New and need advice

[Duckydoodle]

Hello, I have had Hashi's for over 25 yrs, and have only taken various doses of Armour (NDT) for all of these years. I was up until recently taking a total of 90 mg. of Armour, in a divided dose (60 at about 3 am and 30 at about 3 pm)

For the past few months, starting in May, I have had issues with my dose being (seemingly) too high. I've always had a tendency to have a suppressed TSH, that just seems to be part of taking NDT, but my last blood tests showed a TSH of under .05, though my Free T4 was low normal as it always is, and my Free T3 was at the upper end of normal, as it usually is. I had my labs drawn 14 hours after taking my Armour. Apologies for not having reference ranges in front of me.

I was experiencing some hyper symptoms.....anxiety, flushing, random bouts of panic, high blood pressure, too much time in the bathroom, etc.

My gp wants me to see an endo, but I am just about fed up with doctors and have ordered my own labs to be redrawn (thanks goes to this board on how to do that)!

I have slowly been reducing my dose, down from 90 mg. to 60 mg (split as described above), and now down to just 30 mg at 3 am.

I do feel a bit tired, and my hair is getting that fried look, possibly thinning a bit yet I don't see excessive shedding, but I also know there is a lag between symptoms and labs.

So here's the part where it gets very confusing and interesting. For a variety of reasons, in late April I quit drinking alcohol completely. I felt like my wine habit was getting out of control and truth be told had been so for over 15 years. It's hard not to make some sort of connection to this. Is it possible that I am absorbing more of my medication since I quit drinking? Less? I have found very little info on this topic in my searches.

The other thought I had is that I've been going through menopause for a few years now. I know sex hormones can bind to thyroid hormones. Is it possible that my lack of remaining sex hormones is causing me to absorb more medication and therefore need less.

Some combo of the two?

Last question.....when EXACTLY should labs be drawn when you are taking NDT? I have seen various answers, most of them saying to wait at least 12 hours, others saying skip that day entirely. Since I've ordered my labs, I want to time it to get numbers that accurately reflect what is going on, vs. trying to "game" them for fear my gp will reduce me even further. She does not yet know I've on my own dropped down to just 30 mg. I will say my anxiety is better and my blood pressure is almost normal.

I'm sorry this is so long and I thank you for reading it and any and all advice!!

[greygoose]

I'm curious as to why you think you need less. Just because of the TSH? The TSH is irrelevant when taking NDT, you need to look at the FT3 and go by how you feel. Do you feel over-medicated? The TSH on its own certainly can't tell you you are. And, unless your swigged your NDT down with half a pint of lager, I can't see how alcohol would stop you absorbing it.

[Duckydoodle in reply to greygoose]

Hi greygoose, thanks for the reply. Yes, TSH on it's own is useless, as it's not even a thyroid hormone. But, combined with some of the hyper symptoms I mentioned and my 3 being on the higher end (think it was 3.6 and top range was 3.7), it DOES make me wonder.

I get your point about the pint of lager, but it's not that simple. Since alcohol is broken down by the liver (most everything is really), it's conceivable that my "tuned up" liver is processing everything ingest, including my Armour - at least that's my latest theory.

[greygoose in reply to Duckydoodle]

Well, yes, but by the time your thyroid hormone gets to the liver, it's already been absorbed.

Anxiety, flushing, random bouts of panic, high blood pressure, too much time in the bathroom can also be hypo symptoms.

[Duckydoodle in reply to greygoose]

Well, I don’t know at this point. Labs seem to indicate i was running “hot” as do my symptoms. It’s always a bit of a puzzle as as you said symptoms can overlap. Will be curious to see what my next labs say on this even lower dose.

[shaws Administrator]

Maybe this link will be helpful. It is by an Expert who was also an Adviser to Thyroiduk before his accidental death. He'd never prescribe levothyroxine - only NDT and for Thyroid Hormone Resistance people he'd prescribe T3.

All will be helpful, especially 'Safely Getting Well with Thyroid Hormones'.

naturalthyroidsolutions.com...

[Duckydoodle in reply to shaws]

Thank you - I will check it out. Anyone have any ideas on how long to wait between taking Armour and having labs drawn?

[meme in reply to Duckydoodle]

12 hours.

[Duckydoodle in reply to meme]

thanks, that's one of the theories I've read, others say to wait longer....

[meme in reply to Duckydoodle]

You get a false low T3 reading with a longer gap I understand .

[Duckydoodle in reply to meme]

It's confusing I think when you're taking meds that have T3 in them. My last labs were drawn about 14 hours after my 3 am dose of 60 mg (that I've since stopped taking) and my TSH came back suppressed and my Free T3 was almost at the top end of the range. All signs are seeming to indicate that for whatever reason, I was suddenly overmedicated.

[765nottyash]

I'd agree that lower dose is better. I've been lowering my dose slow every couple of months and feel so much more alive, it was as if taking more made my thyroid lazy.

[Duckydoodle in reply to 765nottyash]

That's interesting. Glad you are feeling better. I'll be curious to see where I land as I've taken as much as 180 mg in years past, so 30 mg seems quite low. What dose were you on previously and what are you down to? And yes, being overmedicated is horrible and I do believe it can make a thyroid that is trying to function at all a bit lazier! Crazy stuff.

[765nottyash in reply to Duckydoodle]

Went as high as 230 at my worst, because I really thought more would make me feel better, I've lost over 30lbs since then and I'm now down to 130 which is 2 grains and in range for my weight, I might try to get down even further, will see what my next blood results show.

[Clarrisa]

You do not mention your weight. Did it remain the same after giving up alcohol, &/or spending a lot of time in the bathroom? Doesn’t alcohol act like a diuretic?

Pharmacists it seems calculate so many dosing recommendations for other classes of medications based on weight. That is why I wonder why weight seems not to matter?

[Duckydoodle in reply to Clarrisa]

That's a great question/point. Honestly I've only lost about-4-5 lbs. I suspect mainly water weight. Drinking does act as a diuretic to some degree but after years of use I think that stopped happening and I began to retain water. So in terms of my dose, I don't think that small of a weight loss would impact my levels. I do tend to think that my liver is functioning better and possibly metabolizing everything, including thyroid meds better. I guess time will tell. Thanks for the reply!