PDA

View Full Version : do I need thyroid meds?



gman
08-03-2009, 01:42 PM
I have been on TRT for 20 weeks now. 200 mg of test cyp, 500iu of hcg 2x a week and arimidex .5mg MWF.

I had blood drawn, and the TRT clinic says the doc wants to start me on armour, mainly because of the fact my triiodothyoxine, free, serum level has dropped from 3.5 to 2.4 (normal 2.3-4.2) since my week 8 blood work. Supposedly pretty common in TRT patients to need a thyroid boost for a while.

What is this blood test measuring anyway?

Tatyana
08-04-2009, 11:03 AM
That could be a variation between labs, or a variation in the thyroid binding proteins in the blood.

It is more important to treat the patient, not the lab results, so unless you are experiencing symptoms and your other thyroid hormones are demonstrating abnormalities, I would have the test repeated.


Laboratory Test Interactions: Androgens may decrease levels of thyroxine binding globulin resulting in decreased total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged, however, and there is no clinical evidence of thyroid dysfunction.

[/URL]


Read more: [URL="http://emc.medicines.org.uk/document.aspx?documentId=8834#ixzz0NE6hH0Yc"]http://emc.medicines.org.uk/document.aspx?documentId=8834#ixzz0NE6hH0Yc (http://emc.medicines.org.uk/document.aspx?documentId=8834)

gman
08-04-2009, 12:06 PM
I was on thyroid meds for a while before TRT, and my TSH levels were mid 3 range, indicating my body wanted more. The current clinic weaned me off the Armor, and now is wanting to put me back on 20 weeks later!

Tatyana
08-04-2009, 03:08 PM
I was on thyroid meds for a while before TRT, and my TSH levels were mid 3 range, indicating my body wanted more. The current clinic weaned me off the Armor, and now is wanting to put me back on 20 weeks later!

Why Armor?

I find it a bit bizarre as the dosing is not consistent, it isn't always stable, the ratio of T4:T3 is 1:4 and the human ratio is 1:14 and it is twenty times more expensive than levothyroxine.

I hope more labs start to use the narrower reference range for TSH, which would mean that a TSH less than 2 IU/L is preferable, however, diagnosing on T3 is just a bit odd.

gman
08-04-2009, 04:31 PM
I was going to an alternative antiaging clinic.

Current doctor was going to use Armour as well, but I told him I had a bunch of sample boxes of Levoxyl (same as synthroid) and he is letting me just use those 50mcg a day.

Tatyana, you remember how depressed I was a while back? I thought maybe the TRT would help, but I have been 10x worse in the past several weeks, I am wondering if it's the thyroid or something else? I hope this levoxyl makes a difference

Dr. Joel Nathan
08-08-2009, 09:45 AM
Serum Triiodothyronine and Thyroxine Levels

Thyroid production is initially screened by measuring serum free T4. Total T4, which measures both free and protein-bound hormone, can be affected by changes in hormone production or hormone binding to serum proteins.



Accurate evaluation of thyroid function requires measurement of free T4 levels. However, if a direct free T4 assay is unavailable, indirect methods suffice. The T3 resin uptake test is one of the most common indirect measurements of the proportion of T4 that is not protein bound.

ric
08-09-2009, 02:51 PM
I was going to an alternative antiaging clinic.

Current doctor was going to use Armour as well, but I told him I had a bunch of sample boxes of Levoxyl (same as synthroid) and he is letting me just use those 50mcg a day.

Tatyana, you remember how depressed I was a while back? I thought maybe the TRT would help, but I have been 10x worse in the past several weeks, I am wondering if it's the thyroid or something else? I hope this levoxyl makes a difference

If memoray serves me I had asked my Dr years ago the reason for Armor Thyroid over Synthroid. The Armor stays in your system longer. I beleive Synthroid is much cheaper

