Do I chew Armour Thyroid

[Shredder]

Hi my endocrininologist has just put me on Armour Thyroid. He initially put me on 40mcg of liothyronine and 50mcg of Levo after I struggled on 250mcg up to 200mcg since have RAI treatment for Graves 3 years ago. Since that time I have struggled greatly only having any relief on WP Thyroid which became unavailable. I have tried the recent formula of Naturethroid and found them to be awful. As the Liothyronine gave me horrific insomnia my endo has now prescribed Armour but I have read that it has been reformulated again and needs to be chewed. Any advice as I'm getting desperate with hypo symptoms plus massive weight gain despite restricting calories greatly.

[greygoose]

Any advice as I'm getting desperate with hypo symptoms plus massive weight gain despite restricting calories greatly.

That could be part of the problem. Low-calorie diets are not recommended for hypos.

How much Armour has he put you on? Did it say, where you read, why you should chew the Armour? I was always told that that was a bad idea.

What was wrong with 40mcg liothyronine and 50mcg Levo? You'd have to take a lot of NDT to get that much T3.

[Shredder in reply to greygoose]

2 grains initially but he said I could up it to 3. I haven't started it yet. I was reading the mixed reviews of Armour. Some Armour uses said that because 9t had been reformulated and one of the new binders was harder than previously they advised chewing to release the thyroid ingredients to make them easier to absorb. The 40mcg of liothyronine gave me intolerable insomnia (weeks of no sleep wrecked me.) Thanks for the reply btw.

[greygoose in reply to Shredder]

Well, if you did chew it, you would have to be careful to rinse your mouth out carefully with water afterwards, so that you don't miss bits stuck in your teeth or something. That would reduce your dose.

Did you build up to the 40 mcg lio slowly? If it affected your sleep, did you try reducing it slightly, until your sleep improved?

[Shredder in reply to greygoose]

Initially I took the whole 40 in two doses but then cut it to 25 plus 200mcg of Levo.

[greygoose in reply to Shredder]

No, but I mean did your endo start you off on 5 mcg T3, and increase by 5 mcg every two weeks, or something like that? And, when you reduced, did you come down equally gradually?

[Shredder in reply to greygoose]

No I immediately took the 40mcg from the outset. I managed to get a small amount of WP Thyroid and took it instead of the Liothyronine. I felt much better within 6 weeks. I didn't come of the Liothyronine gradually I just stopped and when the WP ran out and I couldn't get any more owing to the lack of availability I went back on Levo 150mcg plus 25mcg of a different brand of Liothyronine and it was slightly better though my hypo symptoms would re appear again in the late afternoon / early evening.

[greygoose in reply to Shredder]

I think that might be part of your problem, then. Your body is in shock with all these brutal changes.

Levo, lio and NDT are all hormones. And, the golden rule with hormones is to start low and increase slowly - decrease slowly, too. For levo that means 25 mcg every six to eight weeks after retesting. For lio that means 5/6.25 mcg every two weeks, stopping increasing occasionally for six weeks and then a retest. For NDT that means 1/4 grain every two weeks, stopping occasionally for six weeks, etc. And you need to stay on one form of treatment for a few months before changing so that your body can settle into it.

I don't know how long since you started thyroid hormone replacement, but you appear to have had many changes of dose and type of hormone replacement in a very short time. And, that is not good. Your endo should know better! Obviously, he has no idea what he's doing because he's doing it all wrong.

[Shredder in reply to greygoose]

Thank you so much for taking the time to reply. You are right but I just wanted to start to feel normal again as I have gone from a fit and active 46 year old man to a breathless fat blob who couldn't play football with my son. I felt a bit ashamed tbh and when people who I hadn't seen for a while commented on how much weight I'd gained I wanted to regain some of my self respect.

[greygoose in reply to Shredder]

I do understand, honest I do. But, taking short-cuts is shooting yourself in the foot. It just won't work, and will probably make you ten times worse. As you've probably found out. Patience is key. Taking a hormone is not like taking an aspirin. It takes time to make itself felt. And having a d***head for an endo, doesn't help! What is the man thinking?

