Are you currently taking Armour Thyroid but not sure that your dose is where it should be?
Are you still struggling with fatigue, weight gain, or hair loss even after transitioning from levothyroxine to Armour?
Are you thinking about switching medications but not sure if Armour is right for you?
If so, this article is for you.
Article highlights:
- Armour thyroid dosing is highly individualized and each person will need a different dose.
- Several factors influence the dose that you will need.
- The average dose is somewhere between 60 mg (1 grain) and 120mg (2 grains) per day.
- Sensitive individuals will need doses smaller than 60mg while resistant individuals may need a dose higher than 120mg.
- The best way to find your optimal dose is through lab testing and closely following your symptoms.
- Many patients are underdosed when converting to Armour thyroid from other thyroid medications.
Armour Thyroid Dosing – How to Find Your Dose (The Good, the Bad, and the Ugly)
This article is going to be all about Armour thyroid and finding the right dose for your body.
This is probably the most important aspect to consider when taking thyroid medication and it’s not given enough attention by both patients and doctors.
And, believe it or not, it’s not always as straightforward as you think.
There are many factors that can alter how much Armour thyroid your body needs and other factors that can influence how effective the medication is once you take it.
If you are already familiar with Armour thyroid then you can skip to the sections below, but if you are new to it then you’ll want to read this section as well.
First off, what is Armour Thyroid?
Armour thyroid is a thyroid medication that is used to treat conditions that result in LOW thyroid hormone production (known as hypothyroidism).
Armour thyroid is one of many thyroid medications available but it is special because it contains a combination of both biologically active thyroid hormones.
Most doctors prescribe thyroid medications such as Synthroid or levothyroxine which contain only 1 form of thyroid hormone.
Armour thyroid is often considered superior and more powerful than those medications because it contains both T4 and T3 (it also contains other ingredients such as calcitonin, T2, and iodine but we won’t focus on those for today).
But, because it has T3, it’s often inaccurately dosed by doctors who aren’t used to prescribing these types of medications (1).
This can lead to persistent symptoms of hypothyroidism and other issues such as the inability to lose weight, hair loss, and persistent fatigue.
Most of these issues can be improved (or completely resolved in some cases) with accurate dosing.
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Each Person is Different (So is your dose!)
Before we jump into the specifics, it’s important to realize that the dosing of thyroid medication is highly unique and individualized.
Each person will require a slightly different dose compared to the next person, even individuals who have the same body weight/metabolism/etc.
Having said that, I want to give you some idea as to what dose range you should be expecting when taking Armour thyroid. This way you know if you are likely being underdosed or overdosed.
The average dose that most people need is somewhere between 1 grain (60mg) and 2 grains (120mg) per day.
About 60-70% of individuals will fall into this range.
About 5-10% of people will need a dose of less than 60mg per day (anywhere between 15mg and 60mg).
About 10-20% of people will need a dose higher than 120mg per day (anywhere between 120mg and 240mg).
These percentages are not perfect, but they are based on my own personal history of treating patients and discussing various doses with other doctors and practitioners.
Finding out where you fit into this spectrum can be difficult, but you can use the resources found here to help you find your optimal dose.
Dealing with Sensitivities
Even though Armour thyroid may be the right medication for you, you may not tolerate traditional doses.
What do I mean?
Armour thyroid is unique among thyroid medications in that it contains the active thyroid hormone T3.
And T3 is the most potent thyroid hormone available.
While it’s incredibly powerful and useful, there’s also a small chance that you might be someone who is sensitive to this particular ingredient.
You’ll know if you are sensitive because you may experience side effects such as heart palpitations, a jittery or anxious feeling, or a headache after taking your dose.
This doesn’t automatically mean that you shouldn’t take Armour thyroid (though it could), but instead may be a reflection of your sensitivity to the T3 found within the medication.
The good news is that most of the time these side effects can be mitigated by simply altering how much medication you take (and also how frequently you take it which is discussed below).
Those people who find that they are sensitive to Armour thyroid may also need a reduced dose compared to the average (2).
Most people need somewhere between 1 to 2 grains (or 60 to 120mg) per day, and those who are sensitive may only need 1/4 to 1/2 of a grain per day.
If you find that you are sensitive to the medication (3) then you’ll want to start out on a low dose and slowly increase your dose over a prolonged period of time.
Starting out with a dose of around 1/4 of a grain may be ideal.
From there you can increase your dose every 1-2 weeks as needed.
While some individuals may react to the T3 in Armour Thyroid there are others who may react to the inactive ingredients inside the medication as well.
Each medication contains fillers/binders which can potentially cause issues for certain people.
If you are reacting to the binders/fillers then you may need to switch medications entirely.
Do you need to Dose Multiple Times per Day?
Another strategy to mitigate the potential side effects of Armour thyroid is to split your dose and take it multiple times throughout the day.
This is a strategy employed successfully by many people taking all types of thyroid medications (including pure T3 medications and even T4 medications).
The logic for using this strategy is simple:
A normal thyroid gland, when functioning correctly, secretes a small amount of thyroid hormone constantly throughout the day.
When you take thyroid medication by mouth you are taking one massive dose which is supposed to last all day.
This means that you are temporarily taking more than you need first thing in the morning and this large dose of thyroid hormone can cause problems for certain sensitive individuals.
You can combat this by splitting your dose in half (or even thirds) and taking your dose in regular intervals throughout the day.
This reduces the massive flush which occurs from once-a-day dosing and may be ideal for some people, especially those who are sensitive to the T3 found within Armour.
Splitting your dose is actually very easy and shouldn’t cause any issues (as long as you follow all regular precautions when taking your medicine).
Let’s use an example:
Suppose that you are taking 2 grains of Armour thyroid per day.
Let’s also suppose that you are someone who is experiencing palpitations and flushing about 30-60 minutes after you take your medication.
You decide to alter how you take your medicine and split your dose into 2 divided doses.
You would proceed by taking 1 grain (60mg) first thing in the morning around 7:00 am (on an empty stomach).
Following that dose, you would take another 1 grain (60mg) around noon (on an empty stomach).