BadAssBarbie
10-22-2009, 03:19 PM
For the last 2-3 months or so, I have been EXTREMELY tired, lethargic, gaining weight, hardly want to eat. I finally went to my Dr. to have some blood work done. They did, thyroid, liver and kidney function, b-12, and I think a few other vitamins. The first set of labs came back and revealed that my thyroid(I think he only did T4) was low, and my liver enzymes were high. He told me to stop taking my anti-inflammatories and come in for more bloodwork. This time, they are doing a full thyroid panel, liver enzyme test again, hep-b panel, and iron test. Is there anything else I should have him test for?

elite_lifter
10-23-2009, 09:04 PM
If memoray serves me I had asked my Dr years ago the reason for Armor Thyroid over Synthroid. The Armor stays in your system longer. I beleive Synthroid is much cheaperArmor is natural, from pigs. Synthroid is synthetic and has some nasty sides including hairloss. Definately go on Armor if you have to.

elite_lifter
10-23-2009, 09:05 PM
For the last 2-3 months or so, I have been EXTREMELY tired, lethargic, gaining weight, hardly want to eat. I finally went to my Dr. to have some blood work done. They did, thyroid, liver and kidney function, b-12, and I think a few other vitamins. The first set of labs came back and revealed that my thyroid(I think he only did T4) was low, and my liver enzymes were high. He told me to stop taking my anti-inflammatories and come in for more bloodwork. This time, they are doing a full thyroid panel, liver enzyme test again, hep-b panel, and iron test. Is there anything else I should have him test for?Sounds about right, good luck!

Dr. Joel Nathan
10-25-2009, 08:35 AM
For the last 2-3 months or so, I have been EXTREMELY tired, lethargic, gaining weight, hardly want to eat. I finally went to my Dr. to have some blood work done. They did, thyroid, liver and kidney function, b-12, and I think a few other vitamins. The first set of labs came back and revealed that my thyroid(I think he only did T4) was low, and my liver enzymes were high. He told me to stop taking my anti-inflammatories and come in for more bloodwork. This time, they are doing a full thyroid panel, liver enzyme test again, hep-b panel, and iron test. Is there anything else I should have him test for?

Yes, have your health practitioner check a complete blood count, testosterone (free and total), estradiol, fasting blood sugar, fasting insulin level. The fasting tests should be with a 12 hour fast. You can take your meds and as much water as you want during that fast time.

Dr. Joel Nathan
10-25-2009, 08:36 AM
I was going to an alternative antiaging clinic.

Current doctor was going to use Armour as well, but I told him I had a bunch of sample boxes of Levoxyl (same as synthroid) and he is letting me just use those 50mcg a day.

Tatyana, you remember how depressed I was a while back? I thought maybe the TRT would help, but I have been 10x worse in the past several weeks, I am wondering if it's the thyroid or something else? I hope this levoxyl makes a difference

The doc could try T3, possibly 12.5mg twice a day. If you feel better and are less depressed then this could be your thyroid of choice.

gman
10-25-2009, 07:07 PM
The doc could try T3, possibly 12.5mg twice a day. If you feel better and are less depressed then this could be your thyroid of choice.

actually have a new doc...we started on T4/T3 compounded...85mcg T4/ 13.875mcg T3...time release.

been on for only a few days. It will be interesting to see how it makes me feel...I hear it takes several months to kick in totally

Judge
10-26-2009, 10:35 AM
Armor is natural, from pigs. Synthroid is synthetic and has some nasty sides including hairloss. Definately go on Armor if you have to.

hairloss? never heard of this!
Keep also in mind that Synthroid is more accurate in terms of dosing than Armour.

gman
10-26-2009, 11:09 AM
who wants ground up pig thyroid? what if the pig was hypo that they used? lol

...plus you can hardly get armour right now.

Dr. Joel Nathan
10-31-2009, 10:18 AM
For the last 2-3 months or so, I have been EXTREMELY tired, lethargic, gaining weight, hardly want to eat. I finally went to my Dr. to have some blood work done. They did, thyroid, liver and kidney function, b-12, and I think a few other vitamins. The first set of labs came back and revealed that my thyroid(I think he only did T4) was low, and my liver enzymes were high. He told me to stop taking my anti-inflammatories and come in for more bloodwork. This time, they are doing a full thyroid panel, liver enzyme test again, hep-b panel, and iron test. Is there anything else I should have him test for?

