I shared my latest results last week. But I've been thinking since.
I take mainly NDT. 1 grain at 8am and 1 grain at 4pm. Plus 37.5 Levothyroxine at 8am.
For some time now I have been following the timing protocol for NDT users on the Thyroid Patient's Canada blog. The day before a test I take the Levo so it's 24hrs before the blood draw and the second grain of Armour 15 hours before the blood draw.
My FT3 result is 37.50% through the range 15 hours after the last dose of NDT. I would normally take my second dose 8 hours after the first dose, so that would be stacking up on top of the morning dose.
Does this mean that it might be unreasonably high in the first 10 hours after the dose? And then, at the 8 hour mark I add more. Might I actually be taking too much T3 for my body to handle? Because I am feeling rubbish and pretty much always do. My legs are weak and aching all the time. I feel like they might give way under me any moment. I am actually afraid now that I will lose the ability to walk at all soon. Any thoughts? (Vitamins and minerals have just been tested too. Ferritin has dropped a lot due to stress, trauma and a to of nosebleeds,)
16/04/25
Test taken at 08:50
Dose of 2 grains of Armour + 37.5mcg Levo
Last dose of Armour (1 grain) taken 15 hours before the test as per ThyroidPatientsCanada recommendations.
Last dose of Levothyroxine (37.5mcg) was taken 24 hours before the test.
TSH - 2.83 (0.35-4.94)
FT4 14.8 (9.00-19) - 58%
FT3 3.9 (3.0-5.4) - 37.50%
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FancyPants54
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My TSH never seems to behave like I expect though. Most people see it drop a lot when they start adding T3. Not me. It lowers a bit, but not much.
I have taken 2.5 grains of NDT in this 2 year journey with Armour. If anything I felt worse on that and backed off. I started adding Levo in the hope I could get more T3 from conversion to top up what I was getting from the tablet. It hasn't worked. I am thinking to reduce the Levo and eventually stop it and add T3.
The prescribing doctor at Roseway Labs where I buy my NDT is puzzled by my results too. She said I'm not absorbing the NDT. I don't know what to make of that.
I've just been diagnosed with heart failure so I'm doubly worried now. I don't think the HF is terrible yet, nothing leaking, good ejection faction. But it still frightened the willies out of me. Going to see the GP tomorrow to talk about it as the cardiologist left me with more questions than answers.
In the morning it's on an empty stomach. In the afternoon it may or may not be, given other challenges (work, mother, appointments, depressive moods). I don't notice a difference either way.
If 2 grains isn't enough, why would I feel worse on 2&1/4 and then 2&1/2? I increased slowly.
Ours not to wonder why, ours to keep on experimenting until we get somewhere. They ways of the thyroid are beyond rules and regulations, you can't always tell why. But it happens. How long did you stick with each dose?
The relevant bits from my bio. I can't make head or tail of my results. They fluctuate so much in what seems to me to be random fashion. All conditions specified on this site are adhered too. I make sure to keep conditions the same so that I can compare like with like.
Here are the two tests that preceded me switching to Armour, just to compare.
Levo + T3
10/10/22
Test taken at 08:15
62.5mcg Levo and 25mcg Lio. T3 split 10mcg at 07:30, 5mcg at 14:00 and 10mcg at 20:00. (12hrs from last T3 to test)
TSH 5.46 (0.27 - 4.2 mU/L)
FT4 13.8 pmol/L (12 - 22 pmol/L) - 18%
FT3 4.3 pmol/L (3.1 - 6.8 pmol/L) - 32.43%
Going forward with a Levo increase to 75mcg per day and keeping Lio at 25mcg for now.
05/12/22
Test taken at 08:10
75mcg Levothyroxine, 21.75mcg Liothyronine
Last Levo taken 24hrs before and last 7.25mcg of Lio taken 10 hours before the test.
Low temps and high end of normal BP
TSH 4.05
FT4 14.8 - 28% of range
FT3 4.9 - 48.65% of range
T4 absorption 14.8/75 - 0.20
Now for the tests taken using more than 2 grains of Armour.
07/06/23
Test taken approx. 08:30
Dose 2 + 1/8 grains of Armour
Dose adjusted the day before test to provide 3 doses with the final dose 12 hours before test.
TSH 3.55
FT4 14.8 - (12-22) - 28% of range
FT3 4.5 - (3.1-6.8) - 37% of range
04/08/23
NHS Test
Test taken at 08:20
Dose 2 + 1/4 + 1/8 grains of Armour
THIS WAS AN EXPERIMENT TAKING ALL THE ARMOUR FIRST THING IN THE MORNING AND NOTHING ELSE FOR 24 HOURS. Although it worked for a few days, I began to get very tired and anxious in the evening and worse through the night.
TSH 3.25
FT4 11.5 - (9-19) - 25% of range
FT3 3.5 - (3-5.4) - 20.83 % of range
16/10/23
This is the first test taken whilst I self-inject vitamin B12 EOD for neuropathy in my feet.
