I’ve just been sent some results by my private doc. She asked that I swap from 50 Levo/6 t3 at the beginning of June to 2 grains of armour. After 3 weeks I hit a wall and have reduced it to 1 grain and now 1/2 grain fro the past week as I just felt so awful on it. Any thoughts welcome.
TSH: 0.025 (0.27-4.2)
FT4: 10.4 (12-22)
FT3: 4.9 (3.1-6.8)
Vit d: 156 (50-250)
Folate 7.8 (>7)
B12 374 (145-569)
Ferritin 108 (30-332)
My testosterone and androgen index is under-range.
I wouldn't be surprised if two grains of Armour were somewhere towards a doubling of your previous dose.
We have seen several members consider one grain of Armour to be close to 75 micrograms of levothyroxine. But it is always more difficult to come to even a guess level when T3 is part of the equation.
I wouldn't be surprised if you found one grain closer to what you had been on than either two grains or half a grain.
But getting an over-dosed state down to acceptable levels, then adjusting the dose back up a bit, makes it difficult.
Yes, do these results look overdosed? I’ve never had under range ft4 before.
T4 does tend to go down with Armour simply because there is T3 as well.
Two grains of Armour would have 76 T4 and 18 T3.
Compared with 50 T4 and 6 T3 you had been taking.
That is, different quantities and a different balance/ratio.
I was assuming the test results were the last few days, but maybe I have got it wrong?
Thank you Helvella, yes, the test was taken on Tuesday of this week but I’ve been feeling awful since beginning of July and started decreasing armour, the last week was just a half grain so presumably t3 was higher than this before I reduced? Could an under range t4 make you feel unwell?
I've been very much hoping that those with personal experience would have started replying!
Not having that experience makes me reluctant to go very far when discussing desiccated thyroid. I'd ber surprised if some don't come along soon-ish. 
Many thanks.
I had under range T4 on NDT and felt bloody awful. Really dragging myself around and my OCD was worse.
Yes, I can confirm that. Interesting you mention OCD, I don’t have that but it made me feel like that - I couldn’t complete tasks, couldn’t think in a straight line - why is that?
I have since found my 'sweet spot' which is 150mcg T4 and 35mcg T3 so the 75 T4 & half grain Erfa simply wasn't anywhere close to what I needed.
My OCD was hormonal without doubt. Now I have thyroid and female hormone replacement optimal the OCD has disappeared entirely.
Thank you, I think the sex hormones are playing a big part in this and my T is under-range. The doc told me to stop supplementing T, no idea why as it was already very obvious that I was deficient. Hopefully I’ll get an explanation at the update. Thanks again, I certainly recognised the ocd thing.
I shoehorn it into any and every conversation that I can because I simply had NO idea OCD could be hormonal. If I'd known I'd have pushed harder for replacement. 🧡
I think you’re absolutely right to do that, I just couldn’t understand my behaviours, I was a totally different person which, in addition to feeling utterly crap with whacko thyroid levels, had no resemblance to being over medicated as detailed on here. I’ve gone from being someone who kept ALL the plates spinning to someone who couldn’t decide whether to take the washing out of machine or make a cup of tea and in which order. Absolutely wild.
That's me when I'm too low. I'm not far off that again now. I end up doing nothing because I can't decide what to do.
Am I too low according to the test results? Some people have said I’m overmedicated.
I know we're all different but I'd say you're wildly underdosed.
IMO, Even if we argued that you produce enough T3 without the need to convert T4, your T3 is still too low for your whole body needs.
Then if we factor in that you, like most of us, struggle to make T3 you'll need plenty of T4 to convert to T3... Which you don't have.
Some do well on T3 alone and don't need any T4, but you'd need much higher T3 to know that. 🧡
Thank you WitchingHour - I’ve sent the doc another email so will hopefully get a reply this week.
Good luck, Jammy.
You commented on my female hormones results ages ago which really galvanised me to push for HRT. 🧡
I really hope you're able to get sorted soon.
Thank you. Really pleased it worked out for you.
