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Programme for Increasing NDT please : I am on... - Thyroid UK
I am on Armour thyroid and in a dire need of increasing my meds.
I have (through the last 5months) been through the whole palaver of buying and selling my property and moving home from north Essex to the Wirral, to be near family. It’s been horrendous at times, exhausting, and draining and even involved a period of Shingles .
when I started out my levels were quite good and I felt well enough, but it’s a different matter now, and would you believe , a new GP practice (quite near me) weren’t happy to have me as a patient, when I told her I was Hashimotos, and so she has directed me to an Endo in a private hospital, - what was a rather short and sharp manner !
So what I am seeking from anyone of you lovely ladies, who have done this before:- could you please give me a programme of increasing my Armour by a quarter grain slowly over a few weeks. I am currently on 1&3/4 grain
thank you so much for your help
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C70rol
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IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In days before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 if last test result serum B12 was below 500 or active B12 (private test) under 70
Since my last email (above), I have been to see my private Endo, who has given me a private prescription for my existing Armour which is to be ordered through Roseway Labs. However he will not let me increase my level of Armour until June (three months time).
Although I told him all my symptoms , in particular weakness, fatigue, depression, and exhaustion, he says that it is all due to your move of house, so to stay on what I’m already taking! And as my new GP won’t help me, I’m unsure what to do……I would stress that I am seeing my family probably too frequently since we have moved to be near them, and also my house move was extremely stressful .
My TSH is 0.01 (0.27-4.2) T4 is 18.2 (12.0-22.0)
T3 is 5.8(3.1-6.8). The Endo won’t help me at present as he feels my T4 is too high !
I greatly look forward to your advice. Thank you !
So are we to presume that you and your endo has seen ' better ' results from you -
a higher T3 and a lower T4 on this same dose of Armour ?
So if your routine and timing for taking the blood test hasn't changed, maybe your core strength vitamins and minerals are lower this time around -?
No thyroid hormone works well if the core strength vitamins and minerals are not maintained at optimal -
just for reference I now aim for a ferritin at around 100 - folate around 20 - active B12 at around 125 ( serum B12 500++ ) and vitamin D at around 125.
this was the first time I had seen the Endo, because I have only just moved to this area, and my GP openly admitted she knew nothing about “thyroid abnormalities”, so sent me to the private Endo.
Previously for the past 20 years I have had Armour on the NHS from a doctor who was German, so had been taught about thyroid.
But I do think I might have taken my second half of Armour for the previous day before the blood test, a tad later than previous blood tests, which may have given me a slightly higher figure ??
My ferritin blood test was 199 (13-150). And all other mineral levels were good. In fact my B12 was too high : 1072(197.0-771.0). Even though I stopped them for a week prior to blood test. I have stopped them altogether now.
What I would say is two weeks after that blood test (Christmas) , and I went down with a bad case of Shingles, which lasted 6 weeks, shortly after which, (12th Feb) I moved house (220 miles away).. and my ‘ core strength’ hasn’t been good since. And settling in to my new home has been tough.
Ok then - so there are no previous results available on this dose to compare to -
it's a pity we have no back references so to see a pattern emerge -
With NDT I run a T3 at around 90/110% with a T4 at around 25/30% through the ranges -
So I take this to mean I've little T4 left and I've been able to convert very well the T4 content in the NDT.
On NDT we track on the T3 as this is the active hormone and it's ok to have a low T4 if you feel well - though others feel they need a higher T4 as when on synthetics -
With NDT we track on the T3 - and recommend taking a fasting blood test around 10-12 hours after your last main dose - as this should show the peak level of your T3 which one tries to keep within the ranges.
However the ranges and guidelines were introduced to be used when Big Pharma launched synthetic T3 and T4 treatment options ( on the back on NDT ) in the middle of the last century and up until that time everybody was using NDT and you simply dosed to the relief of symptoms.
So, anyway, your T3 is running at around 73% and your T4 at around 68% - so - for me - I would say - I needed to look at the co-factors of vitamins and minerals - and any other stress / upset that could be hampering my conversion -
Within the last 3/4 months you have had several issues going on which hopefully are all short term glitches in your overall health and well being and it seems to me this is how this Dr is ' seeing you ' at this point in time - was a further appointment in a couple of months time suggested ?
Ferritin is high - this can be caused by inflammation - do you have a reading there for CR-P ?
Yes - stop the B12 for now but maybe check again after a few months as presumably there was a need once - and likely will be again - and an active B12 blood test a better option if you have a choice.
Hello again , there are previous results on this dose taken in June ‘24.
My TSH was 0.01.(0.27-4.2). T4 15.8(12.0-22.0). T3 4.6(3.1-6.8)
Ferritin 194(13-150). VitD3 187(25-50). B12 1115(197.0-771.0) cut back on B12 at that time, and as December B12 was still high I have now cut B12 out. Folate is always good, I have a good diet re iron.
