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    Old 04-05-2006, 10:26 PM   #1
    Hypo2004
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    Question Armour switch

    Latest labs from April 1st:

    Medication was 88mcg Sythroid + 5mcg Cytomel...
    I followed directions and waited to test after weeks of feeling ABSOLUTELY terrible... fatigue, hair loss, and cold intolerance... crying everyday and praying so hard...

    TSH 0.85 (0.4-5.5)
    Free T4 1.0 (0.8-1.8)
    Free T3 215 (230-420)

    I called the doctor and increased my Synthroid to 100 immediately after the test. Just yesterday, the Endo prescribed me the equivalent of Armour.... 75 mg (or 1 1/4 grains) broken into two doses during the day.

    So, in summary, I've been on this increased dose of 1 1/4 grains of Armour (or synthetic equivalent) for four days! I have noticed one change... not freezing anymore.... but hair loss continues and still struggling with the morning fatigue. I take the 1/2 + 1/4 grain at 7am and the 1/2 grain at 2pm. Should I split it into three doses a day or take the second dose sooner?

    Any advice on dosing or how long until feeling better (I know we're all different) or Armour transitioning????

     
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    Old 04-06-2006, 08:22 AM   #2
    ellie342
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    Re: Armour switch

    The hair loss can lag behind everything else - when you lose hair, from stress or malnutrition or other causes besides thyroid disease, it often takes a while to recover. I suspect, though, that you will end up needing more Armour than this, so if you still feel crummy after another week or so, consider pushing your endo to increase the dose.

    Ellie

     
    Old 04-06-2006, 03:51 PM   #3
    Divermon
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    Re: Armour switch

    I am assuming you waited a minimum of six weeks of taking those meds, before these tests were performed.

    From your numbers, I would guess that you have some conversion issue. But how much, is hard to say, until your numbers come up higher. I agree with Ellie, that this new dose is unlikely to be enough for you.

    If you ignore all conversion issues, and just calculate the raw dosages, then the new dose you are on, is about 86% of the former dose. You clearly needed more meds in general.

    It's a little tricky to predict, because it's not just a matter of adding T4 med to bring up FT4 levels, and adding T3 meds to bring up FT3 levels. When both levels are low, as yours are, they effect each other.

    In a person with no conversion issues and low T3, the body will grab all the FT4 it can get, and convert it to T3, pulling the T4 levels down. In this case, one approach would have been to increase just the Synthroid. With enough T4 to fuel the conversion, once T3 levels come up, the T4 levels will stop getting depleted, and they will come up too.

    In a person with conversion issues and low T3, you will often see T4 levels maybe a little higher by comparison, because since there isn't enough conversion happening, the T4 levels are not being depleted.

    What you want to watch for, is if the new dose ends up making you hyper, then the right way to adjust the dose would be to drop the Armour some, and add back in some Synthroid (or other T4 med).... as opposed to just dropping the Armour.

    If the new dose just doesn't do enough for you, then great, just raise it.

    At any rate, use the FT levels as your guide. Good that your Doc is testing them.
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    Old 04-06-2006, 04:57 PM   #4
    Hypo2004
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    Re: Armour switch

    Thanks for replying....

    I counted 75 hairs so far after my afternoon shower... it's SLIGHTLY less than it was last time, so I am thrilled... I do suspect that I'll need a small increase soon...

    those labs were prior to a minor increase six days ago... by the weekend, if my hair is still falling out bad, I'll add another 1/4 grain... will call doc to confirm tomorrow...

    I read somewhere that 3-5 grains was a full replacement dose of Armour... and I'm only at 1 1/4!!! Is this true?

     
    Old 04-06-2006, 05:46 PM   #5
    Kharma
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    Re: Armour switch

    Quote:
    Originally Posted by Hypo2004
    T read somewhere that 3-5 grains was a full replacement dose of Armour... and I'm only at 1 1/4!!! Is this true?
    No that's not true. 3 grains of armour is roughly equivalent to 300 mcg of Synthroid, so it's a lot. If you google armour thyroid the official site pops up. You can go there and click on their FAQs. Scroll down the FAQs to find the table that shows equivalencies

     
    Old 04-08-2006, 08:14 PM   #6
    Divermon
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    Re: Armour switch

    You can roughly calculate full T4 replacement dose in micrograms, by multiplying your body weight in pounds by .72. This assumes absorption rate of about 80%.

    For example, if you weigh 130 pounds:
    130 x .72 = 94 mcg

    It's a little more complicated for Armour, but that would be about the same as 1 - 1/4 gr. of Armour.

    However:
    1. Unless you had your thyroid gland removed, you don't know how much of it is still functioning.
    2. These calculations don't necessarily hold true if you have trouble converting T4 into T3.
    3. When and how you take the meds can alter absorption.

    As far as your lingering symptoms go... some of them are quicker to resolve, and some take a while. Although everyone is a little different, I think energy level would be the first thing you would notice.

