Switching from Armour Thyroid to T4/T3

[Karen-Eleanor]

I’m changing from Armour Thyoid to T4/3 prescribed by local Endo partly for financial reasons but also as I’m concerned about supply issues and monitoring. Should I swop gradually or is it better to finish the AT then start the T4/3 the next day. I currently take AT 1 grain am and 3/4 pm and have been given 50 mcg T4 and 20 T3 split into 2 doses.

[radd]

Karen-Eleanor,

You can do a straight switch over. I would finish the Armour one day and then start on Levo + T3 the next day. My only worry would be you might be under dosing.

1 and 3/4 grains of Armour equates to roughly 140mcg T4 and you have only been given around 110mcg T4. A more realistic equivalent dose would be 75mcg T4 + 20mcg T3.

Be interested to hear how you feel after because this switch is something I might have to consider at some point in the future.

[FancyPants54 in reply to radd]

Oh no radd . You are a shining light of Armour usage.

[radd in reply to FancyPants54]

FP,

Yes, I love Armour as it works very well for me but sadly it is expensive. I have a good few years yet and might even go back to work, or my premium bonds might win the big one 🤞😁

[Karen-Eleanor in reply to radd]

Thank you very much - that is my fear! Is there anywhere that tells you how to convert it so that I have evidence?

[radd in reply to Karen-Eleanor]

Karen- Eleanor,

I don't of anywhere that holds credible advice, as the manufacturers claim 1 grain is biochemically equivalent to 100mcg T4, but myself and many others would suggest it more about 80mcg T4. The manufacturers claim T3 to be approximately four times as potent as T4 but I use a 3:1 ratio as many others do also.

Most (unmedicated) T3 comes from conversion of T4, and Armour contains a lot more than our thyroid gland or the amount we would naturally be converting (when well), but when taking any T3 or T3-containing-meds the conversion enzymes become upregulated, meaning you get more hormones than you medicate.

.

[SlowDragon Administrator]

Be aware many people find different brands of levothyroxine are not the same

Which brand of levothyroxine and which brand of T3 are you starting with

[Karen-Eleanor]

I’m restricted as it’s essential that I have lactose free as I’m hyper sensitive to dairy products. It is Teva for T4 and Viatris for T3.

[radd in reply to Karen-Eleanor]

Karen-Eleanor,

You need to click the 'blue reply' button for the recipient to be notified. I will tag her for you .. SlowDragon

[SlowDragon Administrator in reply to Karen-Eleanor]

Levothyroxine

Teva levothyroxine contains mannitol. This upsets some people

Vencamil is lactose free and mannitol free

Currently only available in 100mcg.

But 25mcg and 50mcg due to be available by June this year

Liothyronine 20mcg tablets

Teva T3 is lactose and mannitol free

Thybon Henning (on private prescription) lactose free

Posts that mention viatris

healthunlocked.com/search/p...

[Thursdays]

Hi, I am about to switch from Armour to T3/T4 due to long term costs. How have you got on with the switch & can you offer any advice please ?

[Karen-Eleanor]

Hi You need to be careful how the dose conversion is done, The first few days I was fine but within a week or so became very tired and lacking in energy- hypo symptoms kicked in. I was on 1 grain AT am and 3/4 pm which was dosed as 50 mcg T4 and 10 mcg T3 am and another 20mcg T3 pm. Slightly less -16 mcg T4 but 4.25 mcg T3 - in theory this is about 12 mcg of T4. I talked to Endo and he’s agreed to increase T4 to 75mcg (he made the usual fuss about suppressed TSH , heart issues and osteoporosis as they do). I’ve increased by 12.5 daily since last Saturday with a view to adding the rest later if needed. I’m a big fan of all increases being done slowly and I’m feeling much better. Hubby thinks I’m less tired too. I, too swooped due to cost . Good luck.

