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    Old 05-13-2004, 10:25 AM   #1
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    spin vs. truth: re Cytomel & Armour

    Ok, I've got a question. I hope I can explain it well though.
    I've been working on getting my thryoid levels (i'm hypothyroid after RAI) within a good range for the better part of a year now in order to feel better and maximize my metabolism. I'll not get into specifics regarding my labs (Free T3, T4 & TSH), but they are ok. Not perfect, but ok. I found a PCP recently who I feel is more knowledgable of the thyroid than any endo I have ever seen. It was important to him, at least, to get my TSH under 2, which we have done (just by a hair) successfully. I saw him yesterday and I had found a couple of endo's I wanted a referral to because they prescribe Cytomel & Armour. I like the approach of backing off the synthetic T4 once the TSH it's "normalized" and adding Cytomel. I discussed this with him and he said he would give me the referral with no problems, but it would be against his orders. I was kind of taken aback at his adamancy. Like I said, he had no problem helping me get a referal, but he was absolutely adamant that Cytomel & Armour were not the way to go. He stated his concerns were that these drugs put me at risk for advanced osteoperosis & heart disease amount other things. He said in good conscience, he couldn't stand by my choice to do this. Soooo, this brings me to my questions:

    I've heard nothing but great things about Cytomel & Armour & how much better you feel. I've never heard the "downside". And now after speaking with my doctor I'm not sure what to believe or think. Is this a situation where the end justify the means? I mean, if it will make me feel better NOW is it worth putting myself at risk for other diseases down the road? Or, is my doctor blowing smoke? I mean, if he is blowing smoke, he absolutely believes it and I do feel that he is an educated man. In the meantime, my doctor is testing my insulin & blood sugar levels as the majority of my problem at this point is that I continue to gain weight and it's not in proportion to the amount of food I'm eating or my exercise schedule. That's just an FYI. I really do like my doctor -- he does work with me and works very hard to address any questions or concerns I have. That's why I was so shocked at how stern he was about adding Armour & Cytomel.

    Sorry this got so long -- Any takes on this would be greatly appreciated. Also, any experiences as to how people made their choice about Cytomel & Armour even if there was a risk for other diseases down the road..... Thanks!

     
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    Old 05-13-2004, 10:36 AM   #2
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    Re: spin vs. truth: re Cytomel & Armour

    Armour is high in T3 to begin with and adding Cytomel would be a lot of T3. Do you ever have your Free levels checked or is this something not done once you have RAI?
    Here's my thought though, if your T3 rises too high, it can and will cause heart related symtoms, I took Cytomel for a while and stopped because it drove my heart crazy, extra beats and skips constantly. I now take Nature-Throid (basically same as Armour) and add synthetic T4 (Unithroid) to bring up my T4 level.
    I have heard others that have had heart related symptoms on Cytomel, you have to be careful not to get too much.
    As for heart disease I have not heard that it will cause it, I have heard untreated thryoid problems puts you at greater risk for heart disease.

    I look forward to seeing what others have to say on this.

     
    Old 05-13-2004, 12:49 PM   #3
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    Re: spin vs. truth: re Cytomel & Armour

    Thank you for your response! I have had my Free T's tested and I do not have my labs in front of me, but I study all of my labs when I get them back. My last test was about 3 months ago and I remember thinking it was the first time I felt my labs actually looked ok. I do feel it wouldn't hurt for my TSH to be a little bit lower. It is currently at 1.99 But, I'm on 200mcg of Levoxyl so upping it to 225 would probably make it too low. However, I'm sure my doctor would do it if I asked. Since I had the RAI done, I've had problems with panic and axiety -- especially related to my heart. Maybe this is one of the reasons my doc so strongly disagrees with me going that route. I just want to be better informed before I go back to him to get a referral. I just never would have guessed how much proactive hard work it takes to get yourself well with a thryoid disorder.

     
    Old 05-13-2004, 04:26 PM   #4
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    Re: spin vs. truth: re Cytomel & Armour

    Keep in mind that the TSH is a pituitary response and quite often is a very poor indicator. I'm not sure how it works with RAI, but most people have to watch the frees very closely and they have to be mid to upper in the range.
    I don't pay a lot of attention to my TSH since it tells me basically nothing. At last check mine was 0.18 with a range of .034-4.82, that's below range and looks hyper, if I only went by this I would have been in trouble because both my frees were under mid range and I was hypo not hyper.

