Whats the most accurate and widely used thyroid medication?

[tiny701]

Confusion on what to take
by tiny701


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tiny701
Member since Feb 2009  



, Feb 15, 2009 08:06PM
Tags: thyroid
I had my thyroids remove 5 yrs ago and been a mess every since. I just don't know whats the best mediciation to take. I recently switch to Armour thyroid for 18mths now, and haven't been able to regulate my levels yet. I just got my
blood test back and my levels were tsh 0.05 and my t4 is 0.64. The Dr. lowered my dosage from 135mg to 90mg. I am feeling so bad and the weight gain is horrible. I just don't know what to do anymore. Is that safe to lower the mg. like that and is Armour hard to regulate? I use to take Levothyroixn but just switch because Armour was natural. I don't know if that was smart of me or not. It seems like my eyes twitch and yesterday my cheek was twitching. I am so stressed about all of this. If you have any suggestions I would appreciate it. All my other blood work came out perfect. HDL,LDL.Chlorestrol.and so on...
Sincerely
  tiny701

[tiny701]

Thanks for writing. Did you have your thyroids removed completely? And what do you mean about having all the different test ran? Thats what so confusing. I had blood wk done about 3wks ago and I was taking Armour 135mg about 12mths and switched Drs. and he did a mass amt of blood wk. My levels were tsh 0.05 and my t4 is 0.64.  I dont recall a separate no. ran under t3. There are so many no. to look for. They all mean differnt things. Its learning it all. How much weight have you gained since you have encounter these problems? I been having these problems for 5yrs or so. And I exercise daily and still have gained a total of 30lbs. Have you changed your diet?  If you could break down all the different t # I would appreciate it. I didn't know that each meds meant a different thing.
thanks so much for all your input

[tiny701]

Thanks to all,
How would I every now that Thyroid problems were so great>>It seems like everyone has it.  I am still confused about when everyone speaks about T3 and T4 and TSH. It seems like different meds. represent the T3 and the T4 and when you take a particular med. like Armour one should use another med with it. What catagory does Armour fall into? Nothing is black and white without being so complex All I know is I am still not feeling well and depressed. I don't now if it is because my Dr. cut my meds  in half from 135mg to 90mg once a day. And I just released that I shouldn't take my meds with my vitamins either. what are the different meds for which t3 and t4 are? And what should Cytomel be taken with? I once was on Cytomel but the Endo. stated that it was a questionable weather it worked or not. I just don't know which way to turn. I am waiting for 8wks to pass to retake blood work on the Armour dose of 90. But I am still thinking about switching back to Levothyroxine. And I can't exercise anymore than I do unless I do it twice a day.
  thanks

[Smilerdeb]

Fires arent as bad but still burning as we have 34 degrees celcius today with high winds expected.
I finished work early as my phone line is up the creek and have to use wireless internet until they fix my adsl (broadband) so a day off work for me...whoohoo!

[stella5349]

WOW deb - such a great wealth of information.

Ya know - now that you mention the New Zealand place - I do recall "something" a while back. can't recall b/c is doesn't pertain to me so much - but I do remember something.

Thanks so much !!

How's the fires over there? better I hope!

[Smilerdeb]

Forgot to mention....for those in Melbourne there is a Compounding Chemist at Spotswood (western Subs).
Hope that is of some help to some.

[Smilerdeb]

Hi Stella
I'm not sure who makes Armour in New Zealand but do know it was banned and that anyone who is getting Armour is getting a compunded natural thyroid and not the ™ Armour made in New Zealand.
Compounding Docotrs here and Chemists make it up and it costs an arm and a leg to see a Compounding Doctor. Some range from AU$220 - AU$290 a visit which is ridiculous as they insist on 4-6 weekly visits and these fees cannot be claimed back off Medicare here.
My Doctor told me he was more than happy for me to see one if I felt I wasnt happier with Eutroxzig (not long after RAI) and the Compounding Chemist told me that if I did go, to photocopy the prescription and then my Doctor would know what to prescribe instead of paying out an arm and a leg to see one of these compounding Doctors each time.
Fortunately for me, I didnt need to see one as the Eutroxzig is working for me and my conversion problem was not in fact a conversion problems but a deficiency in Vitamin B12....Calcium and Vitamin D.
Once I got those on track, I was converting very well (too well in facy lol).

So for all the Aussies who see Compounding Doctors, photocopy your prescription (hehehe) and take to your normal GP. They can then copy the script and save you a lot of money.

