Armour vs Metavive : Hello, one year after my... - Thyroid UK

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Armour vs Metavive

Catou142 profile image
13 Replies

Hello, one year after my initial diagnosis, and many more after my hypothyroidism started I am sure...I started Levo 7 days ago, 25mcg (1/2 the dose I was prescribed back in January).

I've had a huge increase in my tinnitus, with a thumping feeling in my head around lunchtime. I think my muscle and joints are starting to ache more, after complete improvement with my gluten/oat free diet. And lastly, my stomach is pretty upset, actually painful at times, when it was doing very well just a week ago.

I started taking the meds as I was worried about my cholesterol and diabetes level, which were both at the top, despite my super healthy diet. TSH averages 7.5. FT4 and FT3 pretty good (FT4 and FT3, 2 weeks ago, respectively 13.6 and 5.5).

I lost 15 kgs since January, walk around 1 hr min. a day, yoga 3x a week. Supplementing in all sorts. Vit.D at 131 as a result. I'm slowing down with this now.

Question is where do you find Armour? What is the difference between Armour and Metavive? I am not happy with supplementing with chemical replacements.

Where is the best place to look for good private endos/ naturopaths around Northampton / Birmingtham area?

Thank you!

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RedApple profile image
RedAppleAdministrator

Catou142, 'What is the difference between Armour and Metavive?'

Armour is a specific brand of prescription desiccated thyroid (i.e. NDT but there are other brands of NDT too). Metavive is an 'over the counter' (OTC) supplement.

This means that within the UK, you can buy Metavive yourself but will need a prescription for Armour. You can however, legally buy Armour and other prescription NDTs yourself from outside the UK.

How either of these medications may work for you is an entirely individual thing. Some people find Metavive works well enough for them. Some people find they need the prescription medications. Trial and error is the only way to find out, and as you are likely to have to self fund, this can be a costly business :(

Catou142 profile image
Catou142 in reply to RedApple

thank you for this! When looking at the composition of Metavive, I like the fact that there is no corn for a start. I was just wondering what the difference is, between the thyroid complex or metavive and Armour...is there a lot more thyroid cells in armour. Metavive doesn't tell you how much thyroid 'meat' you're actually getting. It would be nice to actually compare. the-natural-choice.co.uk/Me...

RedApple profile image
RedAppleAdministrator in reply to Catou142

Neither will tell you how much 'thyroid meat' they contain, because apart from any other reasons we don't know about, this is not really the important aspect. By the time they've gone through all the factory processing and combining with other excipients, they are just little pills! :) Metavive can be purchased without a prescription because there is no declared thyroid hormone content. Prescription NDTs such as Armour, are produced to standardised declared hormone contents (typically they have 9mcg T3 and 38mcg T4 content).

jrbarnes profile image
jrbarnes

I'm in the US and Armour has been around since the early 1900s. It has eight doses available. The talk here is that Armour is still one of the reliable brands of natural desiccated available. The inactive ingredients are calcium stearate, dextrose, microcrystalline cellulose, sodium starch glycolate and opadry white. The downside is that you may not know where they are sourcing the porcine extract from and the welfare of the animals.

RedApple profile image
RedAppleAdministrator

Catou142, 'TSH averages 7.5. FT4 and FT3 pretty good (FT4 and FT3, 2 weeks ago, respectively 13.6 and 5.5).'

We need the accompanying reference ranges to be clear about these numbers. Please add them.

Even without the reference range, TSH around 7.5 sounds far too high and suggests under medication.

FT4 13.6 sounds rather on the low side, also indicating possible under medication.

FT3 5.5 sound reasonable and suggests your body is currently quite good at converting the available T4 to T3.

You may find that the symptoms you've described can be alleviated by increasing your levothyroxine dose.

Catou142 profile image
Catou142 in reply to RedApple

My results from last Monitormyhealth.org.uk were:

TSH: 7.94 mU/L [0.27 - 4.2 mU/L]

FT3: 5.5 pmol/L [3.1 - 6.8 pmol/L]

FT4: 13.6 pmol/L [12 - 22 pmol/L] - Yes, now I'm looking at it closer, it is low.

Vit. D: 131 nmol/L

HbA1c: 42 nmol/L

Cholesterol:

Total 4.5 mmol/L

HDL: 1.15 mmol/L

non-HDL: 3.33 mmol/L

Triglycerides: 1.36 mmol/L

SlowDragon profile image
SlowDragonAdministrator

Standard starter dose of levothyroxine is 50mcg

Starting on too low a dose can be counterproductive

Bloods should be retested 6-8 weeks after each dose increase

Which brand of levothyroxine are you currently taking?

our thyroid controls our metabolism

As an example....if, when perfectly healthy, your own thyroid made the equivalent of 125mcg levothyroxine....and this metabolism is controlled by pituitary sending messages - TSH (Thyroid stimulating hormone)

Then as your thyroid starts to fail (usually due to autoimmune thyroid disease) ....you might get diagnosed when your thyroid has reduced output to roughly equivalent of 75mcg levothyroxine

Pituitary has noticed there’s a drop in thyroid hormones in the blood....(that’s Ft4 and, most importantly, the active hormone Ft3) ....so to try to make more thyroid hormone ...pituitary sends out stronger message to thyroid - TSH rises up

When GP starts you on 50mcg ....initially you feel a bit better ....as you have 75mcg from your own thyroid and 50mcg levothyroxine

But (here’s the bit some GP’s don’t understand)....levothyroxine doesn’t “top up” your own thyroid output.....well it does very briefly....but the pituitary very soon “sees” the levothyroxine in the blood....and TSH starts to drop

So at the end of week 6 ....TSH has dropped a lot. Your thyroid takes a rest ....has a holiday

So at this point you are now only mainly using the 50mcg levothyroxine....which is actually a dose reduction down from managing on 75mcg from your own thyroid before you started on levothyroxine

So you start to feel worse .....and are ready for next 25mcg dose increase in levothyroxine

Modern thinking ....and New NICE guidelines suggests it might actually be better to start on higher dose

.....but many medics just don’t read guidelines

....and many patients can’t tolerate starting on more than 50mcg and need to increase slowly.