    Obviously you don't have the characteristic brain fog, otherwise I suspect you would have lost count on the way up to 75 hairs .
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    Old 04-09-2006, 08:21 AM   #7
    sudufu
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    Re: Armour switch

    I'm too new at this to help with the techical stuff, but:
    75 mcg T4 = 3/4 grain Armour
    150 mcg T4 = 1 1/2 grain Armour
    200 mcg T4 = 2 grains Armour
    300 mcg T4 = 3 grains Armour

    I took just Synthroid for 7 weeks w/ horrific side-effects. I've been tappering down Syn while UPing Armour since switching 11 days ago. Within a couple days I was sleeping better, less cranky & could feel some of the brain fog lifting.

    Everyone is different. Even after getting a full nights sleep, I feel myself crashing most afternoons, so I know my small dose, 3/4 of a grain, needs more tweaking.

     
    Old 04-09-2006, 02:55 PM   #8
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    Re: Armour switch

    Sudufu, I do understand what you are saying, and you seem to have good understanding of the difference. I hope I don't offend anyone, but I just wanted to point out to anyone reading, that might take the wrong meaning from that .......

    Whereas it is true that 75 mcg of a T4 medication (such as Levoxyl, Unithroid or Synthroid) is roughly equivalent in thyroid hormone biologic "power" as is grain of Armour (or Naturethroid or Thyrolar), these are very different medications, and not directly interchangeable.

    In many cases, partial substitution of T4 med in favor of Armour is beneficial. In some cases it is beneficial to substitute all T4 med in favor of Armour. The extent of this substibution should always be under the care of a qualified Doctor, and guided by frequent monitoring of free T4 and free T3 serum levels.

    Care should always be taken in the transition from a T4 med to a med with T3 in it. For some people, a direct substitution, based on the given equation, could be harmful to their health, and even lethal.

    It is important to taper the dose substitution, as you are doing. The reason for this is that with a long half-life of T4, you will still have T4 levels in your blood lingering for weeks after your med substitution.

    And at the same time, the more biologically powerful T3 is being added. If you think about that, the net effect is that on every change-out of T4 in favor of Armour, your blood levels will initially rise. Then, as the T4 (from before the substitution) eliminates from your body, your levels will lower, and even out to the new mix of meds.
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    Old 04-10-2006, 08:53 AM   #9
    sudufu
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    Re: Armour switch

    Thanks Divermom ~ NONE taken

    My ride on the Thy med rollercoaster only began 2+ months ago. Gladly, I'll take ANY knowledge & experience that others want to share.

    In many cases, partial substitution of T4 med in favor of Armour is beneficial. In some cases it is beneficial to substitute all T4 med in favor of Armour. The extent of this substibution should always be under the care of a qualified Doctor, and guided by frequent monitoring of free T4 and free T3 serum levels.


    Is that saying that some patients benefit from partial T4 AND Armour medications, at same time? I tolerated 1/2 Syn & 1/2 Armour GREAT - but as Syn is down to 1/4, I notice myself having daily afternoon crashes ! Yes, I am taking 1/2 dose of Armour in early morning, with other 1/2 noonish.

    I'd like to have all my ducks in a row, for my next Dr visit that's 4-5 weeks away.
    thanks,
    Sue

     
    Old 04-10-2006, 09:47 AM   #10
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    Re: Armour switch

    Yes. It's not all one med or all the other, although many Doctors prescribe that way.

    A healthy human thyroid gland produces all of the T4 you need, and only about 20% of the T3 you need. The rest of the T3 is converted from T4, by your organs, mostly the liver.

    Now, when our glands fail, and we take only a T4 med, the mainstream medical opinion is that the body can simply pick up the slack and convert all of the T3 we need. This actually does seem to work in a lot of people.

    If you have any difficulty in either this new increased level of conversion needed, or even just the former level of conversion, then you'll be short on T3. There are many reasons you could have a conversion issue, most notably any liver compromise.

    Another reason T3 could be lacking is if you have TG Antibodies, as these will effect the amount of total T3 that is bound in the blood, and the amount of free T3 that is left.

    The reason T3 is such an important focus, is that it is the only biologically active hormone of the two we focus most on (T4 and T3). T4 is actually not even a hormone, but a prohormone, meaning it is just laying around, waiting to be turned into an active form of hormone (T3). T3 therefore, is the one thyroid hormone that is most responsible for the symptoms (or lack of) of hypothyroidism or hyperthyroidism.

    For all the above reasons (and more), a given person can be anywhere on the spectrum of either converting all the T3 needed, or barely being able to convert any T3 at all.

    Ok, so why doesn't everyone just take Armour, and not have to worry about it? The answer is that the ratio of T3 to T4 in Armour is much higher than what a healthy thyroid gland produces. Theoretically, the only people who should take Armour as their only med, are those who have significant conversion problems, or have some other reason their FT3 is low in comparison to FT4.

    For most people, some mix of a T4 med and a T4/T3 med such as Armour is probably a better match. The way to guide this, is to first try to get your levels up somewhere in the mid or so area of the reference range. Then start to adjust the med mix according to how the FT4 compares to FT3.
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