Hypothyroid Question (labs included)

**nyjetsfan** · 02-06-2013, 12:40 PM

Guys: just got labs back and TSH looks good but T3/T4 look just above normal. Also T4/T3 seem to be going down after my last lab report. I'm taking 90 MG of armour thyroid and its done wonders for TSH and nothing for T4 and T3. Anyone have similar experience?

thanks!

**flyrs** · 02-06-2013, 03:07 PM

Isn't it just like testosterone in that if you add exogenous it shuts done the bodies' production of it. So the armour has suppressed your normal production and you could maybe bump up your armour dose some to try to get both T3 and T4 higher in their normal ranges....above the midpoint of the ranges might be better............It kinda says to me that you are using more than you are making or supplying. Are you still feeling good from taking armour?

**steroid.com 1** · 02-06-2013, 04:02 PM

Forget TSH it is in many ways useless. Your Free T3 is the one most important as it reflect the bioavailable form of Thyroxine and it's low!

Your T4 and T3 are very low as well.

I would have liked to have seen reverse T3 and antibodies as well.

You probably need to add in T4 into your protocol but you need to see a Physician who understands the thyroid well.

You probably still feel all the symptoms of low Testosterone .

You should also know that when T3 serum levels are this way it can slow the production of sex hormones...not what you want.

Get to your Doc!

**nyjetsfan** · 02-06-2013, 05:35 PM

Thanks guys! Taking 60 mg of Armour and still feel like shit. Seeing doc Tuesday. Good point in possibly adding T4 but will ask doc. Been dealing with this for about a year and its been tough. It's just crazy how even with armour and drastic changes in TSH the T3/T4 and free T3 still low. Ill see what doc says

**Trific** · 02-06-2013, 06:00 PM

I was just reading this: How do patients dose with natural desiccated thyroid? Thyroid patients and their doctors have found it wise to start on a smaller dose of desiccated thyroid than they will ultimately need, such as 1 grain (60 mg). Why? Because the body may need to adjust to getting direct T3 again, and there may be other issues which can reveal themselves, such as sluggish adrenals or low Ferritin/iron levels. Those who start on natural desiccated thyroid have discovered that it can be wise to RAISE within two weeks or less to prevent hypothyroid symptoms from returning due to the internal feedback loop in your body, which can happen if you stay on a low dose too long before raising. Most patients start to slow those raises down in the 2-3 grain area to give the T4 time to build (which can take 4-6 weeks) and show its conversion results. Many patients end up in the 3-5 grain area, but some can be on less, and some more. It’s individual.
http://www.stopthethyroidmadness.com...l-thyroid-101/

**junk2222yard** · 02-06-2013, 06:03 PM

EDIT: I posted my mssg at the same time as Trific above, so it covers some similar stuff.
-----
Hi there,
I didn't see a Free T4 in your labs? Did I miss that?

Anyway, if you are truly hypothyroid and trying to get it addressed through Armour, the usual dose is 2 grains or more. You are doing 1.5 grains, which is a little less than the norm, though fine for some people.

How did you get your dose of 90mg? Did you start low and ramp up?
And did you take Armour earlier the same day you got your labs done? If so, that will skew the results.

I don't know how much you know about Armor and thyroid, so maybe I am telling you stuff you know, but if you don't know a lot this page (and the site) is very informitive: http://www.stopthethyroidmadness.com...patients-make/

Most people on Armor for hypothyroid do not have to further supplement with T4 or T3, they just have to get their dosage right.

**nyjetsfan** · 02-06-2013, 06:22 PM

Guys- thanks again for chiming in. I started on Armour 60mg and ramped up to 90 after T3/t4 were low normal. Thing is : While the TSH dropped significantly my T3/T4 is also dropping. This is what I find so odd. So I guess my only option is to ignore the TSH, go with my symptoms (feel like shit) and the T3/T4 results (low) And up the armour dosage. Of course ill speak to the doc on this for best course of action. Btw- agreed! Stop the Thyroid madness is a very informative site. Just awesome for anyone with Thyroid issues

**nyjetsfan** · 02-06-2013, 06:25 PM

Originally Posted by junk2222yard

EDIT: I posted my mssg at the same time as Trific above, so it covers some similar stuff.
-----
Hi there,
I didn't see a Free T4 in your labs? Did I miss that?

Anyway, if you are truly hypothyroid and trying to get it addressed through Armour, the usual dose is 2 grains or more. You are doing 1.5 grains, which is a little less than the norm, though fine for some people.

How did you get your dose of 90mg? Did you start low and ramp up?
And did you take Armour earlier the same day you got your labs done? If so, that will skew the results.

I don't know how much you know about Armor and thyroid, so maybe I am telling you stuff you know, but if you don't know a lot this page (and the site) is very informitive: http://www.stopthethyroidmadness.com...patients-make/

Most people on Armor for hypothyroid do not have to further supplement with T4 or T3, they just have to get their dosage right.

