# Is it common for improvement to take a year or more?



## laff66 (Mar 9, 2012)

I was diagnosed with Hashi's just over a year ago, and have been going through levo, armour, dosage changes, etc. I've been pretty steady on armour for about 6 months now and labs are good. I've had some really good results with fatigue, but still have quite a few symptoms that I was really hoping I could attribute to thyroid issues. Severe bilateral foot pain in the morning, knee pain, and back pain to name a few. My question is, since its been quite a while now, should I give up hope that there will be more changes, or do some people continue to experience improvements long term?
I guess thats kind of a dumb question, but in the beginning of all this I was so excited to hear stories of people having morning foot pain, back pain, etc that cleared up, and I'm just looking for more encouragement I guess. As a 46yo male in decent shape, it seems like I ought to feel better than this....


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## Andros (Aug 26, 2009)

laff66 said:


> I was diagnosed with Hashi's just over a year ago, and have been going through levo, armour, dosage changes, etc. I've been pretty steady on armour for about 6 months now and labs are good. I've had some really good results with fatigue, but still have quite a few symptoms that I was really hoping I could attribute to thyroid issues. Severe bilateral foot pain in the morning, knee pain, and back pain to name a few. My question is, since its been quite a while now, should I give up hope that there will be more changes, or do some people continue to experience improvements long term?
> I guess thats kind of a dumb question, but in the beginning of all this I was so excited to hear stories of people having morning foot pain, back pain, etc that cleared up, and I'm just looking for more encouragement I guess. As a 46yo male in decent shape, it seems like I ought to feel better than this....


How much Armour are you on? What do your recent TSH, FREE T4 and FREE T3 lab results look like? Please include the ranges.

It sounds like you may be undermedicated and from the time you are in a euthyroid state (feeling good), it takes a good 18 months for everything to "snap back!"

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.
Dr. Mercola (FREES)
http://www.mercola.com/Article/hypothyroid/diagnosis_comp.htm


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## laff66 (Mar 9, 2012)

Im on 120 of armour. I'm still waiting for my latest labs to be mailed to me, as I was only told that all levels were "okay" by phone. So far this doc has been great about keeping the FT's in top of range and low TSH. Ill post them as soon as I get them. 
I'm always curious about how to tell if I've got enough armour though, as I know some docs (although seems rare) will titrate by symptoms with a low priority on the labs. I certainly haven't had any hyper symptoms that I know of!


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## smelliebellie (Oct 14, 2012)

laff, 
how long did it take you to become optimal? is there ever a normal again?


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## laff66 (Mar 9, 2012)

I'm not sure I am optimal or normal at this point. I've been on meds over a year. Fatigue got much better within a few months. Still have a lot of leg pain, and mood has just been kinda blah for a long time. That's really what my original post was about; am I as good as I'm gonna get thyroid-wise, and need to start working on other things to address symptoms? Or is it thyroid and I need to give it more time. We'll see....


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## Octavia (Aug 1, 2011)

Just curious...have you been evaluated for arthritis?


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## CA-Lynn (Apr 29, 2010)

Yes, too often people blame the poor thyroid for everything.


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## Lovlkn (Dec 20, 2009)

smelliebellie said:


> laff,
> how long did it take you to become optimal? is there ever a normal again?


Absolutely - Normal is different than before because you age as you get properly medicated.

For me - I feel completely "normal" for my age.


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## laff66 (Mar 9, 2012)

My doctor ran CRP, and some other tests I can't remember rt now that we're supposed to be for arthritis. I also went to an orthopedic guy recently for a sports injury to my knee and he dismissed arthritis (somewhat)?? I'm still considering a rheumatologist though.


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## CA-Lynn (Apr 29, 2010)

Exactly what kind of leg pain do you have? Where in the leg......describe how it feels, if it's constant, if it goes away after you wake up and have been up for a few hours....


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## laff66 (Mar 9, 2012)

It's primarily in my feet. Kind of where plantar fasciitis would be but more like its in the bones rather than the fascia. Goes away within 30 seconds of walking around after waking up. Used to have a general ache in my legs, particularly lower, but it's gotten WAY better.
Knee pain is bilateral and is primarily when trying to run or kneel down where knees are fully bent (butt on heels, for example).


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## Andros (Aug 26, 2009)

laff66 said:


> I'm not sure I am optimal or normal at this point. I've been on meds over a year. Fatigue got much better within a few months. Still have a lot of leg pain, and mood has just been kinda blah for a long time. That's really what my original post was about; am I as good as I'm gonna get thyroid-wise, and need to start working on other things to address symptoms? Or is it thyroid and I need to give it more time. We'll see....


Check your ferritin and electrolytes for possible cause of leg pain.


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## laff66 (Mar 9, 2012)

Thanks! Ill do that next time. Is it enough to just tell doc to ck electrolytes, or do I need to be more specific?