So, you have to promise yourself that you will take it steady from now on. OK? So, what exactly are you taking at the moment - important to know so that we can decide what dose Armour to start on. You obviously can't trust your endo's advice!

Also very important: have you had your nutrients tested? Vit D, vit B12, folate, ferritin? If so, what were the results, and are you supplementing with anything?

[Shredder in reply to greygoose]

Thank you for the reply. My endo is quite nice and will let me different meds until he hopes he find one that suits. The problem is they never tell you how to take something or how long before you should see results and as a consequence I have tried a number of different types and combinations in the hope is find one that works. I though I had done with WP NDT then they stopped making it.

[greygoose in reply to Shredder]

Yes, but that sounds very haphazard. Did you start out on levo only? One usually does because if that suits, it's so much easier to take. If you prove to have a conversion problem with that, then T3 is usually added, to see how you get on with that. If that doesn't suit, the we try NDT. And, of course, there are so many brands to try. But, we have to stay on one thing long enough to get a result, and that can take months. You're not going to know if it suits you in a few days. And, then, as a last result, we can try T3 only.

All this is going to take time, and you have to get used to that. There are no quick fixes where hormones are concerned. And, if you and your endo can't accept that, then you're never going to get well.

Thyroid hormone, be it T4 or T3 or a mixture of the two, should always be taken on an empty stomach, leaving at least an hour before eating or drinking anything other than water, and at least two hours before taking any other supplements or medication - with some things you need to leave four hours - for maximum absorption. As to when you take it, that's up to you, whatever suits you best, and you need to experiment to find the right time - as long as you obey the above rules. Some people like to split their T3 and/or NDT and take it two or three times a day - sometimes people even split their levo. And, if that makes them feel better, then that's great. But, it's all trial and error to find what suits you.

As to how long it takes to see results, that's impossible to say, because it's different for everyone. When my endo diagnosed me, she told me that in two weeks, I wouldn't recognise myself, I would feel so well! She was partly right. I didn't recognise myself because I felt a hundred times worse! Symptoms I'd never had before appeared. And, she was wrong to tell me that, because it made me feel a failure - what was wrong with me that I didn't feel better? It took me over ten years, trying levo mono-therapy, T4+T3, NDT, and finally T3 mono-therapy, to start feeling better again. That time would have been shorter if doctors had left me to it, but I've never met a doctor that didn't make me worse, rather than better! But, I think I gave safely say that at least I gave everything a good try.

Oh, just as an aside, I did feel well on Armour - until they changed the formulation and put the price up! It became too expensive for me, especially as I needed to increase my dose after the reformulation, and other NDTs just didn't do it for me - made me much worse! So, I do understand where you're coming from, but that's life - for a hypo, anyway!

[Shredder in reply to greygoose]

Yes I was put on Levo initially but felt unwell on it and my insomnia was horrendous but I guess that's because my body wasn't used to it. It also made me itch very badly so assumed I was reacting to something in the medication. I lesser Fred for six months or so going up in dosesuntol I hit 150mcg and of course read and read about my condition. My gp allowed me to try NDT initially Naturethroid which seemed ok but then I discovered WP which was like a godsend. The itching and insomnia stopped and my hypo conditions disappeared. I took this for about four or 5 months and then it became unavailable. I then had to go back on Levo and T3, then T3 was increased to 40mcg and Levo reduced to 50mcg with unbelievably bad insomnia. I am currently taking 200mcg Levo and 25mcg cytomel T3 though end has given me Armour though I haven't started it yet.

[Shredder in reply to Shredder]

Sorry predictictive text. I stayed on Levo for about six months going up in doses until I reached 150mcg.

[greygoose in reply to Shredder]

It must have been the fillers in the levo you reacted to. Did your doctor not suggest you tried other brands? Although, of course, we do often find that new symptoms tend to appear when we start taking levo. Quite why, I'm not certain, but it happens all the time.

So, during that time on levo only, did you have your FT4 and FT3 tested?

I'm pretty certain that if you were taking 40 mcg T3, 200 mcg levo was a bit excessive. Do you have any results from that time?

