3 grains of Armour Thyroid - a very high dose?

[ParlourPalm]

Hi everyone,

I posted recently as I was a bit confused by my results - suppressed TSH but both T3 and T4 at bottom of range. Since then my endocrinologist has increased my dose from 2.5 grains to 3 grains, but said he won't be able to increase any further as this is a high dose for my size and weight (70kg). I don't have any symptoms of being overmedicated - far from it, I feel absolutely exhausted and life has ground to a complete halt, and all the hypo symptoms. I've been on 3 grains for 3 weeks.

I wondered if anyone else is on a similar dose or higher? I feel as if my body isn't absorbing the medication, but I suppose it must be, given the suppressed TSH. I’m not sure if I should give it a bit longer and then self-medicate on a higher dose, or whether that’s asking for trouble.

Any thoughts about all of this would be appreciated. My levels before the increase (last dose 24 hours before test) were:

TSH - 0.07 (0.27-4.2)

Free T4 - 12.8 (12.0-22.0)

Free T3 - 3.7 (3.1-6.8)

Ferritin 64 (30-400)

Vit D 55 (50-174)

Folate 9.3 (>3)

B12 644 (180-999)

Ferritin 64 (30-400)

It’s very hard to stay hopeful when life has become so limited, so any advice would be really appreciated. I'm taking iron tablets and eating more red meat etc to try to raise my ferritin.

Thanks so much in advance.

[Jazzw]

You need what you need. I’m on 3 grains and I consider it to be just about perfect for me—BUT my FT3 is top quartile of the reference range, demonstrating it’s not too much for me.

Your blood test results aren’t reflecting the true position for you on 2.5 grains. You left 24 hrs between taking your last dose and taking the test, which means your FT3 is artificially low. We tend to advise splitting the previous day’s dose into two and taking the second half around 12 hours before a blood test, to get a more accurate picture.

That said, it does seem your FT3 wouldn’t be over-range if you’d done that. Middle of the range perhaps. So an increase is warranted. Half a grain increase might be enough though.

I’d wait and see how it works out. Next time you do a blood test, split your dose as recommended and test 12 hours after taking the second half so that you can see the impact on your FT3.

Your doctor is being overly cautious. Some people can and do need more than 3 grains—there are lots of factors which might mean you need more. However, you personally may not need more than 3 grains. It’s too soon to say. You’ll need a good 6-8 weeks on 3 grains to get full benefit from the dose increase so don’t test before then.

[ParlourPalm in reply to Jazzw]

This is such a helpful and reassuring reply - thanks Jazzw. I was a bit unsure about the 24 hour gap with T3 but didn't want to take it before the test and get a false high result - next time will definitely do as you suggest. I'll hang in there for a few more weeks - as I'm sure you know, it feels like an eternity when you're feeling too tired to function, but I know it's too soon to be sure I need a higher dose. Did you find an endo prepared to prescribe according to how you were feeling, rather than worrying about the numbers? Mine is really helpful, but I guess they all feel they have to be cautious given the general climate around thyroid prescribing.

[pennyannie]

Hello again :

It's generally suggested when taking any form of T3 that we test around 10 -12 hours post dose - having fasted - as this would show the peak of T3 within the blood stream which hopefully ' sits ' within the acknowledged blood test range:

So your results are a little skewed and lower than we usually see as they are after 24 hours - prior to your next dose.

Dosing by weight is a ' ball park ' guess=estimate as to where you likely need to be - but a 1/4 grain NDT up or down from that can make a massive difference to ones health and well being.

Everywhere I researched suggested ferritin needed to be at least over 70 for any thyroid hormone replacement to work well - so maybe you need to try and build back up your core strength vitamins and minerals as previously detailed.

Natural Desiccated Thyroid does take time to build up in the body so suggest you stay with it, and seeing as you did a straight swop to NDT and didn't build up slowly maybe it just needs a bit more time to feel the full effects.

You need what you need in the way of hormones -

[ParlourPalm in reply to pennyannie]

Thanks for replying pennyannie - I'll try to hang on in there and hope things improve. I do seem to be on a high dose, but as I don't have any hyper symptoms whatsoever I suppose I must need it. Will know about the timing for my next test, and continue my efforts to increase my ferritin. Thanks again!

[AmberBee]

I take 2 1/2 grains of erfa, should be on 3 grains that I took for a long time with other products, my tsh is suppressed also. Also consider some possible suppression.

[ParlourPalm in reply to AmberBee]

Thanks for this AmberBee. Could I ask why you went back down to 2 1/2 grains?

[AmberBee in reply to ParlourPalm]

Little late with response sorry, could not access the site for a while. 3 grains actually feels to much but could be my adrenals, I was alsp diagnosed with osteopenia so may not be a bad thing at this stage.

The endo reduced my dosage due to readings going over for a few hours when taking Erfa.

I have tried adrenal support but does not work for me, read that ginseng could help to lower t3 levels that I recently introduced.

[AmberBee in reply to ParlourPalm]

How were you on 3 grains?

[AmberBee in reply to AmberBee]

3 grains were prescribed but suspect my adrenals still struggle with the higher dosage, 2 1/2 is more comfortable. It is said that thyroid meds are not responsible for bone loss as it is more likely linked to vit D levels, I also take strontium but not the nhs version due to the additives possibly being an issue. Will have an osteopenia scan soon to check if things have improved, the nhs still reduce thyroid meds were bone loss is concerned - fingers crossed i have had no deterioration.

[ParlourPalm in reply to AmberBee]

Thanks for getting back to me. I've had a difficult time - I was on 3 grains of Armour for a while but felt awful and went back to 2.5 grains. I ended up in A&E after a few more weeks and was diagnosed with overmedication, with T3 much too high. The endo changed me to 150mcg levothyroxine, but 7 weeks later, after seeing my GP with palpitations, tight chest, vomiting and faintness I was again sent by her to A&E where again I was found to be very overmedicated, with T4 much too high. My dose has now been reduced to 100mcg and so far I'm feeling much better. I think all my fatigue symptoms were to do with being over rather than under medicated. I hope you get all your issues sorted out and are feeling well.

[Alanna012]

It's a bit strange that your T4 is so high.

If after 6 or so weeks the 3 grains still isn't resulting in T3 rising, you can suggest adding a bit of T3 or T4 to your NDT.

[ParlourPalm in reply to Alanna012]

Thanks - will definitely ask about adding T3 if it doesn't increase.