Same Dose of Armour : I was put on 30 mg of... - Thyroid UK

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Same Dose of Armour

sonship_quality1029 profile image

I was put on 30 mg of Armour since I was diagnosed with Hypothyroidism. I am now seeing an Endocrinoligist, who hasn't changed my dose, either.

I've seen where patients, here, have had theirs changed to a higher dose. My last blood test showed where my T3 is high. My doctor has not addressed this with me as he isn't seeing me, in person, due to not being vaccinated. But he hasn't called me, either.

Is this normal to have the same dose for years? I was diagnosed in 2018.

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SeasideSusie profile image
SeasideSusieRemembering

sonship_quality1029

30mg Armour is a very low dose. However, if your levels are stable and you are not symptomatic then there is no need to adjust dose.

What are your latest results? Can you post them with their reference ranges.

Ideally, for a full picture, you need

TSH

Free T4

Free T3

(Total T4 and Total T3 aren't useful tests, it needs to be the Frees).

Thyroid antibodies

It's also useful to keep an eye on nutrient levels - Vit D, B12, Folate, Ferritin.

sonship_quality1029 profile image
sonship_quality1029 in reply to SeasideSusie

Ferratin is iron, right? My T4 tested high for the first time. I don't see anything about iron or Vitamin B12, but the other results are:Vitamin D is 56 ng mL T3 is 4.4 pg mL

T4 is 0.9 ng mL

TSH is 3.6muI/L

Is this helpful?

SeasideSusie profile image
SeasideSusieRemembering in reply to sonship_quality1029

Sonship_quality1029

Ferritin is iron store (not to be mixed up with Serum Iron test).

Need reference ranges for your thyroid results please, ranges vary from lab to lab so can't be interpreted without them.

Are they definitely Free T3 and Free T4?

sonship_quality1029 profile image
sonship_quality1029 in reply to SeasideSusie

Yes. They are Free T3 and T4. I don't see reference ranges on my results chart. The only reference is Low Normal and High. My T3 is High.

SeasideSusie profile image
SeasideSusieRemembering in reply to sonship_quality1029

I don't know how results are displayed in the US but here in the UK a result report would be something like(Made up numbers)

TSH: 2.5mU/L (0.2-4.2)

FT4: 16pmol/L (12-22)

FT3: 5pmol/L (3.1-6.8)

The ranges might be in brackets and would be at the side of the results.

So you can see there's no way we can interpret your FT4 and FT3 without the ranges. Can you ask the lab or doctor for the ranges.

sonship_quality1029 profile image
sonship_quality1029 in reply to SeasideSusie

I went to the Quest Diagnostic Labs website, which is the lab my doctor uses. These are the results I found.

TSH Thyroid Normal Levels [2.00 IU/L] Mine is 3.6muI/L

FREE T4 [0.9-2.2 ng/dL] Mine is 0.9 ng/mL

FREE T3 [210-440 pg/dL] Mine is 4.4 pg/mL

SeasideSusie profile image
SeasideSusieRemembering in reply to sonship_quality1029

TSH Thyroid Normal Levels [2.00 IU/L]That's not a range so I don't know what they mean by that. However, to have a TSH of 3.6 when on Armour means you are way undermedicated.

NDT tends to lower TSH and often suppresses it so one would expect to see it low in range or below range.

NDT also tends to lower FT4 but one would expect to see it somewhere in range whereas yours is at the very bottom.

FREE T3 [210-440 pg/dL] Mine is 4.4 pg/mL

I'm confused by that, the units should be the same.

sonship_quality1029 profile image
sonship_quality1029 in reply to SeasideSusie

I thought so. No wonder I've been feeling so different. I don't sleep well. I'm tired a lot of the time. My hair is falling out. I don't even use a brush anymore so I keep as much as I can. I've lost weight. I have anxiety for the first time in many years. I have gloomy feelings I don't know where they come from. Some times, I cry about things that never use to bring me down. I'm, normally, a very up person. I have woozy spells and lose my balance. Some times, I don't feel like eating at all and when I try to eat, I feel nauseous. At other times, I'm ravenous. I feel foggy when, normally, I'm sharp as a teenager. I have pains shooting in my back and overall just feeling lousy.

I'm only 74 so I'm still quite young yet. I don't like feeling this way.

My Endocrinologist should know I need my medication raised, but he hasn't even called me. Like I said, he won't see me, in person, because I won't get the vaccine. Yet, when I went to get my blood checked, the phlebotomist wasn't even wearing a mask.

Other primaries won't order my Armour, even though I've told them I can't take Levothyroxine. My first physician, who diagnosed me, tried me on it. I became very ill. So she took me off it and put me on Armour, which I was very happy about. I had read it is a better alternative. I started at 15 mg. Within a short time, she upped my dose to 30mg. And I've been on 30 mg ever since 2016.

