Just looking for guidance from the thyroid experts here
I take 180 mg of Armour ( ndt). My freet4 is still low, below normal. I take my meds at 7am on an empty stomach. Drink black coffee an hour later. I typically wake up tired. I feel better by the time I have coffee. And my energy crashes by 12 or 1pm. I have tried splitting doses, but it never really has helped my afternoon energy crash. I have a normal life for about 5 hours, including exercise. My afternoons I can barely move off of my bed. I'm assuming I'm not converting t3 and just absorbing what I take in the morning? My family doctor will not change my prescription, but has referred me to an endocrinologist. Where I live we only recently got one, we didnt have an endo for years. So it may be a year before I see him. Not that I am feeling positive about him anyways. What should I consider? Cytomel in the afternoon? Sometimes I think it's something else and I worry I will never get answers. But it makes sense its thyroid related as I do have a few decent hours. Thank you.
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Daisylain
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What about your FT3? Doesn't your doctor test that? He should do, as you're taking NDT. But, there's no way to tell how well you convert when taking NDT, you need to be on T4 monotherapy to know that.
I would not suggest taking T3 with your NDT until you get your FT3 tested. Although, if you don't convert well, the 27 mcg you're getting from Armour might not be enough.
3 grains of NDT is not an unusually large dose, and you may simply need a dose increase, but without seeing your most recent blood test results and their ranges, it's not possible to say. However when you ingest T3 in whatever form, it is to be expected that your FT4 will be lower, or even low, in range, than you'd expect it to be when taking mono-T4. Likewise, your TSH will be very low/negligible. But it is your FT3 level which is key to understanding whether or not you are optimally medicated, and that should be in the top quartile. Some people are perfectly fine with a lower FT4 when their FT3 is optimal, others less so, and they might need to add in some T4. If you are optimally medicated on NDT such that your FT3 level is where it needs to be for you, T4:T3 conversion isn't a factor. You don't mention what exercise you do, but hard exercise is not good, especially when you are not optimally medicated, as it impacts T3 levels. If you post your most recent blood test results folks can comment more effectively, otherwise it is just guesswork.
Thank you! I guess they have me concerned about raising the dose because my TSH is suppressed. I know this happens but the family and functional doctors both tell me I need to raise it.
Daisy, on this site, you need to click on the blue 'Reply' button underneath the reply you're commenting on, or the person will not know you've replied. But, I'll notify MaisieGray for you.
You do not need to raise your TSH, your doctors are wrong - but I'm sure you know that. They don't tend to take kindly to patients explaining to them why they're wrong, so approach it from a different angle: ask them why you would need to raise your TSH? What is wrong with a suppressed TSH? And have they got any references to research papers to prove it? If they don't, or they don't know, tell them won't raise your TSH, then.
Thank you. So it really isn't a long term concern? My bone density is good. I am surprised that even the functional doctor is concerned about the tsh. I will increase my dose slowly and see if I can climb out of this exhaustion. I appreciate your help!
Plenty of people on here who've had a suppressed TSH for many years with no problems.
I expect even functional doctors go to med school and are given the same mis-information about thyroid. And, unless it is of special interest to them, they are not likely to do their own research. Through reading people's experiences on here, functional doctors seem to have some even weirder ideas about thyroid than conventional doctors! Not sure I'd trust my thyroid to one of them.
Every day there are several posts on here about suppressed TSH. And it is frequently explained that this is to be expected when taking NDT/T3, and it is not a problem.
Thank you. All of those levels are good except iron. I get IV iron and I am getting close to anemia levels now, and will go for IV once it’s down a few more points. I am celiac and have never been able to absorb iron. I also take b12 by injection.
I am not Hashimoto at least I don’t think so. They only did blood work once. It is secondary hypo, as many of my pituitary hormones were way below normal.
Hi daisy, If you are thinking of raising your Armour NDT dose measure you blood pressure (BP) first. I am of the opinion that 180 mcg or 3 grains of Armour NDT is pretty high although I have read that 3+ grains of other NDTs are typical, because they are not so potent. I have no thyroid at all and I run on half that dose (1.5 grains), I would love to raise it even 1/4 grain but it makes my BP shoot up. So, my advice would be to monitor your BP before you start and then throughout any change in dose.
