[SPAM] Re: 7 weeks post TT-help

January 15, 2008

Jan,

Thanks for getting back with me and

reminding me what I had read before: That is to up the Armour in 30 mg increments.

In my hypo stupid state I had forgotten that detail. I found a great

journal/article about time release/compounding different thyroid meds for even

better results in it had an Armour table on it that was really helpful. My

endo even asked for a copy since he didn’t know the correct Armour

values/equivalences or about compounding/time release.

I just bought Ridha Arem’s book and

plan to start it in the next day or two (I’m finishing the 10 steps book

right now).

Penny

From: Texas_Thyroid_Groups [mailto:Texas_Thyroid_Groups ] On Behalf Of Jan

Sent: Monday, January 14, 2008

9:49 PM

To: Texas_Thyroid_Groups

Subject: [sPAM]

Re: 7 weeks post TT-help

Most of the equivalency

charts are not very good. The one on the Armour website states 60 mg

of Armour being equivalent to 100 mcg of T4 only, but contradicts the

prescribing info which would suggest that 60 mg of Armour might be equivalent

to 74 mcg of T4. The truth is probably somewhere in between, and what you may need

is highly individual. It is my personal, not medical, opinion that Armour

should be dosed based on the exact amounts of T3 and T4.

It is generally a good idea

to start low and and increase slowly until you know your tolerance for T3.

Knowing your ferritin and 8 am cortisol levels will give you some clue about

your thyroid hormone tolerance.

Starting with just 60 mg of

Armour would parallel Ridha Arem's protocol for adding Cytomel. He recommends

reducing the T4 med by ~40 mcg and adding two 5 mcg Cytomel tablets. (His

protocol presumes that you are taking your maximum dose of the T4 med, which

you are not.)

60 mg of Armour contains 9

mcg of T3 and 38 mcg of T4.

Your 90 mg of Armour plus 50

mcg of the T4 med is not outrageous, but I would suggest that you start with

just 30 mg the first day or two, then 30 mg twice a day until you feel

comfortable increasing to the 90 mg. But read my last paragraph, because I have

a different suggestion as to the doses.*

Like you, I was on my own

(with my doctor's permission) when starting Armour. I thought I was being very

conservative in allowing myself a full four weeks to get from my 300 mcg of

$ynthroid to my initial target dose of 180 mg of Armour plus 75 mcg of a T4

med. I had no problem, but I now know that I was going pretty fast.

Increasing too quickly can

give one hyper-like symptoms and impair your future tolerance for thyroid

hormone.

*I would note that your Free T4 on 125 mcg of $ynthroid at 1.1 is

a little lower than most of us would like (midpoint = 1.3). For that reason, I

would not want to be taking any less T4, and you might even need a little more.

90 mg of Armour contains 57 mcg of T4 and 13.5 mcg of T3. Adding in 50 mcg of

T4 gives you just 107 mcg of T4. Based on that info, my suggestion would be to

start with 60 mg of Armour plus 100 mcg of a T4 med. That combination

would give you 138 mcg of T4 and 9 mcg of T3. Do discuss this with your doc.*

>

> I have been greatful to read your post over the last 2 months and

> pleased at the files I have also been able to find useful. After

> research and my best attempts to be prepared for today, I find myself

> needing some guidence from those in the know.

>

> First of all here are a few details:

>

> TT on Nov. 27th to resolve Hashimotos, Thyroid enlarged w/nodules,

> new growth & nodules in a 6 month span, windpipe compression and

> esophagus constricted by wrapping of thyriod.

>

> I was on 88 of Synthroid pre-surgery.

> Placed on 100 Synthroid post-surgery.

> Dosage changed to 125 Synthroid after 2 weeks since I felt really

> bad, and instructed to wait 6 more weeks after that (8 week post TT)

> before blood draw.

>

> I couldn't take it anymore and went ahead and had my blood draw last

> Friday (after 4 weeks on 125's) because I knew things had gotten

> really bad.

>

> My TSH was 3.89 before surgery and at that appointment my endo raised

> me up from 75 to the 88 Synthroid. I saw my endo today and my labs

> today told me what I already had felt:

>

> TSH 22.04

> Free T3 231 (range 230-420) didn't phase him, I even told him I

> should be at the top of normal.

> Free T4 1.1 (range .8-1.8)

>

> He just wanted to up me to 150 Synthriod only. I knew enough to ask

> for Armour and had already done the math to get to 150 with

> additional T4 added if that was going to be the next step. I wanted

> to take T4 in addition to Armour for a better human ratio and

> transition to Armour (from what I've read).

>

> He didn't even want me to try Armour but Cytomel instead. I

> mentioned that since I did not have a thyroid I had nothing in my

> body producing T1, T2 or calcitonin. This seemed like a new concept

> to him. He actually got the Armour dosages wrong and when I produced

> a document that explained compounding/time releasing thyriod meds and

> gave the Armour equivalances...he requested to copy it. At first

> when he gave in to my request he was looking at doing 1 grain and the

> rest as Sythroid. I asked him to write a perscription for 1 1/2

> grains Armour and 50 Synthroid that would put my equivalancy closer

> to 160. I even showed him how this worked out in the article.

>

> I went to the pharmasist and here is what I have:

>

> 1 grain 60mg Armour (I'll take first thing in the morning)

> 50 Synthroid (SHOULD I TAKE THEM TOGETHER?)

> 1/2 grain 30mg Armour (I plan to take in the afternoon, WHAT TIME

> USUALLY WORKS BEST).

>

> The doctor does not want to see me again for 6 weeks to check blood.

>

> What are your thoughts as to how I have broken up my meds and what

> does my low Free T3 mean?

>

> Thank you so much for your help,

>

> Penny

>

January 15, 2008

I live in the ville area and endo is Dr. Haque. After

yesterday and then again today I don’t know if I will be going back to

him. His office quoted him as saying that the FT3/T3 values are never reliable.

I don’t know if that is because I am so hypo (TSH 22.04) and until that

comes down the T3’s shouldn’t be looked at. He also says that

adrenals do not need to be checked. I called my surgeon and he wants me to do

blood work in 4 more weeks, so I’m going to listen to Dr. Rosendahl

instead.

Thanks for your info about how to handle

the Armour. I had forgotten that.

Penny

From: Texas_Thyroid_Groups [mailto:Texas_Thyroid_Groups ] On Behalf Of pproft

Sent: Monday, January 14, 2008

9:27 PM

To: Texas_Thyroid_Groups

Subject: [sPAM]

Re: 7 weeks post TT-help

Penny,

When my doctor switched me from 137 Synthroid (I had been taking

Synthroid for 4 years), she told me to start with 30mg of Armour (.5

grains) and to increase the dosage 30mg every 5-7 days until I got to

that " too much coffee " feeling, then back off 30mg. I got to 3 grains

(180 mg) of Armour and stayed there for about 9 months. Just recently I

bumped up to 3.5 grains because I started getting hypo symptoms again

(cold and really dry face).

In June my tsh was .022, but in December it was .3. That gave me

another reason to increase it. I am a thyca patient and my tsh should

be suppressed. Also in June my Ft3 was in the upper third of the range.

I take my meds twice a day. 2 grains (120mg) when I get up and the

other 1.5 grains (90 mg) late afternoon around 5:00.

It takes about 6 weeks for the T4 to be fully aborbed, so that is

probably why he didn't want to see you for 6 weeks. Where do you live,

and who is your endo?

Thanks,

Pat