I did find a link to a compounding chemist in Oz who makes up Thyrolar and also a slow release T3 although T3 is out of the question for me because of heart problems and also due to the fact that my T4 sometimes converts TOO GOOD lol.

Here is the link about the slow release T3 med.

http://www.mortarandpestle.com.au/armourthyroid.html

[Benny0147]

has anyone tried ,time released T3 ?? many swear by it..as we know T3's half life is very short...

[Barb135]

I was dx'd hypo in June '08; Hashimoto's in Dec '08.  My PCP started me out on synthroid (said it HAD to be synthoid; not generic levothyroxine) which brought my TSH down to almost nothing and Free T-4 not much either; he refused to run free T-3.  My dosage was adjusted downward 3 times and did very little to change TSH reading, but did bring Free T4 up where it should be, but without a Free T3 he would only have lowered my dose of synthroid again.  During these months I felt absolutely horrible even though my PCP said there was nothing else wrong with me.  

I was sent to an ENT for what they thought was an unrelated problem, but was actually stemming from thyriod issues; to make a long story short, the ENT referred me on to an endo.  In the meantime, I had found a lab that will do some blood work without a doctor's order, so in Jan, I went and had a TSH, Free T4 and Free T3 (my PCP did not order blood work for 3 whole months, even though my dosage had just been changed and I was unregulated).  Anyway, I got this blood work done just before my appt with the endo, so I had those results to take to my appt.  

After considering my symptoms, and the most recent blood work, along with other blood work and lab reports that I gave him, he again lowered my dose of synthroid to 50 mcg (only he said it didn't matter if I used a generic) and added 10 mcg of cytomel daily.  He also ordered blood work to be done in 4 weeks (not 12 like my PCP).  

I will go this coming Friday for blood work again and we will see how the change has affected the numbers.  I did go to generic levothyroxine, which I take when I get up in the morning and since the cytomel is dosed in 5 mcg tabs, I do split the dosage.  I take one pill with my levothyroxine at 3:30 am and the second one as close to 9:30 am as I can.

I have been on this regimen for approx 3 weeks and I feel like a different person.  I have more energy than I've had in years, my skin is starting to look normal again (it actually helps to apply lotion), my hair is getting healthier, brain fog lifted etc.  I lost a few pounds within a few days of starting on the cytomel, but haven't stuck to my exercise very well due to a brutal work schedule, so haven't lost anymore.  I do start getting tired around 3:00 pm or so, but that's ok because I have to go to bed really early (7:00-7:30 pm) because I get up so early.  I've even started sleeping through most of the night, which just wasn't happening before.  

My point is: I think it's necessary for each of us find a doctor who will listen and work with us and is willing to try different things (easier said than done - I just got lucky with the ENT and endo); then go for what works for us. In addition to getting lucky with my doctor, the info I found here on MH helped immensely.  With the help of everyone here, I was able to filter through the info and use what applied to my situation.  

I've read about the controversy regarding synthroid vs generic, vs armour, vs adding cytomel, etc and though I think it's important to be aware of possible problems, we have to find the combination that's right for our body.  Since I have Hashi's and am still in the die off mode, I don't expect everything to go without any problems from now on,  and I do still have some times when I don't feel just right; however, even then it's so much better than I was, I'll take it.  I did forget that second dose of cytomel one day; I paid dearly for that and it took a couple of days to get back to normal again.  So depending on your schedule, multiple dosing may not be right for some.  I do sometimes run into a problem where I get busy and can't stop or just plain forget, but I get the dose as quickly as I can.  

I feel so much better equipped to handle the problems that I'm sure will come up and at this point am more than willing to try something different if this regimen stops working.  

Good luck with whatever you decide to do.  

[stella5349]

That's unfortunate that the Armour in Australia has had issues Deb. Is it true Armour off Forst Pharm?  I don't know of anyone else produces Armour other then them.

I know with Forest Pharmacuticals - the Armour processed is very strict in processing and the levels of hormones is distributed appropriately. I have had telephone conferences with reps from there and feel I am getting the most up to date information any consumer can get on their processing levels and medication information. They are very open to speaking with thyroid patients on any questions they have regarding their medicines processed in their facility.

The UK is right now going through a ban on Armour. But it has nothing to do with the med itself and it's inability to help the patient. It is the UK Royal College of Physicians that have made the decision to punish any prescriber to the full extent when prescribing Armour ( and soon T3 in general)- not based on anything. The British Thyroid Association (BTA), would need a study conducted to set forth changes and this is the society that states

This is the same establishment that orders - " A TSH of more the 10 is "POSSIBLE" cause to "possibly" consider administering any thyroid medication or treatment for hypothyroidism! How tragic for those UK patients!

