How soon can I increase Armour dosage?

[Canu]

I have Hashimoto's and I recently switched from Levothyroxine to Armour. I was slightly undermedicated when I was on 50mcg Levothyroxine. Now I'm taking 1/2 grain (30mg) Armour. I weigh only 53 kg (117 pounds) so I don't expect to have to increase it too much, but I was wondering how soon I can make that increase. I split the dose - half Levothyroxine and half Armour - for 4 days and now have taken just Armour for 2 days so far. But I don't feel completely well yet and I get palpitations at night. (Or could that be because I take it in the morning and the T3 in it runs out by night?) Is it too soon to increase my dosage? I appreciate your help!

[SilverAvocado]

Two days is definitely too soon to increase your dosage. I am a super cautious one, so if you want to know how quickly you can go I can't really advise. I tend to stay on a dose for the full 6 weeks and get a blood test. Even going this slowly I have run into the odd problem of skipping over issues. But many people will adjust after only a few weeks, and continue that way until they get to about 2 grain before doing a full 6 week pause and having a blood test. Of course pay very close attention to symptoms, and use those as the biggest tool in judging dosage.

Half a grain is a super small dose, so it's very possible you will need to increase a few times to get to your optimal dose. You've had a small dose reduction by moving from 50mcg to half a grain, as that dose of NDT is equivalent to just under 40mcg of Levothyroxine. This means if you don't see an improvement once you're settled on the dose it may just be the decrease that's the issue, so don't give up on NDT until you've adjusted it properly.

[Canu in reply to SilverAvocado]

Ok, thank you very much SilverAvocado!

[pennyannie]

Hello Canu

Totally agree with what has already been said.

The Levothyroxine - T4 is a storage hormone and it will take about 6 weeks to fully leave your body, and so will ' carry you over ' the initial couple of weeks as you build up your NDT.

1 grain NDT generally contains around 38 T4 + 9 T3 and T3 is said to be about 4 times more powerful than T4. with 1 grain NDT equating to about a 75/100 dose of Levothyroxine.

I take my NDT - all 1 + 1/2 grains at around 3 in the morning and read some people split the dose am and pm : I am of a large build being almost 6 feet in height and around a size 16/18 :

With NDT you start low and build up slowly.

You can start on a 1/4 grain for the first week :

Then in the second week increase to 1/2 a grain :

Third week increase to 3/4 grain :

And so forth and so on :

When you increase another 1/4 and you feel edgy and anxious that's your body telling you that you've gone too far, so drop back down to the previous dose and that is your dose on NDT.

Should you reach 2 grains, wait for 6 weeks on that dose, let it ' bed in ' and then have a blood test just to see where your T3 and T4 are :

With NDT you dose to relieve your symptoms and not to fit into the guidelines which were intended to be used with Levothyroxine.

It is also important to ensure that your ferritin, folate, B12 and vitamin D are maintained at optimal levels as no thyroid hormone works effectively if these vitamins are not strong and stable.

P.S. Having Hashimoto's can throw a ' spanner in the works ' as when you experience a hyper swing you'll feel hyper, so remember within and after that phase, you may need to tweek your original dose a little, as your thyroid settles back down again.

[Canu in reply to pennyannie]

Thank you very much pennyannie! I've redefined the word "patience" since I got Hashimoto's!

[pennyannie in reply to Canu]

Hey there,

I should have added that when taking any form of T3 your TSH will go low, suppressed and this does not matter.

Your T4 will ' look ' low in the range and if wanting a T3 reading that a doctor may see as acceptable you need to wait 24 hours between taking the thyroid hormone replacement and the blood draw in my opinion.

My T3 has come in both over and in range at different times of day but I don't feel any different and definitely am not with any hyper symptoms.

Some people ' split ' their NDT dose - I never have.

It is very much a try it and see how you go medication.

It was the successful treatment for over 100 years prior to the introduction of Levothyroxine and the backing singers, TSH and the Guidelines and Ranges that all came about in the 1960's.

It is pigs thyroid, now dried and ground down into tablets commonly referred to as grains.

Years ago your doctor believed your symptoms and gave you a little bit of pig's thyroid to chew on, and if that didn't quite ' fix ' you he would then increase the size of the nugget slowly, over a period of weeks, until such time as your symptoms had all but disappeared.

Good luck - patience is a virtue : tortoise / hare scenario :

P.S. Vitamin D needs topping up to around 100 - where do you live ?

[Canu in reply to pennyannie]

Thank you!

[Canu in reply to pennyannie]

Sorry pennyannie! I just noticed your P.S. My Vitamin D3 (25-OH) two months ago was 47.11 ng/mL (Range: 25 - 80), but I have increased supplementation and time in the sun since then. When you say topping up to around 100 do you mean ng/mL or nmol/L? I live in Cyprus - plenty of sun here now.

[pennyannie in reply to Canu]

Hey there,

I think I must be talking ng/ml :

However, I have no idea how many bucket loads of sunshine equate to that !!!

In England we generally don't see the sun for very long at any one time, however that suits me better, as I'm not comfortable in the UV light or heat as I've lost my temperature gauge, ( also referred to as a thyroid ) !!

P.S. Is Armour easily available and at a reasonable price in Cyprus ? Are you self sourcing and medicating or do you have a medic giving some support to you ?

Many of us in uk are self medicating NDT and buying from Thailand, but the supply chain had now become difficult - should we all come to Cyprus once the planes get off the ground ?

[Canu in reply to pennyannie]

LOL!!! I wish it was that easy! No, I had to get it from the UK. I e-mailed pharmacies that source Armour and found some willing to send it to Cyprus. I paid a UK prescriber, we had a Skype meeting and she prescribed Armour for me. I had it sent here with DHL. It all cost a fortune but I was so unwell on T4 I felt I had no other choice.

[pennyannie in reply to Canu]

Well, I certainly know those sorts of feelings -

Can you get T3 - Liothyronine prescribed, or over the counter in Cyprus ?

That could work out cheaper for you, a T3 / T4 combo maybe :

However, you have purchased NDT so let's focus on that and hopefully get you feeling better -

P.S. just reread your posts and understand you don't get on with the synthetic T4 so maybe my suggestion of a combo, isn't an option :

[Canu in reply to pennyannie]

Yes, I don't seem to do well on T4. Thank you pennyannie!