T4 still dropping on Armour - Normal?

[justy]

Hi, i have posted elsewhere about my appts etc with Dr Skinner and the whole Thyroid issue.
I have been on Armour thyroid for a few months now - started at 1/4 grain, moved up to 1/2 then 1 daily in split dose. As soon as i went up to i grain i felt very good and ahad a few really good weeks. Then odd symtpoms started creeping back (chest pain, palpitations, nervousness, anxiety, fatigue) plus some new ones (feeling faint, very low resting pulse, nearly blacking out, intolerance of being upright for long, severe dizziness)

When i first started Armour my results where in range but lowish:

TSH: 2.69 (0.27 - 4.20)
Free T4: 12.8 (12 - 21)

After two months on Armour they were:

TSH: 2.29 (0.27 - 4.20)
Free T4: 12 (12 -21)

So this week i spoke with Dr S about feeling so ill again and my concerns re chest pain (although i have had this on and off for years and it may be coming from stomach) and general feeling crap after a few great weeks. He said not to increase dose (am supposed to be titrating up to 2 grains or until i feel well) to stick at 1 grain and go see GP for reassurance etc.
Off my own back i decided to cut Armour to 1/2 grain and felat less anxious/restless etc although now feel in full on M.E crash and dizziness is still bad but improving.

GP did ECG - normal
blood pressure - 116/63 - normal
Thyroid bloods, which came back today:

TSH -1.46 (0.27 -4.20)
Free T4: 11.2

On my last visit in early August Dr S said it is normal when taking Armour (which includes T3) for T4 to drop. But mine is still dropping, i feel like crap and i dont understand the rationale behind what he is saying. I understand that i am supplying T3 directly to the cells, but Armour still has T4 in it as well as T3. plus surely my own bosy is still making some?

Can i just expect my T4 to keep dropping? is this normal?
I'm afraid i have no T3 blood tests - and GP will not do them (even if they will it's back on the merry go round of trying to get an appt to discuss with GP which is so hard as i have to find someone to take me and wait with me for hours - it all takes such a long time!)
Can't really afford T3 private test - and i guess i owuld still need to get tp GP for blood draw anyway.

Thanks for reading,
Justy x

 

[Little Bluestem]

I think as long as you are increasing the Armour thyroid, your T4 will continue to decrease since you are increasing your T3 from the Armour. I do not know how long this is expected to continue after a dose increase.

A healthy body makes an ample supply of T4. It makes as much T3 as it needs from the T4 and makes the rest into reverse T3, a waste product.

An unhealthy body may make too little T3 and too much reverse T3. I do not know why your body would make enough less T3 for your level to drop when it is getting some T3 ‘for free’ from the Armour. The fact that you are feeling worse does make me wonder if you have enough T3, though.

Is there any chance you could find a doctor who would do the T3 test and discuss the results in a telephone consult?

Are you familiar with the theories about thyroid function of Dr. Rind? According to his scale, your TSH is where it should be. You T4 must be in different units than he uses. His T4 scale goes from 0.30 to 4.00.

 

[justy]

Thanks Little Bluestem for the reply - i have noticed that once we get into the realm of thyroid hormones it can all get a little ' lcomplex' . The Doctor i am seeing (Dr Skinner in the UK) believes that many cases of M.E are in fact missed cases of Hypothyroidism - he goes on clinical signs and symptoms and a detailed case history and bases meds on 'how you are feeling' rather than just lab results - like in the old days.

I guess the only way to know what is happening as i can expect T4 to go low on Armour is to know what my T3 is doing - i also have the complication of low iron and ferritin which can lead to hormone transport problems as well as the usual host of antioxidant abnormalities that can go hand in hand with M.E - plus it would help to know my saliva cortisol (24 hrs) i am sitting on the test kit at the moment as i cant afford to do the test right now - but i believe that low cortisol can lead to feeling very crap on Armour or any other thyroid hormones.

All the best,
Justy x

 

[Little Bluestem]

Treating according to clinical signs and symptoms is not a bad thing if the dr. is skilled at it. Have you talked to Dr. S. about how you are feeling recently?

 

[justy]

Yes a quick chat last week on the phone - he suggested staying at 1 grain for a further week before increasing. Have tried to contact him this week, but he's not an easy man to get hold of.