Here is UK information from the BTA and RCP that validates the poor movement of govered political health care.

http://notifixio.us/events/3447917

Also - UK conversions issues are ignored and only in rare situation will a physician look at giving even T3 -  everyone has been forced in returning to thyroxine - some doctor are giving them T3 Cytomel to help aid them - but that could soon dimish quickly too.  Again there is NO public "safety" harm that was implied that ruled this situation and doctors are explaining to their patients secretly of how unfair this is - but there hands are tied and are forced to comply. If this order is NOT complied with - . If not they risk being arraigned before the GMC. This is the problem with governed medical care. Once ROYAL word is set forth from the government - all MUST obey

This is NOT what I want for the US health care system at all. This is ignorance and politically suicidal for patients needed other forms of treatment. and will cause a stir in underground medical care that could prove unsafe for many!

Explain the ban in Australia to me Deb - I have information that only the UK is banned and many Aussie's are still recieving care with Armour. I spoke to two yesterday. It's not the prescribing choice of thyroid care - but still prescribed ( if you look for it) from what I am told.

Sorry this is off topic a bit - but it needs to be out there heard too.

[Smilerdeb]

I dont know if anyone is interested but in Australia Armour was 'banned' and is no longer prescribed even though the original manufacturer caem from New Zealand.
The reason it was banned was because they found that some Armour had 'irregular' amounts of T3 in it and there wasnt a standard basic dose of T3 in each batch. The batches differed meaning it was dangerous to prescribe Armour for anyone with heart problems etc.
They do however reccommend that a T3 be given with a T4 med if needed (conversion problems).

So there is a lot of controversy regarding Armour in Australia.
We do have 'Compounding' Doctors and Pharmacists here who will prescribe their own 'concoction' but under the Health and Foods Act, Armour ™ is banned.
Just information I thought some should know.

Personally I am on Thyroxin Sodium (T4) with the brand name Eutroxzig and have been since I went Hypo 5 weeks after RAI (June 2008) and doing really well on it although I must add that 'educating' myself was the secret to getting a good 'balance ' .

[stella5349]

Nope

Just a thyroid patient that went through he//

[Benny0147]

are you a dr ?

[stella5349]

Many on Armour find taking the med through the course of the day give them an even keel with the hormones coming in. Most benefit from splitting the meds up through out the day because of the direct T3 being short lived.

It makes things alot easier to balance for the system to work better. I found - when I got on my correct dosage and found out the best ways to split the meds during the day - the more IN balance my body became and then after I stabilized on Armour - some weight has started to drop off - But my diet has also changed significantly too. About 11 pounds I have lost so far and hoping now that since all of my other symptoms are gone this weight stuff will come off too.

Bottom line is the weight won't fall off without being totally in check with your system

I gained a total of 40 pounds when I wasn't stable.  That's what I was trying to say earlier about the med. It takes some definate tweeking to achieve the optimal results - once you get there - you will see changes. Did you doctor suggest to you at all about splitting your Armour during the day?

I hope what ever path you go is successful -

[Thypatient]

I’m glad you got to respond – since this was all for you anyway.

TT stands for total thyroidectomy or having the thyroid removed.  From your original post I thought that’s what you’ve had.

Like I suggested above, it sounds like you might want to think about trying whatever med you were previously on.  It seemed to be better for you.

As for the T3 aspect of medication, that’s something you should go over with you dr on.  It’s not always necessary and taken when not needed it can cause problems – problems like the twitching you describe in your original post.

There is one thing to keep in mind regarding slow-release or time-release T3 formulas:  There are none right now that are commercially available through a regulated pharmaceutical company.  The only ones available are created through a compounding pharmacy, but these formulas (and this is important) do not have FDA approval.  That means there’s less quality assurance on what one is getting in each pill.  I had read this has caused serious problems for some thyroid patients.

(If anyone knows of whether this FDA approval has recently come about, please correct.)

There currently is a T3 formula that’s commercially available and FDA approved - but it’s not a slow-release or time-release med.

Good luck in whatever you choose to do for your best health.  Wish there was a magic answer on the weight…

Take care.

