Armour Dosage

Here is some info. from Mercola.com. (a great website for overall health info.)

Should You Use Synthetic Hormones?

The traditional approach is to use synthetic hormones like Synthroid/ Levoxyl/Levothroid (levothyroxine). These products only contain T4 hormone, they have no T3.

When a patient attempts to ask their physician for the natural hormone they are usually ridiculed and made to feel stupid that they would request an inferior hormone product.

The common argument the physicians give is that the synthetic provides steady hormone levels. What the doctors tend to overlook is that the vast majority of people can not convert the T4 to the active form of thyroid which is T3. This is easy to cofirm by measuring the free hormone levels, but virtually none of the doctors use these tests.

Armour Thyroid -- The Natural Alternative

When one has low T3 levels, which are typical with synthetic hormone use, the brain does not work properly. It is important to use a preparation with T3 because T3 does 90% of the work of the thyroid in the body. So one should use a combination of T4 and T3 which compensates for the inability to convert T4 to T3. Armour thyroid is desiccated thyroid and has both T3 and T4

A 1999 study published in one of the most prestigious medical journals in the world, the New England Journal of Medicine, showed that the natural hormone product, such as Armour, was far better at controlling the brain problems commonly found in hypothyroidism. Nearly all natural medicine doctors tend to use Armour thyroid which is a mixture of mono and di-iodothryonine and T3 and T4, the entire range of thyroid hormones.

Armour Thyroid Dosing -- TWICE a day.

The most common starting dose for patients with hypothyroidism is Armour thyroid, 90 mg which is cut in half with a razor blade and half is ideally taken twice a day, 10 to 20 minutes before breakfast and dinner. If you have trouble remember taking them, then take the entire dose before breakfast. It is also ideal to chew the tablet before swallowing. Taking it after meals also helps to reduce volatility of the blood-level of T3. If the patient has any problem breaking or cutting the pill, they should purchase a pill-cutter at the pharmacy. The TSH, Free T3 and Free T4 are then repeated in one month and the dose is adjusted.

Taking the Armour thyroid twice a day overcomes traditional medicine's major objection and resistance to using natural thyroid preparations - its variability in its blood-levels. Most doctors using Armour thyroid are not aware that Armour thyroid should be used twice daily and NOT once a day. The major reason is that the T3 component has such a short half life and needs to be taken twice daily to achieve consistent blood levels.

Dose Adjustments With Lab Monitoring

Once on hormone replacement, the dose should be increased until the TSH falls below 0.4. Then one needs to optimize the 2 thyroid hormones by using the Free T4 and Free T3 levels.

The Free T3 and Free T4 are used to monitor the treatment. They should be above the median (middle) but below the upper end of the laboratory normal reference range. The goal for healthy young adults would be to have numbers close to the upper part of the range, and for cardiac and/or elderly patients, the numbers should be in the middle of its range.

The Free T3 and Free T4 levels should be checked every month and the hormone therapy readjusted until the FT3 and FT4 levels are in the therapeutic range described. Once a theraputic range is acheived the levels should be checked at least once a year. A small number of large, overweight, thyroid-resistant women may need 6-8 grains of Armour Thyroid or the equivalent of thyroxine per day (counting 0.1mg of T4 as 1 grain of Armour Thyroid).

For those people who are already on once daily Armour thyroid should split their doses immediately and take half after breakfast and half after dinner. Since the only change will be in the FT3 level, which has a short half-life, the serum FT4 and FT3 levels (and TSH, if indicated) can be measured 48-72 hrs after the splitting of the doses if the patient had been on the hormone for 4-6 weeks before the splitting of the doses. This is because the Free T4 hormone is the one that takes a number of weeks to build up to its steady-state serum-level.

Symptoms of Excessive Thyroid Hormone

There are frequently only temporary during the adaptation stage. The symptoms may include: palpitations

nervousness
feeling hot and sweaty
rapid weight-loss
fine tremor
clammy skin
What To Do If You Can Not Tolerate Armour Thyroid or Want To Continue Synthetic Hormones

My experience is that well over 90% of people do much better on Armour thyroid. However, there are a small number of people who do not tolerate it. This is most frequently done with Armour thyroid. However, Cytomel, which is T3 only, can be used in combination with one of the T4 only synthetic preparations mentioned above. It is important to recognize that T3 should always be prescribed twice daily due to its shorter half life. This is typically after breakfast AND supper for compliance reasons.