    The best thing you can do for yourself is learn as much as you can about your condition, drs don't always know whats best. Panic and Anxiety is often accociated with hyper and yes, if you have any heart related problems you have to be very careful with T3 meds.

     
    Old 05-13-2004, 06:19 PM   #5
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    Re: spin vs. truth: re Cytomel & Armour

    It amazes me how these doc's can all have different viewpoints. I just went to an Endo last month (first visit) and before I saw him I called to see if he will give a patient Armour, and the secretary said yes. When I asked for Armour he was glad to give it to me. He said that he tries to get every paitent he sees on Armour because it is so much better than Synthroid, etc. He is serious about this too. So who knows? Some doc's sware by one med, and others by something else.
    One other thing.....Armour has been around for a long, long, long time. If it was causing bone loss, or heart disease, one would think that the drug wouldn't be available anymore.

    I will say this though........UNTREATED thyroid problems can cause bone loss (sadly, I know this personally, sigh) AND heart problems too. The Endo I saw was telling me that he had just stopped a guy from having a pacemaker put in. The guy's TSH was 10, and after a while on Armour......no more need for a pacemaker.

     
    Old 05-14-2004, 09:10 AM   #6
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    Re: spin vs. truth: re Cytomel & Armour

    There is nothing inherently harmful in Armour nor in Cytomel that would accelerate bone loss any more than there is in Synthroid. Any doctor who suggests that would be in error.

    Overtreatment of hypoT with any of the meds may lead to acceleration of bone loss, particularly in elderly women. But there has never been any proof that proper treatment does. Read the writings of Dr. John Dommisse, Dr. John Lowe, Dr. Ridha Arem, or Barry Durant-Peatfield to find valid arguments for the use of T3 in treatment.

    As Renee' has mentioned, undertreated hypoT carries the same risk of bone deterioration and heart disease as overtreatment does. There are calcium receptors on bone cells that are known to malfunction from deficiency of free thyroid hormones. And the elevated lipid levels associated with hypoT make CVD much more likely to occur with non- or undertreatment.

    I think your doctor has bought Synthroid's party line hook and sinker, and he certainly isn't alone. He probably does put his faith in it... But in my mind, "faith" alone doesn't carry the weight that "science" does. There are too many doctors who have successfully combined faith and science to remove science from the equation and rely solely on faith.

    Last edited by midwest1; 05-14-2004 at 09:14 AM.

     
    Old 05-14-2004, 10:49 AM   #7
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    Re: spin vs. truth: re Cytomel & Armour

    Just to let you know, my Endo. is the exact same way. He went so far as to say he thought Armour has a placebo effect. Fortunately, he has left me on it, but I had to fight for it.
    Now on the other hand, my old Endo. loved Armour and tried to get all of his patients on it also.

    I don't know the answer to your question, but I do know my Doc said something about not being able to control Armour and it not being reliable as far as consistency goes. We all know this is exactly what the companies who make the synthetics set out to do.

     
    Old 05-14-2004, 06:10 PM   #8
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    Talking Re: spin vs. truth: re Cytomel & Armour

    Quote:
    Originally Posted by brandekristene
    Thank you for your response! I have had my Free T's tested and I do not have my labs in front of me, but I study all of my labs when I get them back. My last test was about 3 months ago and I remember thinking it was the first time I felt my labs actually looked ok. I do feel it wouldn't hurt for my TSH to be a little bit lower. It is currently at 1.99 But, I'm on 200mcg of Levoxyl so upping it to 225 would probably make it too low. However, I'm sure my doctor would do it if I asked. Since I had the RAI done, I've had problems with panic and axiety -- especially related to my heart. Maybe this is one of the reasons my doc so strongly disagrees with me going that route. I just want to be better informed before I go back to him to get a referral. I just never would have guessed how much proactive hard work it takes to get yourself well with a thryoid disorder.
    ok, here's the thing: both hyper and hypo patients can get osteo, and both untreated and undertreated hypoT can cause osteo and heart disease ...

    in my case, it was the un-dx'd hypo that caused my osteo, certainly not the T4 ... i broke my hip just after i was dx'd, but i'd had osteo for a few months to a year b/f i was dx'd (i had a bone scan that showed my bone density had plummeted a few months previous) ...

    the only entry i could find on the 'net connecting cytomel with osteo was from dr. lowe, and the entry implies that there is NO causal effect ...

    jb
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    Old 05-15-2004, 02:35 PM   #9
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    Re: spin vs. truth: re Cytomel & Armour

