Wean off Armour?

[Lunahsky]

Hello

I have multinodular goiter for at least 7 years. Largest is 3.5 cm in Feb. Biopsy in Feb of 4 nodules was negative. I was put on Armour Thyroid 60 mg 7 yrs ago for suppression therapy.  Annual ultrasounds showed little to no growth until Feb 14 when there was a "slight" increase in size of 2. However, I used a different facility and tech for this last ultrasound. Last year, my doctor lowered my dose to 45 mg as my TSH was on the active side. In Feb, my doc started lowering more as my TSH was .0700. Retest blood 6 wks later. TSH went to .0564. Dropped dose to 30 mg. To make a long story short - I am now on 15 mg. Last blood test: TSH .0233.   Does this indicate that I am becoming more hyperactive even while reducing dose?  I don't know my T3 and T4 readings but  can get copies of reports during the week.
I was unable to speak to DR. Nurse gave me the results on the phone and told me to cut out Armour entirely. Two questions: Has anyone heard of reducing dose and becoming more hyperactive?
Do I have to wean off Armour or just cold turkey? Also - is my reading considered "high" or "Low" ?  
Thank you

[Barb135]

If the lab report doesn't specify "Free" or FT, the test is Total T4, which isn't nearly as useful as Free T4, but even at that your level does not warrant reducing your Armour dosage.  Your doctor is reacting ONLY to the TSH level. TSH neither causes, nor alleviates symptoms.

Of that Total T4, most is bound by protein is unavailable for use.  Additionally, T4 isn't used, directly, by the cells; it has to be converted to T3 prior to being used and without testing for Free T3, you have no idea how much is being converted.

I don't know where you're located; can you get a Free T3 test, with another Free T4?  They need to come from the same blood draw.

Do you know if you have Hashimoto's?

[Lunahsky]

3/25
TSH  0.254  (0.400 - 5.00)

T4 Thyroxine  7.47  (  4.5 - 12.50)

5/28
TSH  0.244  (same lab as above)

T4  Thyroxine   7.8   (same lab as above)

He didn't test for T3 and it the test results don't state Free or Total.

[Barb135]

Is that Free T4 or Total T4?  If it's not specified as Free, then it's total and is considered obsolete and of little value.  He should be testing Free T4 and Free T3.  

Once we see current levels, we'll be able to offer more comments.

[Lunahsky]

Hi Barb

Thank you for getting back to me. I found my Feb 2014 report.
TSH: 0.3320 (0.4 - 5)
T4: 7.04  (4.50 - 12.50)

He didn't test for T3 here.  I think he did in the next 2 tests, which I'll get copies of this week and post numbers. This is when I eliminated 30 mgs

I'm being treated by my PCP - as my Endo left the practice. What troubles me is that although I have been cutting the Armour, my TSH level keeps dropping. Since cutting dose, I don't seem to feel any different, although I do sleep better now. I may have a bit of a drop in energy early morning, but I'm able to function well. I don't have classic signs of hyperthroidism. Prior to Armour (about 7 yrs ago) I didn't feel sick either. I was given the Armour to suppress my nodules.  

I agree about the roller coaster effect and it concerns me that my system is being upended. Even with the active TSH reading, I have the most difficult time losing weight. I'll post back soon. Thanks again :-)

[Barb135]

Your doctor is going to have you on a roller coaster to he!! if they continue on the path of cutting medications like this.

Be sure to get the T3 and T4 results... make sure they're testing FT3 and FT4, not total T3 and total T4... and post them here.  They should not be adjusting your dosage, based only on TSH; they need to be looking at FT levels, as well.