My Testosterone is also really low, but my hypothyroid symptoms worsened when taking a tiny amount. It's a bit like oestrogen in the way it can interfere with thyroid medication working. So my specialist told me to wait til my thyroid is more stable before trying it again. I've just started NDT just over 2 weeks ago. The specialist said people get symptoms of panic, anxiety, palpitations in the 1st 2 weeks due to the rise in cortisol and introduction of T3. Can you get some advice from your specialist about your NDT dose. My specialist says that I've not to make any changes for 3 months which is frustrating, but I read on here that someone felt rubbish initially on NDT but after a couple of months of sticking with it, they started to feel better. I hope you feel better soon. This condition is so hard to deal with.
Thank you Milburn13 - I’m going to email the doc again today as the update isn’t until 14th and I’d like some advice on how I feel/what to do before then. They sent me the test results with a note attached saying ‘FYI to be discussed at update’. I’m not sure that’s good enough. I didn’t ever have feelings of panic or anxiety in first 2 weeks but I did feel a bit better, then the 3rd week happened, and I couldn’t continue with 2 grains.
Hey WO2.0 🤗 may I ask where your ft4 is along with you ft3 where you feel well? Do you split your dose? Thank you🙏
WitchingHour2point0 should get their attention. Hidden from view in this reply, Incoguto , is how placing an @ symbol before a username turns it into a "summons".
Thanks Blue, because she replied to my comment I still got an alert.
Hi Incoguto,
My current results are
TSH: <0.01
T4: 19.3 (11-22) 73%
T3: 6.3 (3.1-6.8) 89%
I used to split my dose 100/20 & 50/15 wake up and around 3pm.
I got a bit overwhelmed with it though once I added in HRT (estrogen twice a week, progesterone 14/28, and testosterone every other day) as well as well as life and kids and dogs. 😂 So I'm currently trialling full dose on wake up.
I still have a few niggles but I honestly don't think I've ever felt this well. And as I've said upthread my OCD has entirely gone. I got to a point where I was having upwards of 5 panic episodes every day... In all honesty it was likely every hour.
I am, finally, well enough to live the life I want to live. 🧡
I really appreciate your reply ❤️And I'm so glad to hear you're feeling so well!
Did you feel like you needed your ft4 highish? Have you ever tried t3 only? Don't wanna hijack this thread, but I'm currently moving to t3 only and still unsure at times if this is the right thing I'm doing x my ft4 is always lowish
I've never been T3 only. When my T4 was 11.6 by T3 was 5.4 so pretty decently high and I felt wretched so it was enough to confirm for me that I needed T4 as well.
It's all experimenting, which is so frustrating. You won't know if it works or not until you do it but I don't want to do it if it won't work! 😂
You’re right about the experimenting WitchingHour and my latest experiment seems to reveal, like you, I’m better with higher T4 levels. As yet another experiment is in progress, time will tell..
When was your last dose before the test and how much did you take?
The biggest things standing out to me is your much less than optimal B12 & folate. Do you have a problem taking a B complex? This may be why you couldnt tolerate more Armour.
Vit D is a tiny bit on the high side so you could afford to drop that back just a little. Aim for 100-150.
Ferritin looks good.
B complex suggestions: Slightly cheaper options with inactive B6:
amazon.co.uk/Liposomal-Soft...
Contains B6 as P5P an active form:
bigvits.co.uk/thorne-resear...
healf.com/products/basic-b-...
Explanation about the different forms of B6:
helvella.blogspot.com/p/hel...
B complex comparison spreadsheet:
healthunlocked.com/thyroidu...
Thank you Jaydee - I took my last dose of half grain 12 hours before the test. I’m occasionally sporadic with my igennus supps, I’ll try to be more regular. I don’t have a problem taking it.
It looks like the B complex is very important for you. Likely you will need the full dose of 2 tablets per day.
Thank you, would it be worth getting a bvit shot?
You could certainly do with a big boost so probably yes.
Many thanks.
Other than a b12 shot what is the best supplement for folate?
There are separate folate supplements. You could buy a 400mcg methylfolate and take that as well as the B complex for a while.
Ok great, many thanks.
