# Level too low for T4 & Can't get T3 up??



## eacraz (Apr 18, 2012)

Hi.

Here is my recent blood work results (2/13/13)

TSH .657 (RANGE .270-4.2)
FREE T3 2.7 (RANGE 2.3-4.3)
FREE T4 .94 (RANGE .90-1.80)

I am on 90 Armour.

Here are previous results:
As of 10/30

TSH 1.75 uIU/ml RANGE: .270-4.2
FREE T-3 2.9 pg/ml RANGE: 2.3-4.3
FREE T-4 .94 ng/dl RANGE: .90-1.8

AS OF 9/11

TSH 2.330 uIU/ml RANGE: .270-4.2
FREE T3 3.2 pg/ml RANGE: 2.3-4.3
FREE T4 .90 ng/dl RANGE: .90-1.8

Here are my past results:

AS OF 8/8:
TSH 2.330 uIU/ml RANGE: .270-4.2
FREE T3 2.9 pg/ml RANGE: 2.3-4.3
FREE T4 1.01 ng/dl RANGE: .90-1.8

AS OF 6/13:
TSH 2.570 uIU/ml RANGE: .270-4.2
FREE T3 2.9 pg/ml RANGE: 2.3-4.3
FREE T4 1.09 ng/dl RANGE: .90-1.8

AS OF 4/13:
TSH 4.330
FREE T4 1.03 ng/dl
ANTI-TPO >1000 IU/ML

I was wondering if anybody has any thoughts about the new results. I have read that most people feel better when the TSH is below 1. but I am wondering why I can't get my FREE T3 to go higher.

Thanks for any comments!!


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## Octavia (Aug 1, 2011)

What meds are you on?

I'm guessing that if you get your Free T4 higher, your Free T3 will follow suit. Both are pretty low in the range.


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## eacraz (Apr 18, 2012)

Octavia said:


> What meds are you on?
> 
> I'm guessing that if you get your Free T4 higher, your Free T3 will follow suit. Both are pretty low in the range.


Hi Octavia.

I am on 90 Armour


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## Octavia (Aug 1, 2011)

Oh, in that case, scratch what I said a few minutes ago...I'll leave it to the Armour experts to answer your question!


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## Andros (Aug 26, 2009)

eacraz said:


> Hi.
> 
> Here is my recent blood work results (2/13/13)
> 
> ...


Your doc needs to titrate your Armour upward by 1/4 to 1/2 grain every 8 weeks until your FREE T3 is about 75% of the range given by your lab.

It is normal for FT4 to be low when taking any form of T3 and this should not be tampered with as Armour is the perfect 4 to 1 ratio.

TSH is no longer relevant for titration purposes.

Here is some info which may help!

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.

Armour thyroid
http://www.armourthyroid.com/

We are all different in our needs. I have stabilized for a good 12 years on 3 1/2 grains of Armour. My TSH is usually 0.03 or less.


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## eacraz (Apr 18, 2012)

Andros said:


> Your doc needs to titrate your Armour upward by 1/4 to 1/2 grain every 8 weeks until your FREE T3 is about 75% of the range given by your lab.
> 
> It is normal for FT4 to be low when taking any form of T3 and this should not be tampered with as Armour is the perfect 4 to 1 ratio.
> 
> ...


My dr's assistant called back & basically said will not increase my dosage of Armour. Because the TSH is below. Of course, I couldn't let that go. I called back & left a message for the dr. I basically said that I need for her to increase by another 30 (on 90 of Armour now). I said my symptoms have eased up a tad, but not enough for me to say I feel better. I told her that we should give a try & wait for another 8 wks to see if it worked.

Now, I am waiting to hear back. My fingers are crossed. I was hoping she would be the gem of the drs I have had seen so far. UGH.


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## Andros (Aug 26, 2009)

eacraz said:


> My dr's assistant called back & basically said will not increase my dosage of Armour. Because the TSH is below. Of course, I couldn't let that go. I called back & left a message for the dr. I basically said that I need for her to increase by another 30 (on 90 of Armour now). I said my symptoms have eased up a tad, but not enough for me to say I feel better. I told her that we should give a try & wait for another 8 wks to see if it worked.
> 
> Now, I am waiting to hear back. My fingers are crossed. I was hoping she would be the gem of the drs I have had seen so far. UGH.


