Not sure where to post this and I’m sure elements of this have all been covered before but iv had a look through the forums and can’t quite find where to post....sorry!
Long story I’m aftaid but I’ve had hypothyroidism for about 10 years, started on levothyroxine which did nothing at all for my symptoms so after badgering GP I started on armour around 7 years ago with mixed results (since reformulation I feel less well) but generally managing to survive my symptoms day to day. Had antibodies tested at my insistence and I had high levels of both thyroid autoimmune antibodies-does this give me a hashimotos diagnosis as Gp has no idea and doesn’t really recognise the auto immune element. I have gluten intolerance also as well as pcos and psoriasis so think I am queen of autoimmunity anyway😛 Just recently been told Gp will no longer prescribe armour and suggests I go back on levo which I will not do. Am now looking at self medicating with either t3 only or a mix or t3 and armour if I can source both at a reasonable price. I have a few questions I need help with please...
1.when I buy t3 online- Should I start by adding a low dose of t3 into my existing dose of armour as a trial and increase t3 as I decrease armour or should I just try t3 alone? I ask this because even on armour I stil have nagging symptoms so perhaps my t3 conversion isn’t optimal? Or something else is at play?
2. I have a number of baffling symptoms that even on armour were still ongoing which have seen me go back and forth to Gp with no resolution. In particular of concern to me are ever increasing bone and joint pains (have seen rheumatologist but tests inconclusive) lumps and bumps on body eg. Ganglion or lipoma type lump in elbow (mri showed an inconclusive structure) and a hard painful bony-type lump on my ribs on my back (due ultrasound next month) added to this iv had increasing lethargy and fatigue as well as no motivation &low mood (although Gp quick to suggest depression however if I didn’t have these symptoms I know I would feel better!) however although I can feel absolutely beyond exhausted sme days i literally lie awake all night long unable to sleep. This has impacted on quality of life massively.
iv also had middle weight gain which I cannot shift and ongoing abdominal pains & bloating of unknown origin. I guess most of these could be described as under treated hypothyroidism/hashis- in which case what can I do? Would t3 help some of this as I thought armour already had t3 in it? Due to ongoing fuzzy brain fog and generally feeling exhausted(plus working full time shifts as a nurse) I just don’t know where to start or what to do....
I did request bloods from Gp last week and had to beg for t4 and t3 as he only wanted to do tsh...bloods are below (I’m afraid I don’t have reference ranges tho plus he won’t do Rt3 as lab refuses)
Tsh 4.9
FREE t4 12.9
Free t3 4.3
This was the morning after taking my last armour dose the day before which is currently 65mg ( if I increase I get palpitations, severe anxiety, hair loss & more insomnia) I feel I am going backwards not forwards and Gp is next to useless.
any help gratefully received! Thanks so much for reading
Sarah
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It's not possible to accurately interpret your results because ranges are needed. They vary from lab to lab so you need to get the ranges either from your GP surgery or ring the hospital path lab that did the tests and ask them. What is very obvious though is that your TSH is high, either top of range or over range, and that means you are undermedicated. FT4 could be anywhere, my lab's range is 7-17, we also see 9-19 and 12-22, plus others, so you can understand why it's not possible to interpret your results. Chances are FT4 is low in range though.
Yes you have Hashimoto's. Are you strictly gluten free? That should help reduce antibodies, as can supplementing with selenium L-selenomethionine 200mcg daily. Keeping TSH suppressed also can help.
Hashi's often causes nutrient deficiencies, have you had Vit D, B12, Folate and Ferritin tested? Very important that these are optimal for thyroid hormone to work. If not tested then you really need to get them done and post your results for comment.
I didn't get on with Armour or NDT, but many people do well on non-prescription Thai NDT which is a lot cheaper than Armour and, of course there are other brands. I didn't get on with a combination of NDT and T3 either so I can't help with that.
Low vitamin D is extremely common with Hashimoto's
Low B12, folate and ferritin also very common
What supplements do you take, if any?
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne at
tukadmin@thyroiduk.org
Also request list of recommended thyroid specialists, some are T3 friendly
Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine
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.
All thyroid tests should ideally 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, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
Thanks for very informative post I will work my way through the articles. I did request reference ranges but receptionist I spoke to said she wasn’t comfortable reading out/interpreting ranges and figures as she’s not a medical professional. I had to literally beg for the actual result figures. There was also no doctor available to take my call at the time (frustrating as I’m a nurse who interprets blood results all day in my job) I will try again tomorrow.i am indeed gluten free..and try to be dairy free but do slip up occasionally. I take vitamin D, ferrograd C (last ferritin was 50, rising from 9 at diagnosis) magnesium, zinc, B vitamins and selenium. Altho depending on shift work (night shifts) there are days I forget.. I guess my main question is how can I increase armour if I am sensitive to t3 and resultant hyper symptoms? Another member has suggested levothyroxine as an adjunct to armour but I had horrendous symptoms on levothyroxine and am reluctant to go back on it. However I am hearing good reports from those on t3 but am worried how I might respond to it based on the t3 in armour causing me to feel hyper....
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results
UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible. In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up. They can make nominal charge for printing but many will do so for free (£10 max)
You are undermedicated to have TSH 4.9 when taking thyroid replacement. You need to ask your practice or GP for the lab ref ranges to see where in range FT4 and FT3 are. Patients optimally dosed on Armour would have TSH 02 - 1.0, sometimes lower. FT4 will usually be lower in range than when on Levothyroxine. FT3 needs to be in or near the upper third of range.
You probably need to be taking 2 grains (130mg). If you can't tolerate a dose increase perhaps you could add some Levothyroxine as it may be the T3 in Armour which is making you feel hyper.
Low iron/ferritin can make it difficult to increase dose without feeling hyper so ask your GP to check ferritin. tiredthyroid.com/feeling-hy...
Joint pain may be due to undermedication and/or vitamin D deficiency so check that too. Hypothyroid patients are often low in B12 and folate too so ask GP to check all four vitamins and minerals.
If you are going to buy your own NDT you should be aware that Armour is the most expensive. NatureThroid, Acella NP and Erfa brands are less expensive and Thai NDT Thyroid-S and Thiroyd are cheapest.
Elevated thyroid peroxidase and thyroglobulin antibodies means you are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.
If you live in the uk you are entitled to a copy of your results, they might make a small charge to cover the cost of printing them. I am lucky my surgery do not charge. Just have to wait for doctor to check them before they let me have a copy.
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