I am currently taking 90 Mg Armour Thyroid in the mornings and have taken this amount for 2 months, up from 75 Mg.
I feel better than before, not perfect, still have some energy problems, but nothing like they used to be when I was on 60 Mg and lower.
My doctor is concerned that my function is being reduced and that I will have symptoms of hyperthyroid. This has not happened.
Based on a previous ultrasound that showed Right Thyroid Atrophy and elevated antibodies, I am guessing that I have Atrophic Thyroid with Hashimoto's.
Please help me figure out what I should say to my doctor so that she doesn't reduce my dose, unless someone more knowledgeable here sees something to indicate that would be the right move.
Thanks for your help.
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Susieg1
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My doctor is concerned that my function is being reduced and that I will have symptoms of hyperthyroid.
I imagine by 'function' you mean TSH? A low TSH does not automatically mean that you are hyper - what's more, if you're hypo, you cannot become hyper, it doesn't work that way. I guess he means over-medicated?
The most important number is the FT3. And unless that is well over-range, you are not over-medicated. Once the TSH goes below 1, it is a very poor indicator of thyroid status, and should not be used to dose by.
That said, if you have Hashi's - or Ord's - it is possible you might have a 'hyper' swing, when the dying cells deposit their store of hormone into the blood. But, this is only temporary. If you start to feel ove-medicated, I would avoid having a doctor's blood test, if I were you. Do a private one, or just reduce your dose a little yourself. If your doctor reduces it, you will probably have trouble getting him to raise it again when you inevitably become hypo again.
Well, your FT3 looks good, but only you can know if these results are okay for you. Optimal is not a number, it's how you feel.
Some people would need their FT4 higher than that to feel well. Others don't need much at all - if any. We're all different, and you have to find the dose that suits you best.
Hi there, I'm a 61 year old female from the US and was diagnosed with Hypothyroidism 3 to 4 years ago.. I'm a veteran and receive my health care and medications through the VA. After dealing with too many side effects from Levothyroxine, my endocrinologist recently switched me from Levothyroxine (75mg.) to Armour (32 to 32.5mg. > 1/2 grain tabs.) He told me that a half grain tab of Armour is equivalent to aprox. 60mg of the levothyroxine. I've researched it as best I can and am seeing conflicting dose equations. Stating that 1/2 grain of Armour is equivalent to anywhere from 37mg. to 50mg of levothyroxine. I've always found you to be quite knowledgeable and am hoping you can help clear this up for me.
1 grain of Armour (60 mg) contains 38 mcg T4 and 9 mcg T3.
If you assume that T3 is 3 x as potent as T4 (which, by the way, is a pretty useless thing to do because it depends how well you convert) you could say that 9x3 mcg T3 = 27 mcg T4.
27 mcg + 38 mcg = 65 mcg T4 (levothyroxine).
However, some people maintain that 1 mcg T3 is equal to 4 mcg T4, so that is a very rough calculation because, as I said, it depends how well you convert. Without seeing your labs when on T4 only - FT4 and FT3 - we cannot know how well you convert. There is also the possiblity that you might absorb Armour better than levo, anyway. Or, the other way around. So, it's all guess-work.
Then there's the possibility that you were under-medicated on levo, and that your symptoms were actually hypo symptoms, rather than side-effects of the levo. So, all in all, transferring to Armour is going to be very hit and miss. But, if you were on 75 mcg levo, one grain would be a good place to start and you can titrate up or down from there. It's impossible to find a direct aquivalent. It's all trial and error, anyway.
But, one thing is certain, half a grain will not be enough. Your endo is wrong on that.