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## Andros (Aug 26, 2009)

laff66 said:


> My doctor ran CRP, and some other tests I can't remember rt now that we're supposed to be for arthritis. I also went to an orthopedic guy recently for a sports injury to my knee and he dismissed arthritis (somewhat)?? I'm still considering a rheumatologist though.


Do you take statins, metformin or quinalones? They cause tendonitis and tendon rupture in "some" people.


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## laff66 (Mar 9, 2012)

I took Lipitor years ago but stopped about 6 years ago when I did some research on the whole saturated fat/cholesterol/heart disease myth.


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## laff66 (Mar 9, 2012)

Got my results today. Looks like they could actually stand to be a little higher?

FT3: 3.2 (2.3-4.2)
FT4: 1.1 (.8-1.8)
TSH: 0.07 (.4-4.5)

I always see the knowledgeable ones around here recommend being in the upper area of the range, so I'm guessing the same could apply to me? Is it okay for the TSH to be so far below range? I seem to remember reading that TSH is almost irrelevant in hashimotos. Any suggestions on how much I'll need to up the dose to get such a small improvement? Hopefully I can convince the doc.
It's weird though, a few months into all this, 60 of armour had me almost out of range on the high side, and now 120 haseloff in the middle-- the joys of hashimotos I guess??
Thanks as always to all of you for being SOOO helpful and quick with your replies; always amazes me.


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## Andros (Aug 26, 2009)

laff66 said:


> Got my results today. Looks like they could actually stand to be a little higher?
> 
> FT3: 3.2 (2.3-4.2)
> FT4: 1.1 (.8-1.8)
> ...


Yes; you could stand a small increase in your Armour. Perhaps 1/4 to 1/2 grain. It would be better to go w/the 1/4 grain and get labs again in 8 weeks.

You might be amazed that your foot pain goes away. There is nothing worse than not having just the right amount of T3 that "your" body requires.

Most of us like the FT3 at about 75% of the range given by your lab.

If your doc does not agree, find one that will.

TSH is no longer relevant criteria for dosing. Nor is the FT4 as when taking exogenous T3, both are lower and that is the way it is supposed to be.

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.


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## laff66 (Mar 9, 2012)

Just noticed a note on the results that says the following:

"The current lot of free T4 reagent available from the manufacturer produces results that are approx 9% higher than previous reagent lots. Please interpret these results accordingly."

So I guess my T4 number could be a little lower than the results indicate?


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## Andros (Aug 26, 2009)

laff66 said:


> Thanks! Ill do that next time. Is it enough to just tell doc to ck electrolytes, or do I need to be more specific?


 Complete Electrolyte panel I believe this is called.


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## Andros (Aug 26, 2009)

laff66 said:


> Just noticed a note on the results that says the following:
> 
> "The current lot of free T4 reagent available from the manufacturer produces results that are approx 9% higher than previous reagent lots. Please interpret these results accordingly."
> 
> So I guess my T4 number could be a little lower than the results indicate?


Sure sounds like it.


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## laff66 (Mar 9, 2012)

All the reading I've done on this site and somehow I missed the one you sent the link to Andros. Very informative! I've never split my dose and always take it early in the am, before eating anything. He recommended after breakfast and dinner? I thought that was a no no? 
Also my last labs were in the afternoon, and I didn't take armour on the day of, so labs were drawn about 30 hrs after last dose. Think that messed up my numbers?


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## laff66 (Mar 9, 2012)

just got my numbers after 8 weeks of upping the armour by about 1/2 grain. I say "about" because I'm breaking a 120 tablet into 4-5 pieces, tough to do accurately. So after 2 mos of increased dose, my numbers went DOWN? What the heck?

Here they are:

FT4: .9 (.8-1.8) down from 1.1 
FT3: 2.9 (2.3-4.2) down from 3.2

this happened last time my dose went up as well. Should I just chalk this up to the craziness of Hashi's as I've read about regularly? 
One thing that worries me a little is that at night when I first lay down, it seems like my heart is beating "hard." Not rapid, just hard. I've read of others having that so maybe a minor hyper symptom? Weird that my numbers are down though...


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## jenny v (May 6, 2012)

> One thing that worries me a little is that at night when I first lay down, it seems like my heart is beating "hard." Not rapid, just hard. I've read of others having that so maybe a minor hyper symptom?


 I have this symptom when I'm both hypo and hyper. It's not that my heart is racing, it's just that it's pounding with each beat in my chest and I feel every beat. Beta blockers help alleviate the symptom for me.


