# Are more labs needed?



## Julie (Apr 1, 2010)

Hi! Newbie here. I was diagnosed hypo 6.5 years ago. Started on synthroid by GP, then tweeked by endo. Endo was all about the #s. About 2 yrs ago I found a new endo as my labs were within range, I still felt awful. This endo confirmed Hashi's.

New/current endo tweeked meds for about 6-9 months and then changed me to Armour. Was taing 180mg and after about 6 months I felt better then ever. This continued until the fall of 2009 when Armour was not available. Switched to synthroid and cytomel combo. I was only on this about 4 months until Armour was available again. By the time I switched back to the Armour I felt worse than ever. From 9/2009 to 1/2010 I have gained 20# and no amount of dieting or exercising has budged it a bit. I have been back on Armour since 12/2009. No labs were done in 12/2009, but they were just run 3/2010. They seem crazy:

TSH 8.32 (0.45-4.50)*
T4, Free 0.83 (0.82-1.77)
TPO 534 (0-34)*
Thyroxine T4 4.5 (4.5-12.00)
T3 Uptake 29 (24-39)
Free Throxine Index 1.3 (1.2-4.9)
Triiodothyronine T3 63 (71-180)*
Ferritin Serum 15 (10-291)
Iron Saturation 13 (15-55)
Testosterone 78 (6-82)

Prior to labs I was taking 180mg of Armour daily in one dose and 3-500mg metformin in pm.

Since labs I am taking about 210mg of armour in one dose in am (3 and 1/2 tablets), slow fe at lunch with 500mg vit c, and 3-500mg metformin at dinner. I am taking the iron at mimium 6 hours after armour.

Confused by the increase in the TSH and what the other out of range labs are and why the armour is not kicking in.

Are labs comprehensive? Are more needed?

Thanks for input.


----------



## hillaryedrn (Dec 14, 2009)

Hmmm, it looks to me like those indicate you are still hypo, but I'm going to let Andros help you when she gets the chance as she knows more about that than I do. I have a question about your Metformin. Are you diabetic or insulin resistant? Are you taking this for blood sugar control or weight loss?


----------



## Julie (Apr 1, 2010)

Thanks, I forgot to mention why I take Metformin. Endo started me on it for high testostrone and PCOS in Dec 2008.

I do not think that my TSH has been this high since I have started on meds. I am surprised that it is high.


----------



## hillaryedrn (Dec 14, 2009)

Ah, yes, that is a common treatment for PCOS. Have they said anything about insulin resistance? That often goes along with PCOS. Just a thought on the side. I would definitely want more labs done now that you're on an increased dose of Armour. When does the Endo have you scheduled for more labs? That is curious that your TSH is so high now. Bet you feel pretty cruddy. If he hasn't scheduled you for more labs, I'd call back and request some!! It won't do to have them drawn too close to your last set, but you do need more, I think.


----------



## Julie (Apr 1, 2010)

The labs i posted were drawn on 3/5 and the doctor adjusted my meds on 3/9. I will see him at the end of May and have labs done then.

What else should be looked at? Is he misisng anything?

I don't understand why the labs look so hypo and I don't seem to be responding to the armour as well as I did before. I know a lot of people had a hard time with the reformulation, but i think that is all I ever took. Is it the reformulated Armour or is it something else? Is there a way to even tell?


----------



## Andros (Aug 26, 2009)

Julie said:


> Hi! Newbie here. I was diagnosed hypo 6.5 years ago. Started on synthroid by GP, then tweeked by endo. Endo was all about the #s. About 2 yrs ago I found a new endo as my labs were within range, I still felt awful. This endo confirmed Hashi's.
> 
> New/current endo tweeked meds for about 6-9 months and then changed me to Armour. Was taing 180mg and after about 6 months I felt better then ever. This continued until the fall of 2009 when Armour was not available. Switched to synthroid and cytomel combo. I was only on this about 4 months until Armour was available again. By the time I switched back to the Armour I felt worse than ever. From 9/2009 to 1/2010 I have gained 20# and no amount of dieting or exercising has budged it a bit. I have been back on Armour since 12/2009. No labs were done in 12/2009, but they were just run 3/2010. They seem crazy:
> 
> ...


From what I have read, if anything, Metformin aids in lowering the TSH. That said, I believe that you have to give the new Armour a chance. It is a pity that labs were not done prior to your switching back to Armour because we really don't know if there is any movement.