Starting on 50mcg and stepping dose up in 25mcg steps, retesting 6-8 weeks after each increase. But we still very often need to increase up to full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

Aim is to bring TSH down under 2.5 as absolute maximum.

gp-update.co.uk/Latest-Upda...

Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months.

RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.

For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.

For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).

If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.

A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.

BMJ clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

In answer to you question on other post

Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private

tukadmin@thyroiduk.org

Catou142 profile image
Catou142 in reply to SlowDragon

Thank you so much for this SlowDragon. I was feeling so bad after 8 days that I stopped taking the 25mg Actavis.

Worst side effect was my tinnitus which was like never before. At times, I could not think.

Very upset stomach, which had been great since I stopped gluten, dairy and oats...

my brain was also on a massive slowdown and I was really starting to worry for my safety with the kind of things I was doing (like my body was not acting on what my brain was telling it to do).

I am still really sore today, all over my body from the muscle and joint pain that these 8 days brought! I rang up the GP and she said to stop taking the medicine as I was subclinical and did not need it anyway. She prescribed me an NHS blood test booked for 3rd Dec. incl. TSH, FT4, Diabetes, cholesterol, liver function, B12, B9. I had requested ferritin but it was not there. I rang up this morning to find out what was on the blood form and requested ferritin and magnesium.

I have always been incredibly sensitive to medication.

I would like to find a private endo who can prescribe NDT ideally. Last time I was below 2.5 TSH at a blood test was in 1999! I think this test was done because I had joint pains following the birth of my first child in 1998. I had always been a super fit person before. I used to go to fitness classes everyday. Yes, following my first child, I never became that same person again....and it's been 22 years now.

TSH

4.47 in 2009

4.42 in 2014

4.71 in 2015

6.09 in 2019

7.5 Feb 2020

8.57 April 2020

5.82 June 2020

6.87 Aug 2020

7.94 Oct. 2020

Thank you so much for all your advice. It does make sense.

SlowDragon profile image
SlowDragonAdministrator in reply to Catou142

So if you are on dairy free diet you will definitely need lactose free levothyroxine

Tablets or liquid may be better tolerated

Teva, Aristo or Glenmark are the only lactose free tablets

Teva is the most widely available brand. It’s a Marmite brand, those that get on with it find it by far the best. Many people can’t tolerate it

Starting on tiny dose can cause more problems, than starting on 50mcg

It’s difficult to get liquid levothyroxine prescribed via GP as it’s expensive. Usually must be prescribed via endocrinologist initially

Suggest you try Teva tablets first

List of different medication options available in U.K.

thyroiduk.org/medications-f...

What vitamin supplements are you currently taking?

Common for B12 deficiency symptoms to reappear when starting or increasing levothyroxine.

You have been left so long untreated it may be difficult to start on any thyroid hormones

Have you had cortisol test?

When hypothyroid a long time adrenals have to try to compensate for lack of thyroid hormones. Can lead initially to high cortisol, but eventually low cortisol levels

regeneruslabs.com/products/...

cdn.shopify.com/s/files/1/0...

Catou142 profile image
Catou142 in reply to SlowDragon

Thank you SlowDragon! Yes, I only became aware of my thyroid problems last year at my '50 yr old' blood test. My GP was only going to test for cholesterol and I asked for a few more things, seeing as I am not keen on blood tests...and then this came back! I thought I was not feeling well before. Well, that explains it. I was originally given the 50mcg actavis tablets and told to take it. But I wanted to see if I could improve my health through diet change and exercice...this has not helped very much as far as antibodies and TSH / FT4 levels are concerned. Now I am finding that the GPs I talk to (the last 2), don't want to give me the medicine as I am below 10 TSH! I honestly don't know what to think anymore.

SlowDragon profile image
SlowDragonAdministrator in reply to Catou142

High thyroid antibodies and TSH above range is technically sub clinical hypothyroidism

Obviously if you have symptoms it’s wrongly named ....because it’s causing issues

And looking at clear flow chart on top of page 2 you could and should be given trial of levothyroxine

gp-update.co.uk/Latest-Upda...

With Hashimoto’s TSH is notoriously unreliable

High cholesterol is linked to being hypothyroid

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

HLAB35 profile image
HLAB35

I really think that it's important you look at this link on T3 pooling due to critically low cortisol levels ( by Paul Robinson). Your high TSH is linked to the problem.

paulrobinsonthyroid.com/hig...

Extremely low cortisol is often due to autoimmune illness such as Addison's or long term untreated hypothyroidism can wear down the adrenals.

Catou142 profile image
Catou142 in reply to HLAB35

Thank you for that. I'll look at that link. I have been under constant stress for all these years. In fact, every time the level goes up, I can associate it with another period of new stress coming into my life. I have been wondering whether the problems with my thyroid were not a consequence of problems with my adrenals / my stress levels.

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