Following this regimen, you would still take your total dose of 2 grains each day but they would be split by at least 5 hours.
This may allow you to stay on your same dose while mitigating completely the side effects of heart palpitations and flushing.
You can also split this further and take your dose in 3 divided doses if necessary.
That would look something like this:
- Take 1 grain (60 mg) at 7 a.m. in the morning.
- Take 1/2 grain (30 mg) at noon.
- Take another 1/2 grain at 4:00 p.m.
With this regimen, you are still taking a total of 2 grains per day (60 mg + 30mg + 30mg) but it’s split between 3 doses.
If you elect to follow any of these schedules just make sure you take your medication on an empty stomach and away from other supplements (especially calcium or iron!).
Lab Testing on Armour Thyroid
Like other thyroid medications, it’s important that you check your lab tests regularly when you take Armour thyroid.
In the beginning, this may mean getting your labs tested every 6-8 weeks.
Once you find a stable and steady dose you may only need to check your dose every 3-4 months (or less frequently).
But because Armour thyroid is different from other thyroid medications such as levothyroxine and Synthroid, you need to be ordering more than just the standard TSH and free T4.
Remember:
Armour thyroid contains both T4 and T3 thyroid hormones.
When you are taking Armour thyroid you should, therefore, make sure to test BOTH your free T3 and Free T4 in addition to your TSH at a minimum.
I also recommend that you look at other thyroid lab tests, but these should be what you get at a minimum.
You should also be aware of how Armour thyroid changes your thyroid lab tests.
When you take T4-only medications (such as levothyroxine or Synthroid), your TSH should drop and your free T4 should increase (free T3 doesn’t always increase when taking T4-only medications).
When you take Armour thyroid (or other brands of NDT), you should see your TSH drop, your free T4 increase, and your Free T3 increase as well.
This pattern doesn’t always hold true, however.
Some individuals will find that their TSH will drop, their T4 will drop and their free T3 will increase.
This pattern is not always bad, but it does typically indicate that you are someone who is sensitive to the T3 found within the medication.
But, unless you check all these lab tests you won’t have any idea how you are reacting to the medication.
When taking Armour thyroid you should try to find a dose (typically between 1 and 2 grains per day) that keeps your TSH in the low/healthy range, your free T4 in the middle range, and your free T3 in the higher end of the reference range.
You can find more information about these ranges in this post.
If you are taking Armour thyroid and you find that your TSH is NOT decreasing then that is an indication that your dose is insufficient.
This typically occurs when your doctor attempts to transition you from a thyroid medication such as levothyroxine to Armour.
Remember:
The average dose of 1-2 grains per day is simply an average.
You could easily be on the high side or the low side of that average.
Some people may need doses as high as 4 grains per day while some people may need doses as low as 1/4 grain per day.
You can use your lab tests to help you figure out where you fit on this spectrum.
How to Tell if your Dose is Too High
Another issue to watch out for is accidental overdosing on your medication.
Believe it or not, this can happen either accidentally or intentionally and is probably more common than people realize.
But it is something that you want to avoid because overdosing on your thyroid medication can lead to long-term consequences if you aren’t careful.
Some patients have been chronically underdosed with standard T4 medications for many years and, when they finally feel better on Armour thyroid, may think that they need more medication than they really do.
Persistent hypothyroidism can cause a range of issues including hormone imbalances that may not be corrected even when taking the appropriate dose of medication.
This can lead patients to take ever-increasing amounts of Armour thyroid in hopes of fixing these problems.
But the reality is that taking these high doses is not helpful and may be harmful.
You can read more about the dangers of taking too much medication in this post here.
So, how do you tell if your dose is too high?
You can use a combination of your lab tests and your symptoms.
If your dose is too high you will experience symptoms which include heart palpitations that do not decrease over time, flushing, headaches, sweating, weight loss, fatigue, and hair loss.
In addition, you will most likely find that your TSH is suppressed (or very low) and your free T3 is high (flagged as elevated and outside of the reference range).
The combination of these two things is an indication that you are taking too much thyroid medication and that you should reduce your dose.
Experiencing a high dose for a few days to weeks is probably not a huge deal to your body, but you should not continue to take medication causing these symptoms for longer than necessary.
Typically, reducing your dose will be enough to reduce these symptoms and bring your thyroid back to an acceptable level.
When & How to Take Your Medicine
For best results, you will want to make sure that you are taking your medication correctly.
Failing to take your medication correctly can cause all sorts of issues and may reduce the total effectiveness of your dose of medication and, in some cases, can render it completely ineffective.
When you go pick up your medication you are usually given instructions by the pharmacist to ‘take your medication on an empty stomach first thing in the morning’.
This holds true for ALL thyroid medications including Armour thyroid.
And the reason is simple:
Taking your thyroid medication with food has been shown in studies to reduce its absorption (4).
This means that instead of entering into your blood it is exiting your body in your stool!
In addition, you also want to avoid taking your medication with coffee which can also reduce its absorption.
Other items that interfere with thyroid medication include all supplements but especially supplements that contain calcium and/or iron (5).
These two are notorious for binding to and inactivating thyroid hormone before it enters your body.
I typically recommend that you wait for at least 30 to 60 minutes after taking your thyroid medication before you use thyroid supplements, but you’ll want to extend that out to 3-4 hours if you are taking iron or calcium.
You don’t always have to take your medication first thing in the morning as studies have shown that even taking your medication at night is effective (6).
That advice is typically given because it’s easiest to take your medication on an empty stomach first thing in the morning, but you can take it at any point in the day so long as you don’t take it with food/coffee/supplements (7).
Converting from T4 Medications to Armour Thyroid
Another important topic to cover as it relates to your dose is converting from other forms of thyroid medications to Armour thyroid.
This is an important point because typically this is done incorrectly.
The standard advice when transitioning from levothyroxine/Synthroid to Armour thyroid is to replace every 100mcg of Synthroid with 60mg of Armour thyroid.
The problem with this advice is that it typically results in underdosing of Armour thyroid.
Why?
Because each grain of Armour (which is 60mg) contains only 38 mcg of T4 and 9 mcg of T3.
