# Switch from Armour to synthetic?



## thyroidboardsfan (Apr 10, 2018)

I have Hashi (TPO ~30) and my TSH was ~7 before treatment. I requested Armour from the get go as I read most people usually do better on T4/T3 combo. I went from 30mg, then 60mg and now 90mg but still getting fatigue symptoms. My TSH is now near 0 and I'm getting minor hand tremor, headache and heart palpitation so I'm overdosing according to my doc. He recommends me switch to T4 only synthetic so I don't get the ups and downs with T3 and it needs to be at a lower dose. I've never tried synthetic. Would you recommend it? I know some people are dying to get Armour but the doc won't prescribe and I'm the other way round. Any thoughts?

Thanks!


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## joplin1975 (Jul 21, 2011)

My opinion is that you should always start with t4 meds. Get your free t4 to where it needs to be and if your free t3 is still too low, then you can fiddle with the desiccated meds. Otherwise, you run into issues like you are experiencing.

Can you share your latest labs? Were they only testing TSH?


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## thyroidboardsfan (Apr 10, 2018)

My latest lab:

TSH 0.023 (ref 0.27 - 4.2)

T4 Total 6.36 (ref 4.5 - 11.7)

T3 Total 0.99 (ref 0.6 - 1.81)

T3 Free 2.9 (ref 2 - 4.4)

T4 Free 1.14 (ref 0.8 - 1.8)

TP Ab 36.7 (ref <60)

Is there any number you see that is far from optimum and needs to be addressed? I'm still feeling fatigued with brain fog all the time.

BTW, is there anything that can be done about the antibodies? I asked my doc for NDT but he said no.

Thanks.


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## joplin1975 (Jul 21, 2011)

Are these the labs from when you were on T4-only?

Your free t3 is really low -- you are essentially hypo.


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## Lovlkn (Dec 20, 2009)

Your TSH is awful low for such hypo FT-4 and FT-3 labs.

Have you ever had a TSI test run?

When in relation to your lab do you take your replacement hormone?


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## Hopeful (Apr 10, 2018)

Which thyroid antibody was high, so that it showed you have Hashimoto's? TPO and TG are the antibodies for Hashimoto's. Your TPO is not elevated. It's in normal range. Based on this antibody result and in absence of the results of the other Hashimoto's antibody, TG, you don't have Hashimoto's. TPO reference <60, means normal or no-Hashimoto's is less than 60. Any result above 60 is Hashimoto's.


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## thyroidboardsfan (Apr 10, 2018)

Lovlkn said:


> Your TSH is awful low for such hypo FT-4 and FT-3 labs.
> 
> Have you ever had a TSI test run?
> 
> When in relation to your lab do you take your replacement hormone?


My doc uses my lab numbers for dosing Armour. He said my TSH is low and I'm already at the end of the road for Armour (overdosing). He is trying to convince me to switch to T4 only synthetic since it's more stable without the volatile T3 spike ups and downs that may be causing the fatigue.

My FT4 and FT3 are "within range" but look like low "normal". What should be the optimum range? Should they be at the higher end of the scale?

Armour has T3 in it. If T3 is still low after supplementation, does it mean something is not right even though my TSH is low?

What's TSI?


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## joplin1975 (Jul 21, 2011)

You sort of have to ignore TSH when using desiccated meds. It will artificially lower your TSH. Dose by free t3 only. Get your free t3 to the 50-75% of the range. As long as you don't have hyper symptoms, you will be ok.


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## Pamzilla13 (Sep 9, 2013)

How much time passed between each increase in Armour? One week? 6 weeks?

If you are increasing too quickly, it wouldn't be unusual to feel "hyper" symptoms...


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## thyroidboardsfan (Apr 10, 2018)

Pamzilla13 said:


> How much time passed between each increase in Armour? One week? 6 weeks?
> 
> If you are increasing too quickly, it wouldn't be unusual to feel "hyper" symptoms...


It's almost 6 months already since the last increase. So this is not normal.


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## thyroidboardsfan (Apr 10, 2018)

joplin1975 said:


> You sort of have to ignore TSH when using desiccated meds. It will artificially lower your TSH. Dose by free t3 only. Get your free t3 to the 50-75% of the range. As long as you don't have hyper symptoms, you will be ok.


Just did another lab. Here are the results on Armour 90mg:

TSH 0.059 (ref 0.27 - 4.2)

T4 Total 6.07 (ref 4.5 - 11.7)

T3 Total 1.07 (ref 0.8 - 2)

T3 Free 3 (ref 2 - 4.4)

T4 Free 1.16 (ref 0.93 - 1.7)

Doc said my numbers look good but I maybe overdosing since I'm getting the classic hyper symptoms, i.e. fatigue, poor sleep, heart palpitation, hand tremor, headache, high blood pressure and constipation. He's moving me back to synthetic (Synthyroid 100 mcg) and at a lower dose since it's easier to administer with only T4. He can always add synthetic T3 should I need it down the road.


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## Lovlkn (Dec 20, 2009)

> Just did another lab. Here are the results on Armour 90mg:
> 
> TSH 0.059 (ref 0.27 - 4.2)
> 
> ...


Will edit the 1/2 - 3/4 range in bold above

Your "free" thyroid labs are not even 1/2 of the range indicating you are under medicated. When taking Armour your FT-3 should be at 3/4 of the range while FT=4 is usually lower.

If it were me - I would increase Armour slightly and see if symptoms go away.


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## creepingdeath (Apr 6, 2014)

It all depends on the person............
Everyone is different..............

The mighty know it all doctors started me off on synthetic and I almost died............
I wouldn't take that poison again at gun point....

I had to struggled to find a doctor who would let me try desiccated thyroid.......which changed my whole world around........
I never get any ups & downs from Armour Thyroid but if I did it's got to be better than dying...........

My doctor and I used the instructions that come with Armour Thyroid...........
You start off on the lowest dose 15mg...........then increase every month till you start feeling better.
My opinion is your doctor doesn't know how to treat thyroid disease..........
Using TSH "a screening test" to treat thyroid disease shows they are not educated enough. 
I'd find someone else if you're not getting any better.............just my opinion............


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## DanG (Apr 17, 2018)

Funny, I was on NDT and eventually felt like I was going to die!

I wish more doctors were using T3. That's the best way to get FT3 up to snuff. If you can get it up to or slightly beyond the top of the range, good things happen.


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## Lovlkn (Dec 20, 2009)

> If you can get it up to or slightly beyond the top of the range, good things happen.


I have to say - we are all different in this aspect. If I get beyond 3/4 range on FT-3 I feel a bit anxious and have rapid heart rate. Getting to top of range would be too much for me.


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## Hopeful (Apr 10, 2018)

The upper end of the range is where people have more symptoms, just like at the bottom of the range. Having either FT3 or FT4 up over 3/4 can make many people very sick and can be very dangerous. Over the top of the range is even worse and even more dangerous. I would never let myself get over 3/4 of the range either. Not worth the risk for me, anyway.


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## thyroidboardsfan (Apr 10, 2018)

I just finished off my remaining Armour pills and starting synthetic treatment tomorrow. What should I expect when switching from NDT to synthetic? Is there going to be a transitional period until my body adjusts to the new med? Will there be any "shock" to the system? If so, how long does it typically last? Thanks.


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## Lovlkn (Dec 20, 2009)

Your should have labs run prior to switching - has your doctor ordered lab's?

As your FT-3 falls, hypo symptoms will surface unless you convert the T4 hormone properly.

Your low TSH with hypo FT-4 and FT-3 are an issue. TSI antibodies mimic TSH which would address why you have low to no TSH with hypo Free labs.


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