In my opinion your private doctor got your starting dose very wrong. Two grains contain 78 mcg T4 and 18 mcg T3, so 150% of the T4 you had been taking and 300% of the T3 you had been taking! Added to that, it isn't always easy to swap from synthetics straight to an equivalent dose of NDT anyway, let alone to a higher one.
I was taking 125 mcg T4 plus 40 mcg T3 when I was switched to 1.5 grains Armour (57 mcg T4 and 13.5 mcg T3) and told to increase it by half a grain after 10 days, and then by a further half a grain every 3 weeks, until I reached 3 grains (114 mcg T4 and 27 mcg T3) and then reassess. This was the regime given to me by Dr Gordon Skinner who was extremely knowledgeable about Armour. It was a frustratingly slow process, but it worked. In your case, on your previous dose of synthetics, this would translate to starting on half a grain for 10 days, then 1 grain for 3 weeks, then 1.5 grains for 3 weeks and so on, reaching 2 grains after 7 weeks. Some people may even need to increase by a quarter of a grain at a time. It could be that you wouldn't need 2 grains, or that you may need more, but titrating it slowly like this means you have a good chance of working out the correct dose.
My guess is that taking 2 grains for 3 weeks will have affected your adrenals as well as overdosing you, and you need to stabilise them as well as your thyroid levels. On a couple of occasions in the past, when I had been on a stable dose of NDT but felt overdosed and got the awful adrenal reactions, I stopped all thyroid hormones for a few days, then restarted on a low dose and built up again over a week or so. This may not work for others, and isn't necessarily advice, but it worked for me.
Have you told your private doctor how you've felt and how you've had to alter your dose, and if so, what did she suggest? I'm really curious why any doctor, used to prescribing NDT, would start someone on a higher dose than they were already taking without at least warning them to stop if they felt at all ill.
Thank you Framboise - I agree entirely with what you have said, the dose was way too high, way too soon and it has affected my cortisol. Luckily, because I’ve been fiddling around with self medicating and testing (not recommended) I now recognise the symptoms quite easily. I’m absolutely furious with the doc, I emailed her at week 3 when I really just couldn’t keep taking 2 grains, as day on day I felt much worse, that was about 2 weeks ago and I haven’t heard anything other than another invoice for bloods and the follow up appointment. They’re very efficient at invoicing. As I’ve paid upfront for the follow up, I will attend that (zoom) although I’m not sure 15 mins will be enough to convey my anger/disappointment. I know this set-up, I’ve been through it with a menopause specialist, it’s greedy docs recognising a gap in the market and taking advantage of people who are really unwell. Her parting shot was ‘keep taking the adrenavive as you may crash on this dose’, how reassuring.
I did encounter a sweet spot of sorts around week 2 when I felt good, thought armour was ‘the cure’ and things were on the up, so I’m stopping armour for a few days and starting with 1/4 grain and will follow your and other posters advice on increasing.
Thanks again, I feel I’m getting more useful advice on here, free of charge, it’s really not about the money, it’s about the hand holding you expect, at least a return e-mail.
Dr Peatfield had me on all the adrenal supporting supplements for a few months before introducing Armour way back in the day. Then he started me on 2 grains. Day one - felt fantastic. Day 2 - anxiety hit like a brick wall. I was all over the place after that. I still really liked and respected him though. He was a great doctor. He got my starting dose wrong. I guess we are all different. Especially depending on how long we have been suffering and how much stress the adrenals have been under.
Thank you FancyPants, yes I understand what you’re saying but this doc said ‘most women do well on 2 grains’. Maybe they do, but this woman didn’t and when you’re at the point of not functioning, it would be expected that any doc who is treating you private or nhs would have the courtesy to return a call/email. I really do understand the complexities of treating this condition, I have personally tried and failed, paid numerous times for numerous diagnosis and am now at the point where I think I know what’s going on in terms of adrenals so, like your doc, I’ll work from there.
But I never had a saliva cortisol test as bad as yours. That's very low. That should have been a red flag to the doctor to go very slow and careful. It's not the 2 grains that's upsetting you, it's the cortisol reaction.