When you transition from 100 mcg of T4 down to 38 mcg of T4 + 9 mcg of T3, the patient typically feels worse because they are taking a smaller dose of thyroid hormone than they were previously.
So, instead of following this standard advice, just be sure that you are aware that the conversion isn’t perfect and that it may require a higher dose than you or your doctor anticipate.
As long as you are aware of this, you shouldn’t be surprised if your labs look ‘worse’ upon your transition.
They will improve with time and as you adjust your dose appropriately.
In my experience, 100mcg of T4 is probably closer to 1.5 grains (or 90mg) or Armour thyroid than the 60mg that most places recommend.
Armour Thyroid vs. Other Brands of NDT
Armour thyroid falls into a class of drugs known as NDT.
NDT stands for natural desiccated thyroid and drugs in this class are all similar but differ in their inactive ingredients.
Armour thyroid is the original formulation of NDT but there are many other medications including WP thyroid, Nature-throid, NP thyroid, and more.
Each comes with its own advantages and disadvantages.
Because of this, it’s important that you are at least aware of these other brands of medications.
Why?
Because it’s possible that while you may not necessarily tolerate one formulation of NDT it doesn’t mean you won’t tolerate them all.
I’ve seen many patients who don’t tolerate Armour thyroid but do tolerate Nature-throid and vice versa.
Don’t give up on NDT medications if you experience a small reaction during your transition to Armour or when you first start it.
Instead, take note of your symptoms, try to determine what is causing them, and make changes as appropriate.
You may find that your problems are dose-related, medication-specific, or related to your sensitivities.
All of these issues can be overcome with careful consideration.
Conclusion
Armour thyroid is a great medication and one that can potentially help a great many people.
The key to using it correctly is to get your dose right!
This includes adjusting your dose based on your laboratory tests and based on your clinical symptoms.
Don’t be afraid to adjust your dose, take your dose multiple times during the day, or potentially switch to another brand of NDT if you are having trouble.
As you make these changes you will find that your symptoms improve and you should finally start to feel better.
Now I want to hear from you:
Are you currently taking Armour Thyroid?
Do you feel that your dose is optimal?
Are you experiencing any side effects?
Are you sensitive to T3?
Leave your questions or comments below!
Scientific References
#1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4267409/
#2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772692/
#3. https://www.ncbi.nlm.nih.gov/books/NBK279066/
#4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4650787/
#5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3092723/
#6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139142/
#7. https://www.ncbi.nlm.nih.gov/pubmed/18341376
Benn on Armour thyroid 5 months now. My hair is coming back, my fibromyalgia is gone and I am now sleeping 4-5 hrs instead of 0-2 hrs max. $38.00 out of pocket worth every penny.
Hi E. Neel,
I definitely agree! I’m always confused by people who aren’t willing to spend $30-40 per month for medications not covered by insurance but which help them tremendously. Health is the most important thing we have in the world and so we should spend some energy on it, at least in my opinion.
Can you supplement Armour with T3?
Hi Shelley,
If you are asking if you can use both T3 and Armour thyroid together, the answer is yes.
My thyroid lab results keep coming back low. I’m taking 1 grain of Armour, I’m exhausted all day long, my nails are brittle, losing lots of hair. Dr. Uped my dose and I got worse. I feel like stopping my thyroid medication altogether.
Hi Rebecca,
It’s hard to say whether you need more thyroid medication or less thyroid medication based on your symptoms alone. To figure it out you need to make sure that you are getting a complete thyroid lab panel. You can find more information about that panel and how to ensure that your lab tests are optimal here: https://www.restartmed.com/normal-thyroid-levels/
I have been on NDT for a couple months, half of a 65mg capsule 2x/day, then increased to a full 65mg 2x/day. I take 10mg of progesterone on days 14-28 monthly. I added the T3 Booster and Adrenal Supplements in 2 weeks ago, and all was OK and feeling great until Day 14 when the progesterone was added in… I now can’t sleep with high cortisol all through the night, dizziness, heart palpitations, shortness of breath, racy but tired and cannot concentrate. Will I need to decrease the amount of NDT now that I’m supplementing with a T3 Booster and the progesterone is possibly making me dump thyroid hormone? What could be causing these symptoms out of nowhere?
Hi Megan,
I would take a look at this article for more information: https://www.restartmed.com/high-progesterone-symptoms/
Even if your progesterone was low (or even normal) it’s not a good idea to use it unless you fix your thyroid first.
Dear Dr. Child’s,
I have been on Synthroid 200mcg for 9 yrs. I had thyroid cancer in 09 removal and ablation. I have had all kinds of issues with the generic ( levothyroxine) since I am highly sensitive to almost all meds I take for other ailments. I was put on Armour back in 2014 and it worked great. I was diagnosed with free T3 syndrome, went on 30mg at that time and stayed on that dose for 2yrs. I started feeling fatigued, gained a huge amount of weight, hair loss and the labs showed my TSH was almost 31. My cancer developed into the soft tissue of my neck and anything over 10 for my TSH is dangerous and my cancer could come back. As a result of these labs my PCP put me on Armour 60 mg. I never recovered. I am still extremely fatigued, never lost that weight and actually gained 30lb more. I am now off Armour, because I felt that it was not helping. My current PCP doesn’t know I stopped. I gradually cut down my usage and then stopped. I am not feeling any better, very fatigued, insomnia has gotten worse, aches and pains everywhere and persistent swelling in my feet and ankles, which makes it hard to walk. I am still on Synthroid 200mcg, but I feel like I am off daily. I have many health issues and trying to pinpoint any of my symptoms being related to thyroid is hard. My recent labs showed my TSH was 0.80 and I wasn’t given my free T3 at that time. I always get TSH, free T3 drawn every 6 months or so. I too fall into the category of insurance not covering Armour. ($100 for 90 day) Since I cannot tolerate the generic form of Synthroid I sometimes have to fight with that too. Any suggestions would be greatly appreciated. Thank you very much!
Dawn Campbell
Texas
Hi Dawn,
Most people who have their thyroid removed need some form of T3 medication along with T4. If you are taking Synthroid then you are only getting T4 without any T3. Armour does have T3, but not a lot, so your dose of T3 within Armour was very small.