I have been through the same thing. Left off taking 3 3/4 grains of Armour and feeling terrific for years. Then the world blew apart Armour-wise!

With the help of my doc, we winged it w/ cytomel and cutting down on my precious stockpile of Armour (I always had this fear.) I am a mess. Very symptomatic.

Now I am starting back on the Armour. The titration process will take a while. I may require more or I may require less. Like yourself, I suspect I will require more. We will have to wait and see. My doc is having me lab every 8 weeks. So..........................it is time consuming.

Your Total 3 is in the basement so this is one of the few times it is useful. We can only imagine how very little Free T3 you have. You are waaaaaaaaaaaay undermedicated. So am I. My Free T3 is below mid-range. Not good.

Wonder if you may benefit from taking the Fe 8 hours away? Everyone is so so different. If you are hypo, that means you also have hypomotility of the intestines. Yes? You see?

Where is your Ferritin at?

I said all of the above to say that there is no question in my mind but what all this jury rigging of thyroxine meds and switching about has trigger the antibodies and that is why we feel so bad and that is why TSH is lingering at such a high number.

The thyroid body likes nothing better than consistancy. Throw a curve ball and we are down for the count.

Let us know how you are faring and what you think!


----------



## Julie (Apr 1, 2010)

Andros thanks foryour input! It is pretty much what the doctor said, each time you bounce it is a bit harder to bounce back. He did adjust my meds and is waiting to see how I react. He seems to be very good about treating symptoms and not numbers.

I don't know if there are different Ferritan tests, but I had a ferritin serum and it came back at 15 with a range of 10-291. It is in the lower of normal. I understand that this can be thyroid related, it also might be a genetic disposition as well. My sister has very low ferritin levels.

Is there any way to help things along? Or is it just a matter of waiting it out?


----------



## Andros (Aug 26, 2009)

Julie said:


> Andros thanks foryour input! It is pretty much what the doctor said, each time you bounce it is a bit harder to bounce back. He did adjust my meds and is waiting to see how I react. He seems to be very good about treating symptoms and not numbers.
> 
> I don't know if there are different Ferritan tests, but I had a ferritin serum and it came back at 15 with a range of 10-291. It is in the lower of normal. I understand that this can be thyroid related, it also might be a genetic disposition as well. My sister has very low ferritin levels.
> 
> Is there any way to help things along? Or is it just a matter of waiting it out?


Oh, whoa!! Yeah! Ferritin should be 50 to 100 and the closer to 100, the better. Do try taking it more than 6 hours away and do what I do;cook w/ cast iron. Eats lots of beets, beet tops and dark green leafy veggies such as collard, endive, escarole, spinach and raisins.

If I were your sis and if you put a little birdy in her ear, she should have her thyroid checked. We don't know for sure which came first; the cart or the horse but since the thyroid disease body is deficient in a lot of minerals, electrolytes and essential vitamins................................


----------



## Julie (Apr 1, 2010)

It is lab time. I have to call the office to get my lab slip. The receptionist always asks what labs I want or do I want what I had last time. Is there anything that needs to be added to what I had in March? Is it important to have the antibodies run again?

I am still feeling pretty crappy: tired, run down, achey, constipated, irritable, dumpy and no motivation. Not dieting exactly, but very mindful of what I eat, how much and when. I have been rewarded with almost 5# gain. I have not noticed any positive improvement since my armour was upped to 3.5 60mg tabs after last labs. I have been back on Armour for 6 months now and feel no different then I did on the synthetic mix I was taking last fall. I have backed off taking the slo fe daily. I had terrible contipation, even taking it with the vit c. I have been taking it every other day.

Are there any other labs recommended?


----------



## hillaryedrn (Dec 14, 2009)

Oh you poor thing! Man, I am so sorry you aren't doing any better yet! I'm thinking the same labs should be fine, but maybe someone else has a suggestion. Please do let us know what you find!!


----------



## Andros (Aug 26, 2009)

Julie said:


> It is lab time. I have to call the office to get my lab slip. The receptionist always asks what labs I want or do I want what I had last time. Is there anything that needs to be added to what I had in March? Is it important to have the antibodies run again?
> 
> I am still feeling pretty crappy: tired, run down, achey, constipated, irritable, dumpy and no motivation. Not dieting exactly, but very mindful of what I eat, how much and when. I have been rewarded with almost 5# gain. I have not noticed any positive improvement since my armour was upped to 3.5 60mg tabs after last labs. I have been back on Armour for 6 months now and feel no different then I did on the synthetic mix I was taking last fall. I have backed off taking the slo fe daily. I had terrible contipation, even taking it with the vit c. I have been taking it every other day.
> 
> Are there any other labs recommended?


