.5 - 2 grains which can be added to your current 1 grain at the rate of 1/2 grain every 2 weeks. Most people on NDT will be optimally dose when TSH is 0.35 - 1.0 or lower with FT3 3.85 - 4.4.

rT3 is less than halfway through range so no problem there.

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Thank you so much!! So, let me clarify, do I need to increase my current 1 grain dosage by an additional 1.5-2 grains for a total of 2.5-3 grains, or just increase in increments until my dosage is 1.5-2 grains? I talked my Dr into giving me Armour, and he thinks 15 mg is alot, so I have my work cut out for me! He also prescribed 5 mg of Cytomel, but I'm too afraid to take it because I'm just trying to get off Levo and onto NDT.

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Belle307,

I think you will need to increase in 1/2 grain increments at 2 weekly intervals until you are on 2.5 - 3 grains.

Your GP might understand better how little 15mg is if you explain that 1 grain contains 38mcg T4 + 9mcg T3 which combined is equivalent to 65mcg Levothyroxine.

No reason why you shouldn't add 5mcg T3 to NDT until you are optimally dosed on NDT.

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I am so grateful I found this site! I find it so helpful and encouraging. Thank you for taking the time to respond, I so appreciate it. I agree, I will have to explain to him. The pharmacist agreed it is a low dose, and said he would argue with the Dr. if he were me. :) Thank you, thank you, thank you!!

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I took Indapamide for about 8 months. It was extremely effective as a diuretic but caused an unacceptable drop in potassium levels. Fortunately, this was picked up by a routine blood test and the indapamide was stopped.

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