I feel that my armour thyroid dose is way off. I also just learned I can split my dose that has helped with one of my problems. I am very tired because I’m only getting 3-4 hours of sleep, fully awake now. I take 120 mg of my armour thyroid and within an hour, I feel like I haven’t slept in weeks. I lay down anywhere from twenty minutes to an hour and a half. The longer I sleep the second time the better I feel. I noticed months back approximately 12 hours after my morning dose I would get so hot, I only sweat from the neck up, but my body inside felt real, so instead take 150 mg in the am I take 120 mg, then about 10-12 hrs later I take the 30 mg, and the hotness and sweating throughout the night stopped. I also take 15 mg Mon, Wed, and Friday. I now take 15mg every day. Splitting the dose has helped but if I take the 30 and 15 together at night I can’t sleep until 3-4 am because I feel like I’m on an upper. My TSH was very low and T4 very high but he didn’t do the T3. So as of right now, I’m on 135mg in the am then when I start getting hot and sweaty I take the 30mg. I know my thyroid is off he thinks I need more I think less. My hair breaks and all these little pieces are sticking out, my skin is dry, I’m tired no matter how much or how little sleep I get, and my thinking is so slow. Can you tell me what is going on? Thank you and especially thanks for the article. Rose.
Hi Rose,
The first place to start is with a complete panel which includes free T3 and reverse T3. From there you can figure out what needs to be done. You can use this to help you determine if your levels are optimal: https://www.restartmed.com/normal-thyroid-levels/
Hi Dr. Child’s,
Thoughts on taking 210mg armour for 2 yrs and tsh – .007, t4 – 1.0, t3 – 3.4, rt3 – 16….gained 15lbs within last7 months, never lost more than 8lbs since starting at 170lbs/5’7”. Still so fatigued, puffy, just generally unwell. (Granted adrenal fatigue is a factor. 5mg hydrocortisone for a yr but stopped hoping to stop puffiness and continuing with Pure Encapsulation Adrenal ). My body is slow to improve on meds and quick to Herx. Thank you!
Hi! I have been on 60mg of Armour for 5 weeks. I could tell the foggy head had disappeared but I was still so tired. So I had my labs done 4 days ago and am now on 120mg and I already feel better. My TSH was 13.1 when I started and it was 4.5 when I went back 4 days ago. My doctor said since I am at the high end and still so tired is why we are trying me on the 120mg but I am taking it in 2 doses a day.
I really enjoyed reading this article. Thank you.
Hi Chere,
You are welcome! Thanks for sharing your history.
I been on armour 60mg for one month and brought my TSH level from 3.8 to 1.58 I feel so much better and less hair loss. Before I started having hypothyroidism my level was always in 1.4 range and I always felt good. Now that I brought my level down to 1.58, I want to be a dosage of Armour that maintains my level. I asked my doctor if I should try 30mg of Armour now to maintain my TSH level. My doctor recommends that I continue with the 60mg since it was affective for me. I was wondering if this recommendation is ideal since I am worried that with continuing the same dosage my level will decrease and I end up with hypothyroidism.
Hi
I have been on 2 grains of Armour Thyroid since August of last year my TSH is low and my Ft4 and FT3 are low in range. I sleep 8 hours a night and I still feel tired every inch of my body just feels exhausted even breathing makes me tired, is this normal?
I’m not allowed to increase my Armour because my tsh is too low. Any suggestions on getting over this crazy exhaustion would be helpful.
I did have a vitamin panel done and everything is good. I do supplement hours after my last AT.
Great articles, informative and helpful. I am taking Levothyroxine 25 mcg. My thyroid tests were all normal except for my Thyroperoxidase antibody is 129. How can I get this back to normal.
Sandy.nastari@gmail.com
Hi Sandy,
I would take a look at this article for more information on that topic: https://www.restartmed.com/tpo-antibodies/
I was on 75mg of Levothyroxine for three years thinking my Dr knew what was best. Having Myxoedema symptoms (all symptoms minus a coma) for 8 years and continuing within the three years and still today. I asked to be put on Armour. I was given just 30mg. All my test results show up as normal but my symptoms scream severe hypothyroid. Weight increased to the most I’ve ever weighed. It took me 5 months to lose 35 lbs. I used to be about to lose 10 to 15 pounds in a month. Stuck with just 35 lost now for past 3 months. Not budging a pound except to gain when my pitting edema is thicker around my calves. I can carry 10lbs of water weight from one day to the next as the scale keeps within a ten pounds range. I eat very healthy fats, no dairy, and no gluten. I’ve incorporated healthy carbs such as Quinoa and Chia seeds, sweet potatoes to my once Keto regime. Keto and intermittent fasting likely increased my RT3. Body thinks it’s starving and now won’t let go of any weight. I’m trying hard. My lifestyle should produced far better results than I’m getting. I’ve been working hard on sleep hygiene even though insomnia and huge bursts of energy run through me at night. Tired of feeling tired and joint and back pain. Electrolytes are good, no inflammation, no autoimmune antibodies show up, though could be a false negative. I had to request my RT3. Only thing that shows up for an out of range result. In response my Dr upped my 75mg of Levo to 100. Kept my Armour at 30mg. I’m tired of being under dosed, must be as nothing feels good yet. Even the pharmacist said my diuretic (electrolyte friendly) dose was less than half the normal dose. Pitting edema is getting quite old and rather uncomfortable. Especially with the weather getting warmer as I only swell up more where it feels like my skin is going to pop!
With RT3. Is Armour helpful? I’m more than certain I have Adrenal fatigue, have many characteristics that follow under Cushings Syndrome, buffalo hump and all. I want to feel normal, have energy and live more fully instead of compromising my life all the time!
Hi Taresa,
If your question is whether or not Armour thyroid can be used if you have high rT3 the answer is that it can potentially be helpful in that situation (but not always). If that wasn’t the crux of your question then please elaborate and I would be happy to try and answer it.
Is it safe to take a thyroid support supplement with Amour thyroid? I know I do not need extra iodine, or at least I do not think I do. I do know though when I eat shrimp I feel good afterward. I wonder if it really affects me.? I do not get that often tho.
