How to gradually reduce dosage of desiccated thyroid (armour)?

[Aligoth]

I'm on desiccated thyroid, Armour, because my hypothyroidism is non hashimoto and comes from a polymorphism that prevents me from properly converting t4 to t3.I was on T3 only but that didn't affect my t3 levels, just killed my tsh so was out on armour and that kind of works.

However.

I am on 6 grains to get to top of t3 / t4 range.

And I have now concerns about the dosage and even if not feeling optimal I'd like to cut back.

What is your advice on the time / ways to cut back on medication?

I am tempted to just cut drastically to 4 grains (2 grains twice a day, rather than 2 grains 3 times a day) but happy to hear any advice on the matter?

Thank you so much

[greygoose]

And I have now concerns about the dosage and even if not feeling optimal I'd like to cut back.

What are your concerns? And, what are your latest labs? If your FT3 is still in-range, I don't see why you would want to reduce. You'll probably make yourself quite ill if you don't even feel optimal on this dose.

However, to answer your question, you can reduce by 1/4 grain every two weeks.

[Aligoth in reply to greygoose]

Thank you so much. My endo had me going from 4.to 6 so I was hoping to o cut down two already but just in case I'll do less then.

I am currently going through a bit of a health scare about possible breast cancer as it runs in my family and Thyroid hormone rightfully by working on raising metabolism of course speed up the cancer growth if that turns out to be what's wrong with me so that's my reason to prefer to feel less optimal thyroid wise but with less risk to be contributing to possible cancerous growth. This study confirmed what I already knew based on how T4 and t3 work so even when this turns out to be a false alarm I will look to go on the minimum amount of thyroid medication possible in the future.

ncbi.nlm.nih.gov/pmc/articl....

[greygoose in reply to Aligoth]

I see. But, the trouble with that paper - which I readily admit goes straight over my head for the most part - is that it doesn't give quantities. How much T3 has these effects? Obviously your body needs T3 and I'm quite sure that too little can also have an effect on cancer growth. So, how much is too much.

Going from 6 grains to 4 is a massive reduction - and your endo should not have increased by that much in one go! It must have been terribly stressful for your body. But, what are your labs saying? Are they saying that you're over-medicated? And, remember that a blood test is just that, it tells you how much of a substance you have in your blood. There is no way for you to find out how much is getting into the cells, except by the way you feeL So, how do you feel? And, from what I understand, this study is looking at T3 within the cells, not in the blood.

I would imagine that most of us take the mimimum thyroid hormone we can and still feel well. I can't imagine anyone enjoying being over-medicated, it's horrible. But, reduing it too far can backfire on us and cause all sorts of undesirable effects.

[Aligoth in reply to greygoose]

The weird thing is o have developed resistance to thyroid medication over and over. I've been on 6 grains for over a year and my levels still go from the low 4s to high 6s depending on time of the year (lower being winter, higher summer). Honestly with the cancer scare and having always known the only silver lining of hypo is longer life expectancy because everything goes slower I don't mind being mid-low range rather than mid top of it means slowing down bad things too. Ironically being fat never tried to kill me before despite what society told me forever so this heath scare is giving me a lot of new perspectives.

Ps: range where I live for T3 is 3.9-7

Before being medicated at all I was at 3. T3 only brought me to 2.4. With 4 grains I was in the low 4s and on 6 grains I average 5s which is top 1/3 of the range

[greygoose in reply to Aligoth]

How much T3 only were you taking? Sounds rather like you have a gut absorption problem. On 6 grains NDT you're taking about 54 mcg T3, plus whatever you can convert. One would expect your FT3 to be higher.

[Aligoth in reply to greygoose]

On 40mcg of liothyronine I was at 2.4 in t3 a full 0.8 lower than being unmedicated and that was already unde range, however at the time it was absorbed enough to tank my tsh

[greygoose in reply to Aligoth]

Well, tanking your TSH doesn't count for much. It's a pituitary hormone, and the pituitary gets served first when it comes to T3, even when the other organs and tissues are T3 deprived. So, your TSH can be low but so can your FT3 at the same time. So, whatever was getting through satisfied the pituitary, but you didn't absorb enough through the gut to raise your FT3.

[helvella Administrator in reply to Aligoth]

Perhaps you could let us know why you are concerned at your TSH tanking?

In the UK, the Patient Information Leaflets for Liothyronine say this (or very similar):

Adults:

The dose will depend upon your condition, ranging from 10 micrograms to 60 micrograms daily in divided doses.

medicines.org.uk/emc/produc...

And you were only at two thirds that dose.

(In the USA, the equivalent documents say 75 micrograms. Which tends to support the idea that the number is simply derived by multiplying the standard tablet by three. Not for any good scientific or medical reason.)

