Do I need to bump up my Armout Thyroid meds?

[ndodge]

Hi, I have central hypothyroidism. I am currently taking 75 mgs of Armour Thyroid daily.

I am once again experiencing symptoms of low thyroid:

Fatigue, feeling cold, not losing weight anymore (I am on noom diet and have been successful but progress has stopped.)

I didn't take biotin for a few days prior and I took the test at 10: 53 am.

Any help would be much appreciated! Thank you so much.

[SeasideSusie Remembering]

When did you take your last dose of NDT before the test ? When on NDT we should split the dose the day before into 2 or 3 doses and take last dose 8-12 hours before the blood draw .

[ndodge in reply to SeasideSusie]

Hi! Thanks for replying. I took my last dose at 8:30 in the morning, my usual time.

That's very interesting info about when/ how to take it before testing! Thank you.

[SeasideSusie Remembering in reply to ndodge]

So if you took your NDT just a couple of hours before the test then you are measuring peak hormone levels (levels peak 2-4 hours after ingestion) so normal levels would be lower. It looks as though you could do with increasing your dose.

[ndodge in reply to SeasideSusie]

Thank you, Seaside Susie,

That's what I'm thinking, based on my symptoms and the test numbers. I just wanted to make sure my thinking was correct.

I know that folks on this forum are very knowlegable!

Much appreciated,

Nancy

[FancyPants54 in reply to SeasideSusie]

Hello SeasideSusie. I am nervous to pick you up on the timing advice for NDT testing because of your wealth of knowledge and experience, but Diogenes has put up two links to papers recently that report that the T3 in NDT is mostly bound by thyroid hormone binding globulin and releases slowly, a natural slow release T3 in effect. And therefore we should be testing 24 hours after the last dose if we can tolerate all our meds I one go.

[SeasideSusie Remembering in reply to FancyPants54]

Can you link to them FP please. I haven't been round much lately due to illness/surgery so have missed them.

[FancyPants54 in reply to SeasideSusie]

Oh gosh, not sure I'll find them. I will probably be able to find the latest one he posted. Hold on.

[FancyPants54 in reply to SeasideSusie]

Well that was easier than I thought. This was from 4 months ago and I think he reposted a link to the same thing in the past 2 weeks.

healthunlocked.com/thyroidu...

I'm sorry to hear you have been unwell and needed surgery. I hope you are on the mend again now.

[SeasideSusie Remembering in reply to FancyPants54]

Thanks FP, I don't recall seeing it so I'll read through and if necessary I'll amend suggestions I make.

[FancyPants54 in reply to SeasideSusie]

I will be interested in your thoughts on it.

[tattybogle in reply to SeasideSusie]

  FancyPants54 the other relevant posts about NDT and it's release:

diogenes July 31st 2019 ~ healthunlocked.com/thyroidu... t4-and-t3-in-ndt-are-largely-strongly-bound-on-to-thyroglobulin-protein

diogenes Oct 15th 2022 ~

healthunlocked.com/thyroidu... (how-the-t4-and-t3-bound-on-to-thyroglobulin-are-released-as-free-hormones~ direct link to paper being discussed ...... academic.oup.com/endo/artic... The combined action of two thyroidal proteases releases T4 from the dominant hormone-forming site of thyroglobulin )

diogenes march 17th 2023 ~ healthunlocked.com/thyroidu... (rerun-medscape-and-dte-ndt )

new pinned post from radd re. testing protocols for levo / levo+T3/ NDT: healthunlocked.com/thyroidu... suggested-thyroid-hormone-test-timing-protocols

[Jamima]

Hi ndodge - I’m afraid I can’t help with your query but I wonder if you could tell me how you got diagnosed with central hypo? I think I may have CH but no-one seems able to diagnose me. Many thanks.

[ndodge in reply to Jamima]

Hi Jamima,I did not get a specific diagnoses but more of a "soft" one from my endocrinologist. I am working with a naturopath mainly and am going by symptoms and testing.

But I'll explain-

In 2003, I had an MRI for an unrelated ear issue. It also caught my pituitary and showed that it was enlarged with blood from a hemorrhage.

I had no hypo symptoms at that time.

Flash forward to 2016 when I started having low thyroid symptoms. I might have had them before this time but I was low in iron, B12, and many of the symptoms overlap. I stared seeing a naturopath in order to get enough B12 prescribed to me, and she tested my thyroid. No antibodies and my tsh was never high.

So based on test results and symptoms I started on Armour Thyroid.

The endocrinologist did another MRI on my pituitary gland and it showed the blood from the hemorrhage had receded and left me with a "smushed" or damaged pituitary. She never said the words 'Central Hypothyroidism', but what else could it be? My naturopath thinks it is. My thyroid, other than that, is fine. I have had ultra sound tests which show no problem.

Sorry for the long story. Hope it helps!

[ndodge in reply to Jamima]

Hi again, Jemima,If you have hypo symptoms, perhaps you could go to a functional doctor or naturopath (as we call them here in Oregon).

I don't know what country you are living in, but my endocrinologist, like most US doctors, doesn't believe that T3 and T4 are important in diagnosing and treating hypothyroidism. 😳

But I'm lucky, she deferred to my naturopath re: my treatment.

Good luck, Jamima!

[Jamima in reply to ndodge]

Thanks so much ndodge - I’ve booked an appointment with a functional med doctor but she’s so busy it’s been postponed! I’m in the UK and it seems we have the same problem with diagnosis as you in the US. I’ll continue to battle on.

[ndodge in reply to Jamima]

Best wishes, Jamima!Let me know how it goes with the functional doc.

🙏🤞

Nancy