Yes, I think you’re right and she’d seen my latest cortisol results. Her advice was ‘keep taking the adrenavive or you might crash’. Really not good enough.
No, not good enough.
Fancy pants - did you have a preference in terms of adrenal support, did you find one more helpful than the other?
No. I only used NutriAdrenal and I haven't used them in years now.
It would be interesting to know what response you get from the private doctor when you've had the Zoom meeting with her. I do hope she apologises! I'm rather concerned that you had to pay in advance for the follow up appointment, I don't like that. I saw a private doctor a few times who'd do a lot of peripheral tests (vitamins etc) then require a full appointment to tell me the results, when he could simply have emailed me. I didn't stay with him long because he wasn't good in other ways too.
Are you feeling any better yet? I don't know where you found this doctor but I'd suggest that you let TUK know about your experience in case she's on their list, then a comment can be put next to her name.
Hi Framboise - I've already had the update, the doc was kind enough to make it first thing on Tuesday after I'd e-mailed and left phone messages on Monday. It was entirely disappointing, she didn't have the most recent bloods in front of her, or my most recent cortisol, nothing actually so it was an exercise in saying ndt isn't for me (nothing about the dose), and offering me 3 other options which I had to choose! What? The entire point of paying her was for expertise, none of which was forthcoming. It felt at times as though she was blaming me and covering her tracks, she suggested DHEA and I'd already discussed this with her at the 1st meeting, when I told her that she mocked my tone. This, and a variety of other factors made me decide to just leave it, I could see what was happening.
I stopped all thyroid meds for 4 days and started 1/4 armour and 50 levo yesterday and I feel pretty good today, albeit a bit racy. I know this probably won't last but it's the most clear headed I've been in almost 2 months so I'm going to test thyroid every 2 weeks because I want to see what happens on the way down with armour and including levo, just as a record for myself. My gut instinct is that I need my t4 higher, where, I don't know.
I know this doc is well liked by other members who are possibly more straightforward than me and I don't want to rock the boat on that.
You are wise to have reduced your dose. I found I had to start on 1grain for at least 2.5 weeks, then started to increase gradually to 2.5, then 1.75 ( had to order quarter grains - expensive, and split 1 grain tablets. It has taken me 6 months to get to the stage where I feel well on just under 2 grains . With changing to Armour, I found I had to keep increasing the dose very slowly. I did it on the advice of a lovely member of this Forum. The good thing is that my eyesight has improved since being on Armour. I am not sure if anyone else has experienced it.
Be patient, Armour plus core vitamins are likely to help. Good luck!
Thank you Britpol - I really had no option other than reducing as I just couldn’t function - this type of sink/swim approach is absolutely not ok. I’m stopping thyroid entirely for a few days and will restart on 1/4 grain and increase from there. I think I can make it work as I did feel well, albeit briefly, on the way, albeit speedily, up. Thanks again.
Very wise . We are all different; my husband moved from Levo to 1 grain Armour for a month and then moved to 2 grains . May daughter went to 1 grain fir 3 days and then to 2 grains. She said she thought she was going to die because her symptoms were so severe but was advised by her prescriber to push though it and then she started to feel better. All three of us are now doing well on Armour, but I had to introduce it very slowly . If you start feeling hot and your heart rate is too high and cannot sleep. you reduce it for a while, before the next increase. I know a number of people who feel ok on around 2 grains. Once you are settled on the dose that is good good for you, note that Physical exercise increases demand for the hormone so if is worth to have a quarter grain in reserve, if you need it. Good luck!
Many thanks, this is very useful. I think my doc’s approach was tonpush through but I’m afraid I just couldn’t, I don’t have a life where I can sit staring at the walls for hours on end, I’m self employed and need to be able to think clearly, at least for a couple of hours a day. Decision making is also a preferable asset.
Hey there again :
I cant really add much to what I've previously written -
On NDT you must start low and slowly increase - I would have suggested 1/4 grains weekly as this is what I did - and believe I've detailed all this previously.
