# Switching Medication



## chickenpiggy (Nov 8, 2011)

I have taken Armour Thyroid for many years. 180mg. Originally I was on Levoxyl for years until I wanted to try Armour as I felt I needed the T3 because I was fatigued. But in the last few years My FT3 and FT4 are extremely low and TSH is normal. Although my anxiety is worse. I'm wondering if going back to Levoxyl and adding T3 would be a good idea so that I can manage both separately. FYI I had Graves, RAI 15 years ago. Also I have tried to increase Armour several times and it's too much.

Recent Labs

T3, Free 2.5 pg/mL 2.3 - 4.2 pg/mL

Free T4 0.7 ng/dL 0.8 - 1.8 ng/dL

TSH 1.16 mIU/L mIU/L


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## GOLGO13 (Jun 13, 2018)

My thoughts are you are not on enough Armour.

You should also check your Iron and B12 levels.

Before changing back you may consider talking to your provider about your numbers. The folks on here who take combination medication maybe able to help.

Usually TSH is very low on NDT and yours is not. Your free numbers are also quite low.

I would say you do need some sort of change either way.


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## Lovlkn (Dec 20, 2009)

Graves with thyroidectomy usually does better on T4 hormone with added T3 hormone if needed. Personal experiences and experiences of friends.


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## chickenpiggy (Nov 8, 2011)

Would Graves with total RAI not be basically the same as Thyroidectomy. I get no hormones from a thyroid


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## Lovlkn (Dec 20, 2009)

We are talking about replacement hormones - not ablation methods.

On replacement - synthetics seem better accepted than NDT based on my experiences and others


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## creepingdeath (Apr 6, 2014)

180mg is a lot.

I'd say you have absorption problems in the gut or you're a lot bigger than me.

I have hashi's and my thyroid is destroyed and no longer works.

I take 120mg although I weigh 125 to 130 pounds. TSH is below 0..& frees are around midway.

Doctors say I'm taken way too much but I have no signs or symptoms of being hyper.

I'm actually fatigued a lot .

I assume it's from being my Fathers full time caregiver.

He's in his 90's and has significant dementia so I don't get to sleep much.

Good luck leveling things out so you start feeling better.


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## chickenpiggy (Nov 8, 2011)

I usually take mine and then drink coffee about 30 mins later. This past week I waited an hour to drink coffee. By the time the week ended I was on the edge feeling hyperish and I don't like that. I take nexium in the afternoons for GERD. I noticed that coffee def was making an issue but then waiting an hour was too much. I'm really thinking about going back to Levoxyl and T3 added because I cannot get Armour right. And I am 200lbs so yes I am bigger


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## chickenpiggy (Nov 8, 2011)

Got labs done yesterday still at 180mg Armour, they are as follows

TSH 3.76 (0.4-4.5)

FT3 2.5 (2.3-4.2)

FT4 0.8 (0.8-1.8)

Doctor has switched me to 150mcg of Levoxyl and will add Cytomel as needed. I don't think 150 is going to be enough but the Armour was doing nothing much either. Any suggestions?


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## Lovlkn (Dec 20, 2009)

Your labs support under medication on Armour.

Have you considered asking for an increase prior to switching back? Is your doctor experienced in prescribing Armour? It doesn't sound like it.


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## chickenpiggy (Nov 8, 2011)

Yes she is. She has tried to increase me but everytime I try to increase I have bad anxiety. So she said I may be super sensitive to T3. So we are going to Levoxyl and then re lab in 4 weeks then add cytomel or up the Levoxyl depending on what the labs say. I am on day two of the levoxyl and I am super tired already


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## Lovlkn (Dec 20, 2009)

What worked for me was getting both FT-4 and FT-3 to fall somewhere between 1/2-3/4 of range.

Good luck on the switch over.


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## GOLGO13 (Jun 13, 2018)

That is a bummer. It will take some time to settle things out. Stay positive and understand it takes time. Keep stress low as possible.