[tiny701]

Thanks so much for all ya'll comments in regards to the Armour. I am so confused about everything ya'll stating. It seems like the bottom line is that Armour is hard to regulate.  I only swithched to Armour because a certified RBTI Nutrionist suggested it. Before i was taking Synthroid and it was horrible. I lost almost all my hair. I went from thick hair to seeing through my scalp. Before I took Levothroxine an it did me fine. Just trying to lose weight so I kept switching meds. I wished I would never did it. My tsh was 0.05 and my T4 was 0.64.
Laura,
You were saying something about t3 meds and t4 taking throughout the day. How does that work? What is TT ?  All I know is I work out 5 days a wk and do weight training and the weight keeps on coming on. I am miserable.... I went from 150 to now  185. More weight since I have been on Armour for 18mths.  I just don't know what to do anymore. I switched Dr. and now seeing a Internist that also practices more the natural way, which I was very interested in. I am searching for it all just to feel better and get this weight off.
Thanks for everyone and I do appreciate ya'll help. If anyone has any suggestions on getting this weight off,, I am all ears.
thanks
Tiny701

[laura1967]

Hi Tiny....yes for some people it is very hard to regulate Armour, and your Free T4 does seem to be quite low still. I don't see a Free T3 result? You should always have that run if you are on a combo med like Armour.
There are other options out there if you still want to remain on T3 med with your T4. Your doctor can put you back on Levo or Synthroid with the addition of Cytomel. My doctor uses a local pharmacy to compound it into time release so patients don't have to keep dosaging the T3 throughout the day. This is a combo option she has given me as I have been trying armour for 8 months now and still trying to regulate. I am also still in the die-off mode of the thyroid though.
The point is that Armour works for some and doesn't work for others, just as all thyroid meds are concerned. You need to just keep communicating with your doctor and keep working together for your best interest and health.
I hope you get to feeling better soon. It is a hard road. Let us know what you decide with your doctor. :)

[stella5349]

Your taking offense where it is not necessary Thypatient. There are many reputable sources supporting both treatment options. You choose to side with T4 - there is nothing wrong with that. It works for many - that's great.

If this member seeking information want to try other forms of medication - that's great - she deserves to feel better as everyone else should. Not informating her of her questions listed above because of legimate information is crazy.

Yes the poster is looking for information. Let's give it to her on both sides. No one is discrediting anything here and you are fighting something that is senseless.

No one wants to argue about T4. I surely don't

[Thypatient]

I do feel the need to add…

Mentioned above was another misconception that frequently pops up.  It’s in regards to the whole T3, combination T3/T4 therapy and the conversion issue.

I strongly suggest reading through some reputable books and websites on basic thyroid information.  Just about everything needed to know is accurately there.  Start with the American Thyroid Association or the British Thyroid Association perhaps.

~

(On another note:  I figured when I wrote what I orginally did that I'd get beaten up...and I am.   And all for telling the truth.  Now I'll get private messages and see blog spots in support of what I've said by those who know it's right but are too afraid to say so here.  Think about that...)

[Thypatient]

Admit?  I wouldn’t have to admit to things I know to be untrue.

To address your last line…I was originally answering tiny701’s query with what I thought would be best for her health, after seeing her mention she had a TT.  It is a fact that drs recommend a brand named levothyroxine after a TT over any other kind of med, including Armour Thyroid.  To state otherwise, just for the sake of not wanting to offend anyone, would not be forthcoming.  Plus she has stated that she is currently on Armour and is having problems.  To encourage her to continue on that med, especially after observing the difficulties others in her situation have had, again just for the sake of not wanting to offend, would also not be forthcoming.

Honestly, you seem to have gotten sidetracked, starting with interjecting misinformed comments on drs’ training during internships.  Which leads me to getting to ask now:  What source is that kind of information coming from?  How are you so certain just what drs are or are not trained to do?  I guess I could take the time to go through each anecdotal statement like that one (some not even making sense) and ask the same question, but I think I’ll skip to asking the more important question:  Should tiny701 remain on a med that isn’t usually recommended after having the thyroid removed and doesn’t seem to be working for her based on anecdotes?

Please remember:  If you want to make choices or options for yourself and view things in a certain way  – that’s your prerogative.  But this is about giving input on what seems best for someone else’s health, and perhaps life.  Period.

[Benny0147]

I thought its generaly known most dr's have no  clue on how to prescribe thyroid meds..and 99 out of 100 jsut tos you on T4 which is non sense...

[stella5349]

~~ correction
You don't need to convert anylonger if you have no thyroid exsisting -  You don't need to "depend" on the thyroid gland converting along with the other parts of the system. There is no more thyroid conversion.

[stella5349]

Relax my friend - I am not trying to upset anyone.