Dear Barbie,
Consider asking for a complete blood count, fasting blood sugar, fasting blood insulin levels.

BadAssBarbie
11-01-2009, 04:17 PM
Thanks. I just got my lab results back, and everything is normal. He thought it was strange bc my free t4 was so low before, and now it's on the lower end of normal. However, my symptoms still point to thyroid...plus now my breasts are sore/tender. I'm also breaking out all over. SO, my Dr. referred me to an endocrinologist. We'll see what this dr. says....He'll probably just tell me I'm getting old and breaking down! LOL

elite_lifter
11-04-2009, 12:09 AM
hairloss? never heard of this!
Keep also in mind that Synthroid is more accurate in terms of dosing than Armour.
Synthroid Side Effects - for the Professional

Synthroid

Adverse reactions associated with levothyroxine therapy are primarily those of hyperthyroidism due to therapeutic overdosage. They include the following:
General

fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweatinghttp://images.intellitxt.com/ast/adTypes/2.gif (http://forums.rxmuscle.com/#);
Central nervous system

headache, hyperactivity, nervousness, anxiety, irritability, emotional lability, insomnia;
Musculoskeletal

tremors, muscle weakness;
Cardiovascular

palpitations, tachycardia, arrhythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest;
Respiratory

dyspnea;
Gastrointestinal

diarrhea, vomiting, abdominal cramps and elevations in liver function tests;
Dermatologic

hair loss, flushing;---can be irreversible w/long-term use
Endocrine

decreased bone mineral density;
Reproductive

menstrual irregularities, impaired fertility (http://forums.rxmuscle.com/#).
Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in children receiving levothyroxine therapy. Overtreatment may result in craniosynostosis in infants (http://forums.rxmuscle.com/#) and premature closure of the epiphyses in children with resultant compromised adult height.
Seizures have been reported rarely with the institution of levothyroxine therapy.
Inadequate levothyroxine dosage will produce or fail to ameliorate the signs and symptoms of hypothyroidism.
Hypersensitivity reactions to inactive ingredients have occurred in patients treated with thyroid hormone products. These include urticaria, pruritus, skin (http://forums.rxmuscle.com/#) rash, flushing, angioedema, various GI symptoms (abdominal pain, nausea, vomiting and diarrhea), fever, arthralgia, serum sickness and wheezing. Hypersensitivity to levothyroxine itself is not known to occur.

axioma
11-04-2009, 01:15 PM
Doc, I have a number of clients ranging in age from 40-65, from beginner to elite, all interested in getting regular bloodwork. Could you help me design panel that I could approach an independent lab with and try to negotiate a good price? The only thing that would be out of the ordinary would be hemocrit and hemoglobin for a triathlete I have doing epo. Do you think what I am looking for could be done for $300 if I would send the lab 3-4 people a month?

elite_lifter
11-04-2009, 11:02 PM
Doc, I have a number of clients ranging in age from 40-65, from beginner to elite, all interested in getting regular bloodwork. Could you help me design panel that I could approach an independent lab with and try to negotiate a good price? The only thing that would be out of the ordinary would be hemocrit and hemoglobin for a triathlete I have doing epo. Do you think what I am looking for could be done for $300 if I would send the lab 3-4 people a month?Check out www.lef.org (http://www.lef.org) and under their product section look at their blood test options. I don't know if that is what you are looking for but I thought I would put it out there. I use to work there and I have continued using their supplements and taking advantage of their blood testing options. Superb company.

heavyiron
11-06-2009, 12:09 AM
Doc, I have a number of clients ranging in age from 40-65, from beginner to elite, all interested in getting regular bloodwork. Could you help me design panel that I could approach an independent lab with and try to negotiate a good price? The only thing that would be out of the ordinary would be hemocrit and hemoglobin for a triathlete I have doing epo. Do you think what I am looking for could be done for $300 if I would send the lab 3-4 people a month?
PM me if you need a clinic to do a full hormonal panel and blood work.