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## chickenpiggy (Nov 8, 2011)

I know it's been a while on this subject but I have since went up to 175mcg and started having super high blood pressure and panic issues. I have taken nothing in the past 5 days. Blood pressure is still elevated but the panic is gone. I have no idea what to do at this point. Recent labs. These labs are about two weeks before the bad symptoms started

TSH

2.21 mIU/L 0.40-4.50

Free T4

1.6 ng/dL

0.8 - 1.8 ng/dL

T3, Free

3.0 pg/mL

2.3 - 4.2 pg/mL


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## Lovlkn (Dec 20, 2009)

chickenpiggy said:


> I know it's been a while on this subject but I have since went up to 175mcg and started having super high blood pressure and panic issues. I have taken nothing in the past 5 days. Blood pressure is still elevated but the panic is gone. I have no idea what to do at this point. Recent labs. These labs are about two weeks before the bad symptoms started
> 
> TSH
> 
> ...


You are exactly 3/4 range for FT-4 which might be a tad high for you. I do best around 1/2 and definitely experience anxiety and higher heart rate at 3/4 range or higher. You could try skipping a pill or 1/2 pill weekly to see if how you feel improves.

Your FT-3 is below 1/2 range which is 3.25.

If it were me - I would ask for a T4 hormone reduction and 5mcg T3 hormone ( split in 1/2 and taken in 2 doses slit at least 6 hours apart).

It's easier to add T3 hormone with optimal Ferritin and D labs


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## GOLGO13 (Jun 13, 2018)

What medication are you on now? Stopping the meds is not usually a good idea. If you are now on Armour you would be on too little medication with those labs. If you are on some sort of combination therapy, your FT4 is a bit high and could be causing your negative feelings. FT3 a little low (though everyone has a different amount they feel good at).

Best to seek out a good doctor experienced in dosing combination therapy. Unfortunately not many of those out there probably.

As far as something to look into get your Iron levels checked. All 4 tests and ferritin. If your Iron levels are poor you will have issues processing the thyroid meds. Make sure you are eating well and getting enough calories. I suggest taking a good multivitamin. Get your Vitamin D levels checked also. B12 is another thing to consider.

Good luck.


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## chickenpiggy (Nov 8, 2011)

I am on brand Levoxyl. I slowly went back up starting at 112, then 125 and now at 137.5. I was on 175 mcg when I was having the palpatations and high BP. Once I stopped taking it for 5 days my blood pressure went back down to normal, thats when I slowly started back. I have only now been at 137.5mcg for about a week so I'm gonna continue that for the next month and then restest. I am way too scared to get back to what was going on at 175mcg. I took Armour for YEARS but on 180mg my FT3 and FT4 stayed way on the low end and I couldn't handle any more increases. So that is where I am today.


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## Lovlkn (Dec 20, 2009)

If it were me - I would take the 137mcg dose and add a 5 mcg T3 hormone pill.


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## chickenpiggy (Nov 8, 2011)

Well it’s been a while but I’m back on Armour 180mg for about a month now and still feel bad. I have been to the obgyn because no cycle for 4 months. All looked fine. Had an ekg and chest X-ray and blood work. All good there too. But I’m bloated and breathless and tired. I’m losing hope


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## GOLGO13 (Jun 13, 2018)

chickenpiggy said:


> Well it's been a while but I'm back on Armour 180mg for about a month now and still feel bad. I have been to the obgyn because no cycle for 4 months. All looked fine. Had an ekg and chest X-ray and blood work. All good there too. But I'm bloated and breathless and tired. I'm losing hope


Have you tried adjusting your diet? That can help sometimes. Getting rid of Gluten, Dairy, Soy, Added sugars can make a big difference. Just ensure you get enough calories each day as healthy food can be a bit lacking. Limit processed foods as much as possible.

Often we have gut issues and doing these dietary changes can help.

If needed the AIP diet can help for tougher cases.


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## Lovlkn (Dec 20, 2009)

chickenpiggy said:


> Well it's been a while but I'm back on Armour 180mg for about a month now and still feel bad. I have been to the obgyn because no cycle for 4 months. All looked fine. Had an ekg and chest X-ray and blood work. All good there too. But I'm bloated and breathless and tired. I'm losing hope


Changing back and forth from Synthetic to NDT isn't helping your situation.

I'm curious - are your Ferritin, D and B-12 levels all near 3/4 range? I had bad issues adding Cytomel until I got all 3 to 3/4 range and know many others who have had similar issues.


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