On NDT you track on the T3 and the T4 can go much lower than when you were on synthetics and this does not matter - if well and feeling improved - -
Currently you are only taking 1/2 grain - 4.50 T3 + 19 mcg T4 - and not on a dose of any consequence -
I did and do think the original advice given to you was a bit ' gung ho ' :
Thyroid hormones take time to settle in the body - even synthetics -
NDT must seem even slower and lower to take effect -
I think you have taken synthetic T3 before - what happened with building up this T3/T4 combo dose ?
Thank you pennyannie - I did as I was prescribed and it was the wrong, expensive ‘advice’ particularly when the doc knew I had low adrenal output. As I’ve detailed above, I will stop all thyroid hormone for a few days and re-introduce at 1/4 grain. In previous combo experiments I found 9 T3 too much so that may/may not be where I end up with armour, I don’t have a conversion problem and I don’t know if this has an impact with NDT, and if I might need to add Levo to it as I certainly do not feel well on these levels.
Hey there :
You don't need to have a conversion problem to take NDT -
Roll back 50 odd years and NDT was the treatment option for hypothyroidism and has been successfully used to treat for for over 100 years -
it only stopped being prescribed when Big Pharma launched cheaper synthetic treatment options - T3 - Liothyronine and T4 - Levothyroxine - and went about gaining market share.
The ratio of stated thyroid hormone in NDT is - 1/4.22 - T3/T4 - 9mcg T3 + 38 mcg T4 which suits very many thousands of people -
though there are some who find that when very close to optimal and this elusive ' sweet spot ' - find they need to just add a smidgen of T3 - or T4 - to meet their needs - but I wouldn't think you are anywhere near fine tuning your dose yet.
I'm still thinking - so on T3 you couldn't get past 9 mcg - so I wonder if we need to be looking more closely at your adrenal function ?
I also take adrenal glandular and started these 2 years before i switched to NDT - I know they made a difference after 3 months of taking them and continue to do so as well as take NDT.
Thank you pennyannie - yes, I have well documented low cortisol output all day (saliva and SST) which rises at night, this has been going on for 4 years, I explained this to the doc and she told me to keep taking adrenavive as 2 grains might make me crash - well she got that bit right. I’m still taking adrenavive although I feel much better taking hydrocortisone, but I’ll keep going with adrenavive and slowly introduce armour.
My issue is I don't know about the hydrocortisone / cortisol - end of things - as I was 'sorted ' relatively easily once my core strength vitamins and minerals were optimised as my adrenal glandular was already then 2 years in place -
Did your SS Test come back ok ?
If not what was suggested -
Thinking on as i need to go out now :
Yes, I passed my SST, it’s not primary adrenal, but the levels are low throughout the day.
Armour has made my T4 drop too low in range for me. I don't feel well without some of it, so I am adding a bit to my Armour. If you try that, the prescribing pharmacist at Roseway Labs advised me to stick with a dose of added Levo to the Armour for 12 weeks before retesting. She said a number of her patients have found for some reason that it takes longer for everything to level out when adding these 2 hormones together. So I'm doing that.
Thank you, my instinct is that I need my ft4 to be higher, before the test I just felt ‘off’ really weak and fatigued, unable to focus and crashing a lot. I felt almost as bad as I did 4 years ago at the start of this. I recalled the day of the consult when I felt much brighter, a sense of humour, a bit brain fogged but someone resembling me, now I’ve no idea who this person is.
Oh poor you Jamima,
You should have been able to do a straight switch over to Armour as were already medicating both thyroid hormones but I agree with others regarding 2 grains being excessive when you were previously dosing only 50 Levo + 6 T3.
That sudden increase will not only have stressed adrenals but increased binding proteins to protect you from over-stimulation. Hence by the time you reduced your dose by half, much hormone is remaining bound and your labs now show your 'frees' as too low and under-dosed.
Do not reduce to just a quarter grain Armour as this will make you further hypothyroid and feel simply awful. I'm not sure why you have switched to Armour as synthetics give you much more control over the T4:T3 ratio and Armours does not match your previous dose. You also say you do not have a conversion problem.
Therefore, if this were me I would take 1 grain Armour (38 T4 + 9 T3) although you may eventually have to add some Levo back in and reduce Armour if T3 amount were to prove too much. Several members (me included) have had to add Levo to their Armour as have found it too T3 potent.