I know that armour took my brain fog away. I have been on thyroid medicine for 43 years. First Synthroid, for about 35 years. Then it was not helping at all. I finally found a Dr. To try me on Armour. It made a huge difference. We have to change my dose every now and then. But I am really overweight. I hold fluid a lot. I am not a sedentary person. I am moving a lot. So I have a battle. All the time. I did have low adrenal function at one time and with supplements and eating correctly it healed. I try to read and learn all I can. I just do not apply everything I read. I get in a slump and then try to talk myself into starting a diet. A vicious cycle all the time. Thank you for your expertise.
Hi Patricia,
It really depends on your body but, yes, in general, it is safe to take supplements with thyroid medication. I have an entire suite of thyroid-specific supplements that can be used with all types of thyroid medications which you can read about here: https://www.restartmed.com/supplement-guide
jlb404@gmail.com
I have been on Armour for about 8 years, and I probably should have been on it 8 years before that. I think that giving birth to four children in six years is what threw me into hypothyroidism. I used to fall asleep, like a mini nap, while driving or talking to colleagues at work. I thought I was just overextended. I could not control the fatigue. My TSH was “within normal limits”‘. Later, I sought help from a Body Logic doctor for other perimenopause symptoms. This doctor did a full thyroid panel and found I was “subclinical” hypothyroid and started me on Armour. I gradually titrated dose up to 3.5 grains, taking 2 first thing in morning and 1.5 mid morning, about 4-5 hours after first dose. I no longer fall asleep in the middle of a conversation. I feel like me again. And I’m sad that this was not diagnosed earlier. I am working with my family doctor now, and he gets a little upset when my TSH is less than 1, but I explain that the T3, T4 and Reverse T3 are in appropriate range.
I just started taking 15 mg (1/4 grain) of Armour Thyroid 5 days ago. Obviously I am not expecting to see any changes yet but how long do you recommend before upping the dose? My doctor said 4 weeks but I feel like that would be too long. I was diagnosed with Hashimoto’s and my free T3 wasn’t optimal it should be about 3/8 and it’s only at 3.0. I haven’t noticed any changes but this morning I noticed I feel a little bit more anxious and I’m not sure if that means I’m just too low of a dose and should move up or it just doesn’t work for me since I’m on the lowest dose. I definitely don’t want to give up I just don’t know how long I should give it! Thank you!!
Hi Elizabeth,
I base dosing off of a number of factors including the history of the patient, their current dose of thyroid medication, and so on. If you are just starting out on the medication and you are sensitive then a slow titration may be the safest option but I don’t have enough information to say one way or the other.
Are you currently taking Armour thyroid?
Do you feel that your dose is optimal?
Are you experiencing any side effects?
Are you sensitive to T3?
Hi Dr. Childs,
I’ve been taking 2 grains for 5 years, but lately have been having hypo symptoms (depression, fatigue & hair loss always being the worst ones).
Week old Lab:
TSH: 0.186 (0.450 – 4.5)
FT4 : 0.84 (0.82 – 1.77)
FT3 : 1.9 (2.0 – 4.4)
Lab from a few years ago:
(Still taking 2 grains)
TSH 0.008 (0.450 – 4.5)
FT4. 1.25 (0.82 – 1.77)
FT3 2.50 (2.0 – 4.4)
T4 6.0 (4.5 – 12)
Lab from 2014:
(50mcg Synthroid)
TSH: 3.27 (0.4 – 4.5)
FT4: 1.5 (0.8 – 1.8)
FT3: 2.2 (2.3 – 4.2)
Thyroglobulin Antibodies 167 (<20)
Looking at these numbers, what do you think the problem is: Conversion? Low T3?
Is the solution to add more Armour, more T3 or adjust the ratios?
Do I need more tests to find the answers, of so, which ones?
I read at least 5 of your articles, but I don’t think I can answer them myself. Thank you for this wonderful website!
Hi Isa,
Unfortunately, I can’t give you medical advice in this setting but you can check out articles such as this one for more information: https://www.restartmed.com/normal-thyroid-levels/
I have been on Armour for 18 years, I went un DX’d for years, my TSH tests came back normal, turns out I had a Pituitary tumor which seems to somehow “fake out” the TSH test, by the time I got to a doctor that did more labs I had 7 nodules, enlarged thyroid, and a goiter. The problem is most docs freak out when they see my labs, my TSH is completely suppressed between the meds and tumor, my T3 and T4 usually come back high. Fast forward I now live in France, they do not sell Armour or ND meds here, though they will write it for me, a huge hassle getting it. I was taking 2.5 60 mg a day but got lowered to 2 – 60 mg a day, finally I am now taking 1 – 60 mg every morning and 1 – 60 mg at night 3 times a week. So I have gone from 17.5 pills to 10 during the last year. I am SO sick, I can’t get out of bed, I am like a zombie most of the day, not just hair falling out, my fingernails are just crumbling and splitting away, along with all the other hypo symptoms. I have had trouble sleeping all my life and now sleep is impossible, I just lay there all night but can’t get up. I need to somehow show to the doctors here how normal Armour labs look, so they don’t think I am over medicated. Is there a chart somewhere that shows how different labs are when taking Armour? I am also most likely going to have to switch to Lev. and hopefully a little T3, and am dreading it. The last time I got put on T4 only I crashed and was also very sick. I hope you can somehow help me, point me in the right direction of what labs should be when taking Armour, I think the values are more in line with taking just T4 meds, not the ND ones. Thank you for any help you can provide.
Hi Kaylee,
Unfortunately, I do not have any such chart on my blog but I can add it to the list of future blog posts.
Are you currently taking Armour thyroid? yes. 1 gain.
Do you feel that your dose is optimal? better than the past but still have days where fatigue. My TSH test suggested I should lower my dose but I feel better on a higher dose.
Are you experiencing any side effects? I don’t think so.
Are you sensitive to T3? not that I know of.