Start taking your resting temperature when you are still in bed in the mornings. If 36.5 C, that's a good sign that your dosage is OK. If higher, cut back on dosage, if lower, add. Then take your pulse each day and it should be about 75. If much higher, then cut back on your dosage, or if too low, increase. I find these two tests will keep you normal or close to it with regards your NDT dosage.
This is amazing - I’ve been charting my temp and it’s waaay below this - 97.1 or so. If I ovulate it jumps up a bit but I haven’t found any literature on temp correlation to dosage. Do you have access to any? Thank you!
It's a pretty standard test when you are slowly increasing your dose (of thyroid meds) to your optimal level. It is used in conjunction with taking your resting pulse each morning. They are both basic measures of your general metabolism, if you are under medicated both will be low, as you increase your dose both should rise. Personally I find pulse rate is more sensitive than temperature.
Oh, and in answer to your question, if you Goole "Temperature and Pulse rate related to Thyroid" you will find lots of literature.
There is a test, called the Basal Metabolic Temperature test. It is free and, I, for one, believe it works. It goes way back in time to the 50's & beyond. Most GPs and endo's don't refer it for one simple (simple doctors) reason: there is no profit in it for them to do so. You do it yourself and it is free. In the early morning hours , upon awakening: put a mercury thermometer under your arm for 10 minutes, or a digital thermometer in your mouth until it beeps. If your temperature is between 97.8 to 98.2 you are on an optimal dose. If it's below that you have an under-active thyroid, anything over suggests over-active.
There is one caveat, for women, if you are male there is no caveat. For women, if you are experiencing menstrual years your temp's many fluctuate and the temps will be higher before the start of your flow and lowest upon ovulation.
The pulse can be taken at any time, during the temp test, or whenever you wish, usually it's 60-80 bpm but everyone is different.
The idea is to be rested while taking your temps and, it is known, that it is a superior test in diagnosing hypothyroidism. I'm not a doctor or in any way educated in the medical field and my only input is for information I am aware of and use myself. Peace be upon you.
Since I’m in those weird hormonal years I’ve been charting my basal temp for a long time now to see if/when I ovulate. When I don’t I add extra progesterone in that month. I understand that also helps since estrogen dominance hogs t3 receptors, or something like that. Ive seen my temp is too low and it’s so common sensical that it’s correlated to metabolism. Thank you for being an outside voice of reason. Changes happening NOW.
GKeith, I was diagnosed in the early 1960s, at that time the GP was looking at temperature and pulse rate in relation to being underactive. I can’t remember when they stopped checking those, it was some years ago.
Have you been tested for T4 and T3? If not I suggest you get a test done to see those levels. Also your adrenal glands need to be tested to see how that is performing because of the Adrenals are low which means absorption of T3 is hampered. I also recommend taking your temperature first thing in the morning along with a heart rate check before you get up for a pee or anything. In other words as soon as you wake up. Pop in a thermometer and count your heart rate. Normal rested is around 70. 75 and above is on the higher side rested and below 65 is on the low side rested. Your Temperature is also a guide as to your balance and levels. If your temperature is low then it is a suggestion that your still not taking enough hormone replacement. Read Dr Peatfields book and learn to recognise the signs yourself so that you can keep yourself as balanced as possible. The heart rate and temp test first thing in the morning is a good one because its an indication as to how much you should be taking. Bearing in mind also nature thyroid is a natural product and each batch will vary ...I've noticed this over the years with some I will take 3 grain and I get a new bottle of tabs and take the same dosage and I notice a change in temp and heart rate within around say two to three weeks plus I experience heart flutter...I take my temp and heart rate and notice that I am not balanced. Each batch is slightly different. This is why it is very important to do this test at least three times a week because its an indication how your body is balanced.Good luck.