Tatyana
11-06-2009, 12:53 AM
Synthroid Side Effects - for the Professional

Synthroid

Adverse reactions associated with levothyroxine therapy are primarily those of hyperthyroidism due to therapeutic overdosage.

They include the following:
General

fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweatinghttp://images.intellitxt.com/ast/adTypes/2.gif (http://forums.rxmuscle.com/#);
Central nervous system

headache, hyperactivity, nervousness, anxiety, irritability, emotional lability, insomnia;
Musculoskeletal

tremors, muscle weakness;
Cardiovascular

palpitations, tachycardia, arrhythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest;
Respiratory

dyspnea;
Gastrointestinal

diarrhea, vomiting, abdominal cramps and elevations in liver function tests;
Dermatologic

hair loss, flushing;---can be irreversible w/long-term use
Endocrine

decreased bone mineral density;
Reproductive

menstrual irregularities, impaired fertility (http://forums.rxmuscle.com/#).
Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in children receiving levothyroxine therapy. Overtreatment may result in craniosynostosis in infants (http://forums.rxmuscle.com/#) and premature closure of the epiphyses in children with resultant compromised adult height.
Seizures have been reported rarely with the institution of levothyroxine therapy.
Inadequate levothyroxine dosage will produce or fail to ameliorate the signs and symptoms of hypothyroidism.
Hypersensitivity reactions to inactive ingredients have occurred in patients treated with thyroid hormone products. These include urticaria, pruritus, skin (http://forums.rxmuscle.com/#) rash, flushing, angioedema, various GI symptoms (abdominal pain, nausea, vomiting and diarrhea), fever, arthralgia, serum sickness and wheezing. Hypersensitivity to levothyroxine itself is not known to occur.


The same would happen if you took too much armour. Hair loss is also a symptom of hypothyroidism.

Levothyroxine is a very simple molecule and the synthesis of it makes it identical to thyroxine.

There are, in fact, more problems associated with the dessicated pig thyroid.



Armour Thyroid (USP) and combined thyroxine/ tri-iodothyronine as Thyroid Hormone
Replacement
A Statement from the British Thyroid Association Executive Committee
November 2007


Part 1. Use of Armour Thyroid
A. Armour Thyroid contains both thyroxine (T4) and tri-iodothyronine (T3) extracted from the
thyroid gland of pigs.

One grain, about 60 mg, of desiccated pig thyroid extract contains about 38mcg of T4 and 9mcg of T3, a ratio of around 4 to 1. The normal concentration of these hormones
in the human thyroid is, however, at a ratio of 14 to 1. In other words, Armour thyroid extract contains excessive amounts of T3 relative to T4 when used to replace thyroid hormone in man.


Moreover, as pig thyroid contains other substances apart from T4 and T3, Armour Thyroid is not a pure preparation of thyroid hormones.

Historically, extracts of animal thyroid glands were the only
way to treat thyroid underactivity, but since the 1950s pure synthetic thyroid hormones have been available in tablet form (thyroxine sodium [T4] and liothyronine [T3]).


B. The concentration of thyroid hormones in Armour Thyroid USP is regulated by the manufacturer to United States Food and Drug Administration (FDA) standards. Despite this, there have been
significant problems with the stability of Armour Thyroid in recent years, prompting a massive recall of tablets.1 Because of these stability problems with Armour Thyroid, there is potential for fluctuations in thyroid hormone levels in the blood of patients treated with Armour Thyroid. These fluctuations may be unpredictable and have adverse effects on patients’ health.


C. There is no evidence to favour the prescription of Armour Thyroid in the treatment of hypothyroidism over the prescription of thyroxine sodium, as supplied in the United Kingdom.
There has never been a direct comparison of these two treatments. The BTA committee cannot recommend a treatment with possible side-effects, when a safe and equally well-established treatment exists.

D. Armour Thyroid is not on the British National Formulary and is not a licensed therapy in the
UK. Mr. G. Matthews, the Pharmaceutical Assessor of the Medicines and Health Care Products
Regulatory Agency, in a letter sent to BTA dated 19 October 2005, has clarified that “The
regulations on medicine allow doctors to prescribe an unlicensed medicine for a patient to meet
such a special clinical need, on their own direct personal responsibility. Where these unlicensed
medicines are not available in the UK they can be imported by appropriately licensed medicines
wholesalers, for supply to a doctor or pharmacy, to meet these needs.”