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## laff66 (Mar 9, 2012)

Thanks for the reply. The thought of adding another med scares me to death. I'm a paramedic firefighter and everyday I see patients that keep adding new meds to take care of the symptoms that the last med caused. Its a viscious cycle that I'm deathly afraid to jump into. I'm not saying beta blockers aren't right for you, I just worry so much about what kind of domino effect I'm about to run into by being on a lifelong medication. I guess if the armour takes care of a bunch of other problems and I have to add something else I will consider it.


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## Brucergoldberg (May 23, 2011)

dude,

Listen. I have been through this shi7 for 3 years now. I had my thyroid out in february because the pain got so band in my neck (despite nothing showing up except hashis) and the pain is gone.

I just saw this post for the first time. I have lots of friends that have the foot pain in the same place where you have yours. Thiers went away once they got on a decent amount of thyroid. I think you still have some ways to go. Im amazed that with a thyroid you are taking 2 grains and still feel crappy. I have friends that are on 2 grains as full replacement dose.

Its not from eating gluten, or from drinking milk or any of that witchcraft. Its from the stupid thyroid. Ive got the same EXACT thing as you. I am also 46, male. I was 175 pounds now im down to 164 because im on 300 mcg t4 only and when i was on 330 mcg t4 only, the weight shed off of me like paula dean at a weight watchers meeting.

I wish i had a solution for you. Im on 1 year now, and my labs go back and forth. and you are right about the quest labs changing the regeant. They need to just change the freakin ranges and quit confusing people.

DO your ears ring? Death wave about 5 hours after waking up? did you lose your galbladder too?


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## Brucergoldberg (May 23, 2011)

also, where is the back pain exactly? is it under your shoulder blade?


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## laff66 (Mar 9, 2012)

I've always been a little concerned too about the armour dose?? Seems like I always see posts where people w/o thyroids are on the same amount. I upped my dose as mentioned, and it seems foot pain might be easing a little. My fatigue that I always had in the afternoon is absolutely GONE. I'm 175 lbs and none of this roller coaster of thyroid meds has ever seemed to affect that. Which is good cuz I'm 6'2" and can't afford to lose any weight. Love the Paula Dean comment!
Back pain is low back, right in the disc btwn L4 and L5. 
I've tried keeping notes but the changes with this stuff are so gradual its hard to remember what I felt like before. I know I'm not as tired, and I think my mood is much better, but could be better still. I'm afraid to keep going up on the dose, but my freakin numbers keep dropping the more I take!
Bruce, what led you to having yours removed? You mentioned pain, was that the only thing? I'm wondering if people like me get them taken out often?
Also, no gall bladder problems.


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## Brucergoldberg (May 23, 2011)

this is from my blog but i added some comments at the bottom:

I was just a normal 43 year old at work one day and new something was just not right. I started a new job back in August of 2010. The day that i went to work was going to be a special day for me, but I just didnt know it. Woke up and went to the gym, got my workout in for the day. Headed over to grab a coffee at my favorite little bagel shop. Went to work and for some reason about an hour into my day I started to get really bad back pain. The pain radiated from around my right shoulder blade to the front underneath my rib cage. It hurt really bad like someone had a finger in my back. I also had really bad knee pain. My right knee especially. It hurt so bad i could barely walk. I have really bad feet so I just assumed that the knee pain was from being on my feet at my new job all day. I could hardly make it. At lunchtime I sat down that day and i felt like i had a knife stabbing me in my knees. On top of everything else, I had this horrible anxiety and tremor in my hands. I have always had a slight tremor, but for some reason, that day was worse.

Long story short, tried every thyroid and dose known to mankind. Then i started getting pain in my throat in the trachea area. Pain kept getting worse to the point i could not swallow. 3 sonograms 4 months apart showed rapid degeneration of the gland and i wasnt getting any better. I had to get rid of the pain so i decided to have the whole thing out. Honestly, it must of been dead because nothing changed once it was out. The pain is gone.

I had the back pain too. I ended up having a 2 rhizotomys that eliminated the pain completely. I would do it again in a heart beat.

Did you ever try synthetic or did you go right on armour?

I still get the waves of fatigue. Or maybe its anxiety. I cant really tell what it is. Feels like im on one of those teeter totter things we had when we were kids. Or that weird feeling you get off the ride at the state fair (like one of those big boats that swings back and forth). You know what i mean?


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## laff66 (Mar 9, 2012)

I did try generic Levo first. The original Dr would not increase dose once TSH got below 4.5 so I switched. New doc went straight to armour. Man, sounds like you went through hell! I do still have the ocassional tiredness but not near like before. I'm never rested when I wake up either. I'm sure part of that is my crazy sleep schedule but I figure thyroid has to affect that!


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## Brucergoldberg (May 23, 2011)

thats definitely hypo. I feel rested when i wake up, i just get the fatigue wave about 5 hours later. You either need more meds, or to be on your meds longer. Do your ears ring at all? if not, count your blessings.


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