I figured I should give you the full recent history of my problems while taking Levothyroxine, so you'd have a better idea of what's been going on. So here goes ... I had been on 75mcg of Levothyroxine for 2 years, maybe a little longer. Then one day my GP called me and asked if I had stopped taking my Levothyroxine as my tsh levels had doubled. I told her no, I had not. She then increased by dose to 100mcg. After aprox. 6 weeks I began to have side effects that included high blood pressure , heart palpitations, server ringing in my ears, insomnia and episodes of Tachycardia as well. I was then taken back to 88mcg for 2 weeks and then back to my original 75mcg. and put on blood pressure meds. (propanol and metropole) . Ten days Iater I ended up in the Emergency room with a blood pressure spike of over 200. They kept me there for 6 hours, monitoring my heart rate and blood pressure. After awhile my blood pressure went down to normal. The Dr. told me I did not have hypertension and asked me if I had been having any stress or anxiety in my life. I told him yes both, abnd that my combat ptsd service parrot who went "everywhere" with me for over 12 years had passed away recently after battling cancer for over a year and that it left me devastated as she "RoRo" had been my constant companion for 12 years and was my everything, my life partner and soulmate. He explained that when going through such a stressful time, that your cortisol levels can go through the roof and affect the absorption of the Levothyroxine. He took me off of the blood pressure meds. and said I should have been treated for stress and not hypertension. So I stayed the original 75mcg. After 5 to 6 weeks blood work was done and my tsh levels were at 1. something. I have always done better when in the 3 to 4 range. Then came the stiff muscles in my shoulders and neck along with tension headaches and my ears were still ringing away and I was still having bouts of higher than normal blood pressure. So I was put on methocarbamol and ibuprofen. for the muscle stiffness and headaches. Soon after I came down diverticulitis (which could have been helped along with the methocarbamol and the nasids). After a week on antibiotics with not much relief, I was admitted to the hospital and put on IV antibiotics for 5 days at which time I was not given my 75mcg of Levothyroxine for 3 days, until someone snuck them in and I took them for the remaining 2 days. The day I was discharged I was given a dose of Amoxicillin/Calamite (which was to big for me swallow) . So the CNA crushed it up and mixed in some applesauce, which I took on an empty stomach. Needless to say, once I got home I immediately threw up and went through the dry heaves for over an hour, ending back in the Emergency room for tiny tares in my esophagus. The next day I took my last 75mcg. dose of Levothyroxine. I then went for 3 more days without any thyroid meds. until my Armour showed up, at which time I started taking it and have been on the 1/2 grain dosage for 6 days now. My blood pressure is getting better and I haven't had any heart palpitations. The stiff muscles in my shoulders and arms, remain, though there is a slight improvement and the tension headaches are are starting to go away. After the first 3 days on the Armour my ears had started to quite down, but are now starting to bother me again. I have been through several months of hell. As you mentioned earlier, the 1/2 grain dose of the Armour is probable not enough, but I'm not sure if I should up it a 1/4 of a grain myself or wait and call my Endocrinologist on Monday. I'm soooo hoping that increasing my dose will calm the ringing in my ears again and that it will help with the muscle stiffness as well. I also read that splitting up your dose of Armour and taking the original dose in the morning and then the increase in afternoon may help as well. If you have any advice, again, I'd appreciate any help you can throw my way.
I will see if can get the results of my last blood test from my GP sent to me, and ask her to do a more complete blood work/labs as well. If you have a minute, could you please tell me what I should ask her for as far as the blood work goes, besides my t3 and t4. I want to be a through as I can.
I am so sorry to hear about your parrot. I can imagine how you feel. It must have been terrible for you.
Well, that sounds like a lot of changes in a short time, which won't have helped you, either.
When do you see your endo again? If it's soon, wait until you see him to increase your dose. But, on the other hand, you don't want to stay on a dose that is too low, too long.
As you already know you have Hashi's, there's not much needs testing apart from TSH/FT4/FT3. But, it would be a good idea to test your nutrients: vit D, vit B12, folate and ferritin. If these are too low, it can make you feel worse.
Thank you for replying so quickly. I'm not suppose to get my blood/levels tested again until July, which is a ways out. But I can try and call him sometime this week. I've never been told I have Hashi's. I usually just see a GP at the Women's Clinic at the VA here in Tacoma where I live and she's not a lot of help. I had to ask her for a referral to see the Endocrinologist in Seattle (which is an hour away). When I was first diagnosed with hypothyroidism about 5 years ago the VA wouldn't prescribe Armour, but thank God they will now. The Endocrinologist I'm seeing now seems to be very knowledgeable about NDT. He knew about some of the earliest studies done on NTD in another country, which was nice to hear. Hopefully he will help me when I reach out to him. Though he didn't tell me anything about Hashi's either. What brought you to this conclusion ?
Based on a previous ultrasound that showed Right Thyroid Atrophy and elevated antibodies, I am guessing that I have Atrophic Thyroid with Hashimoto's.
If you have elevated antibodies, you have Autoimmune Thyroiditis, aka Hashi's. Although, to be strictly accurate, if your gland is atrophied you actually have Ord's. But, it comes to the same thing: the immune system destroying the thyroid.
Is the muscle stiffness in my shoulders, neck and tension headaches I started having after my dose was increased by too much common and should it go away as my levels even back out ?
Thank you for mentioning my girl RoRo, she was a beautiful red Eclectus Parrot. Up to the last minutes before she passed, she was still kissing away my tears and telling me "it's ok" and "I love you". She was amazing. When an animal can talk to you, it's a whole new level. She wasn't just a pet, she was my partner in life. I keep a red candle burning in her cage and will do so until the day I take my last breath. Oh how I miss her ...
You are welcome here. Please feel free to participate.
However, what you have done, surely inadvertently, is post what is a whole question about you and your situation in a thread that was started by another member.
This causes confusion - to the original poster, to other members replying and, not least, to you.
Please, please, start a new post when you have a question.
At the moment, Susieg1 really can't separate out what applies to her.
There is nothing in these results to suggest ' hyper ' or overmedication.
With NDT you track on the T3 result and it is in range :
With Hashimoto's you can experience ' swings ' and erratic thyroid hormone production as the gland dies.
Just be aware of this, and if you sense a ' swing ' in symptoms, drop back down on your Armour, to try and off set the severity of the swing and after the swing has swung back, you may find, that you will need a little extra Armour than your original dose.
Dose in 1/4 grain increments up or down as your levels rebalance.
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