Didn't get free T4 test done. Should have. Will look into possible upping the dosage though based on results and symptoms. Ramped up from 60 to 90 mg over 2 months. Didn't take meds day of test. All good questions btw

**junk2222yard** · 02-06-2013, 08:55 PM

Originally Posted by nyjetsfan

Didn't get free T4 test done. Should have. Will look into possible upping the dosage though based on results and symptoms. Ramped up from 60 to 90 mg over 2 months. Didn't take meds day of test. All good questions btw

Well if you put stock in the advice at STTM, you should ramp up pretty quickly to two grains, and then slow down. Going fro 60 to 90 over 2 months is too conservative. It is recommended 30mg every 2 weeks, unless suddenly you feel hyperthyroid. Once you hit two grains (120mg), *then* slow down, and get labs done, but do not take the meds just before getting blood! Also, keep track of your daily temperature taken before you get out of bed.

I think by the sounds of it, you are guilty of #1 from the link I gave you:
STICKING WITH TOO LOW A DOSE.

If I were you, and was at 90mg now and not feeling better, I would bump dose by an additional 15mg, then a week later add another 15mg, then when I was at 120mg (2 grains) I would do it for a month and get labs done.

I don't think TSH matters when you are on NDT. You should go by how you feel, your temperature, and labs that include Free T3 and Free T4.

FWIW I am in the same boat as you, and ramping up my own doses as we speak, and giving you advice based on what I have read and how I am doing it myself.

**Vahevahe** · 02-07-2013, 03:14 AM

+1 Gdevine. Tsh is just a signal and is useless in a majority of cases.

**nyjetsfan** · 02-07-2013, 09:34 AM

Originally Posted by junk2222yard

Well if you put stock in the advice at STTM, you should ramp up pretty quickly to two grains, and then slow down. Going fro 60 to 90 over 2 months is too conservative. It is recommended 30mg every 2 weeks, unless suddenly you feel hyperthyroid. Once you hit two grains (120mg), *then* slow down, and get labs done, but do not take the meds just before getting blood! Also, keep track of your daily temperature taken before you get out of bed.

I think by the sounds of it, you are guilty of #1 from the link I gave you:
STICKING WITH TOO LOW A DOSE.

If I were you, and was at 90mg now and not feeling better, I would bump dose by an additional 15mg, then a week later add another 15mg, then when I was at 120mg (2 grains) I would do it for a month and get labs done.

I don't think TSH matters when you are on NDT. You should go by how you feel, your temperature, and labs that include Free T3 and Free T4.

FWIW I am in the same boat as you, and ramping up my own doses as we speak, and giving you advice based on what I have read and how I am doing it myself.

Great advice and thx. I was puzzled by a great tsh and low t4/t3 but I think the best solution is to ramp up and retest as you stated. My doc is great and agrees that Tsh is useless. I will see him Tuesday and adjust. My dhea was also border line low so my add that to protocol as well starting slow.

**steroid.com 1** · 02-07-2013, 10:49 AM

You need more labs before discussing dosages of armour.

Reverse T3 (RT3) is critical and reveal a lot!

Also, need to see Thyroid antibodies as well.

Your T4 is low (really need to see Free T4) and you are converting to T3 very poorly as well.

Sometimes just adding in T4 can do the trick but it's really not that simple.

I hope your Doctor is a specialist, most PCP don't know much after TSH and a standard armour protocol.

**HRTstudent** · 02-07-2013, 06:33 PM

This is from Dr Mariano, an HRT specialist who is concerned most with patient behavior:

As a rule of thumb, I like to see thyroid levels in an adult which are in these ranges:
Free T3 = 330 - 340 pg/dL
Free T4 = 1.2 - 1.76 ng/dL
Total T3 = 130 - 205 pg/dL
Total T4 = 8.0 - 12.0 ug/dL

**nyjetsfan** · 02-07-2013, 06:53 PM

Originally Posted by gdevine

You need more labs before discussing dosages of armour.

Reverse T3 (RT3) is critical and reveal a lot!

Also, need to see Thyroid antibodies as well.

Your T4 is low (really need to see Free T4) and you are converting to T3 very poorly as well.

Sometimes just adding in T4 can do the trick but it's really not that simple.

I hope your Doctor is a specialist, most PCP don't know much after TSH and a standard armour protocol.

Going to ask for more labs as stated. Also - Anti thyroglobulin was 20 (range 0-40). Dr is good - knows his stuff. I will let him know about this thread and this teams feedback. Lots of good info. Thyroid def seems more complicated than TRT for me no doubt. Need to get this straightened out because like you said : really feeling like I'm getting the low t symptoms all over again.

**nyjetsfan** · 02-07-2013, 06:55 PM

Originally Posted by HRTstudent

This is from Dr Mariano, an HRT specialist who is concerned most with patient behavior:

As a rule of thumb, I like to see thyroid levels in an adult which are in these ranges:
Free T3 = 330 - 340 pg/dL
Free T4 = 1.2 - 1.76 ng/dL
Total T3 = 130 - 205 pg/dL
Total T4 = 8.0 - 12.0 ug/dL

Good info. Thx

**TMan96** · 02-18-2013, 06:59 PM

Great thread. I have been diagnosed with hypo as well and am on Armour. I think my TSH has been lowered to a good range, but I wonder about my T3. These reference numbers will come in handy. I should have my new #s available after my 3 month bw with my doc tomorrow . I'll start a new thread with this info and current protocol.