I found more information. This information is from Dr. Sean Breen.

Standard is [0.45-4.5] Mine is 3.6muI/L

T4 FREE [0.85-1.79] Mine is 0.9 ng/mL

T3 Total [4.0-4.4] Mine is 4.4 pg/mL I

Thanks for trying to help me understand all this.

SeasideSusie profile image
SeasideSusieRemembering in reply to sonship_quality1029

sonship_quality1029

I found more information. This information is from Dr. Sean Breen.

Standard is [0.45-4.5] Mine is 3.6muI/L

T4 FREE [0.85-1.79] Mine is 0.9 ng/mL

T3 Total [4.0-4.4] Mine is 4.4 pg/mL

If those reference ranges didn't come with your results then they are of no use. You can only use the ranges that the lab who did your test provide, because ranges vary from lab to lab.

That is a Total T3 test and I did ask was yours definitely Free T3 and that I couldn't understand this result/range

FREE T3 [210-440 pg/dL] Mine is 4.4 pg/mL

It doesn't make sense to have a range that is in the hundreds with a result in single figures.

Xheila has responded below with an image of her results from the same lab and it clear shows Free T3 with a range of 2.3-4.2

I have my doubts about your T3, with a high TSH and bottom of range FT4 then your FT3 would normally tend to be low as well. However, it does depend on when you took your last dose of Armour before the test. Last dose should be 8-12 hours before the blood draw, splitting the dose the day before and adjusting time if necessary and taking the last part of the dose at the recommended time. If you took your Armour before the blood test then that accounts for the high T3 result.

However, your symptoms point to being undermedicated.

My Endocrinologist should know I need my medication raised, but he hasn't even called me. Like I said, he won't see me, in person, because I won't get the vaccine. Yet, when I went to get my blood checked, the phlebotomist wasn't even wearing a mask.

You all have a choice. Your choice is not to vaccinate. The phlebotomist is happy to have contact with you without protection. Your endo's choice is not to see patients face to face who haven't vaccinated. Everybody is entitled to their choice so you can't complain that your endo's choice excludes seeing you in person. Maybe a zoom or telephone appointment can be arranged with your endo.

As this is a UK forum and I am in the UK, I have no idea how your health system works and why your endo can give you Armour but your primary doctor wont but I think it's fairly obvious that you need an increase in dose.

helvella profile image
helvellaAdministratorThyroid UK in reply to SeasideSusie

It doesn't make sense to have a range that is in the hundreds with a result in single figures.

It sort-of does as the unit changes from between pg/dL and pg/mL! Which itself doesn't make sense - why would a lab change units in that way? (A decilitre is a hundred millilitres.)

SeasideSusie profile image
SeasideSusieRemembering in reply to helvella

I used a calculator last night because I knew I'd be able to find the equivalent, but even that didn't make sense.

FREE T3 [210-440 pg/dL] Mine is 4.4 pg/mL

endmemo.com/sconvert/pg_mlp...

Put 4.4 into pg/ml and it gives 0.44 pg/dl yet the OP has given the range as 210-440pg/dl. Now maths isn't my strongest point but I couldn't make head nor tale of that. Is it something I'm not understanding?

helvella profile image
helvellaAdministratorThyroid UK in reply to SeasideSusie

There are a hundred times as many pg in one dL as in one mL. That makes it 440 pg/mL.

The calculator behaves a bit oddly and you have to click on Reverse to make it do what it needs to do! :-)

Image of calculator numbers
SeasideSusie profile image
SeasideSusieRemembering in reply to helvella

Ah, right. I didn't know about the "Reverse" thing. Thanks for clearing that up 😊

Obviously it would be better if the lab made it easier for those of us who are mathematically challenged 😕

helvella profile image
helvellaAdministratorThyroid UK in reply to SeasideSusie

It is utter nonsense to switch units.

And I always like to use units that (to the greatest extent reasonably achievable) avoid numbers after the decimal point. Hence, levothyroxine dosing in micrograms not milligrams. I find 0.1, 0.05, 0.025, (or .1, .05, .025) milligrams much less easy to read than 100, 50, 25 micrograms.

SeasideSusie profile image
SeasideSusieRemembering in reply to helvella

Totally agree with you helvella I much prefer to see doses in mcg.

sonship_quality1029 profile image
sonship_quality1029 in reply to SeasideSusie

These are my lab results.

Results of Lab Test
sonship_quality1029 profile image
sonship_quality1029 in reply to SeasideSusie

This is from Quest Diagnostics Range Results for Free T3. That is the way they term it.

