I had a TT on April 2016. I’m very active and enjoy running long distances. I’m struggling with weight gain and fluid retention in arms, thighs, buttocks. Low bp 100/60, lower temp 97 degrees to 97.5.
I was taking 90mg (1.5 grains ) of armour at time of surgery. Since this time I Have steadily increased dose to 180mg (3 grains) armour split dosing 120 in morning 60 in afternoon 8 hours after morning dose.
I recently added 30 mg in afternoon to make a total of 210mg per day (120 in AM and 90 in PM)
I still feel hypo often and the weight gain and puffiness have not improved.
My latest labs prior to 30 mg increase 2 weeks ago are:
Labs:
TSH .01 (.40 - 4.5)
T3 uptake 37% (22-35%)
Free T4 1.0. (.8 - 1.8)
Reverse T3 11 (8-25)
B12 607 (200-1200) this is with b12 injections monthly and supplementation
Vit D 45 (30-100) I take 2000 IU daily
Folate 12.9 (>5.4)
Iron total 80 (40-190)
Ferratin 55 (10-232)
Zinc 7.2 (9.0-14.7)
opinions are greatly appreciated! Wondering if I should try T3 only, switch to a different NDT, or increase armour to 240/day (4 grains total). I have appointment with my GP next week for annual physical. Have also recently consulted a naturopathic doctor. He prescribed ADR (2 in morning , 1 at lunch ) for adrenal fatigue.
I did all day saliva test and cortisol is high in morning then plummets by lunch and rest of day.
I’m also gluten free. Eat mostly low carb.
Thank you!
Written by
Bethy1972
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Your low zinc could be significant as closely assocoated with weight gain. Vit d is also low.Vitmain d coucil recommend 5,000 units to maintain levels and 10,000units to treat low levels. I would want my iron a bit higher I think about 90 recommneded for good thyroid uptake. It is a while since I haveseen someone on armour as cost often prohibative. Some sea salt may help low BP. It sounds like you have only just started on some cortisal support so give that some time andprogress re thyroid is often a long and winding rd.
Vitmain d coucil recommend 5,000 units to maintain levels and 10,000units to treat low levels.
Actually that isn't correct. There is no general set amount anyone should take. You need levels testing first and dose of D3 dependent on the result. And of course it is very important to know if the unit of measurement is NG/ML or NMOL/L.
Are you in the US and is the unit of measurement NG/ML? If so the Vit D Council recommends a level of 40-60ng/ml so you are within that range but you may want to nudge it up nearer the 60 with a slight increase in your dose of D3.
If the unit of measurement is NMOL/L then you are a long way from the recommended level of 100-150nmol/L.
Are you taking D3's important cofactors Vit K2-MK7 and magnesium?
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.
Magnesium helps D3 to work and comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds
As you're having B12 injections, you should take a good B Complex to balance all the B vitamins.
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For thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range. You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...
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Zinc is on the low side, half way through range would be better.
For K2-MK7 I like Healthy Origins which is a US brand so you should be able to find it easily.
Is there a reason you're taking the extra B6? Just asking because taking large doses of B6 over time can cause neurological problems such as tingling of the extremities and other problems. A decent amount to take in a B Complex would be 10mg and the maximum recommended dose is 100mg.
Multivitamins and minerals are generally not a good idea as they contain too little of anything to help and often use the cheapest and least absorbable form of active ingredients. If it contains iron then absorption of the other ingredients will be affected as iron should be taken at least 2 hours away from other supplements. If it contains iodine or calcium then both of those should be tested before taking them and supplemented only if found to be deficient, with iodine needing to be supplemented under the guidance of an experienced practioner.
It's not possible to say if you need to increase your Armour more because the results you have given are from your previous dose, we would have to see what your results are like on your current dose. And T3 uptake test doesn't mean anything to us in the UK, it's Free T3 test that is important, particularly when thyroid meds contain T3.
At the moment my suggestion would be to concentrate on getting Ferritin level raised as that is so important for thyroid hormone to work.
Thank you Susie! Yes ill be getting new labs next week at my physical and will post them when I receive them. I was taking b-6 as I read it could help with fluid retention . It has not yet helped so I guess ill discontinue b-6.
What brand of iron or ferratin do you like? And also what form of zinc and amount should I take ?
I never recommend iron tablets as there is so much involved with iron and I don't fully understand it. You can have a high serum iron and low ferritin and you wouldn't want to take iron tablets. I only ever recommend eating iron rich foods, in particular liver which raised my ferritin from 39 to 109 by eating 120-140g per week.
Zinc, definitely avoid zinc oxide as that is the sort used in sunscreen. Check out these two articles, you should be able to decide which one is right for you, and it might be an idea to test copper if you are supplementing with zinc
Bethy1972, I've searched for T3 uptake test online, and all I can find is that its not actually a test about T3, its a test that tells you something about T4.