I will be waiting to hear w/bated breath. Can't say I am encouraged because like doctor, like assistant.....................I would think. I do hope I am wrong.

Your doc needs to read this................
Armour thyroid
http://www.armourthyroid.com/

The prescribing info is very clear on titrating to the euthyroid status.


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## eacraz (Apr 18, 2012)

Andros said:


> I will be waiting to hear w/bated breath. Can't say I am encouraged because like doctor, like assistant.....................I would think. I do hope I am wrong.
> 
> Your doc needs to read this................
> Armour thyroid
> ...


I am not one of those people that back down easily. The dr did say to me that she treats the patient & not the test results. I will definitely remind her of that if/when she/assistant calls me back. I am willing to even make an appointment with her & have the discussion face to face again.

I am true believer that at times I am my own advocate. :winking0051:


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## Andros (Aug 26, 2009)

eacraz said:


> I am not one of those people that back down easily. The dr did say to me that she treats the patient & not the test results. I will definitely remind her of that if/when she/assistant calls me back. I am willing to even make an appointment with her & have the discussion face to face again.
> 
> I am true believer that at times I am my own advocate. :winking0051:


Absolutely; if you don't advocate for yourself, nobody else will.


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## eacraz (Apr 18, 2012)

Andros said:


> Absolutely; if you don't advocate for yourself, nobody else will.


The dr did call back & is very conerned that my TSH LEVEL is too low. She feels that I am overmedicated with the Armour, regardless what the level is for my FREE T3. She said that I should wait 3 months!!

I told her that I am willing take a chance and we can get the blood work done then.

Dr hunting I will go AGAIN. UGH!!


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## Andros (Aug 26, 2009)

eacraz said:


> The dr did call back & is very conerned that my TSH LEVEL is too low. She feels that I am overmedicated with the Armour, regardless what the level is for my FREE T3. She said that I should wait 3 months!!
> 
> I told her that I am willing take a chance and we can get the blood work done then.
> 
> Dr hunting I will go AGAIN. UGH!!


Yep; sad but true but I am glad you did not burn bridges. That is always a good thing.


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## eacraz (Apr 18, 2012)

Andros said:


> Yep; sad but true but I am glad you did not burn bridges. That is always a good thing.


I actually did some research to see if there is a THYROID GROUP on YAHOO GROUPS for my home state. And there is a group on there and it looks like they have a database of doctors that do not just go by TSH LEVEL results. 

From looking @ the database, most of the doctors are nautropath doctors. I just want a doctor that treats the patient and not the blood results. But then again, aren't we all?!?!:winking0051:


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## Andros (Aug 26, 2009)

eacraz said:


> I actually did some research to see if there is a THYROID GROUP on YAHOO GROUPS for my home state. And there is a group on there and it looks like they have a database of doctors that do not just go by TSH LEVEL results.
> 
> From looking @ the database, most of the doctors are nautropath doctors. I just want a doctor that treats the patient and not the blood results. But then again, aren't we all?!?!:winking0051:


Georgia Thyroid Group (Yahoo) kicks butt. They also provide a database. Good for you! Go for it!


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## eacraz (Apr 18, 2012)

Andros said:


> Georgia Thyroid Group (Yahoo) kicks butt. They also provide a database. Good for you! Go for it!


Update on finding the right doctor. One of the doctors is not accepting new patients. The other doctor charges 450.00, but the consultation last for 3 hours. He wants you to get the following blood work done before the visit:
COMPLETE BLOOD COUNT, COMPLETE METABOIC PANEL, THYROID PLUS(TSH, F3,F4,TPO, & THYROGLOBULIN ABYS). He also wants a week worth of basal body temperature. And follow up visits are 150.00.

The other doctors on the database have ok reviews by other members. So, I am sort what lost on what to do. UGH and DOUBLE UGH.


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## eacraz (Apr 18, 2012)

Are there people out there that take Armour & maybe T3 only medicine? Just curious, since my T3 is not @ the optimal range YET.


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## Andros (Aug 26, 2009)

eacraz said:


> Are there people out there that take Armour & maybe T3 only medicine? Just curious, since my T3 is not @ the optimal range YET.


You don't want to mix meds here. Armour is the perfect 4 to 1 ratio. You are just way undermedicated.