    Unfortunately for that Endo, he is only going by the training done at the medical school and hospitals that were funded by the Synthroid drug company. Only the osteopaths appear to be free from their influences (mostly). I know it sounds like a conspirousy theory, but it's true. When that drug came out in the 1970's, they had to make a niche for themselves so that's what they did. They convince docs that Armour was "dirty" since it was a natural product made from pig and beef glands and that their dosage was inconsistent. Not true....every batch is tested for dosage and purity. Synthroid, however, is being sued for having doseages that were more than 20% variant and only 10% is allowed by the FDA.
    Also, they convinced the docs that only the TSH need be checked, and that doesn't come close to accurate. The TSH is only a pituitary response to the thyroid level in your body....not a test for the thyroid at all.
    Please have your Free T3 AND Free T4's done. They are the only real indicators of your thyroid standing. Both should be in the mid-upper range of your lab normals!
    Good luck!

     
    Old 05-15-2004, 11:57 PM   #10
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    Talking Re: spin vs. truth: re Cytomel & Armour

    Quote:
    Originally Posted by jinglebts
    ok, here's the thing: both hyper and hypo patients can get osteo, and both untreated and undertreated hypoT can cause osteo and heart disease ...

    in my case, it was the un-dx'd hypo that caused my osteo, certainly not the T4 ... i broke my hip just after i was dx'd, but i'd had osteo for a few months to a year b/f i was dx'd (i had a bone scan that showed my bone density had plummeted a few months previous) ...

    the only entry i could find on the 'net connecting cytomel with osteo was from dr. lowe, and the entry implies that there is NO causal effect ...

    jb
    and how about 212 instead of 225?

    jb
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    Old 05-16-2004, 09:20 AM   #11
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    Re: spin vs. truth: re Cytomel & Armour

    Something else just occurred to me brandik...
    You are now taking more than the average full replacement dose of T4, and you've experimented with an even higher dose in the effort to feel better. This suggests to me that you have a problem with either conversion or cellular resistance. Adding some T3 to your med regimen could help with either problem. There is proven harm to bone density with high T4 dosing.

    You should get a copy of Dr. Arem's book and pay particular attention to chapter 17. He isn't an avid fan of Armour, but he routinely uses T4 plus Cytomel to help people attain a good result. I daresay his experience is far more extensive than your doctor's; if he says Cytomel is safe when properly used, I'd believe him in a heartbeat.

     
    Old 05-17-2004, 07:57 AM   #12
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    Re: spin vs. truth: re Cytomel & Armour

    Thank you ALL for your responses. I really, really appreciate all of the excellent information. I think I will go against my doctors wishes and have him refer me to an endocrinologist in the area that I know prescribes Armour & Cytomel. However, I didn't want to do that unless I had good ammo, you know? He's always willing to listen to me and discuss things in detail, but I guess this is going to be one area that we just are not going to agree on. I don't think pointing out that an undertreated thyroid carries just as much risk for osteoperosis will convince him of anything, as he feels my thyroid IS treated. I mean, the guys not an endo, and I when I first found him, I was excited because he wanted to get my TSH under 2 (my previous endo was of the 5.5 variety). This is all such a slow process -- I guess because as the patient, we have to do most of the work. Again, thank you all for your responses.

    Midwest-- I was interested in a comment that you made about my dose being above average for full replacement of T4 -- what is average? I always thought my dose was a little higher than most peoples I was seeing. Also, I've never heard of cellular resistance - - maybe that is something I can discuss with the endo (once I see him). And, what you are suggesting is EXACTLY what I suggested to my doctor. To back me off the synthetic a bit and add some Cytomel. I'm not as die hard about the ARmour, but I really, really want to try the Cytomel. Anyhow. Thank you!

    Last edited by brandekristene; 05-17-2004 at 08:00 AM.

     
    Old 05-17-2004, 08:53 AM   #13
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    Re: spin vs. truth: re Cytomel & Armour

    Of course, nothing's set in stone, but the "average" full replacement dose would be about 100-150 mcgs. for most adults. The fact that you're already much higher than that and have considered going higher tells me that you - like most hypos - have other considerations that are preventing your body from making use of all that T4.