So at the moment you don't have any blood test here that tells you about your thyroid hormone levels. Your freeT4 is low, but that's always the case on NDT, and TSH doesn't tell us much once on hormone replacement. I think you really need to get hold of a freeT3 test, because its possible that your dose is completely wrong for you. We just don't know at the moment, because there's no information. FreeT3 tells you how much active hormone you have in your blood, and is the closest predictor of symptoms.
Unfortunately you've just changed dose, so it's a bit of a nuisance, you need to wait 6 weeks on a stable dose before getting a thyroid panel. But I think you should do this as soon as you get a chance. Once you've got that information you can think about tuning the dose, and ask questions like whether to add T3.
You've had loads of good advice on vitamins. I was thinking your B12 is maybe a bit low for someone injecting, and maybe you should consider more frequent injections. But I know nothing about this in comparison to other great people who have commented!
The only other thing is that it sounds like you're doing a lot of exercise. This will be using up your T3, and if you have adrenal problems it will be taxing them. It's not clear whether people commonly get back to 100% on thyroid replacement, or if many people are more like 80%, and just not able to keep up these very taxing activities. At the moment your body has a fixed amount of energy available to it, its what it can make with those tablets you're giving it. A healthy person can make more whenever they need to. If you're using up that energy going for a run, your body won't have it to keep your organs healthy, make you warm, pump your blood, etc. Exercising uses up nutrients, too.
You'll almost certainly feel improvement if you cut back the exercise. Try cutting back for a couple of weeks, see if you get an energy boost, and then slowly build in gentle exercise like walking, swimming, and see how much you can do without losing out on energy.
Thank you silverAvacado for responding and taking the time to look into the T3 uptake text online.
I agree with you that I do need Free T3 labs and will get these next week.
The last free T3 test I have is from December while I was on 180mg of armour daily . Result was 3.8 (2.3-4.2 pg/ml) and T3 total was 91 (76-181 ng/dl)
What you say about T3 and exercise does make sense given I do not have a thyroid and must rely solely on replacements by pill form.
I think I forgot to mention I was also diagnosed with Hashimotos ~20 years ago (I’m now 45).
Last I knew I no longer had positive antibodies but will have them both re checked. I did have a borderline positive ANA titer (1:80) test last year, but re checked this year it is no longer positive.
Is 180mcg the dose you were on before this last increase? You've got a bit of room for increase there, but not a huge amount.
Its hard to know what to do when getting to the top of the range and still having symptoms Theoretically you don't want to cross it. But personally I have done, because I was getting consistent improvement with every increase.
Hopefully getting your vitamins a bit more in order will improve how the symptoms a bit, too. Adrenal glands can also give some improvement, tweaking the amount of exercise. Its kind of a balancing act. People with Hashimotos often gave food or chemical intolerances, so you can look into that.
Yes, I thought that was a bit strange, a T3 uptake and a reverse T3 measurement but no T3 measurement neither free nor total. From a recent post by Helvella I understand that T3 uptake measures one's level of Thyroid Binding Globulin (TBGs). I didn't know that for a long time and I now find it a very interesting measurement. It tells you if you can accommodate a second medication which require the TBGs as it's transporter. If your T3 uptake is low, then you might be able to take a medication that otherwise interacts with thyroid medication. If your TBGs are already busied out with your thyroid meds then any other medication which requires TBGs will cause unpleasant side effects.
Oh, and note to Bethy, you can get Zinc from Cashew Nuts, I buy mine from Nuts.com (in the US).
Interesting, LAHs. I found it hard toyhmake sense of what the test was. It sound like it was invented before we had freeT4 or freeT3. But also that it is influenced by estrogen and a few other things!
Yes, estrogen, statins, NSAIDs and others all use the TBGs to get around the body so these will have side effects if there are no available TBGs to latch on to, i.e. in someone with an already high T3 uptake.
Lots of great advice above Bethy, I thought I would add this general point. I realize that we are all very different in our responses to medications but 3 grains of Armour is a very high dose. I too had a TT, I take 1.5 grains (of Armour) and my doctor argues with me to reduce it to 1.25 grains! I take 1.5 for 50 days then I have to pill cut for my second "half" of my pills. I have asked him to just prescribe 1.5 pills and he says, "No way, 1.5 is way too much Armour". Which, of course, is rubbish but I thought I would give you a different perspective on dosing of Armour. There are other NDTs which are not so strong so you will often here of 3 -5 grains being taken, but these are on a different scale.
Thank you both LAHs and silverAvacado, this is great information.
I know that 210mg/day of armour (which I’ve been on for 2 weeks. Up from 180) is a hefty dose.
My gut told me I was still hypo given my symptoms, but have wondered if the fluid retention and swelling in last 6 could also be from too much armour? It gets very confusing and easy to convince myself of either. I will try to stick to the newest free t3 # and make a decision based on that.
Thank you again and I’ll post my results when I have them!
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Theoretically you don't want to cross it. But personally I have done, because I was getting consistent improvement with every increase. 
Gaining weight on Armour
Dr is lowering my dosage, lab results help please
Results with symptoms
Lab Results on 2 grains NDT - Switching to T3 Only
Fatigue and weight gain
