# Question about T4 & TSH



## beachy29 (Jul 17, 2011)

Another Question for Anyone...
I posted a few days about some recent labs. I have a few more questions I hope you all can help mw with.

So I went to a Naturopath today after getting nowhere with traditional Dr.'s for years in regards to me thyroid. She looked at my labs from 7/11 and said that my T4 was low (which I knew). She recommended I take Armour as this may help bring up my T4. I thought Armour suppressed T4 because of T3, but she said that it does not - the majority of Armour is still T4.

So...I got a call from my Endo with my lab results (which I already knew because I work in the health proefssion and got them early). I was curious to hear what they would say. They said that based on my current labs, EVERYTHING looks normal and they'd see in August. THey never mentioned by low Vitamin D.

Okay...So finally my question....How do you raise T4 without lowering TSH into hyper range? Does anyone think Armour would do the trick? Is this a sign of a potential pituitary issue?

*7/11:*
*Cortisol: 13.4* (None Estab). Did some research on the internet and found that 8am cortisol of this # is slightly low and further testing should be done
*Free T3: 3.3* (2.77-5.27)
*Free T4: .98* (.79-2.35)
*TSH: 1.08* (.45-4.68)
*Prolactin: 13.6* (3-18.6)
*ACTH: 15* (6-58)
*C-Peptide: 1.4* (.9-7.1)
*Glucose: 92* (65-99)
*Vitamin D: 23.1* (30-100)


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## Lovlkn (Dec 20, 2009)

> How do you raise T4 without lowering TSH into hyper range? Does anyone think Armour would do the trick? Is this a sign of a potential pituitary issue?


I posted this on your other thread but will do it again as you are on while I am on.

I personally would increase your levo before changing to Armour unless the Armour made you feel your best while on replacement meds.


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## Lovlkn (Dec 20, 2009)

Your Neuro is also wrong - Armour has a higher concentration of T-3.


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## beachy29 (Jul 17, 2011)

Hi Lovlkn, Thanks for your reply. I am going to stick with Synthroid until I have my next Endo appt in a dfew weeks. This is what I found in regards to Armour and its T4/T3:

_"Because Armour Thyroid medications require a 4.22 to 1 ratio of T4 to T3, batches of desiccated thyroid are mixed until the desired ratio is obtained. This method ensures that each strength of Armour Thyroid will be consistent every time."_

Wouldn't this mean that there is my T4 4.22:1 ?

I saw that you posted on my other thread. Sorry about that, I decided to start a new thread since it is a slightly different topic. What do you mean by "add my replacement doses to my labs."

I am currently on 75mcg of Synthroid and frequently alternate between 75 and 88mcg. I have been on 75's since May 2011. Everything else before that has been 88mcg.

I still feel lousy on 88mcg. It seems that it _slightly_ raises my T4 and T3 (still not enough) but it puts my TSH below range which prompts the Dr to then reduce my dose


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## lainey (Aug 26, 2010)

Armour has a T4/T3 ratio of about 4:1. In a normal human thyroid, that is closer to 14:1. "Natural" thyroid products do not duplicate the normal ratio of T4/T3 found in the human body--the result is the excess of T3 tends to suppress T4 and therefore TSH. Taking Armour isn't going to raise your T4.

Your vitamin D is below range. You should discuss supplementing that with the dr. How is your iron/ferritin?

At this point, if you are relatively stable on the T4 meds, the answer might be to add a small amount of T3 medication as cytomel--5 mcg is the usual starting dose.


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## beachy29 (Jul 17, 2011)

I have started taking Vitamin D supplement daily. I asked my Dr about adding Cytomel but he doesn't want to because I will be trying to conceive again (miscarriage in June) in the near future - Once I get my levels optimized. I haven't had ferritin checked yet, but last time I got my iron checked, it was normal.


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## Lovlkn (Dec 20, 2009)

Beachy,

Now I need to go find the other post with all your labs before I make my non medically approved recommendation for dosing ;-)


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## Lovlkn (Dec 20, 2009)

> At time of diagnosis 12/08:
> TSH: 10.955 Range (.45-4.5)
> TPOAb: 1,740 (0-34)
> T4, Free: 061 (.61-1.76)
> ...


How were you feeling 5/11? Your lab results look the best there.

I bet your doctor made you reduce your levo there because of the lack of TSH -right?

You most likely have some stimulating antibodies suppressing your TSH and will need to dose off of FT-4 and FT-3 (just like I do) to feel your best.

There are doctors out there that understand this - finding them can take some time and your natruopath seems to get it although they may get mad if you do not take the Armour. How did you feel the last time you took Armour? How long were you on it? Even though it has a higher ratio of T-3 in the mix many people's bodies simply adjust and they feel fabulous.

My thought's of keeping you on Levo for a few more weeks it to see what happens when you have plenty of it to get your FT-4 and FT-3 in mid range at the same time. Levo has a long 1/2 life so you can literally add an extra pill then average your doses to figure your daily dose. I have done this quite often. Keep searching for a doc who is willing to work with you and "gets" the TSH suppression thing. TSH frequently suppresses when adjusting doses.


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## Andros (Aug 26, 2009)

beachy29 said:


> Another Question for Anyone...
> I posted a few days about some recent labs. I have a few more questions I hope you all can help mw with.
> 
> So I went to a Naturopath today after getting nowhere with traditional Dr.'s for years in regards to me thyroid. She looked at my labs from 7/11 and said that my T4 was low (which I knew). She recommended I take Armour as this may help bring up my T4. I thought Armour suppressed T4 because of T3, but she said that it does not - the majority of Armour is still T4.
> ...


Your FT3 is also in the basement. Mid-range of the range given by your lab is 4.02.

You only need a little T4 for deiodination to take place. Each grain of Armour has 38 mcgs. of T4 and 9 mcgs. of T3. I personally feel that the ratio is ideal.

FT3 is your active hormone and with your FT3 so low, I cannot see how you function at all.

I would take your Naturopath's advice. And I would recommend that you start on 1/2 grain (30 mgs.) for 8 weeks, get labs and have doc titrate by only 1/2 grain as needed every 8 weeks until you feel wonderful which you probably will if my advice is followed!!

You have nothing to lose and much to gain.

Just one person's humble opinion!


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