Thyroid UK

Help! Armour + Levo dose post thyroidectomy

Hi all

I feel a bit desperate and confused when it comes to my treatment and medication following a total thyroidectomy in 2016.

I see a private endocrinologist who is open to the idea of NDT, and after trying just Levo alone for a while, we decided my conversion to FT3 wasn’t fantastic (FT4 19-20 but FT3 ~3), so he prescribed a combination of Levo and Armour Thyroid.

My FT4 and FT3 is technically in the “normal” range so I think he feels it is job done, but I feel rubbish :-(

I had a baby 5 months ago, so he puts my tiredness down to that, but I feel I’ve never felt “right” since my thyroidectomy, and also I’m fortunate in that my son sleeps 12hrs at night so I can’t really blame him for feeling this way!

My last blood results were:

TSH 0.038

FT4 13.7

FT3 4.86

And I’m currently taking 50mcg levo and 60mg or 1 grain Armour Thyroid.

My endo advises that I can’t up my dose of either Levo or Armour because my TSH is so low, so I just feel I have no options.

I wondered if anybody had any advice or has been in a similar position. I’m up for trying anything including supplement and lifestyle/diet changes (I already take B12, iron, D3, magnesium & selenium).

I have heard that testing my reverse T3 and cortisol may be a good idea? I also wonder if I should scrap the Armour and just take a higher dose of levo...even with the poor conversion, but my endo just said I was the one who wanted the Armour so it didn’t make sense.

As an aside, I was on the same dose of levo & Armour prior to my pregnancy (I went to just levo during pregnancy), and my TSH and FT4 were almost the same as they are now, but my FT3 was 5.5 and I definitely felt better (again, my endo just said it’s because I didn’t have a baby then!).

Thank you for reading and apologies for the length!

3 Replies
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You had a thyroidectomy presumably for Graves Hyperthyroid ?

therefore after this only NDT tends to work and only with a totally suppressed TSH and t4 and t3 right at the top or slightly over top of their ranges simply because the body was so highly sensitised before the op ....few Endos are aware of this situation although Professir Lant ( long since retired ) certainly was

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Your body is going through huge hormonal changes after having a baby. When we don't have a thyroid, we are dependent on replacement which is maybe not as responsive as our own thyroid?

Maybe it's harder for our body to make the fine adjustments needed and so everything feels sluggish.

When all your hormones settle down and that could vary for different people then it should be easier to maintain an even keel. Even women with a thyroid can feel very tired with a small baby even with good sleep just because of all the hormonal adjustments.

Try to attend to your own nutrition which is hard with a baby. And don't get too hung up on thyroid levels. Sounds like they are ok.

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I cannot understand the reasoning of your endo - or perhaps he didn't use any reasoning at all! Armour is mainly T4 with just a tiny bit of T3. He knows you don't convert very well, so what on earth was the point of adding all that T4 on top? That just doesn't make any sense, in my book. Have you tried asking him to cut out the levo, and increase the Armour to 2 grains? Technically that would be around the same T4 equivalent but you'd have more T3.

He really doesn't know that much about thyroid, does he, because once you're on thyroid hormone replacement, the TSH is more or less irrelevant. It doesn't matter how low it goes, as long as it doesn't go high. The most important number - especially on T3 or NDT - is the FT3. So, with his ignorance, he's keeping you ill.

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