Test taken at 08:30
Dose 2 + 1/2 grains of Armour
Dose adjusted the day before into 3 doses. 07:00 1 grain. 13:30 1 grain. 20:20 1/2 grain.
TSH 3.78 - (0.27-4.2)
FT4 14.4 - (12-22) 24% of range
FT3 4.7 - (3.1-6.8) 50% of range
29/01/24
Test taken at 08:30
Dose 2 + 1/2 grains of Armour
Dose adjusted the day before into 3 doses. 07:00 1 grain. 13:30 1 grain. 20:20 1/2 grain.
TSH 3.61 - (0.27-4.2)
FT4 13.7 - (12-22) 17% of range
FT3 4.5 - (3.1-6.8) 37.84% of range
21/03/24
Test taken at 08:50
Dose of 2+1/4 grains of Armour + 25mcg Levo
Last dose of Armour (1 grain) taken a 19:00 day before test, 14 hours before the test as per ThyroidPatientsCanada recommendations.
Last dose of Levothyroxine (25mcg) was unfortunately taken 31 hours before the test because I calculated the alteration to the timing incorrectly!
TSH 3.09 (.30-4.20)
FT4 13.4 (9.0-19.0) - 44.1% through range
FT3 4.8 (3-5.4) - 75% through range
07/05/24
Test taken at 08:45
Dose of 2+1/4 grains of Armour + 25mcg Levo
Last dose of Armour (1 grain) taken 13.25 hours before the test as per ThyroidPatientsCanada recommendations.
Last dose of Levothyroxine (25mcg) was taken 24 hours before the test.
Well, it does appear to be haphazard, but there are small changes, like changing the amount for the last dose, and the length of time. And absorption would seem to vary, too.
You say that the afternoon dose is not always taken away from food, etc. Could be that that is having a greater impact than one would expect. But in the main it would appear that you're just under-medicated.
Have done totally gluten and dairy free just before I was diagnosed with hypothyroidism. I lost weight because I also did low carb at the same time. But it wasn’t sustainable for me. I didn’t feel like either of the exclusions helped me other than they reduced my food intake along with the low carb.
I use Wokhart and Mercury. They are fine for me. Tiva is a real no-no for me. I filled in a yellow card. It caused nosebleeds.
I did a 6 point saliva cortisol test a few months back in early October before my fall (injured but didn’t hit head) and then nosebleeds from hell that started 1 week later in late October and November.
Your last sentence. Exactly! And I don't understand it. Everyone says I need more T3, but the results don't improve. I have no idea why.
Hard to know how I can change doses in smaller amounts. I have used 12.5mcg Levo since I added it to NDT and I never increase NDT by more than 1/4 grain. I even tried 1/8 grain at one point.
Too frequently? I allow 6-8 weeks between blood tests. How might I better do it?
But everyone says my results are always too low for T3 and I never feel well, just different degrees of unwell.
I'm starting to wonder if I was actually better off on Levo only. But I have no idea how to get back there from here safely. I know I don't have good conversion though. I have the genetic fault on the Dio2 inherited from one parent.
The heart needs a lot of T3....your heart isn't getting enough
Until you are taking enough replacement T3, for you as an individual, the timing of your dose won't solve the problem
FT3 3.9 (3.0-5.4) - 37.50%
If testing protocol was robust then this result is your red flag
We aim to have FT3 roughly approaching 75% throigh the reference range....at 37.50% you are seriously undermedicated and will feel unwell
NDT provides only 9 mcg T3 per grain/60mg which is inadequate replacement for some people
It provides 38mcg T4 per grain
On your current dose of 2 grains of Armour + 37.5mcg Levo (total 18mcg T3 + 113.5mcg T4) you have room to increase Armour
However that dose isn't working for you so i suggest you try dropping the levo and increasing the NDT, half a grain at a time, until your labs improve and you feel better
Or, think of trying a T4/T3 combo with higher T3 content and less T4. New labs will guide you
I do have access to Thybon Henning. But I find it hits me fast and leaves as fast at the other end. It's very up and down for me and can give me anxiety. I was hoping NDT would be better from that point of view. And it is.
But regardless of it being NDT or T3, it increases my HR and that's not acceptable for someone with permanent atrial fibrillation, a heart that is enlarged in part because of it and newly diagnosed, but still clueless (going to talk to GP today), heart failure. I need the T3, but not the high HR. I have tried increasing my beta blocker but I feel like a zombie and literally was falling asleep typing a word - mid word!
I agree that no wonder you feel terrible , your FT3 is far low. I've always dosed on symptoms, rather than obsessed with getting the right blood test result . If I did I'd have got nowhere at times ! I think your body is telling you regardless of what the blood tests might say.... Hope you can adjust and feel better soon!
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