# Is this the right meds?



## jiffer (Apr 1, 2013)

A little back story about my thyroid issue. They found a nodule on my thyroid and they removed the left half of my thyroid March 2013. Thank god it was not cancer. My thyroid is now running hypo (im not surprised). My endo dr prescribed me 25mcg of levothyroxine to start out with.

I was a little worried about the side effect of hair loss with the meds since I have PCOS and had a MAJOR hair shed last fall/winter and since my thyroid surgery I am having MAJOR hairloss again. I talked it over with my dr and she said she has never heard of patients having hair loss with that med. she pretty much blew me off.

She didn't test my free T3 level either. Just TSH and free T4. I asked her about this and she said she never tests for that she treats from the TSH. Well I had enough of that dr and decided to switch.

I found a new endo dr who seems every good and listens to all my concerns. When I talked to him about it he suggested Armour as a alternate med. He said the hair loss side effect seems less with Armour patients.

He didn't test my free T3 yet. He said is will it tested once I am on Armour for 4 weeks.

The dr also said he thinks the 25 mcg of levothyroxine is to low for me and he gave me 30 mg of Armour which he said is equilavent of 50mcg of levothyroxine. He mentioned something about chewing Armour to make it more effective and he has me taking it twice a day.

My thyroid test results were TSH 5.94 (0.40-4.50) and free T4 1.0 (0.8-1.8)

So the few questions I have are:

1. Should my free T3 be tested before I start taking Armour?
2. Do people who take Armour have less side effect of hair loss?
3. Should I chew Armour?
4. Have you guys heard of taking Armour twice a day?
5. Do I take the Armour on a empty stomach? I know in the morning that wont be a problem but the evening dosage it might be since I eat dinner late and I am one of the people who graze all day long to keep me going.

Since joining this board you guys have been very helpful and I want to thank everyone for the great advice.


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## bigfoot (May 13, 2011)

jiffer said:


> I talked it over with my dr and she said she has never heard of patients having hair loss with that med. she pretty much blew me off.


Perhaps your doctor should brush up on pharmacology. (And bedside manner.) The insert with my Synthroid prescription clearly states that upon initiating treatment, temporary hair loss may show up. And we all know that if you are hypothyroid to begin with, or under-medicated, this can have hair loss as a sign/symptom.

Glad you took it upon yourself to find another doc! Probably the best thing you could have done. And not only that, but it's an endocrinologist who believes in Armour. Score!!

1. In theory, your doctor could test your Free T3 within days of you starting Armour. That's because the half-life of T3 is measured in hours and days. But to be complete he probably wants to check Free T4, too. And T4's half-life is measured in weeks. You could ask to be tested before starting treatment with Armour; that would give you a good baseline to compare against in a month when he runs the whole gamut of tests.

2. Dunno. I really haven't had much hair loss on synthetics like Levoxyl and Synthroid, or desiccated thyroid such as Nature-Throid (comparable to Armour, but different fillers). But we are all so individual in how we react.

3. I've read of this. Supposedly this is because the manufacturer changed Armour's fillers & binders a couple of years ago. After the change people noticed they weren't absorbing it as well, and some began chewing it or taking it sublingually. If this turns out to be a problem for you, you could ask for something like Nature-Throid or West-Throid with different fillers & binders.

4. Yes, absolutely. Armour (and similar T3-containing drugs) work best when taken throughout the day, thanks to the short half-life of T3. You may have to experiment and play around with the timing that works for you. You could try first thing in the AM, and then in early afternoon, and go from there. See where your afternoon 'slump' is.

5. Take thyroid medications (any kind, really) on an empty stomach. For morning, take it a half-hour or hour before eating breakfast. Otherwise, if you eat a meal, take it a few hours afterwards. These meds are absorbed through the GI tract. Eating speeds up the GI tract, leading to less absorption. And take it a few hours away from any significant amount of calcium, or calcium supplements, or iron supplements.

Related to #4 and #5, you could also take some medication around bedtime. Your GI tract is even slower at night, so there is better absorption. But I would try the morning and early afternoon first, and go from there.

FYI, expect to see your Free T4 on the low end of the range while taking a drug like Armour. This is common when people take meds with T3 in it. Your doc probably knows this and won't be surprised. Also, with a TSH of 5.94, you will likely need to increase your dosage slowly over time. Don't bump up more than 1/4 to 1/2 grain at a time (you could even split the 1/4 grain into 1/8 if you wanted). Low 'n' slow is the name of the game. Don't let your doctor stick you with an arbitrary limit of 1 grain or something.

For a long-term goal, shoot for a TSH of 1.0 or less, and Free T3 and Free T4 in the upper 75% of the range. But that is easier said than done, and you should eventually reach a point where you feel good. You are trying to optimize treatment and eliminate signs & symptoms. Hard to say exactly where those lab numbers will be, it could be far different than the goal above.


