what levels to aim for?

[AnnaS69]

I just got the results of my latest labs, on 5 grains (300 mg) of reformulated Armour Thyroid:

TSH 0.01 (ref 0.2-4.0)
FT4 1.1 (ref 0.7-1.5)
FT3 2.9 (ref 1.8-3.8)


I still feel quite hypo, although the doctor says labs look OK.

Could anyone please tell me what my FTs SHOULD look like when optimally dosed???

5 grains is a huge dose, isn't it? Does this mean that Armour is not working for me, and that I should try Erfa Thyroid instead?

My FT4 levels look OK; I've read they should be more or less midrange on NDT, but I wonder why my FT3 is not higher, with the 190 mcg of T4 and 45 mcg of direct T3 daily from Armour...?!

Also, I recently switched labs after moving, and my former lab used different reference ranges: 0.8-1.8 for FT4 and 2.2-4.2 for FT3. I don't know if I risk ending up even more hypo with my new lab and its lower reference ranges?

Any thoughts or ideas?

Thanks.

[nicolelm]

I notice that I feel a difference in the positive when I don't wait long to eat. I only wait 30 minutes and then I eat whatever I want. I seem to be getting a jolt of energy that way. I am on Armour too. I read a member's response years ago, and he said that the FT3 in Armour needs food or you will still feel lousy.

He suggested to have the Armour 20 minutes after breakfast, but I think this must have been the old formulation. My prescription bottle says before so I just do 20-30 minute before breakfast. No later. It made such a difference for me.

Do you wait long to eat?

[goolarra]

I'm assuming that your RT3 was tested on this same dose of Armour???

T3 has a very short half life, so most people split the dose, part first thing in the morning and part in the late morning to early afternoon.  If you don't split it, you often end up with a real dip in energy in the later part of the day.  That would be the first thing I'd try if I were you.  You can experiment with exactly what time works best for you.  Most people avoid taking it after about 3:00 pm so that it doesn't interfere with sleep.  You also don't have to do a strictly 50/50 split.  You might take 3 grains in the morning and 2 in the afternoon, for example.

[Brucergoldberg]

sounds like some sttm whackyness.   swallow the pills.  how long have you been on 5 grains?  dont be surprised if it doesnt sneak up on you ....

[AnnaS69]

I had RT3 tested six months ago, and the FT3/RT3 ratio came back 22.

I take the whole dose in the morning, upon waking ,as my doctor says that NDT is meant to be taken in one single dose in the morning? I chew the pills up and swallow them, I don't take them sublingually.

I always have labs 24 h after latest dose.

[goolarra]

The rule of thumb is, as you say, midrange for FT4.  Many people on desiccated find they need FT3 in the upper half to upper third of range.  Yours is just slightly over midrange, and of course, symptom relief is much more important than lab results.

Five grains is a pretty big dose.  You have to wonder where all that T3 and T4 is going.  

The different reference ranges from different labs reflect their methodology.  So, no, you shouldn't be even more hypo with the lower ranges.  One would expect you to test slightly differently at the two labs.  As a percentage of range, you should be about the same.

So, back to where's it all going...  You could have an absorption problem.  However, I'm kind of shying away from that because your FT4 looks so good, and it's T4 that has the absorption issues more than T3.  How do you split your dose?  Had you taken meds before this draw, and if so how long before?

Another posibility is that your RT3 level is high.  Have you had RT3 tested?