That doc sounds really expensive. I would not jump the guns. If you have time, look further. You can find a Naturopathic doctor for less money, I believe. Many here see a Naturopath and are very very pleased.


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## eacraz (Apr 18, 2012)

Andros said:


> Georgia Thyroid Group (Yahoo) kicks butt. They also provide a database. Good for you! Go for it!


I found a Naturopathic doctor. 
She said that she was surprised that my last endo did not run the ANTIBODIES test. She said that is rare, but it does happen when people take ARMOUR that the ANTIBODIES level can increase. And the endo should have tested for the ANTIBODIES, since I was taking ARMOUR.
She also think that there is something might be wrong the adrenal. Like adrenal insufficiency is a possibility.

So, she has ordered more blood work. In addition to the normal TSH FREE T3 & FREE T4, she ordered REVERSE T3, TPO-ab, and ANTIBODIES. Also, she wants to test 8AM CORTISOL, DHEA-S & other hormone tests. She suggested the SALIVA test, but she informed me that my insurance would not cover the test. I told her that I am not going to that test, just yet.

She doesn't watch the TSH LEVEL result & a fan of Armour. With that being said, if she thinks that the Armour is having adverse affect on the ANTIBODIES, she will prescribe SYNTHETIC meds. She mentioned LEVOTHYROXINE & CYTOMEL or using a compounding pharmacy.

Has any one had any of those tests done? Or seen a NATUROPATHIC DOCTOR?

PS
I am just frustrated that I have to start the process again. :sick0012:
UGH!!


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## jenny v (May 6, 2012)

Don't be frustrated about going through the process again, be excited that you have finally found a doctor who sounds like she is up on things and open to multiple solutions to get you feeling good again. Sometimes it takes multiple doctors before you finally find a good one. It took me 4 times.


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## Lovlkn (Dec 20, 2009)

eacraz said:


> The dr did call back & is very conerned that my TSH LEVEL is too low. She feels that I am overmedicated with the Armour, regardless what the level is for my FREE T3. She said that I should wait 3 months!!
> 
> I told her that I am willing take a chance and we can get the blood work done then.
> 
> Dr hunting I will go AGAIN. UGH!!


3 Endo's
2 GP's
1 DO - this is my current favorite because he ignores TSH which is always non existent.


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## laff66 (Mar 9, 2012)

I'm in the same boat as you. we keep upping my armour, the ft3 will increase, then slowly drop back down. Its currently at 2.9, right where you are. 
I read a book a while ago by dr. Mark Starr, and I have no idea what his reputation is, but he apparently treats tons of thyroid people. He was a big advocate of armour over synthetic EXCEPT for hashimoto patients. I don't remember why that was, but I always wonder about that when the doc increases my dose. I just got upped to 150 yesterday!


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## Andros (Aug 26, 2009)

eacraz said:


> I found a Naturopathic doctor.
> She said that she was surprised that my last endo did not run the ANTIBODIES test. She said that is rare, but it does happen when people take ARMOUR that the ANTIBODIES level can increase. And the endo should have tested for the ANTIBODIES, since I was taking ARMOUR.
> She also think that there is something might be wrong the adrenal. Like adrenal insufficiency is a possibility.
> 
> ...


Very excellent. If starting over means you will feel good; go for the gold. It will be worth it.

Keep us in the loop re your progress and you "know" we want to see your lab results and ranges. Especially the antibodies.


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## rajaenchen (Feb 28, 2013)

I have been on compounded Armor thyroid for years. I have trouble getting my T3 up even if my T4 is relatively normal. I just saw a new doc yesterday who knows about this, and she recommended doing a different type of compound (not Armor) that can regulate exactly the amount of T4 & T3 I need. I think it's based on a new type of synthetic thyroid. It may be worth a try.


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## eacraz (Apr 18, 2012)

Dr. Mark Starr is actually located here in Arizona. He has about a month waiting list to see him. His first initial vist cost 450.00 & it lasts about 3 hours. I did not see him, but I did call to inquire about what the initial vists entails.


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## eacraz (Apr 18, 2012)

rajaenchen said:


> I have been on compounded Armor thyroid for years. I have trouble getting my T3 up even if my T4 is relatively normal. I just saw a new doc yesterday who knows about this, and she recommended doing a different type of compound (not Armor) that can regulate exactly the amount of T4 & T3 I need. I think it's based on a new type of synthetic thyroid. It may be worth a try.