Have started slowly increasing my dose again this week. will see how it goes.

Thanks Little Bluestem for taking the time to read my posts.

All the best,
Justy

 

[Ema]

justy

What you are describing is totally normal due to the feedback mechanism. That is why you have to raise every few weeks until you get to your therapeutic dose - because otherwise you will feel a return of hypo symptoms.

It's normal for FT4 to drop because your TSH has dropped so your body is making less. Now it is time to raise so you get more from your meds to compensate.

It's almost impossible to add to your own thyroid production due to the feedback mechanism unfortunately. And most people will need at least 3 grains of NTH to have good thyroid labs and feel well.

If it was me, I would make sure my adrenals and iron levels were good (because both are necessary to tolerate thyroid hormone) and consider raising on a more consistent schedule until you get your FT4 to about the UK equivalent of 1.3 and your FT3 in the upper third of the range.

ETA: I missed the post earlier about your iron and adrenals. I think I would do the saliva test before paying for a private FT3. I think that is crucial info. Are you also working on your iron?

 

[justy]

Ema thanks for the reply - yes have been supplementing with iron for the past 3 years. Have managed to only get my ferritin up to 14 from a low of 5 and also during this time of supplementation i have BECOME iron deficient. My iron levels are now at the bottom end of normal. I understand that ferritin should be at approx 80 to feel better - can't imagine ever getting mine that high. GP not interested in finding cause - just mutters 'we should find out what's causing this' and then tells me i will probabaly have to take iron daily forever!

Still trying to contact Dr S clinic - their answering machine has been full since last week and they have NO e mail.

I understand now from reading around that it is normal for T4 to go low as the T3 is being supplied directly (with the NDT) BUT i can't find any info that says it should keep going low and be so low.

I also get it about the feedback mechanisms etc - but i do wonder if it is not Hypothyroidism causing my ill health (as suggested by Dr S ) then surely i am just knocking out my own system and then replacing which seems mad.

If i decided to stop treatment altogether at some point would my body then struggle to start producing its own thyroid hormones again. Bit worried about it all now

 

[seansee]

Do you have any updates?

 

[Little Bluestem]

It's here: http://forums.phoenixrising.me/index.php?threads/stopping-armour-more-ill-than-ever.25479/

 

[xks201]

The obvious answer is that you are taking just enough armor to inhibit your kwn thyroid function and thus lower your t4. You need the equivalence of like 200 to 300mcg of t4 daily to notice any improvements. If your doc couldn't explain to the above tk you he is a tool and most are.

 

[xks201]

Idk why you are being masochistic and stopping treatment if you had a deficiency. Lol

 

[justy]

Hi xks201 - as usual loving your very direct approach.

I'm afraid its not that simple - i dont KNOW i have a thyroid deficiency - my bloods are always in range but low side of 'normal'. I recently decided to visit a Dr who specialises in helping people with M.E - he was initially a virologist but has come to believe that most cases of M.E are in fact missed Hypothyroidism - he treats the old fashioned way, based on your symptoms, as they did before blood tests for thyroid became widely available.

He has made many people fully well again and his patients think very highly of him. As many of my symptoms overlap with Hypo i decided to see him. He believes i have hypo, not M.E (a thing he doesnt really believe in - he thinks there is always something else wrong. I dont know if he is right or not, but i thought it was worth a shot.

However, the Armour made me much more ill than beofre i began, although i initially had an improvement with it. It is possible i am not handling the Armour well due to low adrenal function and low iron. I had to stop the Armour in order to see if it was that that was making me so ill (more severe fatrigue, nervousness, severe dizziness so i couldnt stand and hair loss)Now i have been off it a couple of weeks i am not feeling good, but the extra symptoms listed above have gone away. I was awaiting the result of adrenal saliva testingbefore deciding what to do.

The Dr explained to me that my T4 was dropping because of the T3 in the Armour - my bpdy wasnt needing to make any or much T4, in fact he said some people on T3 only can end up with T4 of 0 and be fine. I still think this is a bit strange as Armour does contain T4 as well as T3.

Where i am now is worse off than before i went to see the Dr and tried the Armour.
Hey ho, thats life with M.E - sometimes i wonder if it is worth mucking about with all this stuff at all - many things have made me worse and only time and rest have made me feel better in any way.

Justy.