You have to admit - Doctors are not given a steady learning of using T3/T4 meds since Synthroid has come to focus. You can't say they are as well understanding about this med and knowing about T4 - It's just not true. They are more familiar with conversions than direct - you know that.  I have been to dozens of doctors in my histroy and recently - now on Armour - "many" of them honestly admit to not knowing much about it at all. That's just one person's experience with doctors. They establish that they "think" it is not consistant - but when approached by people that are doing well - and questioned this- so they as wanting to be an informed patient asks this - they openly admit to not undestanding the med and dosages to a degree. It's the protacol of using the Armour - not being treated just with it.

How many posts are seen here where a member asked about labs and someone offers additional testing to see if something else should be uncovered. Simply - do the tests- It's a blessing the medical world uncovered blood test- now use them. ......... a person should not have to come to a board for answers or thoughts - the doctor should be right on top of it and doing what should be done. period. Why aren't these done? It's insane!

I have said this a millions times and one more for the record - Not everyone fits the same profile when it comes to treatments - meds - and hormones. not one soul is identical. There is absolutely no reason for a doctor to ~not~ consider looking at a different level of treatment when a patient is crying for help whether on Armour and wanting Synthroid - or vice versa - and basing a lab test is not always correct.

Come on Thy - You know how this goes. A doctor that believes in Armour will go the extra mile more with it than someone who thinks Synthroid is better. Be real! - you can't agrue that.

and most only look at Synthroid as the proper med to use. Not b/c of anything but what they were taught.  For heaven's sake - the endo I went to in Madison openly admits to saying a direct T3 would be fine for someone with absolutely no thyroid whether RAI'd or TT - but the down slide of losing the short lived hormones can be horrendous for that person IF they miss a dose.  

You don't need to convert anylonger if you have no thyroid exsisting. It's just the med and what the body needs to do now with it to convert it into T3. What's the difference?

Higher T3 in Armour?- Yep maybe........ can the body adjust?? - absolutely for some.

Stop this constant crusade of what's right and wrong with Armour. It's the person getting well and having quality care to get there.

[Thypatient]

I think since it’s been mentioned that the thyroid has been removed, that’s the crux of this question.  What is a chosen med for someone dealing with another aspect of thyroid disease doesn’t really apply here, so debate on thyroid meds isn’t really pertinent for this question.

However, I’d like to give input on some misconceptions that continually seem to pop up regarding the meds.

The main one is that drs are unfamiliar with Armour Thyroid and desiccated thyroid hormone meds.  This is simply untrue.  I’ve not read or come across any qualified dr not knowing about it.  If that were to be the case, I’d seriously think twice about such a person.  My own endos and surgeon have the training and leeway to prescribe it if they see fit.  But they don’t for the reasons I mention above.  Also, as a personal note, I know pharmacists who back up the drs (who don’t care what med someone would take because they get paid the same either way).

Another one is that when someone starts having issues being on Armour Thyroid, it’s a failure coming from not knowing how it works.  This would make no sense after hearing that it only gets prescribed by drs who are highly informed.  (Who would take a drug from a dr who doesn’t know how to dose and treat with it?)

Yet another is the unschooled contemplation between thyroid disease/meds and vitamin deficiencies, other hormonal levels and (most especially) Adrenal disease.  These things get brought up, and though they could be and might be taking place, a qualified dr can make that determination through consult and testing.

BTW:  In case it’s not clear regarding thyroid blood testing…in the case of someone who’s had the thyroid removed, a dr is usually ordering all the necessary blood work.

Take care.

[stella5349]

T4 meds are more widely prescribed than Armour or T3/T4 meds are. I think one of the reasons is they are taught on how to use the T4 meds more so than learning about how to treat with a combo medication. Armour is not learned about in training during internships any longer.

Both medications have benefits - yet if the T4 meds fail for an individual - then some prescribers will suggest Armour - but be unfamiliar on how to dose and treat with it. Most likely the thyroid patient will then feel worse due to mis information and un clear lab tests. It's not harder to regulate with Armour - but it is a different form of treatment that is not understood as much as the others. Many reep positive benefits from proper treatment with Armour if they find a doctor willing to take the extra time involved treating with it.

Also putting aside the meds - many thyroid patients have other issues like mineral and Vit deficiencies that work against thyroid medications - when these are issues. Armour is especially sensitive to these deficiencies and when they are a problem - this med can interact negatively on a patient. Not necessarl\ily with thyroid labs tests - but by symptoms.

Key is to look at everything with as much testing as you can get on the whole picture of your health. Adrenal testing - FSH/LS panels ran and simple blood work for deficiencies along with precise thyroid testing on TSH - Free T3 and Free T4 levels could hold the answer to how you can feel better regardless of what med you are on.