Armour dosing advice

[ThyroidFrazzled]

Hello wonderful community,

I have Hashimoto (or more accurately, Ord's). I am a poor converter from T4 to T3 and am quite symptomatic.

These are my latest labs from Medicheck:

TSH 1.41 mIU/L (Range: 0.27 - 4.2)

Free T3 4.1 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 18.7 pmol/l (Range: 12 - 22)

My Folate, Vit B12 and Ferritin are fine, Vitamin D needs to be increased slightly, I am doing that.

After many years on 100 mcg Levothyroxine, I have now been prescribed Armour 60 by a private endo.

I have stopped Levothyroxine as per the Endo's instructions. I have started with half a grain of Armour twice a day (30 and 30) and should work my way up gradually to 2 and a half grains a day.

I've been on half a grain twice a day for a week now. No side effects.

Here is my question:

Does anyone have any particular advice re how I should do this gradual increase?

I realise I need to play it be ear and that there is no one right way to do this - I must follow my symptoms and monitor for side effects. But does this sound logical to start with:

For example, increase to one grain in the morning and keep half at 3 pm, in this second week?

And if that goes well, increase the midday dose from half to one grain for the third week?

And finally add the extra half grain (to reach 2.5 grains) in the fourth week, if side effects are manageable?

My next appointment with the endo is in 2.5 months.

Many thanks

[greygoose]

I think that would be much too fast! It's often recommended not to increase by more than quarter grain every two weeks. Why are you in such a hurry to get to two and a half grains? You could find yourself back at square 1 going so fast.

[ThyroidFrazzled in reply to greygoose]

Thank you ! I'm not in a hurry at all- that's why I'm asking here. I wasn't given guidelines on how fast or slow to do it.

Its quite hard to cut the Armour tablets into even halves, even with a pill cutter. Not sure how I would manage to get quarters, but I'll try.

Thanks again

[greygoose in reply to ThyroidFrazzled]

Doesn't much matter how even the pieces are because you'll be taking them all, anyway.

Very few doctors have any idea how to dose NDT, so that doesn't surprise me.

[ThyroidFrazzled in reply to greygoose]

Thank you

[greygoose in reply to ThyroidFrazzled]

You're welcome.

[pennyannie]

Hello ThyroidFrazzled :

The T4 will take around 6 - 8 weeks to fully leave your body so you need to start low and slow as as T4 reduces in your blood stream you replace with full spectrum thyroid hormone replacement.

I increased by dose of NDT by 1/4 grains every week - monitoring myself on blood pressure, pulse and body temperature AM & PM - daily along with symptoms relieved along the way.

I read, if you get to to 2 grains you then hold this dose for 6 -8 weeks and then run a blood test to compare to your T3 and T4 blood tests results from before starting this experiment.

If T3 hasn't moved very much and you are still with your symptoms - maybe NDT is not the best treatment option for you at this point in time.

If your T3 has moved and improved and some symptoms relieved but you are not quite 'there' yet repeat and carrying on again slow and low increases.

There comes a week when you will feel a little uncomfortable in yourself, maybe edgey, nervous and just not as good as the week before so you simply drop back down to the previous weeks dose - stay on that dose for 6 - 8 weeks and then run a blood test - and this likely your best dose on NDT.

Your TSH will likely be low suppressed - but this does not matter - your T3 should be higher than when on T4 monotherapy and your T4 maybe lower than when on T4 only and that's ok if you feel good.

No thyroid hormone replacement works well until your core strength vitamins and minerals - those of ferritin, folate, B12 and vitamin D are up and maintained at optimal levels - which we can advise on if you have some current blood tests you care to share with forum members.

Having Hashimoto's you are liable to own erratic thyroid hormone production so it may not be a straight line - I read some with Hashimoto's do better on Efra rather than Armour as it is said to contain less fillers -

I only take NDT once a day - and my temperature slowly rose from 35.40 to 36.60 - which seems to be my normal as its now 7 years later and it still hangs around there -

and my T3 and T4 blood tests results totally switched places and now my T3 at around 90/110% through the range with a T4 at around 25/30% through its range after a fasting blood test drawn around 10-12 hours after my last dose of NDT.

[ThyroidFrazzled in reply to pennyannie]

Thank you Pannyannie, this is very helpful.