Even now, with 25 mcg T3, if you're not converting well, that's an awful lot of levo.

So, Armour contains 38 mcg T4 and 9 mcg T3. To get 200 mcg T4, you would need to take 5 1/4 grains. Which would give you 47. 25 mcg T3. That would seem a little much, going from 25 mcg. So, I would suggest you start on 2 3/4 grains. Which would be a lot less T4 than you're taking at the moment, but get your FT3 to a good level first, increasing as necessary - 1/4 grain every 2 weeks - and then add more levo if you feel you need it.

All things considered, it might be a good idea to start on 2 3/4 grains, see how you feel. Increase by 1/4 after two weeks, if you feel the need. Then hold for six weeks and retest. See how you feel and see what your FT3 level is. How does that sound?

[Shredder in reply to greygoose]

Thanks so much for the reply. Your advice has been very greatly received.

[greygoose in reply to Shredder]

You're very welcome.

[Shredder in reply to greygoose]

Could I possibly ask one other question? If I have had my thyroid removed because of RAI should i still start off slowly with Armour or should I combine Armour and Levo then come off Levo slowly?

[greygoose in reply to Shredder]

Doesn't matter what the cause of your hypo is, it's still treated the same.

But, you've raised a very good question, there. And, thinking about it, it might be a good idea to reduce the levo slowly.

At the moment, you're taking 200 mcg. So, perhaps it might be a good idea to reduce it by 75, and start on 3 grains of Armour. That would give you 114 mcg in the Armour, plus 75 from levo, would give you a total of 189 mcg. And, 27 mcg T3, which is just slightly more than you're taking at the moment. See how you feel on that for a couple of weeks. Then, you could slowly reduce your levo, 25 mcg every six weeks, and leave the Armour as it is. See how you feel. It's all about listening to your body, it will tell you what it needs. And, doing it that way will be less brutal than a straight swop. You'll never get a perfect match dose of dose, because you are taking so much levo. But, doing it that way, you'll be better able to feel how much T4 your body actually needs.

[Shredder in reply to greygoose]

Thanks again so much.

[greygoose in reply to Shredder]

You're welcome.

[Shredder in reply to greygoose]

I found that if I eat my symptoms reappear rather quickly strangely.

[danym in reply to Shredder]

does it work better if you chew it?

[prussianblue]

I agree with greygoose low calorie diet is not a good approach. I am not aware of recommendations to chew Armour, but to be honest I’d find that impossible, it tastes revolting, swig back with water asap is my approach. I used to take it with chocolate to trick my throat to let it pass

[Shredder in reply to prussianblue]

Thanks for the reply.

[SlowDragon Administrator]

After Graves' disease low vitamins are extremely common

Have you had vitamin D, folate, ferritin and B12 tested?

Also many Hashimoto's and Graves patients find strictly gluten free diet helps or is essential

A diet rich in protein and good fats, but not too much sugar

Ideally ask GP for coeliac blood test first

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

As greygoose said....with any thyroid hormones we have to introduce or adjust levels slowly and very carefully

When starting to introduce T3 - typical dose is 5mcg twice daily, one dose on waking. The second dose mid afternoon . Wait 6-8 weeks and retest bloods BEFORE considering another increase

Any further increases only 5mcg at a time and retest 6-8 weeks later

More or quicker increases often backfire

Only testing after 6-8 weeks on constant dose

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If also on T3, or NDT make sure to take last dose 8- 12 hours prior to test

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins

thyroiduk.org.uk/tuk/testin...

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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

[Nanny23]

I can certainly sympathize with you. I’m on 50 mcg Synthroid and just raises to 15 Liothyronine. I’m bloated all the time now swelling feet legs and hands. I have mega stomach problems my whole life. Barrett’s esophagus ulcers colon polyps. I do hope you find a solution. Grey Goode should be able to help you she has spot on advice. Stay well I know how hard that is to do. Never stop advocating for yourself

[danym in reply to Nanny23]

the meds don't bother your stomach?

[Nanny23 in reply to danym]

My stomach always hurts so I don’t know if it’s meds or not