Opinion requested on recent issues and dose increase

[deniseross]

Hello,

I recently am feeling awful. I am concerned that one of my meds is defective but also I recently tried switching to taking them in the evening. I don’t think I was very compliant with meal spacing and this may have been the cause of the problem. I was doing pretty well for awhile and then 9 days ago just started feeling nauseous, fatigued, had a lot of post-nasal drip and shortness of breath. I may have had some virus in there mixed in with hypo symptomes. Caffeine had very little effect on energy levels. I also just feel odd, not emotionally depressed but physically so. I wake up after 5-6 hours sleep with a rush of cortisol, hard to catch a breath, flushed, anxious, pulsatile tinnitus. I had this in the past in late perimenopause but it has been very controlled with HRT since I found a good balance. I think it is the thyroid being a bit low too long but maybe not. Have also had a lot of job stress and had just came out of a 70 hour work week prior to this flare up.

Decided to raise my Armour Thyroid another ¼ grain 5 days ago and switched back to morning dosing. I felt some improvement but I know I can’t expect full results right away. I usually have a good week and then feel awful for a week or so and then level out.

I am just wondering if I did bad. Too much change at once? Or would others consider that these levels have been subpar for long enough that a little raise in dosage is fairly well indicated?

Appreciate your viewpoints and I have included the recent dosage and lab history below:

June 4, 2024: TSH - .34 mlU/L Free T3 – 2.9 pg/ml Free T4 - .9 ng/dl

In June 2024 I increased my Armour Thryoid 25 mg (1/4 grain)

I was taking 75 mg (1 ¼ grain ) + 75 mcg Synthroid for 6 months and had these results:

July 30, 2024 : TSH - .1 mlU/L Free T3 – 3 pg/ml Free T4 – 1.1 ng/dl

September 20, 2024 : TSH -.14 mlU/L Free T3 – 2.9 pg/ml Free T4 – 1.2 ng/dl

January 3, 2025: TSH - .12 mlU/L Free T3 – 3.3 pg/ml Free T4 – 1.2 ng/dl

January 27 forgot meds on trip, went a day without and switched to evening doses after that when I got the meds. I had wanted to try that and got the meds late so did it then. However, after that, I wasn’t as good about meal spacing as I should have been.

February 17, 2025: TSH : .2 mlU/L Free T3 – 2.9 pg/ml Free T4 – 1.1 ng/dl

T3 Reference Range: 2.3-4.2 pg/mL

T4 Reference Range: 0.8-1.8 ng/dL

Also of note is my ferritin is quite low at 27 ng/ml. Was 16 in 2021. I take supplements but struggle to raise it. (Ferritin Reference Range: 16-232 ng/mL)

[Regenallotment Ambassador]

Hi there, sorry you haven't had a reply in a while.

I've put your results and ranges for Feb into a calculator online (do you mean Feb 2025 or 2024, your message says 2024 but the context suggests these are the most recent?

Free T4 (fT4) 1.1 pmol/L (0.8 - 1.8) 30.0%

Free T3 (fT3) 2.9 pmol/L (2.3 - 4.2) 31.6%

T4:T3 Ratio 0.379 

Jan 2025

Free T4 (fT4) 1.2 pmol/L (0.8 - 1.8) 40.0%

Free T3 (fT3) 3.3 pmol/L (2.3 - 4.2) 52.6%

T4:T3 Ratio 0.364 

You say you raised armour by 1/4 grain but what is your total daily dose?

Hopefully answers to these questions will help you can see the Feb results are onlly 30% through range.

What time of day was the test? Had you taken a dose that day? How long since previous dose?

[deniseross in reply to Regenallotment]

Hi there, thank you for answering. Good thing is that I am in U.S. so to me the reply was very quick as it is only 10 am here for me, ;).

I fixed my bad date, yes, last results listed were Febrary 2025.

My total daily dose would now be:

75 mcg Synthroid (always name brand) + 90 mg Armour Thyroid (ie. 1.5 grains)

Test was taken in morning while still on lower dose (75 synth + 75 ndt) . I always test in the morning before food or dosing per instructions on this site and all other savvy advice.Last dose had been take 24-26 hours prior.

So, yes...when you really lay out the math for me like that it does seem very obviously insufficient; even in January when I was at my best.

I suppose I have known this all along as I am good at math but I just needed to post here and get a little validation. My doctor is very flexible and sort of lets me guide the process because I think he trusts that I am possibly more savvy than him on this and plus it's my body...I'm the one feeling the results. I ended up with extra 1/4 grain pills and figured I'd try it.

Another question I have is that this crash really came on quite suddenly. I went from doing quiet well to awful almost overnight. I wonder if there is any connection to the fact that I had recently gotten some new bottles of all of my meds. How would I know if there was a bad batch?

[Regenallotment Ambassador in reply to deniseross]

Could it be the batch… maybe but hard to test that

Could it be being under replaced - yes

Could it be that your getting is stubbornly low - yes

Could it be you just had a really tough time at work - 100% yes

You need a bit of TLC and a strategy to up your levels 🙏🤗

[marceen]

Synthroid is T4 only, but yes I always wonder about armour. It is not covered with our health insurance here in the US, nor is it FDA approved. But still...........I get very tired in the afternoon and the company that makes synthroid does have a T3 version (not the bovine kind) It is always a good idea to check your PTH and calcium in your blood....my doctor delayed on that and I now have osteoporosis......I (my choice) had surgery for only one bad parathyroid and all is level now.......such a big miss by the doctor..........

[deniseross in reply to marceen]

I didn’t know about PTH. Thank you for the suggestion, I will look into it. My last calcium test was good. Last checked and I am planning on doing a bone density test soon.

I take estradiol in hopes that will help too .

I did try using straight T3, but never had a good experience even after a few attempts to make it work.

I too am in the US; that’s lame that that your insurance won’t cover Armour. Mine does to some degree.

[Sweetpeas-Mom]

Hi there! I’m only on Synthroid .125 but I do know that ever time I get sick my numbers get very wacky. It usually takes me a few weeks to feel back to normal. I have also taken my meds at night if I’d not been well or whatever and I never noticed any changes in my numbers or how I feel. So I’m just wondering if you had a slight virus or something that caused some of the symptoms you mentioned.

[deniseross in reply to Sweetpeas-Mom]

I think I might have had a virus. There is an norovirus going aroundAnd it is true sometimes it feels like everything goes way off balance when that happens. This was pretty bad though this time. But with the checklist of other factors, all put together added onto a virus I am not surprised. I guess that everything got really ‘wacky’. It made me feel like I should go on medical leave. But I am feeling improvement. The nausea and shortness of breath are mostly gone, and that seems to have been an indicator that more was going on because that’s not common for me.

[marceen]

if calcium is "too" high, it would mean it is sucking it "out of the bones" The issue here is osteoporosis not necessarily the thyroid hormones. Parathyroid has a totally different function.......