My questions. Does calcitonin have anything to do with calcium as measured for bone density test? Would it impact arthritis? What does T2 do? Your article talks about iron impacting absorption of Armour (and I assume other thyroid meds), would having unusual iron results cause absorption issues? Like high iron levels, though after a series of test it was determined my iron was not high, the unusual part keeps me wondering. What could one do for better absorption?
Also, could you explain the difference in NDT like Armour and a supplement like “NatureSources Raw Thyroid” which according to label is Whole Raw tissue concentrated from bovine? Is it just the quality or is it different from Armour?
Hi Sher,
Over the counter thyroid supplements, if manufactured in the United States, do not contain any active hormone whereas Armour thyroid contains a standardized concentration of T4 and T3 per grain. Over the counter supplements are not a substitute for thyroid medications because they work differently and contain different ingredients.
Dr. Westin,
I have been taking 30 mg of Armour thyroid in the morning and at night and getting bioidentical hormone pellets. I also take a drop of nascent iodine in the morning with my thryoid.
I am still exhausted most of the time and unable to lose weight, even with a healthy diet and exercise.
I did know to wait at least 30 minutes in the morning before eating, but didn’t know about not having coffee -which I drink as soon as I get up. How long should I wait before drinking coffee and having supplements?
My doctor said it was okay for me to go up to 60 mg twice a day so I am about to try that.
Hi Jodi,
While those medications can potentially help with weight loss, it doesn’t guarantee that they will work. For instance, they will only work if the problem leading to your weight gain is related to your thyroid or other hormones, but this isn’t always the case. In addition, weight loss, particularly when it comes to thyroid medication, is dose-dependent.
Hello,
I transitioned from Synthroid to Armour after 24 years use of Synthroid. I changed to a second doctor after that, then a third, who both want me back on Synthroid. I feel better on Armour, but admittedly was overdosed by the first doctor and had heart palps.
My issue is that I am a thryoid cancer survivor. Current doctor wants my TSH under 0.1 and my T4 higher and T3 lower. He also has lowered me to 150mg Armour a day and says he wants T3 lower and T4 higher, and is concerned that my TSH is too low. Incidentally, my blood glucose A1C rose to 6.8 after the dose reduction. My question is would I necessarily feel better on a divided dose of Armour, and have more reasonable lab numbers? Last two doctors complain that their lab ranges dictate my T4 should be increased and my T3 should be decreased. I really believe some of these doctors are shills for pharmaceutical companies or just plain lazy. Really fed up after two surgeries and 26 years of thyroid medication side effects.
Appreciate your thoughts.
Hi Lee,
The major problem is the paradigm treatment which puts major emphasis on the TSH and T4. This is why all doctors seem to be obsessed with these values even if altering them causes obvious symptoms of hypothyroidism in patients. I don’t think they are necessarily lazy or shilling out for pharmaceutical companies but instead following guidelines which themselves are flawed.
The divided dose probably won’t have a major effect on your symptoms because dividing the dose is probably not the main issue. Instead, it’s probably just that you need a total higher dose.
Dr. Childs,
A little backstory. I was diagnosed Hashimoto’s at 22. I was put on Armour thyroid from the start and did well on 90-120mg for about 12 years. I saw a new Endo about 3.5 years ago who would not prescribe it, and I was put on Tirosint 112 mcg and 5 mcg of Cytomel. My labs were perfect.
My body, however, was not. I gained 25 lbs. over that period of time, my cholesterol, which had always been normal, shot up to high levels, and I began developing a rash on my arms and torso when I’d work out. At first, I chalked it up to getting older and other supplements, but one day I decided to try not taking my thyroid meds and almost instantly noticed a difference in how I felt. In hindsight, I wish I had not stopped taking the meds for a month as I waited for my next appointment with my PCP since I through myself into a major hypo State (TSH went up to 40), but I was put back on Armour in May of this year.
Since May 1, I have been back on 90 mg of Armour, which I’m splitting and taking twice a day. With a small tweak to my diet, I have already lost 15 of the 25 lbs. I’d gained and feel better overall. I do have increased anxiety, but everything else feels good (the rash when working out has been reduced by about 80-90% in both frequency and intensity).
That takes me to today. I just got my 8 week check on my labs, and my FT4 was at .82 (normal but tad low), FT3 was 4.6 (a tad high) and my TSH is down to 17.7 (still too high but moving in the right direction from my last test in May. I did take my half dose of Armour the morning of my last appointment not realizing I’d be getting my labs done in office, so I am almost certain the T3 spike is from that. I think I should move up to 120 mg of Armour, but I’m a little concerned that T3 may be too high (or the doctor will be hesitant because of the higher T3 on these labs). Supplement wise, I am also taking a standard men’s multi vitamin, extra Vitamin D, and have added Cholest-Off and Red Yeast Rice (half the recommended dose of each), as well as Psyllium husk and fish oil to help speed up the reduction of cholesterol that I assume Armour will help with also. Any suggestions on next steps?
Thanks in advance,
Stephen
Hi,
This site has been invaluable to me on my journey, thank you.
May I ask a question please:
I’m UK based and so will not be prescribed anything with T3, or have T3 tested. I was on 75mcg Levothyroxine which had no effect on my health but levels of T4 and TSH were in range (not optimal).
I went private for a full range of blood tests and am now on supplementation and have managed to secure some 60mg NDT (I Have both Thiroyd and Thyroid-S to trial).
As I have no access to personal advice on NDT dosage I am wondering where to start, and whether to also continue with a lowered dose of Levothyroxine?
For the past 4 days I’ve taken 1/2 grain Thiroyd 30mg once a day, no Levothyroxine and can feel the heart rate and anxiety raised above normal (but manageable) so assuming this is the T3 element.
Do I stick at this to see how I get on?
Add in some Levothyroxine as the NDT will not be providing enough?
Add in some Levothyroxine and lower the NDT slightly?
I know it’s going to be a bit of trial and error but a prod in the right direction would be appreciated.
Bloods 06/06/2019 75mcg Levothyroxine, before I started on supplements:
Free T3: 3.67 pg/ml
Free T4: 1.69ng/dl
TSH: 2.76 miu/l
25 OH Vit D: 23.2ng/ml
TPO: 453 iu/ml
TGA: 110 iu/ml
CRP HS: 0.47mg/l
Ferritin: 360ug/l
Folate: 4 ug/l
Any help you can provide is very much appreciated.
