Help with test results please

[Badmintonteresas]

I have a thyroid problem sparked off by thyroiditis following parathyroidectomy then ending up with hypothyroidism. Since then my thyroid has been unstable and I have many symtoms of hypothyroidism inc weight gain muscle and joint pain insomnia etc

I have recently started taking armour NDT but very low dose.This was based on previous bloods which showed TSH of 3.88 t4 13.9 t3 4.6 ref ranges same as following 12 days ago started First 1 quarter grain every three days now reduced to every other day. Had my bloods tested yesterday 10am no NDT taken on that day 7am the day before I fasted also only drinking water.

My results are as follows TSH 1.90 (0.27. 4.2) Ft3 4.7 (3.5. 6.5) FrT 4 14.9 ( 10. 21)

Ferritin 35 . 9 which is slowly rising with intervention vitamin B12 698 ( 180 2000)

I don’t seem to have any relief of symptoms

Any advice welcome

[Lalatoot]

As NDT contains T3 you MUST take the same dose or doses at around the same time each day. That is how the body likes T3. you cannot take different doses on different day.

Your recent blood results don't reveal the full picture as they have been done too soon and you are not taking your T3 properly. You need to take T3 daily and wait 6 to 8 weeks after dose changes to see the full effects.

As with everything thyroid being methodical and going slowly gives the most chance of success.

It can take years to find the correct doses and whether to dose one, twice or three times a day.. Our symptoms don't resolve all at the same time. Our body has had to adapt and change to survive on reduced levels of thyroid hormones; it needs time to change and adapt to increased levels of hormones and that takes time.

[SeasideSusie Remembering]

B admintonteresas

Why Armour? Did you not give Levo a chance?

Is your Armour prescribed?

12 days ago started First 1 quarter grain every three days now reduced to every other day.

This is not the normal protocol for starting NDT. The usual protocol is:

Starting dose: 1/4 grain (15mgs) in the morning and quarter of a grain in the afternoon and stay on this for 7 days. If no adverse effects:

Week 2: increase your dose by another 1/2 grain (30mgs) a day. Take half a grain in the morning and half a grain in the afternoon (total 1 grain daily) and stay on this dose for at least 3 weeks. If no adverse effects:

Week 5-6: increase by another 1/2 grain and take 1 grain (60mgs) in the morning and 1/2 grain (30mg) in the afternoon (total 1 and 1/2 grains daily). Stay on this dose for 3 weeks and again, if no adverse effects:

Week 8-9: increase by another half grain and take one grain in the morning and one grain in the afternoon and stay on this for another 3 weeks (total 2 grains daily).

This may or may not be enough. If you are still symptomatic, increase by 1/4 grain (15mg) every 3 weeks. If you feel overmedicated then drop back to the previous dose.

Because NDT contains T3 we have to take the same amount every day because T3 only has a half life of 24 hours.

Had my bloods tested yesterday 10am no NDT taken on that day 7am the day before I fasted also only drinking water.

No point in testing yet, your hormone levels need to have stabilised on the same dose for 6 weeks before testing.

I don’t seem to have any relief of symptoms

It's far too soon, you have to work up to an effective dose. It can take up to 6 weeks for T4 to stabilise after starting, or any dose change, hence the advice to not test until 6 weeks later. It's not a quick fix like aspirin for a headache.

Ferritin 35 . 9 which is slowly rising with intervention

For thyroid hormone to work properly some experts say that the optimal level for thyroid function is 90-110ug/L, and half way through range is generally recommended, so yours still has a long way to go.

[Badmintonteresas in reply to SeasideSusie]

Armour prescribed by private Dr who wanted to make sure my body could tolerate t3 . I will do as you say take every day and monitor my symptoms Will test again in 6weeks time. This seems to be taking so long to resolve I am not very patient. We eat healthy and try to eat for thyroid health. Acupuncturist is also trying to balance my hormones.

Thanks for the advice

[SlowDragon Administrator in reply to Badmintonteresas]

You can’t rush hormones

It typically takes 6-12 months to get on right dose, fine tune and get all vitamins optimal….and let your body settle to a new metabolism

[SlowDragon Administrator]

You absolutely must take same dose NDT every day as it contains T3

No point testing until been on unchanging dose for at least 6-8 weeks

If you can’t tolerate NDT ….better to start on levothyroxine

Because of your age, standard starter dose is 25mcg levothyroxine

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

Likely to need further increase in levothyroxine over coming months

Always test thyroid levels early morning, ideally before 9am and last dose levothyroxine 24 hours before test

If on NDT …..day before test split your dose into 2 or 3 smaller doses spread through the day ….last dose approx 8-12 hours before test

Also important to test vitamin D and folate