Hi wondering if anyone can share some insight:
History: 50 year old female (me), plenty of thyroid Symotoms
Current meds: 50mg Sertraline(zoloft) & 1grain/60mg Armour
Chronic low WBCs
Chronic Low D (if I take time off from high dose supplementation)
Low TIBC & UIBC
Normal TSH with low T4 & Free T4 (on 60g Armour)
Is this pointing to Pituitary???
Any leads greatly appreciated!
Louisa
Your TSH is telling you that you are not on enough thyroid hormone replacement. This is echoed by the T4 which is low. It is below the normal range.When on replacement hormones TSH as a guide should be around 1.
Simply you are needing an increase in dose. Sertraline can affect the absorption of thyroid meds as it alters the serotonin in the gut. this means that folks on sertraline may need a slightly higher dose of thyroid meds.
The aim, once diagnosed and prescribed levothyroxine, is a TSH of 1 or lower.
Levothyroxine is the standard prescription and is T4 only.
Many doctors seem to think that we're taking too high a dose if TSH is very low and I think their training is poor.
Blood tests were introduced along with levothyroxine which is T4 alone.
If we take NDTs - as you are -and was first given in 1892 and from then on lives were saved and there were no blood tests. The patient had small increases added until they felt well again. Most modern-day doctors do not know how treat patients with anything but levothyroxine.
NDT contains all of the hormones a healthy thyroid gland would do so the numbers of the blood tests whilst on NDTs will differ from those who take levo alone. The best way to judge if dose is optimal, is:-
We feel well.
Our clinical symptoms are reducing or have reduced.
NDTs (Armour etc) were inroduced in 1892 and from then on people didn't die due to hypothyroidism.
The following is an excerpt from one of TUK's Advisers - Dr John Lowe who died due to an accident and he is missed enormously. The following is from one of Dr Lowe's responses:-
Armour Thyroid, like Nature-Throid and Westhroid, is more effective than levothyroxine at reducing body fat. The reason is that these products contain T3.
Some researchers say that T3 has a “lipolytic”—that is, a fat-decomposing—action in fat cells.[3] One way T3 reduces fat in the cells is by inhibiting an enzyme (cyclic-AMP phosphodiesterase) that slows down metabolism shortly after adrenaline and noradrenaline speeds it up.[1][3][8] By blocking this enzyme, T3 sustains the fat-decomposing effect of adrenaline and noradrenaline in fat cells.[1][2][8] Another way T3 reduces fat is by altering gene transcription for several compounds. When T3, acting through the relevant genes, increases fat cells’ production of these compounds, the compounds augment adrenaline’s and noradrenaline’s fat-lowering effect in the cells.[10]
In addition to weight loss, you may get another benefit from the T3 in Armour: that is, a reduction of fat that probably accumulated in your arteries[3] while you were on T4 replacement. As Duntas wrote,[11] As Duntas noted in 2002, the composition and transport of blood fats “are seriously disturbed in thyroid diseases.” Among patients with an high TSH and low thyroid hormone levels, cholesterol and LDL are typically high. Even when thyroid hormone levels are within the reference range but the TSH is high, patients on average have a slightly high total cholesterol, high LDL, and low HDL. These patients also have abnormalities of the linings of arteries, inflammation and fat accumulation in the aorta, and they are subject to have myocardial infarctions. They also have increased resistance to blood flow, weaker contractions of the heart muscle, and increase diastolic blood pressure. As Duntas pointed out, thyroid hormone therapy—especially with TSH-suppressive dosages—“usually leads to a considerable improvement in the lipid profile.”
drlowe.com/thyroidscience/l...
Thank you Shaws! I forgot to show my T3 levels... It there any suggested reading that would let me understand optimal levels or is at all just how one feels? with my T3 in range and T4 low I am wondering if I need a combo or is Armour good on its own and I just need to increase dose...?
And yes my LDL has been climbing despite very good dietary habits. Its up to 153 with a range of 0-99. As a reference point I am 140lbs now. I used to be stable at 125-130 but the end of last year my functional med Dr wanted to try to take me off of thyroid meds and see if Standard Process thyroid supplements would work better for me. Well, they didn't; I became super lethargic and achey and gained 15 lbs. I've been back on Armour for 2 months and trying to find the right dose...
Does it matter if tsh is very low ie. 0.010? My T4 sits around 17
It doesn't matter if our TSH is towards the bottom of the ranges. It is beneficial if both 'frees' i.e. FT4 and FT3 are in the upper part of the ranges.
Always put the ranges of the results - the reason being that labs have different machines and therefore ranges may be different. Ranges are in brackets ( ) after the results and as labs differ in their machines, so can the ranges.
Free T4 and Free T3 are more informative than T4 and T3.
excerpt:
The thyroid gland makes T4 in response to thyroid-stimulating hormone (TSH). ... Because T4 is converted into another thyroid hormone called T3 (triiodothyronine), free T4 is the more important hormone to measure. Any changes show up in T4 first. T3 and T4 help to control how your body stores and uses energy (metabolism).
Results on Armour 
ARMOUR: T3 always high,T4 always low,TSH EXTREMELY low--docs won't help. Advice, please...
Armour to t4/t3 combo 
Transitioning from T4 to Armour
