Ready to give up

[AprilPaonessa]

I've been on Armour 90mg for over 6 months.  When I first switched from Synthroid it was like a night and day difference.  It only took 2 YEARS to convince my Endo to let me switch.  As time has gone by I can feel I need to increase my dose.  The Docs think I am crazy but I know how I feel.  You would think that the VISIBLE symptoms would be enough.  She will not up my dose.  She told me to go on an anti-depressant.  I'm more than insulted.  I can't find an Endo  that will prescribe Armour and will not go back on Synthroid as I felt worse on that.  My GP doesn't feel comfortable upping my dose based on my most recent bloodwork.  What do you guys think?  
TSH 0.288 (reference range of 0.178-4.530)
FT3 2.6 (reference range of 2.0-4.7)
FT4 0.81 (reference range of 0.80-1.73)
Any feedback is more than appreciated!

[gimel]

I did not have a doctor on my lists, from your area.  so, I called local compounding pharmacies and asked for names of doctors for whom they filled prescriptions for T3 meds.  I sorted through the names by googling all available info and came up with two prospects.  Just sent PM with names.  To access, just click on your name and then click on messages.  

[AprilPaonessa]

Thank you for your very informative post above!  

I am located in Wappingers Falls, NY, about 2 hours north of NYC.

[gimel]

Meant to mention that if you will tell us your location perhaps we can suggest a doctor that has been recommended by hypothyroid patients.

[gimel]

I agree with goolarra.  Also, TSH is frequently suppressed when taking adequate doses of thyroid med.  There are lots of scientific studies that show this.  Following are some that you can use to influence the doctor.

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

"When TSH was suppressed, FT4 was elevated in 30.4% but normal in 69.6% of patients."

http://www.ncbi.nlm.nih.gov/pubmed/12481949

"Suppression of TSH by thyroid replacement to levels below 0.1 mU/L predicted euthyroidism in 92% of cases, compared to 34% when TSH was above 1 mU/L (p < 0.0001). In conclusion, in central hypothyroidism baseline TSH is usually within normal values, and is further suppressed by exogenous thyroid hormone as in primary hypothyroidism, but to lower levels. Thus, insufficient replacement may be reflected by inappropriately elevated TSH levels, and may lead to dosage increment."

http://www.bmj.com/content/326/7384/311

"Therefore, the biological effects of thyroid hormones at the peripheral tissues—and not TSH concentrations—reflect the clinical severity of hypothyroidism. A judicious initiation of thyroxine treatment should be guided by clinical and metabolic presentation and thyroid hormone concentrations (free thyroxine) and not by serum TSH concentrations."

If the doctor resists, just ask him why a suppressed TSH would be a concern when the biologically active thyroid hormones, Free T3 and free T4 are within their reference ranges.  Also you can make use of this link to a study that concluded that hypothyroid symptoms correlated best with Free T3, while Free T4 and TSH did not correlate at all with symptoms.  

http://informahealthcare.com/doi/abs/10.1080/13590840050043521

[AprilPaonessa]

Thank you so much.  From my research, I know this!  I just don't know what to do to get the Docs to realize it too.  I've gone the angry route, the crying to the Doctor route, the I've done tons of research route and this is what I think and nothing works.  I have seen multiple Endos and none will prescribe Armour and have wasted my time.  I go to a new one on the 31st and I am praying that he listens to me.  I wish I could just get my meds online without a script. You comment has made me feel so much better, because I know I'm not insane.  I swear they try to make you feel that way.

[goolarra]

You definitely need an increase.

The T3 in Armour is depressing your TSH, so you have to ignore it.

FT4 is on the floor, and it should be closer to midrange (1.27 on your range).

Your FT3 is at 22% of range, and on desiccated, FT3 should be upper half of range, often upper third.

Your symptoms support that.