You will need to remain on 1 grain Armour much longer than the usual six weeks before further testing or dose adjustments, say 3 months to allow hormones and protein binders/carriers to re-right themselves. Some binders that carry thyroid hormones also carry other hormones that will have been influenced. It will take time to reverse the mistake of your endo but it will right itself with time. I agree you should continue with your adrenal supports.
Thank you Radd - yes, 2 grains was way too much, I never felt overstimulated, just briefly ‘normal’ around week 2 and then staring at the wall unable to think from week 3 onwards, I know that’s adrenal. Would stopping for a few days allow the bound hormones to stabilise? I switched to Armour as it’s the only thing I haven’t tried and the doc asked if I’d like to try it. My gut feeling is I’m better with t4 higher in the range and should add a small amount of Levo to an armour dose, just not sure what the armour dose should be or when to add Levo. Right now, I’m just taking adrenavive and vits, trying to increase b vits and I’ll re-start armour in a few days. I actually feel quite clear headed this morning although I crashed yesterday and slept for 2 hours - go figure.
Jamima,
'-go figure'
It’s because you keep changing your dose. You need to decide which med you want to try and stick with it for 3 months.
At present your FT3 labs are way more than T4 frees. However, if you add Levo at this stage you risk raising FT3 levels further because you say you don't have troubles converting.
If you are happy to stop Armour, then Levo + T3 synthetics would likely be the better choice as you can titivate T3 doses to exactly the level you feel best, with the knowledge that T4 is working steadily in the background. That or reduce Armour to 1/2 grain and add Levo but as said I would recommend waiting until hormones re-stabilise.
I need T3 but only a small amount to aid with further T4 conversion. Initially I medicated 20mcg but as everything improved I have had to reduce to just 1 grain Armour (containing just 9 T3) and have added some Levo. Our needs change over time but initially you must remain on the same dose to establish whether your dose is correct or requires titivating.
I do feel sorry for you as when hypo its awful and difficult to think straight 🤗.
Thank you Radd, I haven’t switched over the past week and honestly I’ve done it because I'm just not brave enough or stupid enough to take something I know will make me crash 2 hours later. I KNOW it’s making me unwell through no fault of mine, I’m paying A LOT of money for someone to put me in this place when I could quite easily have done it to myself, for free. Right now, I’m mopping up the mess a doctor put me in. So thank you for the encouragement and advice, but really saying it’s my fault is a bit much for me to take.
No, it's not your fault Jamima, you were simply following an uneducated Drs advice 🤗.
What I'm saying is to go against that advice but stick with one dose and med of your choice to allow all hormones to re-stabilise. This can take months but 3 is a good aim when you are hypo. Once there you can titivate dose according to new labs. If symptoms don't reduce once dose is looking good, then you can address other influential factors such as sex hormones, etc (eg testosterone).
I know what it's like. Most/all of us have been there at some point ☹️.
I am prescribed Armour by a private Dr. I wasn’t treated by NHS so I cannot compare experiences there because I built up slowly from zero but it’s a good 6-8 weeks needed on every dose adjustment. I did feel worse initially, after a few weeks I started to pick up. When the good feeling drops off I go back to Dr and my dose is upped. But if you’re having awful side effects it’s best to discuss with the Dr, email in and get advice. It’s took 9 months to get to a steady dose of one and a quarter grain. HTH
Thank you Insomania - I was entirely in the doc’s hands on this one, I’d provided recent blood tests on no hormone and 50 t4/6t3 and she decided on this route. Like you, I agree it should have been a slower, steadier pathway, particularly because I have low adrenal output which she was well informed on. I’m not sure how I will proceed with thyroid hormone, my initial thoughts are to stop entirely and have monthly tests to see where I am and how I feel before I add anything back. I’m going to work on adrenals and b vits in the meantime. At the moment I feel toxic. I agree with your approach.
Post TT blood results
Need Advice Please 
Increased anxiety…
Menopaused. Would starting HRT mean reducing NDT? Has anyone experience of this please?