If you are currently taking Synthroid (thyroxine), your Free T4 level is usually at or above the high end of its normal range and your Free T3 level is usually below. In this situation, one may then add 5-12.5 mcg Cytomel (pure-T3) after breakfast and supper daily, rather than Armour Thyroid or Thyrolar (synthetic T4/T3 combo).

Once or twice daily dosing one can then optimize both the T4 and T3 levels, with whatever thyroid preparation is required. This is not possible in most hypothyroid patients with T4 only preparations.

People Who Should Not Take Cytomel

The only exception to pursue optimization of the T3 level without using Armour thyroid is in severe acute cardio-pulmonary conditions, such as congestive heart failure, when the metabolic slowing effect of a low FT3 level can actually be life-saving. However, the vast majority of hypothyroid patients do not have this problem.
 
thats the link.

I'm a bit confused about one thing though. According to Mercola, "The most common starting dose for patients with hypothyroidism is Armour thyroid, 90 mg which is cut in half with a razor blade and half is ideally taken twice a day, 10 to 20 minutes before breakfast and dinner."

But then he says, " For those people who are already on once daily Armour thyroid should split their doses immediately and take half after breakfast and half after dinner. Since the only change will be in the FT3 level, which has a short half-life, the serum FT4 and FT3 levels (and TSH, if indicated) can be measured 48-72 hrs after the splitting of the doses if the patient had been on the hormone for 4-6 weeks before the splitting of the doses. This is because the Free T4 hormone is the one that takes a number of weeks to build up to its steady-state serum-level.

I don't understand the difference?
 
Thanks Smitty4.

Jasonshadow, I believe that thyroid hormones are supposed to be taken on an empty stomach.
 
Vforcer2 said:
I currently take 3 grains a day sub-L split in 2 doses, and am still looking to increase my dosage until I get my basal morning temps up to 98 degrees. I can say the Armour has made all the difference for me. Cognition, memory, mental sharpness, skin, acne, food allergies, energy, and more were all fairly well resolved by Armour. There is evidence to suggest low T levels can also be improved with proper Armour dosing.

I bumped myself up to 3 grains (with an ok from the doc) but then when my labs came back he said Free T3 and T4 were too high and I was aputting myself at risk for osteoperosis. I felt fine on the higher dose. I don't do basal body temp testing since the Wilson's protocol several years ago.

Vforcer2 said:
My tonsils and adnoids were removed as a child, and this reduces blood flow to the thryoid causing it to become sluggish in some people. I was skinny as a rail prior to this surgery. Since the surgery, I have struggled with weight my whole life. These organs are designed in our body for a reason and should not be so quickly removed.

My thyroid must have been going bad for several years without me paying attention to it...hindsight I see all the symptoms. I really had no choice on removing what was once upon a time my thryoid gland. It was hemorhaging blood into my next. Nodules had turned it into a "bloody pulp" - the surgeon said she'd never seen anything like it - and she is a very experienced ENT surgeoin.

I miss having normal hormones. This is hard work, and I'd really just like to be healthy for a while. Okay, whining over. LOL
 
1cc said:
Jasonshadow, I believe that thyroid hormones are supposed to be taken on an empty stomach.

If you're doing Sub-L, not an issue I'd think.

For the rest of us, with or without food has been a long debate. The common wisdom in the thyroid group is that CONSISTENCY is what matters. Food can affect some absorbtion, but if you consistently take with food, your dose will be titrated with that in account, and you'll be balanced, albeit it with a slightly higher dose.

Personally, I just take all my meds first thing in the morning with a few sips of water, then do the S/S/S thing, then drink my proteing shake for breakfast.

I'm interested in splitting the Armour AM/PM, but don't remember "feeling" any differently doing it that way.

Logically, it shouldn't make a difference, even if T3 does have a very short half-life, because you've got the T4 blood reserve to keep you going. The only problem I see, which Mercola mentions, is if the T3 is too much from single dosing, you'll get palpitations and the such. Hasn't been an issue for me.
 
DSA said:
I bumped myself up to 3 grains (with an ok from the doc) but then when my labs came back he said Free T3 and T4 were too high and I was aputting myself at risk for osteoperosis. I felt fine on the higher dose. I don't do basal body temp testing since the Wilson's protocol several years ago.