I had the exact same problem as you. Too low free T4. When I tried to raise the NDT, I'd get tired from too much T3. When I tried to lower the NDT, I'd become exhausted because not enough T4. I was in a state of being hyper and hypo at the same time. I was following Janie Bowthorpe and her disciples and they kept counseling that I needed to raise the dose, add adrenal support. Nothing was working. And I felt that bad, long term problems were starting to happen with my joints. So I went online and started doing some searching, and I came across research that says the problem with porcine thyroid in humans is that the T4 to T3 ratio in NDT is not right for humans. There's way too much T3 in it. Human thyroid is : 15-19 parts T4 to 1 part T3. Pig thyroid is 4 parts T4 to 1 part T3. I was taking 2 grains of NDT. I was running out of NDT because of the national shortage at the same time that I found the info on pig thyroid being not quite right, so I asked my doctor if I could substitute some levothyroxine for the NDT. I am now taking 1 and a half grains of NDT and 50 mcgs of T4 and feel so much better. I got blocked by pro-NDT people because I started talking about this ratio issue. Some people think you only need T4, some think you only need T3. What if you really need the right combo of both? Work with a doctor to find the right combo for you. 32 mg of NDT=50 mcg of T4. Ask your doctor if you can start swapping out one for the other and see how you feel.
I agree with SlowDragon . We have receptor sights for both T4 and T3 . Our body takes what it needs . Granted some of us do better with more T3 less T4 or in reverse more T4 to our lesser T3 . Journaling our symptoms will help us get to our Optimal that we individually need . No two people are alike . And it's not one size fits all . Slow and steady wins the race .
I had a total thyroid removal 5 years ago, I take 90 mg of Armour daily, and sometimes I feel its too much and I get jittery and I cut back a day. 180mg seems really high.
Do you split your doses with your NDT ? It might just be if you don' split your doses that your taking in more T3 than your body can handle at one time . If that doesn't work for you because the T3 in the 90 mg might just be to much for you .You may want to try lowering your NDT and introducing lower dose T4 and see if that might work for you .
I had TT several years ago and was dosed on Synthroid only . I had very bad reactions and symptoms . I switched Endo and he introduced me to NDT with T4 . At first it worked very well . But with time journaling my symptoms I felt as yourself that the T3 was causing me to be jittery sweating more and having insomnia feeling my thigh muscles gaining weight feeling unmotivated . My Endo goes by symptoms more so than BP . What a Blessing .
With my Endo's blessing I lowered my NDT and raised my T4 slowly by 25mcg at a time and lowered my NDT by 1/8 -1/4 grain at a time . Holding my new changes for two weeks to see if symptoms get resolved . Each time journaling new or old symptoms .
Vitamins will make a huge help too . Vitamin "D" /K2 , B-Complex , B-12/Folate , Vitamin "C" , Magnesium , Iron if you test low . Celtic Sea Salt is great for electrolytes /adrenals .
I hope you get sorted out and feel your best self .
Can you try to cut back for a week to just see if it helps? My Endo always says start low and slowly increase to find your perfect level, too high can be harmful to your body. When are you taking it, how are you taking it. Some do better taking it in am, some do better in the PM. But I still thing the dosage is way to high.
Other people can't judge what is the right dosage for you (unless they're commenting on blood tests) Ignore anyone who says it's too high/low because they take less/more. You need to take the right amount for you. (Btw I take 180mg of Armour all at the same time!)
I agree with those above who say you need to get FT3 tested at the same time as everything else so we have a clearer picture. You do know to take NDT 12 hours before early morning blood test and don't eat or drink(apart from water) before test, don't you? The day before my blood test I split my dose, taking 2 grains first thing then 1 grain 12 hours before my appointment, again 2 hours after and 1 hour before food.
Thank you. I'm really surprised they didnt test t3. They usually do. Typically my levels are t4 is below the normal range and t3 is smack in the middle. I guess maybe that was the doctors thought process...to check what is normally "considered " abnormal. Thank you I will get this done asap.
Hi. I am celiac/gluten free for 17 yrs. I also love pilates and am 99.9% organic. Dont take on an empty stomach? I have always been advised the opposite. You take ndt with a meal? What made you try this?
There are quite specific and different factors that impact the absorption of meds, particularly via the bucal or sublingual routes. Hence why meds are designed pharmacokinetically, to be taken by the specific method pertaining to each. It is generally advised that the molecules of NDT are too large to allow them to be absorbed by the process of osmosis under the tongue, and therefore all that happens is that they slowly dribble or are swallowed down the throat. Independently of that, in some cases there are reports of people holding tablets under their tongue or in their cheek for longer than is advised, that aren't designed to be taken by that route, who end up with sore areas or even ulcers due to the irritation of the med.
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