I have recently in the last 3 months been placed on an Amour Thyroid NDT trial by my Endo. I was originally on 150 mcg of Levo T4 only and felt dreadful to the point of completely crashing at the end of Feb of this year and have not managed to work since. My GP referred me back to my original Endo ( I had a Total Thyroidectomy in 2014 due to Graves disease and have not felt right since.) and I was given 1.75 grains of Amour Thyroid which I started on the 9th March this year.
Having seen the Endo today and still experiencing many Hypo symptoms he has increased my dose to 2 grains a day but has stated that there is not much more room for any further increase in dosage. I would be grateful for any advice from those that are on NDT what levels I should be looking at. I am getting confused as to whether TSH or FT4 levels has any significance now.
I am now gluten free and supplement Vit D, Selenium, B12 and Ferrtin based on the excellent advise from many on this forum.
My current results are:
TSH - 6.68 (0.27 - 4.20)
FT4 - 9.5 (12.00 - 22.00)
FT3 - 4 (3.10 - 6.80)
Ferrtin - 49 (30.00 - 470.00)
Vit D - 98 (No range given just states >50 Sufficient for almost the whole population)
I don't have a current B12 level as the nurse forgot to tick the box but my last reading was 347 (145-250 deemed as insufficient, >569 consider reducing dose). I am currently supplementing.
The bloods were taken at 8.30am, 24 hours after my last dose of NDT.
Many thanks in advance.
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Projectgirl
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"but has stated that there is not much more room for any further increase in dosage."
Good heavens! Where does he want your levels to lie then?
No wonder you are still having symptoms with a TSH that high. Most hypo patients feel best when TSH is 1 or below.
When taking Armour (or any NDT) it will lower, even suppress, TSH and also lower FT4. As long as FT3 remains in range then it's fine, and most people feel best when FT3 is in the upper part of the range. There is plenty of room for increased dose.
By the way, when taking NDT, the last dose should be 12 hours before blood draw when testing. Any longer and you will get a false low FT3. 24 hours is for patients taking Levo.
Thanks for the replay SeasideSusie, I really don't know where he thinks my levels should be, but it was not until he stated that there was not much room for further increase that alarm bells started to go off in my head. At this point he was actually showing me that door so too late to elaborate on the statement. I will have a followup with him in 8 weeks but at this stage my increase is only 1/4 of a grain.
After today's appointment I am seriously thinking of changing my Endo, he was really pushing the fact that my tiredness was down to potential sleep apnea and not thyroid. I am very heavy for my height but I know what lack of sleep feels like and hypo tiredness is on a different level. He also wanted me to talk to the GP about anti depressants for my mood issues.
I had such high hopes as he was happy to switch me to NDT but I may now need to look further afield.
Thank you again for all you advice, I have made notes for future tests.
Perhaps add in a good vitamin B complex too. One with folate in, rather than cheaper folic avid Recommended to keep B vitamin levels balanced, especially when supplementing B12
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
Thanks for replying SlowDragon. Between yourself and SeasideSusie I have learned so much about supplements and Gluten sensitivity.
I am currently on nutri advanced Women's Multi Essentials which does have B1,2,6 and 12 in large quantities but I will certainly check the levels against a good B complex. It also contains Folate as well as Biotin. I was not aware of the issues with biotin's potential to affect results, thank you for this really interesting nugget. I will certain read up on this, many thanks again.
Yep, you are under medicated. I am on Armour NDT and if I had a TSH of 6.68 I would be in a coma. My TSH is <0.1, once it approaches 1.0 I begin to feel very ill - I experimented. You could take and extra 1/4 grain and see how you feel, that's what I had to do before I felt well. Keep an eye on your blood pressure (BP), that's the only side effect you may want to avoid. If you feel a bit better with the slight increase in dose, add another 1/4 grain. Measure your pulse, body temp and BP as you increase and back off to the previous dose if any of these quantities get too high. Remember that it is the T3 which is the main active ingredient in NDT and it only has a half life of about 7 hours so any ill effects will die off by about 4:00pm (assuming you take it in the morning) - and if you did have an ill effect, back off to the previous dose.
Oh, and BTW, it bothers me that your doc/Endo didn't react to a TSH of >6, that screams hypothyroidism. That's less than Endocrinology 101 (US terminology, it means that you would get that info. in an O-level biology class). You may want to consider changing docs - BUT... he prescribes Armour NDT, probably keep him for NDT and blood tests but dose yourself and don't tell him, that's what I have to do.
Hi LAHs, do you have any references about half life of T3 in Armour please. I thought T3 always has a half life of about 3 hours, but the T3 in Armour feels like slow release to me. x
Hi Aurealis, that's a good question! If you Google "What is the half life of T3" - (which is the same T3 you will find in Armour NDT) - you will find answers that range from 4 hours to 2.5 days and one which even said ???. The most quoted number is 1 day. So I hesitate to give one reference. Now, how long T3 remains in your system will depend upon your lifestyle, if you are very athletic you will use it up pretty quickly, maybe before you have finished your exercise, this has happened to me once when riding my bike. You could say well, when I have a blood test 24 hours after my last dose I am midrange. But, you do not know how much of that T3 is what you have converted yourself, it is not all of your externally taken T3 unless you are a zero converter (of T4 to T3). Personally I would listen to your own body, I feel my energy start to wain about 4 in the afternoon, that's about 8 hours after I have taken my pill and I have "nothing" left by 9:00pm when, if I am not by my bed, I think I would fall on the floor! So, for me T3's half life is about 8 hours, a number I read in the literature a long time ago when I first started to study all this and that seemed to make sense.
Give it a try, Google "What is the half life of T3", you will be surprised.
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