[Thursdays in reply to Karen-Eleanor]

Thank you so much, thats a great help. I am slight dreading the switch as I am settled at the moment with decent energy levels, good mood etc . Just hope my endo doesn’t under dose due to the TSH argument etc . 🤞

[Karen-Eleanor]

Hi Unfortunately they usually do but Tbf it’s not a clean cut conversion because it isn’t exactly the same product and it does absorb differently!

[Karen-Eleanor]

PS It is usually accepted that T3 is 3 times as potent as T4. How much AT are you taking and what has been prescribed as the alternative? I’m assuming you are in the UK.

[Thursdays in reply to Karen-Eleanor]

Hi, thanks , yes Im in UK. I currently take 1.25 armour in a morning, and 1 grain about 2-3 pm . I used to take 50 levothyroxine before switching. Im trying to figure out what the equivalent dose of T4/T3 is to the Armour that Im taking, and hope I wont be under dosed because of the TSH suppression opinion! I used to have a medication conversion chart, I came upon it on one of my many searches, but cant find it now ! I think it was on a Paul Robinson blog. I found the switch to Armour hard, so am hoping T3 wont be as tricky .

Im due to get my new meds Wednesday at endo appointment , had bloods taken before he would prescribe (antibodies t3/4 TSH) .

[helvella Administrator in reply to Thursdays]

The standard. conversion charts say that one grain is equivalent to 100 micrograms of levothyroxine. Most who have been on both think this is significantly wrong. If you changed to levothyroxine only using that, you'd very likely end up somewhat over-dosed.

A more realistic value might be one grain being near 74 micrograms of levothyroxine. You can get to that number by taking the T4 content of Armour (38 micrograms) and multiplying the T3 content (9 micrograms) by four. And adding them.

Some people find that a better conversion. However, we are all different.

If converting to a combination, as you ask, you could try simply using the T4 and T3 content of Armour. But lots of people have said that really is not right for them. And the differences in absorption might be a part of the reason. Both how fast you absorb, and how completely.

[Thursdays in reply to helvella]

Thank you helvella . I think that the 74/36 t4/t3 sounds more logical for sure.

[helvella Administrator in reply to Thursdays]

Just to make sure you are interpreting what I wrote as I meant!

One grain of Armour might be around 74 micrograms of T4-only.

OR

One grain of Armour might be around 38 micrograms of T4 plus 9 micrograms of T3.

(The 36 is got by multiplying the actual 9 micrograms of T3 by 4 to approximate the equivalence. But this is very rough and ready and must not be taken as a definite conversion factor.)

[Karen-Eleanor in reply to helvella]

Hi I’ve interpreted that as meaning 1 grain of AT is the equivalent of 74mcg T4 (as in the T4 and T3 added together 9x4=36+38).

[Karen-Eleanor in reply to helvella]

I was under the impression that T3 x 3 gave the equivalent T4?

[helvella Administrator in reply to Karen-Eleanor]

There really is no equivalent that we can derive by using a simply arithmetic approach.

But using factor of 3 or 4 - or somewhere between - still gives a more likely result than the "official" conversion tables.

helvella - How much more potent is T3?

A discussion about the relative potency of T4 and T3.

helvella.blogspot.com/p/hel...

[Thursdays in reply to helvella]

Gosh! this takes some thinking & clearly not whilst cooking dinner 🙈, so will take myself off to a quiet room and consider all this advice later🥴, thank you both for your help.

[helvella Administrator in reply to Thursdays]

The simple version is that you can't plug a simple number in and get a definitive answer!

The rest is just an explanation as to why I say that.

[Karen-Eleanor]

Following on from my previous posts I’m now taking 75 mcg and 10 mcg T3 am and another 10 mcg T3 pm. I’m wondering if there is any benefit to splitting the T4 dose into 50 mcg am and 25 mcg pm to mimic the way my Armour Thyroid was taken.

Has/does anyone do this?

( apologies I’d duplicated)