Many thanks,
Tom
Tom, you can easily get NDT (nature throid) in the UK on NHS, you just need a competent Endo! Been on it for several years now, currently on 2 grains x twice a day, and I have some life back. Keep fighting for it!
i can’t tolerate much thyroid medication. I was too high on armour thyroid. The dr cut me down to 45 from 60. I have to take. 35 and a 15. It does not sem to be enough.
I can’t synthyroid, it make my heart race, i speed.
Armour is hard to get a correct dose
Hi Diane,
It kind of depends on what you were feeling when your dose was too high. It may not actually have been too high.
very racey. eyes felt dilated. shaky. heart racing. scared.
Ihave had the issue since starting thyroid meds yrs ago.
I have always had energy, and thyroid meds make it worse.
my pulse rate is alway high 80’s. my bp is normal. my weight is normal. i’m a small person 5’1. helthy other wise
I was diagnosed 6 weeks ago. Are you currently taking Armour thyroid? Yes I have been working up and now at 120.
Do you feel that your dose is optimal? No I am still running body temp around 96 degrees and freezing all the time.
Any suggestions?
Hi Jodi,
Yes 🙂 Get a complete thyroid lab panel to see where you are at! https://www.restartmed.com/normal-thyroid-levels/
i can’t find the correct dose. I am very sensitive to thyroid meds. They make me speed. I have plenty of energy. my wight is normal They make me anxious.
I was on 60 mg of armour, it was too much. I was cut cut down to 45. 35 and a 15. didn;t work. not to mention the phamarcy kept screwing up. I am now taking a little under 60. My recent blood work my t 4 was low other levels were normal.
I am in the process of fin a G P mine retired. The one i went too was totally wrong on my dose.
how do i get a dose that does not make me speed and anxious?
Hi Dr. Childs, I was diagnosed hyper with hot nodules and had RAI that made me hypo in 2015. I’ve been on an up and down rollercoaster ever since with synthroid working at first and then suddenly getting hypo again, fighting to find a Dr to prescribe armour, but being under-medicated. As a result, my hypo symptoms along with my cholesterol, triglycerides, and sugars sky-rocketed despite a healthy lifestyle, and while going through severe life stress I had a heart attack in 2017 (at age 43). After that, struggling with debilitating side effects from heart and cholesterol meds, I found a functional med dr willing to listen to my symptoms, switch me to higher dose of NP thyroid, and manage my heart disease naturally. I grew healthier and stronger but still struggled with weight gain, fatigue, and hair loss so he slowly upped my dose to a total of 240mg of NP split 2Xs per day. I didn’t feel anxious, jittery or my heart racing, though my pulse was ran a little higher than normal. I couldn’t afford to keep paying that Dr out of pocket, and a new endo dr said that I’ve actually been hyper and my numbers are most likely fluctuating too high after each dose. My labs 3 hours after my morning dose were: TSH .006, T3 5.7, T4 1.5, and TSI of 6.98. So she dropped my dose to 210mg split 3 times per day a few weeks ago and wants to continue lowering the dose until my TSH is “normal”. But I already feel awful. I’m exhausted, foggy, gaining weight, puffy, achy, and the worst is that my heart if fluttering even though my resting HR rate has dropped back into the low 70’s. Most of what I read says an abnormal heartbeat is a sign of being over-medicated, but it makes no sense since it started happening after lowering the dose, and I feel so hypo. My dr says my body needs time to adjust to less hormone, but I’m afraid I’ll only get worse and end up having another heart attack. Have you ever seen symptoms that appear so reversed? Is she right about taking time to adjust? If so, how do I function and keep from gaining another 20 lbs and losing what’s left of my hair in the meantime? Thanks much!
I have a general question for you. I get these daytime fatigue naps around 4-5 pm. My labs showed me low on 2.5 grains armour ( tsh 10.5, low ft3, low ft4) bumped to 3.0 and still feel woozy. I am going to do labs again at 5 weeks. My question is, do you ever see people on 3.5 to 5 grains armour in order to feel normal? Just seems a little unusual since the clinical paperwork on armour says most people will need 1-2 grains with 3 being the exception and im talking 4……. thoughts?
Hi Bob,
4 grains is a high dose but there are some people who need it. You’ll want to look at other hormones such as Cortisol which may explain your symptoms.
I’m 72 year old male who is on Armour. I had my thyroid ablated about 20 years ago. I was put on synthroid for 10 years and did well for awhile then boom it didn’t work. I was put on NP Thyroid 2 grains and it was perfect then they changed the formulary and went to Armour Thyroid. While on NDT I always had a low TSH 0.80; low FT4 .07 and FT3 of 2.4. And felt great. Since switching to Armour I experience infrequent brain fog. I need to get my FT3 higher. Would it be ok to increase my dosage by 1/4 gram?
Hi Dr. Childs
Your website is wonderful and a great reference. I started seeing an endocrinologist in February of this year. My labs were never “out of range” but I knew something was wrong (thyroid), even though my PCP office said all labs were fine. I felt like a lawyer pleading a case to the endo. She finally consented to try me on a low dose of med and I asked to try Armour. She goes “low and slow”. I am now up to 60mg and with each lab draw, my Free T3 gets LOWER. The Armour has gotten my TSH down to .82 and my Free T4 is 1.2 ( Of course this number barely changes. All thyroid labs done this year have my Ft4 at 1.1 until my labs yesterday). So, I’m not sure why yesterday’s labs are TSH of .82, Ft4 of 1.2, and Ft3 of 2.3. I feel terrible. A lot of docs would now just look at my TSH, and maybe Ft4 and say “all good”! I messaged my endo doc and questioned maybe trying a T3 med. She has mentioned that if we would ever go that route, she does not give an NDT with a T3 at the same time. Really not sure if that is the route to go. Getting desperate to feel better!!
