# Labs & Dosage??



## Jazzy (Aug 27, 2011)

I was looking for some information on normal lab values when I came across this forum. It looks like people here have great knowledge and feedback. I was diagnosed with Hashi's 2 years ago. At the time of dx my lab values were: 
TSH 11 
Free T4: .61 (.82-1.77)
TPO: 1800 (0-34)
No T3 done at time of diagnosis.

I have been taking 75-88mcg of Levothyroxine but have been feeling horrible. I have been going to various Dr.'s trying to get someone to prescribe me Armour, hoping it would be my savior. I finally found an Endo who agreed, although he stated that I would not feel any better and it is an ineffective medication. I do not think he is used to working with Armour and uses outdated thinking, using total T4 and T3. He says that TSH is the only indicator of thyroid function (of course I know better). He said that I have a very mild case of hypothyroid and the symptoms I am describing cannot be due from hypo. I have had multiple other tests to rule out other causes but always come up empty. I am at a loss.

I have been on Armour 90mcg for 6 weeks. I felt great the first week or so...no more brain fog, more energetic, clear headed. Felt like I did when in high school. I thought this was too good to be true. Well...I started feeling worse and the symptoms were just as bad or worse from when taking the Levo. I am always tired, brain fog where it is difficult to do my job, decreased memory, blurry vision, dizzy, shakey, basal body temp in the 96's, hands and feet so cold they feel like they are burning, hair falls out easily in the shower. These are most of the same symptoms I felt on Levo but maybe a tad worse.

My lab results from 90mcg of Armour are:
TSH: .021 (.450-4.50)
Total T4:7.4 (4.5-12.5)
Total T3: 109 (71-180)

I have always had Free T4 & T3 tests done so I do not know how to interpret these. This endo (who I greatly dislike and have never felt so offended by) will not use those tests.

When on Levo, my labs were pretty normal, with T4 and T3 being in low/normal range, and TSH either normal or suppressed. However, none of my symptoms ever went away.

Can anyone tell me what these lab values mean? Am I being medicated properly on Armour? I am feeling so bad, I am thinking of switching back to Levo.

Also...Out of curiosity, I have a strange symptom that I have noticed over the past year or so. When on Levo and Armour (except for that 1st week on Armour), I feel like I am always straining my eye(brow) muscles. I won't know I am doing it until I relax and the pressure goes back. Has anyone else ever experienced such a symptom?


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## Andros (Aug 26, 2009)

Jazzy said:


> I was looking for some information on normal lab values when I came across this forum. It looks like people here have great knowledge and feedback. I was diagnosed with Hashi's 2 years ago. At the time of dx my lab values were:
> TSH 11
> Free T4: .61 (.82-1.77)
> TPO: 1800 (0-34)
> ...


As you know, the totals are bound and unbound; therefore, when they are below mid-range of the range offered by your lab, you could be undermedicted never mind the TSH as you know also.

T4 mid-range is 8.5

T3 mid-range is 1.26

When taking Armour, we expect to see the T4 and the FREE T4 low as the T3 is your active hormone.

You are in my very humble opinion undermedicated and that is why you do not feel good.

It would be good to find a doc who knows how tititrate your Armour until you feel well.

The "best" protocul is to get labs every 8 weeks (FT3 and FT4) and titrate by 1/4 grain (15mgs.) each time until you feel terrific.

As you can see in my siggie; I take 3 1/2 grains of Armour. I am 68, feel great, TSH always 0.03 or less and no way am I hyper. LOL!!

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.
http://www.drlam.com/articles/hypothyroidism.asp?page=3

Also, see if you can get your own labs. (Darn it)

HealthCheckUSA

http://www.healthcheckusa.com/

I hope you can find a doc who "gets all of this" otherwise you will never feel well.


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## Jazzy (Aug 27, 2011)

Thank you for your response. It is frustrating when Dr.'s aren't willing to listen to your symptoms and just base on labs. Based on these labs, I am thinking my Dr will want to reduce my dosage (I called in to check the labs, the Dr hasn't called me yet) as he has stated before that TSH is the only indicator of thyroid function.

I am trying to get my thyroid in check before trying to conceive again due to a previous miscarriage. It does scare me a bit that my labs may look out of range, even if I feel ok, if I were pregnant. It is too bad that I finally found a Dr to prescribe Armour but then won't prescribe it effectively or really show any interest in me and my symptoms.

I am thinking because I want to get pregant, I may return to Levo and maybe try Armour again afterwards. Because I am in a military family, we will be moving within the next year and maybe I can find a better Endo. 

My Dr started me on 90mcg of Armour. Taken in the morning on an empty stomach (just like Levo). Do you think this huge change could be the result of me feeling really great for the first week and then crash after that? I also have high cortisol in the morning, evening, and night, which I am taking supplements for as prescribed by a naturopath.


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## Andros (Aug 26, 2009)

Jazzy said:


> Thank you for your response. It is frustrating when Dr.'s aren't willing to listen to your symptoms and just base on labs. Based on these labs, I am thinking my Dr will want to reduce my dosage (I called in to check the labs, the Dr hasn't called me yet) as he has stated before that TSH is the only indicator of thyroid function.
> 
> I am trying to get my thyroid in check before trying to conceive again due to a previous miscarriage. It does scare me a bit that my labs may look out of range, even if I feel ok, if I were pregnant. It is too bad that I finally found a Dr to prescribe Armour but then won't prescribe it effectively or really show any interest in me and my symptoms.
> 
> ...


More importantly, it is frustrating when they don't run the "appropriate" labs. That is my story and I am sticking to it! LOL!!

You feel better which causes you to be more active which necessitates labs every 8 weeks and titration until you stabilize. Because you became more active, you need a bit more. It continues like that for a while until you reach the euthyroid status.

Moving around could be a problem and maybe not. I am in favor of riding one horse at a time. Stick to the program. Changing around cause major set backs and further confuses your body. Humble opinion.


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## Jazzy (Aug 27, 2011)

If I continue on a dose of Levo that would be appropriate to raise those levels (120mcg maybe), it seems my TSH would go even lower. Is it possible or even healthy to have a TSH of 0.00 or around there?


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## Andros (Aug 26, 2009)

Jazzy said:


> If I continue on a dose of Levo that would be appropriate to raise those levels (120mcg maybe), it seems my TSH would go even lower. Is it possible or even healthy to have a TSH of 0.00 or around there?


It most certainly is possible as long as the FREES are about 3/4 and/or 75% of the range given by your lab. Another way to put it is about 1/4 above the mid-range of the range given by your lab.

My TSH is always 0.03; sometimes less. Depending.


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## Jazzy (Aug 27, 2011)

Ooops.. I meant to say Armour (120mg) would suppress TSH.


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## Andros (Aug 26, 2009)

Jazzy said:


> Ooops.. I meant to say Armour (120mg) would suppress TSH.


Everyone is different. My TSH is suppressed on 3 1/2 grains of Armour. (210 mgs.)

However, if I backed down on the Armour, my TSH may stay suppressed at a lower dose but my FREES would probably be whacked and I would start to not feel so good.

It's complicated. Mainly because no 2 persons react the same.


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