On Synthroid - would like to add Armour

[Yplg]

Hello everyone, would love some advice :)

I'm female / 60kg/ 32 years old.
I'm on 100mcg synthroid for 4 months, and last 3 weeks feeling REALLY tired + total brain fog + sometimes insomnia.

Last labs:
TSH: 10.96  (range: 0.4 - 5.6)
FT4: 0.95 ng/dL  (range: 0.61 - 1.12)
FT3: 2.7  pg/mL  (range: 2.5 - 3.9)

I would like to add a bit of Armour thyroid.

How do you suggest doing this?

Thanks SO much to anyone for your thoughts :))

[Yplg]

THANKS SO MUCH!!!
So quick and helpful!:))

[gimel]

From your Free T4 result, it does not appear that you need any more T4, just T3.  So, reducing from 100 mcg of Synthroid down to 75 would be directionally correct since the 1/2 grain of Armour contains 19.5 mcg of T4 and 4.5 mcg of T3.  Then in a couple of weeks your could drop to 50 mcg of T4 and add another 1/2 grain of Armour.  Then in another 2 weeks it would be a good time to re-test Free T3 and Free T4.  Keep in mind that it is always best to split T3 meds and take half in the morning and half in the early afternoon.  T3 is very fast acting and that approach maintains a more uniform effect over the day.  

Don't forget to test for Vitamin D, B12 and ferritin at first opportunity.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

[Yplg]

Thanks so much for the quick reply!:)

Yes, I know the FT4 range is weird..i'm in Italy and that's what it says..:(

I was actually thinking of adding some Armour, just because I have access to it and not to other meds right now..

So I wasn't sure if I should do:
75mcg synthroid + 1/2 grain Armour  OR
increase to 100mcg + 1/2 Armour  
OR other suggestion..?

THNX AGAIN!!!:)

[gimel]

From your symptoms and lab results it seems that you are still hypothyroid and need to increase your levels, mostly your Free T3.  I am somewhat surprised at the range you listed for Free T4.  That is much narrower than any I have ever seen.  Please double check it.  

There is nothing magic about Armour Thyroid, compared to taking T4 and T3 separately.  It is all about getting your Free T4 to the middle of the range, and adjusting Free T3 as necessary to relieve symptoms.  So you could just add a bit of T3 to your meds and gradually increase as necessary.  In my opinion, at this point that would be much easier to achieve levels you need, than switching to Armour.  

If you are dead set on going to Armour, the equivalent dosage would be dependent on which assumption is made.  One says that a grain of Armour is equal to 75 mcg of T4.  The other says that it is more like 1 grain to 100 mcg of T4. So your 100 mcg of T4 would be either one grain or one and one third of a grain of Armour.  Even then I don't think your would want to make the switch all at once, due to the rapid effect of T3.  

If you haven't been tested for Vitamin D, B12 and ferritin, I highly suggest those as well.  Deficiency in either can cause symptoms somewhat like hypothyroidism.  Plus low D or ferritin can also affect how thyroid hormone is metabolized.