Lab Values on Armour

[DanelleS]

Hello!  I have Hashimoto's and am taking 1.5 grains of Armour thyroid 1x/day in the morning.  When I was first diagnosed with Hashimoto's more than 3 years ago I was put on levothroxine which did not help. I have been on Armour for more than two years. I started at 2 grains and went down to 1.5 grains more than a year ago. I felt that it was an appropriate dosage based on my symptoms. For the past 6 months, however,  I have been feeling just terrible. The exhaustion from just normal activities has been unbelievable. One day of regular activity means the next day in bed. So, I went to my internist and had blood cortisol levels taken. The levels were extremely low - 2 - way outside of the reference range of 8-23. She referred me to an endocrinologist at U of M where all of my tests are being repeated.

The first test results to come back were my thyroid levels. This doctor says I am on too high a dose of thyroid medication. He does not advocate the use Armour at all (citing all the misinformation that physicians often do) and wants me to go back to Levothroxine. I told him that Levothroxine did not work for me, and I do not want to be forced to go off of Armour just because he does not like it. Here are my recent levels. They are not where they should be, so I know something needs to be done, but I think I should wait to see what my cortisol level is before making any adjustments to any thyroid meds. Any advice would be greatly appreciated. Thank you in advance, Danelle.

10/22/13
TSH 1.04

8/15/14
TSH 0.14 (range 0.3 - 1.5)
T3 - 255 (uppermost limit 175)
T4 - 0.94 (range 0.7 - 1.7)

[gimel]

If you are able to get the testing done again, make sure they test for Free T3 and Free T4.  I'd even confirm with the person drawing your blood which tests are to be done.  They frequently operate on auto pilot and don't get the tests you want.

I'd also ask for Vitamin D, B12 and ferritin.  Hypothyroid patients are frequently too low in the range for those, due to lack of absorption, caused by low stomach acid, due to the hypothyroidism.  Each of these is very important for adequately metabolizing thyroid hormone.  Plus, insufficient levels can cause symptoms as well.

[DanelleS]

Thank you so much for arming me with this information. I am extremely grateful. I am certain that the T3 was the total value, not the free value. I left a message for my endo yesterday letting him know that I wanted to have the tests repeated and not adjust the dosage at this time. I appreciate the support of this community that I have already received. I will keep yo posted.

[gimel]

And here's another good link for you to make use of.

http://www.ncbi.nlm.nih.gov/pubmed/1366242

Note from the study that , "When TSH was suppressed, FT4 was elevated in 30.4% but normal in 69.6% of patients."   So obviously TSH is frequently suppressed when taking doses of thyroid hormone adequate to relieve symptoms.  And don't forget that patients go to doctors because of their symptoms, not because of their TSH level.  Why are doctors treating based on lab results instead of patient symptoms?  It is a lot easier and less costly than doing it the right way, which is treating clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms,without being constrained by resultant TSH levels.  

There is even a scientific study that concluded that each person has a "set point" for thyroid hormone, at which they feel best, and that diagnosis based on group reference ranges does not necessarily work well for an individual.  

[gimel]

I think a copy of this might be helpful in any discussion with your doctor.  

http://worldlinkmedical.com/hypothyroid-symptoms-but-normal-tsh-levels-how-to-treat-symptoms-of-low-thyroid-by-optimizing-free-t3-levels/

If you read through the paper you will find numerous recommendations that conflict with what your doctor likes to believe.

[flyingfool]

ALSO it is VERy important to confirm and if not DEMAND that you are being tested for the FREE T4 and FREE T3. Not total T4 and total T3.

Total tests are obsolete and of little value.  Free test only counts the hormone that is free and available for use.  Once the hormone is attached to a protein it is useless.  

[DanelleS]

Thank you. I will share that information with my new endo and ask that the test be repeated to obtain a more accurate level.

[Red_Star]

Excerpt from Tired Thyroid - Thyroid Lab Results are Affected by the Time of Your Last Dose...

"T3 containing medications (such as desiccated thyroid or Cytomel) cause a peak in Free T3 levels a few hours after ingestion (42% within the first 4 hours), and then a decline until the next dose. [1]  Even T4 medications like Synthroid or levothyroxine cause a small bump in thyroid levels a few hours after a dose (16% rise in Free T4 with no change in free T3)."

[DanelleS]

Additional information: I did take my Armour the morning of the test. I did not realize that I should not have done so.  Would that have likely caused the high T3 value that was seen? Also, wondering if splitting my dose of 1.5 grains might be a better way to take it. I don't want my new endo to take me off it because he personally does not like it or prescribe it. I also don't want to necessarily assume that I am now hyper if I am not.