Re: Timing of blood work -follow up question

[Guest guest]

It is really, really hard to tell that you just need the T3 from your labs at

this point. It is possible that your body is still converting some of the T4

to T3 - perhaps just not enough.

It takes time to get to your optimal dosage. A key sign that you are not at

your optimal dose is feeling good when you first increase and then reaching the

point where you felt before you started the higher dose. It's also not unusual

when you first start to increase your dosage (or start taking the Armour) for

you TSH to go up and your Free T4 and Free T3 to actually decrease. That was my

son's experience when he started with 90 mg of Armour.

My experience was that when I doubled the amount of T4 I was taking that got me

just 1/4 into the range (and my Free T4 also decreased when I started

replacement thyroid hormone) and it took 5 times the dosage of T3 that I

originally started with to get my Free T3 towards the upper end of the range

where I felt well (it hovered at about 1/4 into the range on the lower dosage).

So, the increases in Free T4 and Free T3 are not linear based on your dosage.

Also, even though the T3 has a half life of about 5 hours (i.e., it isn't all

gone) there is still residual amounts in your system since the decrease in the

amount of T3 slows down as the amount decreases (since the decay is exponential

and not linear. Thus, you really aren't starting from scratch each day. You

are really just trying to add the amount of bioavailable thyroid hormone you

would have if your thyroid was working right and you didn't have issues with the

conversions or toxins impacting the receptors, etc.

Many of us have to split doses of T3 since the amount does decrease with 4-6

hours as you note. So, you seem to be on the right track in that respect.

It can take 6 months to a year to reach an optimal dosage - it is very

individual. Many of us have to do increases every 2-4 weeks initially (e.g.,

first few months), then retest and increase or decrease based on symptoms. The

labs serve as a guideline in terms of where you are in the ranges and give you a

very rough idea as to whether you might benefit from an increase, however, they

do not accurately reflect if your dosage is adequate since that is a very

individual thing. It's the resolution of symptoms that is indicative of an

adequate dosage. In the majority of cases the mid-range is optimal for the Free

T4 and many of us need the Free T3 higher in the range. Even when you reach

your optimal dosage, it is not unusual to have to tweak one's dosage as time

goes by as our bodies are not static entities. It's at this point that the labs

are more helpful because you have a much better idea of the range at which you

typically feel well.

By the way, your questions are not all silly - they are extremely reasonable and

are the same questions many of us had when we were first dealing with these

issues.

Be well,

B.

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> Thanks to all who replied. I took your wise advice...

>

> Another question to follow up, please...

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> When I look at my labs from the end of September, 2010, when I was undiagnosed

and unmedicated, it shows my Ft4 is in the mid-range, but I am low in FT3. It

seems I don't convert Ft4 to Ft3.

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> I'm on a split dose of 1 grain Armour, but if I'm reading my old labs right, I

mostly just need T3. Does Armour help my body convert Ft4 to Ft3? If not, should

I just be on Cytomel?

>

> Sorry to ask if this is a silly question....I'm just sort of wondering what

blood work without taking medication will really measure in my particular case.

It will show low FT3 again, I'm sure, and probably adequate amounts of Ft4. From

what I understand, my body is using up the small amount of T3 in the Armour and

it is used up in about 5 hours, so I split the small dose I'm on.

>

> My symptoms improved initially, but after about week six out of the eight I've

been on it, it seems I'm back to square one again. Has my thyroid recognized the

incoming hormone and decided it is not needed anymore?

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> Just trying to understand things a bit more, and prepare myself for the

results. I'm not sure what I'll do if the labs are just like they were in

September.

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> Can anyone help?

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> Thanks in advance.

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> Spoon

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