    Cellular resistance is exactly what the term implies... There may be something wrong with the cell receptors that absorb the converted T4. Some of the T4 must be converted to T3 and sent into circulation by the liver, and some organs [such as the brain, for one] do their own conversion directly. If that conversion process goes awry, as it often does, a shortage of T3 results ... Or the problem may be a combination of both resistance and conversion. These conditions are often overlooked as the origin of continuing symptoms, because blood hormone levels often will appear normal even though the cells aren't receiving enough T3. When extra T3 is prescribed, it usually overcomes these defects. Doctors have been taught for decades that supplying T4 is enough ... that the body will perform flawlessly in doing what it's supposed to do. That's absurd when you think about it. There is no other intricate system on earth in which all the parts of the system are guaranteed to work when one of them doesn't; why would the endocrine system be different?

    BTW, I don't fully understand your doctor's misgivings about T3 in and of itself causing bone loss. I've never seen reference to anything other than inappropriate thyroxine (T4) treatment causing such loss. I found an journal article that effectively debunks the theory of T4 causing bone destruction, if you want to look it up or refer your doctor to it. I agree with you though, that you won't change his mind... Not unless he's the kind of old dog who can learn new tricks.
    The article from the British Medical Journal is ~
    Toft AD, Beckett, GJ. Thyroid function tests and hypothyroidism. Brit Med J 2003;326:1087 (17 May) Letters

     
    Old 05-17-2004, 10:53 PM   #14
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    Talking Re: spin vs. truth: re Cytomel & Armour

    Quote:
    Originally Posted by brandekristene
    Ok, I've got a question. I hope I can explain it well though.
    I've been working on getting my thryoid levels (i'm hypothyroid after RAI) within a good range for the better part of a year now in order to feel better and maximize my metabolism. I'll not get into specifics regarding my labs (Free T3, T4 & TSH), but they are ok. Not perfect, but ok. I found a PCP recently who I feel is more knowledgable of the thyroid than any endo I have ever seen. It was important to him, at least, to get my TSH under 2, which we have done (just by a hair) successfully. I saw him yesterday and I had found a couple of endo's I wanted a referral to because they prescribe Cytomel & Armour. I like the approach of backing off the synthetic T4 once the TSH it's "normalized" and adding Cytomel. I discussed this with him and he said he would give me the referral with no problems, but it would be against his orders. I was kind of taken aback at his adamancy. Like I said, he had no problem helping me get a referal, but he was absolutely adamant that Cytomel & Armour were not the way to go. He stated his concerns were that these drugs put me at risk for advanced osteoperosis & heart disease amount other things. He said in good conscience, he couldn't stand by my choice to do this. Soooo, this brings me to my questions:

    I've heard nothing but great things about Cytomel & Armour & how much better you feel. I've never heard the "downside". And now after speaking with my doctor I'm not sure what to believe or think. Is this a situation where the end justify the means? I mean, if it will make me feel better NOW is it worth putting myself at risk for other diseases down the road? Or, is my doctor blowing smoke? I mean, if he is blowing smoke, he absolutely believes it and I do feel that he is an educated man. In the meantime, my doctor is testing my insulin & blood sugar levels as the majority of my problem at this point is that I continue to gain weight and it's not in proportion to the amount of food I'm eating or my exercise schedule. That's just an FYI. I really do like my doctor -- he does work with me and works very hard to address any questions or concerns I have. That's why I was so shocked at how stern he was about adding Armour & Cytomel.

    Sorry this got so long -- Any takes on this would be greatly appreciated. Also, any experiences as to how people made their choice about Cytomel & Armour even if there was a risk for other diseases down the road..... Thanks!

    just occurred to me -- are you taking any meds that could interfere with it? for example, my anti-seizure meds do, and i have (i think) false readings for my lab levels ...

    jb
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    Old 05-18-2004, 07:29 AM   #15
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    Re: spin vs. truth: re Cytomel & Armour

    surprise, surprise -- just Zoloft. and occasionally a .25 xanax (as needed for panic attacks). I don't think these meds interfer though. When I saw my doctor last, I asked to be taken off the Zoloft -- so I've been off it now for almost a week. It did seem to help, but more weight gain is just not something I'm willing to content with anymore. It did seem to help my "brain fog" that lead to my anxiety that lead to my panic attacks The brain fog is kind of creeping back, but I really don't want to start any other meds. I guess I just absolutly must have him refer me to an endo -- I've really done my research and think I've found a good one.

    on a side note -- is it outside the realm of "normal" to start having panic attacks AFTER being hypothyroid. I mean you would think if I was going to have panic attacks they would have happened when I had Graves, not once my thyroid was ablated? hmmm. Anyhow. I really do appreciate your responses -- I had really made up my mind to try it my doc's way for a while, but now I really feel like I need to keep pushing forward and find a way to get some more T3 in my body!!

     
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