[Aligoth in reply to helvella]

I was never concerned about tsh tanking cause T3 is supposed to do that. Unfortunately even on a very high dosage my tsb was tanked (so no endogenous t3 produced) but my t3 levels werent high enough, in fact, they were lower than being unmedicated, hence the switch and increase of dosage with armour

[helvella Administrator in reply to Aligoth]

Good. Glad suppressed TSH isn't in itself a concern.

But why not increase the liothyronine dose?

40 micrograms isn't a high dose for T3-only.

Or am I not understanding the situation?

[Aligoth in reply to helvella]

It was increased. I was put on 6 grains, equivalent to 54mcg.

[helvella Administrator in reply to Aligoth]

But you didn't do so on T3-only - if I have the right understanding?

54 is still less than the UK PIL says (60) and significantly less than the USA (75). And several take more than that!

[Aligoth in reply to helvella]

I don't have an interest in raising t3 and metabolism but in lowering it at the moment due to cancer concerns.

[gabkad in reply to Aligoth]

There is a possibility that even though you appear to be on a relatively high dose of Armour, you are not absorbing it well. It wouldn't make sense to take less Armour especially when your doctor raised the dose. Ask your doctor about absorption issues and is that why you need 6 grains.

Synthetic T3 at a higher dose than what you had been taking might be your better option since it is virtually 100% absorbed even if there is some food in the stomach.

[waveylines in reply to Aligoth]

I adjust my Armour according to the time of year. I need slightly more in winter.... Cold weather and slightly less in hot weather. .In very extreme weather such as the long heatwave we had last summer I dropped it further down.Mary Shomans talks about this on her website. So you are not strange or unusual. It does make sense because normally a functioning thyroid would fluctuate depending on the demands not only through activity but weather conditions. Your body has to work hard to keep you at your usual temperature whether in hot or cold weather. Hence why the body sweats or shivers.

[molliemdz in reply to Aligoth]

This is the first I’ve heard of hypothyroidism being linked to longer life expectancy. I’d always heard the opposite. Can I ask where you read/ heard that? Thanks!

[waveylines]

Hello Aligoth. I had breast cancer. I'm now 9,yrs clear. It was very aggressive. I wa on a NDT before diagnosis and since. To feel well I do need my thyroid hormine levels in the top third of the range.... If not nearer the top. Of the ranges. My Oncologist was very clear he did not want me to lower the dose at all, wanted my Ft4 & Ft3 high in range. The private Endo wanted to cut my thyroid levels drastically as she spouted that it would increase cancer growth. He did not agree and said I need a good level of thyroid hormones to fight the condition and to cope with the treatment. He was spot on!! I ditched the private Endo and went to a NHS Endo who totally agreed with my Oncologist

The treatment was long and gruelling - a year and then I had reconstruction a year after treatment.

Why don't you wait to see if you are diagnosed and talk to the Oncologist. Now is not the time to be messing with your thyroid hormones.

[Aligoth in reply to waveylines]

Thank you for sharing this does help immensely

[FreeBlueBare]

As someone who has actually reduced Armour dosage, is diagnosed Sub-Clinical Hypothyroid and as someone who is also a poor converter of T4 to T3 who has had a suppressed TSH, I can tell you that my heart rate went crazy when I first lowered my dose. It went so crazy that I actually took myself to urgent care and then eventually the Emergency room/hospital. I was eventually released after some testing that did not reveal any issues but for awhile they thought it could of been a pulmonary embolism. I was winded/short of breath just walking around and my heart was pounding and racing in my chest. It was beating over 150 bpm just sitting there. To this day, I have no idea if my heart incident was related to lowering my Armour dosage but the nursing staff suspected it. For the record, I'm in my 30s and other than poor thyroid function and excessive body weight I am in good health.

[Karen-Eleanor in reply to FreeBlueBare]

How long did it take for your heart rate to settle?

[FreeBlueBare in reply to Karen-Eleanor]

It was probably a full day or a day and a half before I didn't think something was wrong with my heart based on what it was doing. I think I waited 3 or 4 hours before I took myself to urgent care where they did an echocardiagram and told me I should probably go to the ER as the echo did in fact align with the symptoms I was having.

But it took much much longer for me to feel like my heart was behaving normally. I had an endocrinologist explain why my heart was going bananas so its part of the process but it was not fun lol

[Beau55]

I know you are worried but I strongly advise against doing such a huge reduction at once. Your system and adrenals will panic and I suspect you will feel awful in a couple of days and then progressively worse. Any alterations down need to be slow (unless over medicated, which you aren’t). Lowering your meds to be deliberately hypo will just result in a weaker immune system which is the opposite of what you want right now. X

[BB001]

Decrease very gradually to give your body time to adjust.