Feeling worse on Armour

[Milburn13]

I started Armour 5 weeks ago after taking 87.5 levo and 10 Liothyronin. Taking 2 grains, 1 on waking and the other in the afternoon. For the first 3 weeks my health started to improve a bit however it has got worse over the last 2 weeks. I've changed to taking both grains on waking. I'm hoping that it's just going to take a bit time to work & a few weeks to feel the benefit of taking both grains first thing in the morning.. My pulse has been staring to go up which is a good sign. My thyroid doctor says she doesn't expect me to feel any better by October at my next appt.

Just wondered if it's normal to feel a bit rubbish when starting Armour and how long it took people to get better on it.

Thanks

[SlowDragon Administrator]

Is your hypothyroidism caused by autoimmune thyroid disease aka Hashimoto’s

What are your most recent thyroid and vitamin results and ranges BEFORE changing to Armour

Did you always get same brand levothyroxine at each prescription

How long on 10mcg T3 and did you split dose

Exactly what vitamin supplements are you taking

Always test early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

If you have Hashimoto’s are you on gluten free/dairy free diet

[Milburn13 in reply to SlowDragon]

Hi, thanks for getting back to me. I don't have Hashimotos, I have had suspected Lupus or Lyme, Mcas and Anti phospholid Syndrome (APS- sticky blood) for 15 years. So I have been on dairy and gluten free diet for a long time to help. I have a basic healthy diet to reduce these symptoms . I've generally only drank water over the past 2 years as was more reactive to things and have recently just started drinking weak peppermint tea. My body has problems absorbing nutrients.

I took the 10mg T3 in one dose for 9 months prior to starting Armour. I built up to this 10mg dose gradually. I tried split the dose but it didn't help. I always took liquid teva Levothyroxine and never missed a dose. There was a change to the bottle packaging earlier this year and it tasted a bit different. I usually get tested about 9.

I also took an adrenal bovine supplement from nov 23 and it helped but I stopped this in May this year.

I'm late 40s and my sex hormones are very low. I started projestorone in June. I have managed to introduce some more foods to my diet since.

My T4, TSH levels were almost optimal in Jan this year and I had a levo increase and then my T4 and t3 levels dropped and my symptoms worsened.

So Prior to starting Armour in July my levels were

T3 4.2 (3.1-6.8)

T4 15.1 (12-22)

B12 93.9 (37-188) this increased since previous test

Folate 32.1

Vit D 81.7 (50-250) this has gone up since previous test- I have taken vit D since it was thought I had lupus 15 years ago- I have problems tolerating vit k and vit k foods.

Ferritin- 136 (30-207) this has gone down by 30 since previous test.

My Selenium, Magnesium, Zinc and Calcium are low. My copper and potassium are high. I take selenium, zinc, enzyme Q10, omega, vit D, magnesium, b12, b6, b complex, vit C.

Thanks, there's a lot going on!

[SlowDragon Administrator in reply to Milburn13]

You have other autoimmune diseases, so it’s possible your hypothyroidism is autoimmune

ever had ultrasound scan of thyroid

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

poor nutrient absorption and low stomach acid typical hypo issues

So Prior to starting Armour in July my levels were

T3 4.2 (3.1-6.8)

T4 15.1 (12-22)

Was test done early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

Assuming yes

Free T4 (fT4) 15.1 pmol/L (12 - 22) 

Ft4 only 31.0% through range

Free T3 (fT3) 4.2 pmol/L (3.1 - 6.8) 

Ft3 only 29.7% through range

Shows you were very under medicated

Most/many people on Levo plus small doses of T3 find they need both Ft4 and Ft3 at least 60% through range minimum

Most common doses probably 15mcg or 20mcg T3 per day alongside levothyroxine

[Milburn13 in reply to SlowDragon]

Thanks so much, that's interesting

[pennyannie in reply to Milburn13]

Hello Milburn :

Considering you have an absorption issue and needing to take liquid T4 -

maybe grain/tablet form NDT is not the best option -

I read a compounding pharmacy can just use the Thyroid USP powder in a capsule form -which you then swallow down with water -

with some choosing to break open the capsule and just swallowing down the powder mixed with some water.

Your July readings when on synthetic T3/T4 are too low - we generally feel best with the T4 up towards the top quadrant at around 60/70% with the T3 tracking behind at around 60% :

[Milburn13 in reply to pennyannie]

Thanks that's really helpful.