Quest Diagnostics
sonship_quality1029 profile image
sonship_quality1029 in reply to SeasideSusie

This is T4 Free from Quest Diagnostics page.

Quest Diagnostics
sonship_quality1029 profile image
sonship_quality1029 in reply to SeasideSusie

And this is Quest Diagnostics TSH range.

Quest Diagnostics
helvella profile image
helvellaAdministratorThyroid UK in reply to sonship_quality1029

That is NOT TSH. It is TSH receptor binding globulin.

An antibody which blocks TSH receptors.

SeasideSusie profile image
SeasideSusieRemembering in reply to sonship_quality1029

As helvella has pointed out that is an antibody test, the one used to diagnose Graves disease (overactive thyroid), it is not the Thyroid Stimulating Hormone (TSH) test.

TSH Thyroid Normal Levels [2.00 IU/L] Mine is 3.6muI/L - so this is raised antibodies not the TSH test

FREE T4 [0.9-2.2 ng/dL] Mine is 0.9 ng/mL - this is low in range

FREE T3 [210-440 pg/dL] Mine is 4.4 pg/mL - this top of the range.

helvella profile image
helvellaAdministratorThyroid UK in reply to SeasideSusie

No - the blocking antibodies are not the Graves' disease antibodies. :-)

These ones attach to the TSH receptor and do nothing - but prevent real TSH from attaching. (A mix of blocking and stimulating can cause confusion. Some over-stimulating and some blocking with a very uncertain net result.) On their own, they can result in hypothyroidism.

SeasideSusie profile image
SeasideSusieRemembering in reply to helvella

Oops, beg pardon! 'Twas early for me, not 100% focused 😴

sonship_quality1029 profile image
sonship_quality1029 in reply to SeasideSusie

That is the only results I found on Quest Diagnostics.

Xheila profile image
Xheila

Hi, I am also on Armour and use Quest Diagnostics. When you look at your results online they should look something like this picture.

It might be possible that you had Total T3 tested, not Free T3. Can you log in to Quest to double check? Your Free T3 result seems very odd and the range is not the same as what I always get from quest, and not at all consistent with your other lab results.

I was started on way too low a dose and kept at way too low a dose for years. I felt exactly like you did in your last post until my FT3 went higher in range. It seems like you are quite undermedicated but that would not be the case if your Free T3 is 4.4 pg/mL (2.3-4.2 pg/mL).

ft3
sonship_quality1029 profile image
sonship_quality1029 in reply to Xheila

According to my test results, it states that my T3 FREE is High. I checked out Quest Diagnostics, but then I went to Dr. Sean Breen's website and found the information I need. I do need my dosage raised.

At this time, I am looking for a new naturist Endocrinologist or a primary physician who will continue my treatment with NDT. As I said, I cannot take Levothyroxine. But I told my recent primary doctors that and they looked at me like I'm from a different planet. One tried to even argue with me that there isn't any proof that Armour is any better and that there is too much variance from one refill to another. Of course, I never found that to be true.

One of my situations, I'm running into is, my insurance will only pay for doctors in their plan. What I need and am looking for are far and few between.

Xheila profile image
Xheila in reply to sonship_quality1029

I was hopeful that you had gotten a false result for your T3, because I understand how terrible you feel. Did you maybe take your Armour on the same day you had your test? That would give you a false high range. Are you able to look at your results on the Quest website?

According to my test results, it states that my T3 FREE is High. I checked out Quest Diagnostics, but then I went to Dr. Sean Breen's website and found the information I need. I do need my dosage raised.

I don't know... if your Free T3 is high, you need to be careful. If you hadn't had your FT3 tested, I would go by your other lab results and your symptoms and tell you to up your dose right now, but a FT3 higher than range would really not suggest that.

Yes, I had a former doctor who told me in strong terms that NDTs were completely unreliable. This is also the doctor who told me I had no thyroid problem and tried to treat my Hashimoto's with anti-depressants and sleeping pills.

Considering insurance and how hard it is to find a doctor who understand hypothyroidism (and especially NDTs), you will not have an easy time finding a doctor who will treat you, and you definitely won't find someone quickly enough to end the symptoms you're enduring. Can you set up a phone consult with your endocrinologist?

Like I said, he hasn't called me or tried to contact me, even in my messages on their page. I did put the information, from Quest Diagnostics as they show them, but was told the results did not make sense. None of it makes sense to me.

I don't remember if I was supposed to not take Armour, the day of my test. No. I seem to remember I had to wait an hour, after getting home, after taking my meds. And I was extremely hungry. I will have to see if I can find the message they sent me ahead of time. I just don't remember. This is another problem I'm having. I don't remember things like I used to and it's getting worse.

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