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## jiffer (Apr 1, 2013)

WOW.. Thanks for all the info. Armour is new to me and I am sure I will have a ton more questions about it.

What is considered a grain? My prescription is 15mg 2x a day.

I don't mind chewing the pill if that is what is needed. The pill is very tiny and I am sure it wont be a problem.


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## bigfoot (May 13, 2011)

A grain is 60 mg. "Grains" are old school. Since drugs like Armour and Nature-Throid have been around for so many years, I guess they are old school, too.

http://en.wikipedia.org/wiki/Grain_(unit)


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## jiffer (Apr 1, 2013)

Ahh I understand. Thanks for the info.

I took my first 15mg dose this morning. I hope all goes well.


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## Andros (Aug 26, 2009)

jiffer said:


> A little back story about my thyroid issue. They found a nodule on my thyroid and they removed the left half of my thyroid March 2013. Thank god it was not cancer. My thyroid is now running hypo (im not surprised). My endo dr prescribed me 25mcg of levothyroxine to start out with.
> 
> I was a little worried about the side effect of hair loss with the meds since I have PCOS and had a MAJOR hair shed last fall/winter and since my thyroid surgery I am having MAJOR hairloss again. I talked it over with my dr and she said she has never heard of patients having hair loss with that med. she pretty much blew me off.
> 
> ...


You are lucky to have this doctor. It's all a matter of what is convenient for you to do bearing in mind that "consistency" is key here.

Since you found such a good doc, you may be wise to follow instructions to the letter.

Good for you!


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## jiffer (Apr 1, 2013)

I took my first dose this morning. I have to say I feel like I am in a brain fog and I am tired. Did anyone else have this problem when they started Armour?

I was taking Levo for the past 1 1/2 weeks I didnt feel like that on that med.

I wonder if i have to get use to the new med.


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## Andros (Aug 26, 2009)

jiffer said:


> I took my first dose this morning. I have to say I feel like I am in a brain fog and I am tired. Did anyone else have this problem when they started Armour?
> 
> I was taking Levo for the past 1 1/2 weeks I didnt feel like that on that med.
> 
> I wonder if i have to get use to the new med.


Transition can cause a little nuance but you will be fine. By the way; one grain of Armour equals 60 mgs. and on grain contains 38 mcg. of T4 and 9 mcg. of T3.

Hang in there; you will be good to go.


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## jiffer (Apr 1, 2013)

Andros said:


> Transition can cause a little nuance but you will be fine. By the way; one grain of Armour equals 60 mgs. and on grain contains 38 mcg. of T4 and 9 mcg. of T3.
> 
> Hang in there; you will be good to go.


I am going to stick it out and see how I do. The brain fog is yukky. i drove to work this morning and vaguely remember doing it. I am struggling to do my job today. Also I am really tired. I want to take a nap soooo bad. i also am feeling a little anxious.


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## bigfoot (May 13, 2011)

You are taking a total of 1/2 grain; it's very likely you will need more.


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## jiffer (Apr 1, 2013)

bigfoot said:


> You are taking a total of 1/2 grain; it's very likely you will need more.


Ok. Taking thyroid meds is new to me. I just stated Levo a week and half ago. Before that I was not on any meds. before I started the Levo I was feeling tired and dog tired. Then my hair started falling out bad. I went and saw the endo and she put me on 25mcg Levo a day. I must say I was feeling a little bit better on that dosage and the brain fog was starting to get better, But I was still not 100% myself. I was lucky I didn't have any issues taking Levo. I did not have any side effects (yet) it but with my history of hair loss (PCOS) the new dr thought Armour would be a better choice.

I am curious. Do any of your guys chew the pill when you take it?


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## bigfoot (May 13, 2011)

Nope, no chewing here. But you could always try it and see what happens, especially if your doc recommended it. But perhaps you would want to be safely at home with nothing to do that day, just in case chewing it sends you into the stratosphere. Honestly, these drugs are designed to be swallowed whole and then let the GI tract do its work. But perhaps your doc knows something that we don't...

That being said, you gotta do what works for you. And you really have gotten very lucky having an endocrinologist that point blank recommended Armour. That is like the Holy Grail to many folks, who spend years and years trying to get to that point. Many docs refuse to prescribe desiccated thyroid products like Armour, Nature-Throid, etc. They have been around so long, are effective, and are downright dirt cheap. (But they don't come with free lunches, gifts, and patient samples that the drug reps like to bring around, LOL.)