As I mentioned in my previous post, I decided to see an NATUROPATHIC DR. She actually suggested to go on the synthetic meds for me. She said that in rare cases people who take Armour has an ADVERSE EFFECT on ANTI-TPO. She wants me to try the new dosage of 120 Armour & then tests the THYROIDS in about 4-5 weeks.


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## eacraz (Apr 18, 2012)

Andros said:



> Very excellent. If starting over means you will feel good; go for the gold. It will be worth it.
> 
> Keep us in the loop re your progress and you "know" we want to see your lab results and ranges. Especially the antibodies.


Here are some (it will be long post if I posted all the results)blood work results:
TSH .32 (.45-4.50 mU/L)
F T3 3.2 (2.0-4.8 pg/mL)
F T4 1.0 (.8-1.7 ng/dL)
REVERSE T3 19 (11-3 ng/dL)
TPO-ab >1000
THYROGLOBULIN ANTIBODIES <20
8 AM CORTISOL 24.4 (4.0-22.0 ug/dL)


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## Andros (Aug 26, 2009)

eacraz said:


> Here are some (it will be long post if I posted all the results)blood work results:
> TSH .32 (.45-4.50 mU/L)
> F T3 3.2 (2.0-4.8 pg/mL)
> F T4 1.0 (.8-1.7 ng/dL)
> ...


I believe you will see a difference on the higher dose of Armour; given time on the proper dose you will see the TPO come down. It is my contention that being on the incorrect dose (and that cannot be helped during titration) aggravates the antibodies.

And you have had an ultra-sound recently; correct?


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## eacraz (Apr 18, 2012)

Andros said:


> I believe you will see a difference on the higher dose of Armour; given time on the proper dose you will see the TPO come down. It is my contention that being on the incorrect dose (and that cannot be helped during titration) aggravates the antibodies.
> 
> And you have had an ultra-sound recently; correct?


Thanks for your insight on the TPO issue. Right now, I am on 120 of Armour.

I wonder why she would say take 90 in the am & then the 30 late mornings??

I had an ultra sound about a year ago. The dr. is going to wait for the next set of blood work to order the ultra sound for me.


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## Andros (Aug 26, 2009)

eacraz said:


> Thanks for your insight on the TPO issue. Right now, I am on 120 of Armour.
> 
> I wonder why she would say take 90 in the am & then the 30 late mornings??
> 
> I had an ultra sound about a year ago. The dr. is going to wait for the next set of blood work to order the ultra sound for me.


Good; you do need a current ultra-sound. Let us know when this is scheduled, please!

I have no idea; I just take mine in one fell swoop. If you are consistent, it stabilizes and there really is no need to break the dosing regimen up.

The above is humble opinion not to mention the prescribing info does not say to take it more than once a day. LOL!


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## eacraz (Apr 18, 2012)

Andros said:


> Good; you do need a current ultra-sound. Let us know when this is scheduled, please!
> 
> I have no idea; I just take mine in one fell swoop. If you are consistent, it stabilizes and there really is no need to break the dosing regimen up.
> 
> The above is humble opinion not to mention the prescribing info does not say to take it more than once a day. LOL!


hahaha
I will let anybody know when the ultra sound will takes place or results. 
It would be easier for me to take all 120 @ once rather than 90 in am & 30 in the pm.


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## Andros (Aug 26, 2009)

eacraz said:


> hahaha
> I will let anybody know when the ultra sound will takes place or results.
> It would be easier for me to take all 120 @ once rather than 90 in am & 30 in the pm.


Ditto that. I take 3 1/2 grains (210 mgs.) at 5:30 AM every morning. I am good to go. Once it builds up, it stays stable as long as you don't miss your doses and take in a timely manner.

You most likely may forget to take the remaining dose if you get busy and most of us do in the mornings.


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## rajaenchen (Feb 28, 2013)

I'm due to be upped as soon as my levels are taken. I've been waiting to change insurance companies so I have to wait for my new cards, then get my levels done. This doc is checking everything! There is a "suspision" I may have Hashimotos Encephalopathy. It could also be other things... who knows. I have heard that Armor is not good for Hash. also. My new doc tends to beleive that and she will see about changing me over to asynthetic compound.


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