Thank you Pennyannie for all your advice. I am having another blood test in 3 months time ( requested by Endo). I think he is hoping I will have settled in that time, hence a slightly lower T4 last June, but T3 was also slightly lower ? However he certainly wasn’t going to give me any help before then June !
thanks for that , but one important comment I must make to you is that the “current” blood test was in fact taken in early December.
My new GP where I currently live wouldn’t take another blood test , in fact my endocrinologist also didn’t think the December figures would make much difference and wanted to leave the next test until June…….and I’m pretty sure that since the shingles and move of house, I feel my levels have gone down a lot. ….. OR in your opinion could my wretched fatique, thick brain fog, exhaustion and poor sleep mean lower thyroid levels. …….My T3 feels like it’s non- existent !
OK - so the current December results are pre - shingles and all the upset you speak of so we have no current readings -
so suggest you arrange a private blood test yourself for a full thyroid advanced blood test 10/11 bio markers - that covers TSH, Free T3 + Free T4 + inflammation, ferritin, folate, B12 and vitamin D and then we can work from accurate readings - post the shingles virus and everything else.
Thyroid Uk the charity that supports this patient to patient open forum have a page dedicated to Private Blood Test companies and between them Medichecks and Blue Horizon are able to offer a nurse home visit service, at check out - to draw your blood for you if this is easier for you.
It's an additional cost - but I do this once a year just to monitor myself - as doctors do not understand how NDT presents in blood test results and can't run the vitamins and minerals, and just see a TSH and claim we are all over medicated - so it's all just a waste of everybody's time.
We suggest an early morning appointment - by around 9.00am - as this should show the highest possible TSH reading -
it is a fasting blood test - and you just take in water o/night until after the blood draw - which should be around 10- 12 hours from your last dose which is likely as high as your T3 on this particular dose will rise.
I take my NDT just once a day at around 2.00 am at a toilet break so arrange a blood test for late morning - as I'm not concerned about my TSH and self medicating.
Is this how you ran your previous blood test since it would be better to be able to compare like for like since your dose hasn't changed - do you split your NDT ?
leave off all supplements you maybe taking, and anything containing biotin for the week before the blood test so we measure what your body is holding and not that just ingested.
Since we are relying on the post - arrange the appointment for the beginning of the week, Monday / Tuesday so it will arrive and be actioned before the weekend and not left sitting congealing in a post box somewhere -
When with the results simply start a new post with the results and ranges and we can talk through anything that is amiss.
Thank you PennyAnnie for those instructions. - no I have never been self medicating. My GP prescribed it for me on the instructions from my NHS Endo. Because of lack of conversion for T3. Which is what I think is happening re; the margin of difference between my T4 and T3 results.on Armour, and why my current Endo “ doesn’t like my T4 (the storage hormone) to go any higher !?
Interesting that Erfa behaves differently ? I wonder if I should switch to Erfa. My Endo actually keeps that product.
Thank you for your clear instructions above. I will keep it. Though it’s much the same as I’ve always done. It’s good to follow your clearly written notes, especially as I have never used Medichecks.
B12 I have always left off for I week and B complex for 3/4 days.
I'm a little confused - presume you found my PM under the Chat Icon;
Armour and Efra are just different brands of NDT - both imported and readily available from a compounding pharmacy, and act the same way in the body ?
You originally just thought you needed an increase in your dose - and were refused - hence my PM :
I didn't realise your prescription for Amour was on the NHS - some members have found when they have moved and / or changed doctors that their prescription for Armour has to be approved by the new Health Authority / ICB board they have moved to:
Obviously now we know we haven't any current blood tests we are going that route first so we are better prepared for your next best step back to better health.
Please start a new post with the results and ranges when you get them back as then all forum members will be able to view and offer support, rather than tack them on the bottom of there as by then this post will be seen as an ' old and answered post ':
yes I’m sorry I went on to your Chat icon. I think once on there I wasn’t sure what to put on your site or should I stay in the more public domain ?
I just wanted to thank you for all your efforts. When ready with my new figures I will report under a new title. I’m not rushing into things and will look into Medichecks . Settling into a new life , in a new house a new part of the country, a new (awful) doctor and new Endo, plus no friends yet, is not easy ,especially as I’m in my 80’s !
May I just say that the comment I made on the difference between Erfa and Armour, were made to me by a fellow TUK member, who I knew personally,. She switched from Armour to Erfa and found a difference and had to switch back again. But I guess it must have been her own sensitivity to the product , as both products have to match the make up of our own gland after all?
The difference between Stateside Armour and Canadian Efra is likely in the ' fillers ' used to make the powder into a tablet - with Efra said to use the least fillers-
The medically graded declared content in Armour is 9mg T3 + 38 mcg T4 per grain -
whilst the medically graded declared content in Efra is 8mcg T3 + 35 mcg T4 :
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