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## jiffer (Apr 1, 2013)

bigfoot said:


> Nope, no chewing here. But you could always try it and see what happens, especially if your doc recommended it. But perhaps you would want to be safely at home with nothing to do that day, just in case chewing it sends you into the stratosphere. Honestly, these drugs are designed to be swallowed whole and then let the GI tract do its work. But perhaps your doc knows something that we don't...
> 
> That being said, you gotta do what works for you. And you really have gotten very lucky having an endocrinologist that point blank recommended Armour. That is like the Holy Grail to many folks, who spend years and years trying to get to that point. Many docs refuse to prescribe desiccated thyroid products like Armour, Nature-Throid, etc. They have been around so long, are effective, and are downright dirt cheap. (But they don't come with free lunches, gifts, and patient samples that the drug reps like to bring around, LOL.)


I chewed mine the first day and this morning dose. Maybe that is why I feel so off. I will try not chewing and see how I feel.


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## jiffer (Apr 1, 2013)

I talked to my dr last night because I am having a difficult time functioning since starting the Armour. I feel like I am drunk. Dizzy, nervous, anxious, forgetting things, insides shaking like having bad nerves and have foggy brain. I drove to work today and don't remember much of the drive. I felt like I was a daze. I don't understand how I can feel nervous/anxious and lethargic all at the same time. WTH??

I didn't have most of the these symptoms until I started the med. He said maybe it was to high of a dose to start out with and he is having me take 15 mg a day until I adjust. I started that dose today and still no improvement. Still feeling really off. I really hope this new meds works out. I would much rather take a natural med then synthetic.

This may sound strange but I am going to ask anyways. My T3 was not tested before I started taking Armour. Is it possible my body is converting T4 into T3 fine and I don't need a med with T3 in it and I have been giving myself to much T3? I don't know if this is even possible but I figure what the heck and ask.


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## joplin1975 (Jul 21, 2011)

Very possible. It's why t4 meds should be tried first, and then move to dessicated hormone if needed. I am convinced I'd likely stroke out if I had any t3.


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## jiffer (Apr 1, 2013)

joplin1975 said:


> Very possible. It's why t4 meds should be tried first, and then move to dessicated hormone if needed. I am convinced I'd likely stroke out if I had any t3.


Thank you for the quick reply. I am going to call my dr on Monday and see what he thinks. I am leaning towards switching back. I think one of the main reasons he wanted me to switch to Armour is due my past history of hair loss. I 
would prefer to take something natural but I am not willing to effect my quality of life to do that.

I just wasn't sure if having to much T3 is possible. Does anyone know what the symptoms of to much T3 are? Is there a natural T4 only med?


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## joplin1975 (Jul 21, 2011)

Well, I'm all for natural...and, yes, it is naturally derived...but by the time you get it in drug form, there's very little that's natural about it.  So definitely put quality of life first.

Good luck!


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## jiffer (Apr 1, 2013)

joplin1975 said:


> Well, I'm all for natural...and, yes, it is naturally derived...but by the time you get it in drug form, there's very little that's natural about it.  So definitely put quality of life first.
> 
> Good luck!


Something I have noticed is within a hr or two of me taking my dose I feel the worse and as the day wears on i feel a little better and then when i take my afternoon/evening dose i feel bad again. which leads me to believe the T3 is wearing off and i feel better and then i take another dose and i am loading myself up with t3 again.

i want to thank everyone here that has been so helpful with my questions. Even the silly ones. lol. This forum has educated me more on the thyroid then my endo has.


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## bigfoot (May 13, 2011)

jiffer said:


> My T3 was not tested before I started taking Armour. Is it possible my body is converting T4 into T3 fine and I don't need a med with T3 in it and I have been giving myself to much T3? I don't know if this is even possible but I figure what the heck and ask.


Absolutely possible. That is one more reason not to start a T3-containing medication before testing Free T3 levels. I will also tell you that when I am seemingly over-medicated, I get a brain fog, spaced out, fatigued, etc. Many symptoms of hypo- and hyperthyroidism mimic each other, and conversely so can being under- and over-medicated.

Lots of folks can convert T4 to T3 just fine, and that's certainly a good place to start, instead of going for the jet fuel first.


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## jiffer (Apr 1, 2013)

I decided to not take my dose this morning. I will talk to the dr on Monday and see about taking the Levo I was on and see how I do. I am sure not taking anything for a day or two is not good but I just cant function on Armour. How long do you guys think it takes to get out of my system?


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## bigfoot (May 13, 2011)

Half-life of T4 is 7 days; the half-life of T3 is one to two days.

So, in theory, the T3 component of Armour should be pretty much out of your system by this coming Monday. The T4 component won't have diminished much by then after only a couple of days. But that's okay. The T3 portion is likely the part giving you problems, or else the fillers/binders in Armour.


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## jiffer (Apr 1, 2013)

bigfoot said:


> Half-life of T4 is 7 days; the half-life of T3 is one to two days.
> 
> So, in theory, the T3 component of Armour should be pretty much out of your system by this coming Monday. The T4 component won't have diminished much by then after only a couple of days. But that's okay. The T3 portion is likely the part giving you problems, or else the fillers/binders in Armour.


That is good to hear. Thanks


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