I need verification of your Armour dose. You are taking 210 mgs.? 3 1/2 grains?

Are you active? It does not sound like it from your list of symptoms. I am really worried because that is a lot of Armour (and exactly the amount I take but I am very very very active.)

I would suggest for that reason that you definitely get TSH, Free T4 and Free T3 and ferritin once again.

Something does not sound right to me. Can't put my finger on it but I am putting on the thinking cap.

Do you have IBS? Any other absorption problems that you can think of? Are you eating foods high in goitrogens such as soy,are you on any med that would negate the effects of your thyroxine replacement?

Have you been checked for EBV, Mono?


----------



## Andros (Aug 26, 2009)

Andros said:


> I need verification of your Armour dose. You are taking 210 mgs.? 3 1/2 grains?
> 
> Are you active? It does not sound like it from your list of symptoms. I am really worried because that is a lot of Armour (and exactly the amount I take but I am very very very active.)
> 
> ...


By the way, my 89 year old neighbor says Metformin makes her horribly constipated. Doc put her on a new drug and she is doing well in that department and also lost a lot of weight. I asked her the name of the Rx but she could not say. Bless her heart.

http://www.drugs.com/metformin.html It says here that thyroid meds affect Metformin so I am going to say that the reverse might also be true; that Metformin may affect thyroid meds.

Plus, some of the symptoms you have described sound like side-effects of Metformin.

Please go to the link and read it if you will?


----------



## Julie (Apr 1, 2010)

Thank you for your input. You all are so informative and I greatly appreciate your input!!

Yes, I am talking 210mg of Armour per day. I was taking 180 and after 10 weeks of being on it, my TSH was still 8.32. I am not overly active, I walk 3 miles over other day and I sit at a desk all day. To round out the picture, I am 5'9" and currently weigh 165#. I was 140# and then added 20# between last fall (when I started levoxyl and cytomel) and when I restarted on Armour last December. In the last 2-3 months I have gained another 5#.

I do not eat soy. I aim for lower carb just by better food choices because my dad and all 6 of his siblings are Type II diabetics, but I do crave carbs - sweets especially. I do not say I have IBS. I have had issues with constipation recently, but I really believe it is from the iron. It did not start until I started taking it and clears within a couple of days if I stop. I have felt an achy pain in the gallbladder area intermittently, but nothing that impacts my activities. I am not sure of it is really gallbladder, gas or constipation.

I have never been tested for EBV, that I am aware of. I had mono in my teens, but not tested recently.

Until I started with the iron, I was never constipated. When I started the Metformin, I would say it was the opposite. I have been on Metformin for almost 18 months. Thanks for the website. I acknowledge that some of the systems are similar to what I am now experiencing, but would side effects kick in after being on a medication for several months?

I am frustrated. Last spring and last summer, I felt great. I had energy, never felt the need for a nap, and I could think. It is very disheartening that I finally get back the medication that helped me feel that way and it is not working.


----------



## Andros (Aug 26, 2009)

Julie said:


> Thank you for your input. You all are so informative and I greatly appreciate your input!!
> 
> Yes, I am talking 210mg of Armour per day. I was taking 180 and after 10 weeks of being on it, my TSH was still 8.32. I am not overly active, I walk 3 miles over other day and I sit at a desk all day. To round out the picture, I am 5'9" and currently weigh 165#. I was 140# and then added 20# between last fall (when I started levoxyl and cytomel) and when I restarted on Armour last December. In the last 2-3 months I have gained another 5#.
> 
> ...


I am disheartened for you and especially because you are a person that tries so hard. Good for you for the walking. Doing what ever you can do when you feel so poo is really hard so I want you to know that I admire that.

Perhaps you need a really good talk w/ your doc or maybe even a different doc. Something is not right here.

If I were to stop walking 4 to 6 miles a day (fast walking) and going to the gym doing high rep weight lifting and all kinds of stuff twice a day six days a week plus doing my gardening and housework and all else I do;no way could I stay on 3 1/2 grains of Armour. I would pop through the rough into hyper mode.

So,it is my humble opinion that something is askew and you are not receiving the full benefit of your Armour dose.

