New Armour Labs...help?

[cuzsis]

Hi Everyone,

I need advice on my latest labs and my dosage.

A brief history... I got diagnosed hypo some years ago and put on Synthiroid. I had some slight improvement, but not much. Went back, TSH was too good so was told "No." by multiple doctors. Saved my pennies to get better insurance so I could go see a specialist. Fortunately for me a specialist came to the clinic as a new doctor. She took one look at my charts and demanded I schedule an appt with her to deal with my hypo. I nearly cried.

So earlier this fall we ran a full run of blood work. Results are as follows (lab results are first, range is second set of numbers).

Anti-TPO:   69    0 - 6  

Thyroglobulin Anitbodies:  Less than 20

Reverse T3:    12.4        9 - 27
Free T3:          2.4        2.4 - 4.4
TSH:              3.87       0.3 - 5.5
T3 Total:         130        70 - 170
Free T4          1.00       0.9 - 1.8

From this it was deduced that I had Hashimotos and it was mutually decided to switch to Armour (since it was the only affordable T3 option for me.) The ultrasound of my thyroid indicated a noticeable goiter.

I started on Armour at 60mg in November. At the end of December I felt a slight improvement (could actually go to work all 5 days, which before had been hit and miss), but not much. Still was exhausted and symptomatic. We upped the dose to 90mg.

After a month I was to get new blood work and schedule a follow up appointment.

I just got the results of the new blood work:

Free T3:     4.3         2.4 - 4.4
TSH:         .694        0.3 - 5.5
T3 Total:    188         70 - 170
Free T4      .87         0.9 - 1.8

I should note, I do take birth control pills (low estrogen version) so that, I believe, explains the high T3 total value.

As for the rest of it, I still feel massively hypo. My temp still runs around 97.6, occasionally dipping as low as 96.4. I'm still exhausted, drained, can't exercise, losing hair ect...

I'll be honest there has been *some* improvement. Two weeks ago, I was called to do an extra hour at work (I drive 5hrs day), and I was able to do so and not need to call in "sick" later in the week due to overwhelming exhaustion. Earlier this fall I had not been able to do this. Heck, before the switch to Armour I couldn't even always get to work 5 days a week. Also one of my eyebrows is almost back to normal. Hairwise I mean.

I want to be educated when I go in for my follow up appointment. I still feel really hypo. Was probably hypo for years (with all those docs telling me "No, your TSH is fine.") Do I need to increase my dose? Is it my adrenals?

Other Info:
I take my medication in the morning about 30-45min before eating. I do not split my dose.

I take Mg and Vit D everyday, 100% RDA for Mg and Vit D is 2,00 IU I believe. I have some really top notch vitamins I take every few days or so. (http://www.****.com/sports-nutrition-629/precision-engineered-elite-training-packs-015722) I would take them everyday, but we're very tight on money right now so I need to make them last.

Thoughts?

/ps. Sorry for the terse nature of the post. I had a lot of info to convey and didn't want it to turn into a wall of text. Also, I'm exhausted and my brain is foggy/not sharp. Per usual... :P

[cuzsis]

If it helps any, I've been taking these a lot longer than Armour. And it wasn't a laxative effect, I just had to pee a lot. Usually it's B-vitamins that cause that for me. I get the same effect (plus that nice neon color) when I take them a few days in a row as a separate supplement.

I'll make sure not to take them if we do the test.

[Barb135]

The flushing of excess vitamins shouldn't be that noticeable that you have to spend so much extra time in the bathroom on the days you take the vitamins.

The fact that your FT3 is so high could have more to do with that than the vitamins.  Oh, I just took a look at the ingredients in your vitamin pack and most likely, it's the enzymes and magnesium oxide that are keeping you in the bathroom.  Magnesium oxide is pretty much a laxative and doesn't do much else.  I also notice that the pack has soybean oil... soy should be avoided whenever possible.

Some  links are allowed, but not all.

Yes, if you're going to test for vitamin D, B12 and ferritin, you should probably not take the vitamins for a few days prior to the test in order to make sure they are flushed out.

[cuzsis]

Dang, I wish they had an edit feature here... Regarding the vitamin packs. It's somewhat complex. I do have to stretch them a bit (although I can get help procuring them if absolutely necessary). But I have noticed that when I'm not exercising, taking a pack a day is a really good way to end up spending quite a bit of time in the bathroom owing to the body flushing the excess.

So I'm doing a balancing act between the two. Sorry, for not being more clear earlier. (Darn brain fog. :P )

[cuzsis]

@gimel: Thank you for the info on the T3. I had heard it was fast acting, but had no data on the subject. For this test we were about 6hrs out from when I took it. (I take my meds at 6am and the test was just before noon.)

@Barb135: I am a little careful with my vitamins owing to my diet. Some days are more healthy than others and I don't want to overdo some of them. (apparently links are not allowed here, but if you are curious, the vitamin pack I take is from Vitamin World. It's the "elite training pack". I take 1 pack, not 2. It's about .88 cents per pack last I checked.)

  I do have cheaper vitamins that I take daily, the Vit D at 2,000 IU (fixed from earlier post) and the Mg. The B-complex supplement I take depending on my diet that day (so I'm not spending too much time in the bathroom, as I found out the hard way, lol.) There is some iron in the birthcontrol, but not much.

I will definitely ask my doctor about testing for those. Thank you! If we do, do you recommend I abstain from the vitamins the day of the testing in order to get a  more accurate readout?

[Barb135]

I would agree that you have Hashimoto's and were definitely hypo when you started on medication, since your FT3 was literally on the floor of the range.

Desiccated hormones have much more T3 in them than humans, typically, produce, so that would be why your FT3 level is so high.  We often see people on Armour with a very low FT4 and high FT3.  You might need to cut back on the Armour and add a small dose of T4 med to bring up your FT4.

Do you know what your actual vitamin D level is?  Have you had vitamin B12 tested?  Vitamin D deficiency can cause some hypo like symptoms.  Vitamin B12 deficiency can cause the fatigue and foggy head.  Left untreated B12 deficiency can cause numbing/tingling in the hands/feet.  Because you still have the symptoms you have, I strongly urge you to get those tested.  Your insurance should pay for those.  Because iron is necessary for the metabolism of thyroid hormones, you might want to get ferritn tested, as well. but if finances make you choose, go for the vitamin B12 first, then the vitamin D.

I can understand about money being tight, but it really doesn't do much good to take vitamins "every few days"; they need to be taken daily, in order to get/keep levels high enough to do some good.  There are many inexpensive vitamins/minerals on the market that work just as well, that you could take every day.

[gimel]

Several things of note.  First is that T3 is so fast acting that it is best to skip the morning dose before the blood draw for thyroid tests.  Especially since you do not split the dose.  That avoids the possibility of a false high Free T3 result.  

Next is that your Free T4 is way too low in the range.  It should be around the middle of the range.  With that Free T3 result, at this point you can't know if you need to increase your Armour dosage, as I expect, or if you need to just add some T4 med.  I expect that the doctor will be reluctant to increase Armour with that Free T3 result, so you may need to re-test for Free T3, after skipping your morning dose of Armour.  

Note that T3 reaches max. effect on your serum levels about 3-4 hours after you take it and lasts about the same length of time.  So, I also think you should reconsider and split your daily dose of Armour, to extend the effect of the T3 over the whole day.  

Since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, in order for you to feel your best, you need to have those tested and supplemented as necessary.  The recommended levels are middle of the range for D, upper part of its range for B12 and 70-80 for ferritin.