Blood result- thoughts?

[Compostella1]

Hi,

I have my blood results following 1 month on Armour 15mg (1 grain). My original TSHwas 53.

Results today

TSH - 13.9 (0.27 - 4.2)

FT4 8.2 (12-22)

FT3 4.7 (3.1 -6.8)

My Dr has advised to go up to 30mg of Armour a day.

I’m quite symptomatic some days- cold, buzzing, hands and joints swollen, aches etc. My anxiety and low mood have improved over the last few weeks. There are some days when I find the above hard to manage tho.

I see some people split the dose daily- is there a reason for this?

Any thoughts?

Thanks

A

[SeasideSusie Remembering]

Compostella1

I have my blood results following 1 month on Armour 15mg (1 grain)

1 grain Armour = 60mg

so there's something not quite right there. If you are taking 15mg Armour you are taking 1/4 of a grain. The normal protocol for starting NDT is 1/4 of a grain morning and 1/4 of a grain afternoon for 7 days then if no adverse reaction then increase to 1/2 a grain morning and 1/2 a grain afternoon and stay on that one full grain for 4 weeks. After that it would be increase of 1/2 a grain every 3 weeks until 2 full grains reached, then after that increases would be 1/4 of a grain each time.

You are still very hypothyroid so no wonder you have symptoms. When on NDT and optimally medicated one expects to see TSH low in range and FT3 high in range, with FT4 at the lower end of it's range.

The reason for splitting the dose is because NDT contains T4 and T3 and T3 is much quicker to react and has a much shorter half life than T4, some people need to multidose with any T3 or T3 containing medication because it suits them to "top up" throughout the day rather than take it all in one dose.

[Compostella1 in reply to SeasideSusie]

Hi,

Thanks for your reply. Apologies I’m on 1/4 grain- my error. And am to increase to 1/2 grain.

My symptoms are def worse in the evening/night so hopefully taking the extra meds in the afternoon will improve that.

Thanks for all your info!

[pennyannie in reply to Compostella1]

Hello Compostella

How long will you be on 1/2 a grain before your doctor acts again.

It is my understanding to slowly increase NDT by 1/4 grain every week monitoring by temperature and blood pressure readings twice daily.

If you have no adverse reactions and still with hypothyroid symptoms you slowly keep increasing in 1/4 grain increments a least, every other week and if you reach 2 grains you then hold this dose for 6-8 weeks letting the NDT bed in and then run a blood test just to see where your T3 is from your bench mark, pre NDT blood test.

If your T3 isn't moving and you still have symptoms this may not be the best thyroid hormone replacement option for you.

If your T3 has moved but you still have symptoms simply start again with slow 1/4 grain increments every week.

There will come a week where you don't feel as good as the week before, maybe edgey and little anxious, just drop back down to the previous weeks dose and that is your dose on NDT at that point in time.

No thyroid hormone replacement works well if you core strength vitamins and minerals are not maintained optimal levels so keep an eye on your levels of ferritin, folate, B12 and vitamin D.

This is how I switched to NDT and my temperature rose from 35.5 to 36 6 and my blood pressure remained stable throughout :

I only need a relatively small dose of NDT - and didn't reach 2 grains before I felt I was going a little backwards and didn't need to split my dose - but many people do this - it's just a question of trying and seeing what makes sense for you.

I'm with Graves disease post RAI thyroid ablation and now manage lingering Graves, thyroid eye disease and hypothyroidism:

NDT was used successfully for over 100 years to treat hypothyroidism and you dose to the relief of symptoms and not a blood test or set of guidelines and ranges that were introduced to be used alongside synthetic thyroid hormone replacement by Big Pharma.

[Compostella1 in reply to pennyannie]

Thank u for ur explanation and the good point raised abt ranges used for Synthetic hormone.

So I feel it is only T3 that shd be looked at.

Do u have to get to 2 grains? If my T3 is good and symptoms improve after 1/2 grain can I stay there??

[pennyannie in reply to Compostella1]

Yes of course I only got to 1 + 1/2 grains and so held that dose for 6-8 weeks and then took a blood test just to see where my levels were and I am still on this dose 3 years on.

You go up in 1/4 grain increases and when you feel ok - you stay on that dose for 6-8 weeks and then take a blood test to see if your T3 has moved as it is low T3 that gives you the hypo symptoms.

I took my temperture and blood pressure twice daily and over 6 weeks my temperature rose from 35.4 to 36.6 - my blood pressure and pulse remained level.

[Compostella1 in reply to pennyannie]

Just out of interest does ur TSH tend to be completely out of range but FT3 correct?

Is the temperature linked in with a. Good metabolic rate in your body?

What is the BP link?

Sorry for all the questions!

[pennyannie in reply to Compostella1]

Forget the TSH - when taking any form of thyroid hormone replacement containing T3 your TSH will go low suppressed - it's just what happens - you need to be looking at T3 and T4 numbers -

If I wait 8 hours from last dose to blood draw and have no food - my T3 is at 110% - if I wait 12 hours my T3 is 90 % - if I wait 24 hours I'm sure my T3 is low in range :

Yes of course temperature needs to up at around 36.8 for good metabilic rate :

Blood pressure monitors give readings and I simply read these twice daily and i had no untoward changes showing my body wasn't showing under any levels of stress or uncomfortable .

The TSH is the first sign of your needing medical attention and help as it is your body's response when your thyroid is crying out for more thyroid hormones.

So as you take more thyroid hormones your TSH will reduce down, into range and we generally feel better when our TSH is down at around 1 or under - and if you take any thyroid hormones containing T3 this will lower your TSH further AND once on thyroid hormones the TSH is the lest important number as we need to be looking at our T3 being as high as it needs to be for us to feel better.

[Compostella1 in reply to SeasideSusie]

My dr doesn’t appear to monitor that closely- no bp! No temperatures.. just in it 4 weeks.. bloods and now she said increase to 1/2 grain.

I am hopeful I won’t have to increase again as it appears to have come down quite quick.. but maybe I am naive!!

[radd]

Compostella1,

Armour is available in many strengths and 1 grain is 60mg, so 15mg Armour is a quarter grain. This is a tiny dose. Do you mean you are on 60mg?

You are still symptomatic because are still under-medicated. I agree with your doctor to only increase by another 15mg because the T3 within Armour can not be rushed, and you may well need further increases after.

Many members split their dose between two to three times a day to reduce the rapidity of T3 onset and prolong the duration of its action. This is kinder to the body when adrenals have been supporting long term low thyroid hormone and become compromised, and should prevent intolerance, ie heart bangs, too much inner heat, jiittery feelings, etc.

I take mine at 7am & 4pm every day. I am pleased you're seeing some improvements.