I'll bet you are younger than me? I am 67. You should be running circles around me.

And you will; all of us here are going to help you best we can.


----------



## Julie (Apr 1, 2010)

Andros - Bless you!! May I be as active as you one day! I am 40.

I have tossed around the thought of changing doctors, but my current doctor is the only one I have had who will treat based on symptoms not labs. When I was feeling well last year, my TSH was low about 0.07. I was doing great, sleeping well and had great energy, but not too much.

I wonder if it is the Armour reform. I guess we will wait to see what the labs have to say and go from there.

Thank you for all you do here.


----------



## Julie (Apr 1, 2010)

Labs are in:

TSH 0.01 (0.45-4.50)*
T4, Free 1.32 (0.82-1.77)
T3 Uptake 28 (24-39)
Triiodothyronine Free Serum 3.8 (2.0-4.4)
Ferritin Serum 28 (10-291)
Iron Saturation 17 (15-55)
Testosterone 76 (6-82)

I am still taking about 210mg of armour in one dose in am (3 and 1/2 - 60 mg tablets), slow fe at lunch with 500mg vit c, and 3-500mg metformin at dinner.

I have an appt with my Dr on Wednesday.

I still have that run down, tired feeling. What now?


----------



## GD Women (Mar 5, 2007)

Is there a reason for your TSH to be suppressed? If not this is not good and can be dangerous to your health! It also means you are over medicated - your Armour is too high of a dose.

The body seems to do better with a steady state of energy. T4 acts slowly but T3 is rapid to come and leave the system. Therefore, to maintain a steadier blood level of T3, it is best taken in divided doses.

Actually, fatigue (run down, tired feeling) comes from a T4 deficiency. You might do better lowering Armour and adding small dose of T4 medication.

The most important is to bring up your TSH before it does irreversible damage to your body/system.


----------



## Julie (Apr 1, 2010)

GD

No, we were not intentionally trying to suppress my TSH. Last labs in 3/2010 my TSH was over 8, so he bumped my Armour up by 30mg. My current labs reflect the increased dosage.

I just have not been able to get back that well feeling I had before Armour was unavailable. I was looking for input before going to the doctor next week. To see if anyone had any other ideas of what was happening here.


----------



## GD Women (Mar 5, 2007)

You might keep in mind that your issues may not be from thyroid. Other health issues can mimic thyroid symptoms. Not everyone does well or find health from taking Armour especially if their issues are not from thyroid.

Symptoms of our immune system is a general feeling of unwellness when other health issues are ruled out. The only thing that might help is proper nutrition, vitamins/minerals taken in their proper order and dose, and exercise. Then we just have to live with the rest because there is not much we can do about our immune system.

I think you will possibly feel better when your TSH is back up to normal Lab range. If not then check other health avenues. So many health issues with the same thyroid symptoms can effect us, some we don't even know about or think of. Example teeth in what type of filling we have and more.

I hate to hear people feeling bad especially when there is a possibility its not from thyroid. We can't blame everything directly on thyroid.

Hope your doctor doesn't keep your TSH suppressed, if so I'd find another doctor. He who treats by symptoms alone - is a fool (of a doctor).

Good luck and feel better soon.


----------



## Lovlkn (Dec 20, 2009)

Julie said:


> GD
> 
> No, we were not intentionally trying to suppress my TSH. Last labs in 3/2010 my TSH was over 8, so he bumped my Armour up by 30mg. My current labs reflect the increased dosage.
> 
> I just have not been able to get back that well feeling I had before Armour was unavailable. I was looking for input before going to the doctor next week. To see if anyone had any other ideas of what was happening here.


Have they checked your Vit D levels? I know I feel fatigued if I do not take my Vit D supplements.

Do you have any copies of your old lab work before making the switch in medications?

I would not worry about your TSH levels for now as long as your FT's are well within range - which they are and in time once you stabilize the TSH may reappear.


----------



## hillaryedrn (Dec 14, 2009)

Ugh! You poor thing!! That is just horrible that you don't feel well on a medication that worked for you in the past! I'm at a loss as to what might be going on. Go ahead and check your vit D as advised. Who knows what you might find.


----------



## Julie (Apr 1, 2010)

Thanks for your input. I will discuss dividing my dose and Vitamin D with the doctor.

I read to be informed, but sometimes it gets confusing since there are so many things interacting/related to the thyroid.


----------

