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Thyroid Replacement Therapy

Last Updated: · Patients


Dr. Lazarus:

Thyroid is a very confusing issue and I, after taking thyroid meds for almost ten years am still confused. I have a doctor that only uses tsh to calculate. Six months ago I had a tsh at of .27 and doc was concerned that I was too low. Cut my Armour back to 45mg. Six months later my tsh is 3.57 and I have been suffering from headaches, neckaches, heartburn, some insomnia and slight depression, all of which I don't know relate to the thyroid at all. I don't know what to do. Should I go back to taking the whole grain or should I take 3 and 1/2 --15mg tablets?? This is an extremely confusing situation. My numbers have never ever remained steady and I don't know if my body is suffering because of the constant change of doses. Do you have any suggestions for me?

Thank you.

Dee Ohio


Dear Ms Although,

Armour may suit a few people it is generally accepted that thyroxine alone (ie T4) is the optimal replacement therapy for underactive thyroid (hypothyroidism). Armour has T3 in it Which is actually made from T4 and this makes it a bit more difficult to assess in the long term. TSH is certainly useful to assess but the T4 and even the T3 level can also be useful on occasions. I do not think a TSH of .27 is significantly low, and if you feel better on the original dose I would make a case for going back to it. You should also be aware that some substances eg soya, iron and some indigestion remedies can affect the absorption of thyroid hormone into the body which or course may alter the levels of TSH.

Yours sincerely,

John Lazarus