[greygoose]

I would have thought that going straight onto 2 grains was rather a large increase in dose - that's an increase of 8 mcg T3. It might have been better to start on 1.5 grains of NDT.

[FancyPants54 in reply to greygoose]

Hi Milburn13 I agree with greygoose , 2 grains was too strong a start for you. I would have started on 1.5 grains and worked up slowly. I also don't think taking it all at one go is a great idea given the way you have been feeling.

My recommendation would be to reduct now to 1 & 3/4 grains, split morning and afternoon and see how you feel in 2 weeks time. I'm no suggesting go back to 1 & 1/2 grains now you have been on Armour for a few weeks. Just drop back 1/4 grain and let it settle. You can go back further if necessary, but it's important not to jump the gun and miss your ideal dose.

[debjs]

I have taken Armour for 12 years. As others have said going in at 2 grains was perhaps too much. I found I had to make any changes very slowly & split my dose over the day. Also found it better to chew tablets for maximum absorption. Took a while to find what suited me.

[Hidden]

You’re now takin 18 mcg T3 in 2 grains of Armour so you’ve increased T3 by 8 mcg - quite a jump.

I think I’d have been inclined to start on 1.5 grains Armour. I know from experience that changing from a Levo/T3 dose to NDT isn’t as easy as we might think. I know that 1.5 grains reduces the amount of T4 to 57 mcg instead of the 87.5 mcg Levo that you’ve been used to …. It’s a hard call but bear in mind that the Levo will be washing out of your system for a while and sustaining the decrease in T4 so by the time you’re ready to increase to 2 grains things should be more stable.

I changed to 2 grains NDT in 2018 and was overwhelmed by symptoms of excess T4. If I could do it again I’d change to 1.5 grains for 2-3 weeks.

I take all my NDT in one morning dose. Unlike T3 (Liothyronine) NDT doesn’t “like” being split. Like the last poster, I chew my NDT and swallow with water

I wish you well.

[Milburn13]

Thanks, I'm going to start chewing them 😊 I have felt a slight improvement since taking the one dose. I was a bit shocked that the specialist told me to go straight to 2 grains, but I don't think my body would cope with even less t4. I have hypothyroid symptoms so I don't want to decrease. My pulse has increased to low 50's which is progress. I get a sense the NDT is a big change for the system so I'll give it a bit more time. It's such a complicated condition! Thanks 😊

[pennyannie in reply to Milburn13]

Try monitoring yourself on blood pressure, pulse and body temperature just twice a day - once AM and PM - whilst these first 2 remained constant - I tracked my temperature rise from 35,4 to 36.6 where is still hangs around some 6 years later.

The T4 synthetic will take around 6-8 weeks to fully leave your body and in that time frame you slowly build up the NDT - in 1/4 grain doses weekly/fortnightly - so as 1 treatment option reduces another starts increasing so there is as smoother a transition as possible.

Oh, shucks, why didn't I suggest chewing - an obvious first and hopefully your solution.!!

[Hidden in reply to Milburn13]

I too was told to go straight to 2 grains. Quite a nightmare when I followed that advice. It wasn’t T3 that was the issue - I’d been on 20 mcg T3 (a higher dose) with 75 mcg Levothyroxine so it was almost a straight swap. My issue was that until ‘washout’ was completed I was being dosed with 151 mcg T4 and 18 mcg T3. I felt incredibly ill.

Tbh if I had to do it all again, I’d take no meds at all for a few days and then start the 2 grains. Most certainly not suggesting that you do that!!

I think the ‘long and slow’ approach is needed with people who are transferring from Levo only medication and whose bodies have never experienced the high impact of T3 only medication.

It’s such an immensely difficult issue. I was steered through the hell by an admin on this forum  Clutter who no longer has admin status and no longer contributes although she is still a member. I shall never forget the acquired wisdom and knowledge which she shared with me and so many others and which has never been replaced.

[Milburn13]

Thanks, I hope you're right and that chewing is the answer!😊That's really interesting. Are you well at 36.6? I do take my pulse, temp and BP daily, it's a good way to track it.

Thanks lots

[pennyannie in reply to Milburn13]

Yes if you are referring to me - always make sure you actually reply using the other forum member reply icon otherwise it's pot luck if they read any of your messages.

Yes, I'm much improved - NDT does take time to settle in the body - so just go low and slow :