Blood test results on NDT

[Flossiewestie2020]

Hi All,

I've just had some blood tests and I'm unsure whether to change my dose or not. I'm currently on 1 3/4 grains of Armour.

My results are:

TSH: 0.31 (0.27-4.2)

T3: 4.05 (3.1-6.8)

T4: 9.6 (12-22)

Overall, I feel ok. I tend to hit a wall mid afternoon (when my meds are due), but I tend to perk up again by the evening. This isn't really an issue as I tend to rest then anyway. Other than that, I don't feel like I really have any hypo symptoms. I do seem to have worsening PMT over the past year and have recently started bleeding between periods and have lots of itching on my back and scalp, but I'm 38, so I'm putting that down to changing hormones separate to thyroid.

I know my practitioner will recommend an increase in medication but when I was on two grains before I felt how i imagine 'hyper' feels: I was really anxious and was having heart palpitations - I just felt really wired and like I couldn't cope with life. I've also tried alternating doses but that didn't agree with me at all and all my hypo symptoms came back.

I'm not sure whether to just stay on the dose I am, try increasing it again, or whether to try taking T4 alongside Armour. As I said, generally I feel ok and I don't feel like Hashimoto's is really stopping me living my life (although I do a lot less these days than I used to). I could definitely feel better but not sure if i want to mess with my dose as I feel pretty stable on the whole!

Any advice would be appreciated. Thanks in advance!

[pennyannie]

Hey there again :

Well on 2 grains you were listing many symptoms and had a T3 at 6 ;

Now on 1 + 3/4 grains your symptoms are ' minimal ' but your T3 has dropped down to 4 : ??

I wonder if the last results and especially the symptoms experienced were a Hashimoto's flare ?

Do you have any results on your ferritin - as that was said to be low a few posts back ?

What about your folate, B12 and vitamin D ?

[Flossiewestie2020 in reply to pennyannie]

Hi Again!

Thanks for this. If it was a flare, do you think I should try 2 grains again?

My vitamins are all slowly increasing:

Ferritin 65.8 (13-150)

Folate 11.92 (>3.89)

B12 80.1 (37.5-150)

Vit D 101 (50-200)

Do you know anything about what causes flares and how long they last? My symptoms did seem to coincide with increasing my dose and seemed to calm down quite quickly after reducing it.

[pennyannie in reply to Flossiewestie2020]

Did you see your antibody levels fluctuate at all - as these usually released to clean up the blood after a flare ?

Well, I don't know, maybe you could try inching up the 1/4 grain again :

Your T4 is also very low - need to go back and see where it was on the 2 grains :

OK so on 2 grains your T4 was in range at 15 which looks a lot better with your T3 at around 6 : in fact perfect looking results :

So, ferritin needs to be over 70 for any thyroid hormone replacement to work well :

I find i feel at my best when my ferritin is at around 100 ;folate at around 20 ; B12 active at around 75 ++ and vitamin D at around 100 :

Did you follow the same procedures - time gap - etc between last dose and blood draw - how long did you leave it this time between last dose and blood draw ?

[Flossiewestie2020 in reply to pennyannie]

Annoyingly, I didn't get my antibodies checked when I was on 2 grains. My T4 was 15 then. In my most recent blood tests, my TPOAb antibodies have reduced quite a bit but the TgAb ones have gone up slightly since March.

[pennyannie in reply to Flossiewestie2020]

Ok - yes and I looked back as your results on 2 grains looked pretty much perfect ??

Think we may have crossed in the air over Heathrow with the last question.

[pennyannie in reply to Flossiewestie2020]

Yes your body isn't comfortable and there's likely inflammation with this itching on back and scalp - what's that all about - is it a new symptom - have you a diagnosis ?

[Flossiewestie2020 in reply to pennyannie]

I'm not sure. I've had it a while but it seems to fluctuate. It was really bad when I was pregnant, which is why I'm assuming it's to do with female hormones. I'm going to speak to my doctor this week as I'm particularly concerned/annoyed by bleeding between periods! My inflammation marker came back as normal in blood tests.

[pennyannie in reply to Flossiewestie2020]

Well, yes, something is going on - I don't know what else I can add :

With NDT you dose to relief of symptoms and not a blood test -

though we are all guilty of taking bench mark readings to look back on and confirm we are going in the right direction but your blood tests are confusing me as from 2 grains to 1 and 3/4 the differential seems much too much :

It's going under my pillow for at least tonight !!

[Luna1390]

This was how NDT worked for me, as well. It didn't give me enough T4. I added Synthroid to it. Started with 12 and slowly worked up to 50 mcg. My T4 went from 0.8 up to 1.3. My dr likes FT4 to be 1.1-1.4. (This is based on my lab's range). I have felt great ever since and my hair and eyebrows went back to normal, which is a plus!

[Luna1390 in reply to Luna1390]

0.8 was the bottom of the range for my lab. You are actually under range on yours. Ugh!

[Flossiewestie2020 in reply to Luna1390]

Thanks for this! I'm tempted to add some T4. When I was on Levo, I always felt best when my T4 was above range. My numbers actually looked much better on Levo but I know it's not all about the numbers!

[Jazzw]

Personally, I’d try adding another quarter grain.

Your body might have struggled with the additional T3 in it previously because of low ferritin (I don’t know how it works, only that when ferritin is low it can sometimes be difficult to raise thyroid hormone doses without experiencing hyper type symptoms).

[adin]

I don't feel good only on ndt, bcs t4 is to low. So I need to add some levo. Now I'm on 2 grains +25 levo, I feel ok but I have pins and needles in my feet.

[Ajva]

I am on 1 grain armour and added in 25 then 50mg of t4 tirosint. I feel much better but my t4 is still on the low end of the scale. I am considering switching to t4 tirisont and compounded t3.

The issue I have is my t3 is top range, t4 low and tsh suppressed and low. If I increase my dose then my t3 will go over (always makes me feel hyper over range). So I think I have no choice.

[Swissgirl]

Good morning. How about raising NDT by just a an 1/8 grain rather than a 1/4. I have had to do this to be able to tolerate any increases. I am currently on 3 3/8 grain, split over day ( 1 1/8 - 1 1/4 - 1 grain). Also your T4 does look low - my optimal levels are T4 mid/ high in range and T3 at the very top of the range, sometimes even very slightly over. However, each individual is different of course. What’s right for me may not be right for you. I tend to dose by symptoms but just keep a regular check on my levels as a reference.

[Thyroid63]

I’m having the same problems- all bloods look perfect on 2.5 grains, but it makes me feel hyper. I’ve gone back down to 2 - feel ok, I’ve started taking B12 now ( I wasn’t deficient, just the low side of normal) , see what happens…