E. The cost of Armour Thyroid may be up to £20 per month, compared to an equivalent cost of £1 per month for thyroxine.


Part 2. Use of Combination Thyroxine/ Tri-iodothyronine (Liothyronine) Therapy

A. There is no currently available tablet preparation containing thyroxine and tri-iodothyronine (T4/T3) in a combination that adequately reproduces the relative quantities of these hormones produced by the human thyroid gland. Neither is there a preparation that produces a sustained
release of thyroid hormones in a pattern similar to that from the human thyroid gland.

B. Having been disregarded as a therapeutic approach to the treatment of hypothyroidism since the
1970s, interest in combination thyroxine/tri-iodothyronine (T4/T3) therapy was re-ignited by a
study of 31 patients published in 1999.2 Although this study showed promising results, with improvement in quality of life, wellbeing and brain (psychometric) function with combination
therapy, the majority of the patients in the study had been treated previously for thyroid cancer. The relatively high doses of thyroxine that formed the routine treatment for thyroid cancer (compared to
a lesser replacement dose that would be normal in hypothyroidism) could have confounded the results of the study.

C. Since this initial study, there have been a further seven rigorously conducted (“randomised, double-blind, placebo-controlled”) studies, encompassing more than 900 hypothyroid patients
(summarised in refs. 3 & 4). None of the subsequent studies showed a beneficial effect of combined T4/T3 therapy on measures of wellbeing, health and mental functioning. Three of the seven studies
show harmful or undesirable effects of the T4/T3 combination.


D. In three of the subsequent studies of combination treatment, the patients were asked which treatment they preferred, and in two of these 3 studies more patients preferred the combination
T4/T3 therapy. There is no obvious explanation for these observations, and it may or may not be a reproducible effect.


E. The BTA keeps an open mind about whether using an appropriate formulation of T4/T3 combination tablet would, in the future, provide health and quality of life benefits in the treatment
of hypothyroidism for a subgroup of patients. However, based on the current evidence from
rigorous studies of large numbers of patients using the currently available formulations of synthetic thyroid hormones, combined T4/T3 cannot be recommended because of a lack of benefit and a small number of undesirable and harmful effects seen on combination treatment.



British Thyroid Association Executive Committee, November 2007

References

1. An FDA enforcement removed more than half a million bottles of Armour Thyroid from US pharmacies
in 2005 due to unstable concentrations of thyroid hormone in the preparation.
[www.fda.gov/bbs/topics/enforce/2005/ENF00899.html]
2. Bunevicius R, Kazanavicius G, Zalinkevicius R, Prange AJ Jr. Effects of thyroxine as compared with
thyroxine plus triiodothyronine in patients with hypothyroidism. N Engl J Med. 1999; 340: 424-9.
3. Escobar-Morreale HF, Botella-Carretero JI, Escobar del Rey F, Morreale de Escobar G. Review:
Treatment of hypothyroidism with combinations of levothyroxine plus liothyronine. J Clin Endocrinol
Metab. 2005; 90: 4946-54.
4. Grozinsky-Glasberg S, Fraser A, Nahshoni E, Weizman A, Leibovici L. Thyroxine-triiodothyronine
combination therapy versus thyroxine monotherapy for clinical hypothyroidism: meta-analysis of
randomized controlled trials. J Clin Endocrinol Metab 2006; 91: 2592-9

Bryan Hildebrand
12-01-2009, 12:20 AM
however, diagnosing on T3 is just a bit odd.

guaranteed the physician pent 12 weeks in an endo clinic and thats it. specializing in Social HRT is a whole lot more profitable and the fun factor is much higher too.

Armor has outlived its purpose. and you are rigt, Levo is dirt cheap by comparison.

gman
12-01-2009, 01:01 PM
I am taking compounded T4/T3, it's dirt cheap

.875mcg of T4/.175mcg of T3, time release once a day.