My thyroid must have been going bad for several years without me paying attention to it...hindsight I see all the symptoms. I really had no choice on removing what was once upon a time my thryoid gland. It was hemorhaging blood into my next. Nodules had turned it into a "bloody pulp" - the surgeon said she'd never seen anything like it - and she is a very experienced ENT surgeoin.

I miss having normal hormones. This is hard work, and I'd really just like to be healthy for a while. Okay, whining over. LOL

This article addresses the osteoporosis question. It appears to not really be an issue, if you keep your T3 levels in the normal range, and it may be more of a problem for women (?):
http://www.findarticles.com/p/articles/mi_m0ISW/is_241-242/ai_107201245
 
jasonshadow said:
thats the link.

I'm a bit confused about one thing though. According to Mercola, "The most common starting dose for patients with hypothyroidism is Armour thyroid, 90 mg which is cut in half with a razor blade and half is ideally taken twice a day, 10 to 20 minutes before breakfast and dinner."

But then he says, " For those people who are already on once daily Armour thyroid should split their doses immediately and take half after breakfast and half after dinner. Since the only change will be in the FT3 level, which has a short half-life, the serum FT4 and FT3 levels (and TSH, if indicated) can be measured 48-72 hrs after the splitting of the doses if the patient had been on the hormone for 4-6 weeks before the splitting of the doses. This is because the Free T4 hormone is the one that takes a number of weeks to build up to its steady-state serum-level.

I don't understand the difference?


Jason, thanks for the info but I think the problem is Mercola is generally thought of as way out there and read what he writes with a grain of salt.

Still no Swale?

:(
 
Please try to be understanding. Swale is one of the premier HRT physicians out there. After all, it is exactly because he is so good at his craft that you are eager for his input on the subject. As a result, it makes perfect sense to me that he would be extremely busy. I personally consider it a blessing that he finds any time to devote to the board.
 
Rangeball said:
Jason, thanks for the info but I think the problem is Mercola is generally thought of as way out there and read what he writes with a grain of salt.

Still no Swale?

:(

I don't find Mercola "way out there", I usually find him pretty much dead on, and his integrity is impeccable. He is extreme with his suggestion on healthy eating, but I would bet that he is still correct, based on the research he backs it all up with. We Americans just do not want to give up our tasty indulgences.

BTW, Swale also likes Mercola.
 
Vforcer2 said:
I don't find Mercola "way out there", I usually find him pretty much dead on, and his integrity is impeccable. He is extreme with his suggestion on healthy eating, but I would bet that he is still correct, based on the research he backs it all up with. We Americans just do not want to give up our tasty indulgences.

BTW, Swale also likes Mercola.

This guy seems to disagree about the integrity part :)

http://www.johndommissemd.com/site/965699/page/368503
 
Well...I increased my dosage from 1/2 grain to 1.0 grain. Then when I had other labs being drawn, I asked my doctor to add Free T4 & Free T3. When I got my results today, I discovered that he had order TSH instead. The results of that were .734 ranges are .350-5.500. Does it sound reasonable to infer that the increase is not causing a problem since the TSH is not shut down? By the way, I should also mention that I feel absolutely great on the 1 grain per day.
 
smitty4 said:
Well...I increased my dosage from 1/2 grain to 1.0 grain. Then when I had other labs being drawn, I asked my doctor to add Free T4 & Free T3. When I got my results today, I discovered that he had order TSH instead. The results of that were .734 ranges are .350-5.500. Does it sound reasonable to infer that the increase is not causing a problem since the TSH is not shut down? By the way, I should also mention that I feel absolutely great on the 1 grain per day.


Yes, the more I read it seems the goal is to get FT4 and FT3 in the upper part of their range and monitor symptom improvement, and ignore TSH.

Have you called your doc yet and asked him why he didn't order the tests you requested? I'd be pissed and refuse to pay for the TSH.

Related to this thread, I had been taking my 2 grain dose all at once on an empty stomach in the morning. I started to notice some symptoms of over-stimulation, such as hot flashed, increased heart rate and palpatations, so I started splitting my dose, with 1 grain at breakfast and the second after work. I feel noticeably better and all the over-stimulation symptoms resolved.

For what it's worth.
 

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