Hi! Would you ever combine Armour (60mg) with a T4 only (like Levo at a low dose) med? I have been on levo for 20 years, on different doses, up and down, depending upon if I am pregnant or not. My last dose was 125mcg. I tried Armour for the first time about 6-7 weeks ago at 60 mg because of conversion issues. No side effects which was a relief as I am very sensitive to meds. But recent lab results showed that my TSH was even more elevated (over 5) and my T4 Free & T3 Free were both low. So doc increased me to 90mg to give my body more T4. Whoah! Anxiety came, hot flashes, mood swings, loss of appetite. I finally put two and two together to realize I was having side effects from the higher T3 in the Armour. I feel soooo much better having gone back down to 60mg. But clearly my thyroid needs more support. That’s why I am considering adding a small amount of T4 only as well. Wanted to run this by you before I asked my doc about it. Thank you!
Hi Carrie,
I never personally do that but I could see a scenario in which it may be beneficial.
Hi I began using armour last year. Recently I have begun to feel a little more sluggish and tired in the afternoons. Both my T4 and T3 have decreased since taking the armour but my TSH has remained right around 2.0. Do you think I need to increase my dose? I am currently taking 45mg daily
Hi,
Been on armour for a year, increased dose recently to 30mg and my TSH came down some as did my T3 and T4 going up to 45mg and having levels checked in a few weeks.
Is it common to have TSH come down on therapy as well as decrease in T3 and T4, and if so does this indicate the need to increase my dosing?
I have Hashimotos, just got switched from Nature Throid (due to recall) to Armour. I have been on Armour for 3 months( 1 &1/4 grain). My TSH has been decent for years 1.3 to 2.5, but my T4 and T3 is literally on the bottom line always!! Nature Throid didn’t raise it either. Should I have other test? This has been going on for years . Not sure if I need to just up my dose, or have other test done ? Thanks for any insight
I don’t think 1.5 grain is more like 100mcg of Levo. I’ve been on 88mcg of Levo for 10 years and 1.5 grain had my T4 at ‘1’ and T3 at ‘2.5.’ On 88mcg of Levo my T4 was 1.7 and T3 at 2.5. The only difference between the two is that I started to suffer swelling of the face and extreme fatigue on the 1.5 grain. Went up to 2 grains and felt heat intolerance all day and dizziness but my labs didn’t show that I was over medicated yet I couldn’t even take a walk in the sun. My skin felt hot yet body temp was normal. T4 was ‘1.2’ and T3 was 3.6. TSH was .05. Went back down to 1.5 grain, felt great for one week then like crap again so I went up to 1.75 grain and a week later started to develop extreme swelling in face and painful carpal tunnel/swelling in wrist and fingers. The next day I went back to 88mcg of Levo and all the swelling went away. If I wanted to get my T4 midrange on NDT that would mean taking 2 + 1/4 grain. Tried to add T3 to a lower amount but there does not seem to be any amount of T3 that compensates for low T4 levels.
Came off Synthroid 112 in Feb, 2021 Started new Dr, was tols she works closley with T3 and T4 TSH…etc…. Convinced her to try me on Armour..Started Armour at 60,,, I couldn’t move and ached for 2 weeks,,,,upped myself to 90 … waited 2 weeks did blood work….
T3 3.2 pg/ml
T4 .83 ING/DL
TSH 3.33 uIM/ML
vit D 37,2 ng/ml
Now she has me up to 90…. still dragging … can I up my self again by takin 2 60 pills ??? need to get my life back
Thank you
Hello Dr. Childs,
I left a comment a couple years ago when I was first dx with Thyroid cancer. I don’t remember exactly when and am not finding my other comment.
Over the course of the past two and half years I’ve learned a few things, for example I should be at optimal levels rather than good levels. And I’ve gotten more bold with my talking to my doctors, I’m not the nurse anymore, I don’t have to worry about loosing a job, I’m the patient who needs answers for optimal outcome. I didn’t do anything wrong to get this horrid disease that is not so easy as some say it is.
In any event, why I’m messaging now is in regard to my labs after my whole body scan and thyrogen a week ago. I am on 90 mg of Armour Thyroid (It was discovered that I’m allergic to Levothyroxine and Synthroid) and even at 90mg I’m doing much better than on the others. But I’d like to be at optimal levels with my labs.
Most recent values I just received post thyrogen and scan are:
TSH is 45.7 (Optimal level would be 0.5)
Free T4 1.05 (Optimal level would be 0.8)
Free T3 0.47 (Optimal level would be 2.3)
I also take B vitamin supplements, as well Selenium, Biotin, Beta Carotene, etc. to promote T3 production. I’m also a vegan/plant based diet person.
Would it be unreasonable to ask my endocrinologist to increase my Armour Thyroid to 120mg? And if this is ok to ask, what I mentioned to you, is that statement enough to make me not look like I just want it raised but have a valid reason for this request? I’ve been at this dose of Armour for seven months so far.
Thank you,
Dora Mose.
I’m on 105mg of Armour and was feeling ok until like a week ago and my labs came back tsh is high at 4.82 and t4 low 0.89 free t3 right in the middle like 3.3. I obviously need a higher dose but last time I took 120 I started having bad hyper symptoms. Those labs came back low TSH 0.89, t4 1.0 and free t3 high 6.5. I was having the worst insomnia ive ever had, anxiety, jittery etc. My endocrinologist and I both don’t really know what to do next since 105 isn’t enough and 120 may be too much? So many ups and downs it’s getting truly discouraging and frustrating!!!
Hi Alexi,
You might try compounded T4 + T3 thyroid medication to really hone in on the dose that your body wants: https://www.restartmed.com/compounded-thyroid-medication/
I take Armour, only because Naturethroid is no longer available. My FT3 and FT4 are both just below mid-range but my TSH is 0.02. I can’t lose weight, I hurt everywhere, I have lost half of my hair, I am depressed. SHBG is very high. I take HRT, progesterone and estradiol, but still suffer from hot flashes and night sweats. My thyroid tests do not add up. I see a hormone specialist who says the sex hormones have to be good before the thyroid hormones will work. You say don’t take progesterone until thyroid hormones are good. The only way my TSH is ever in normal range is when T3 is at low end of range. I have no thyroid. My doctor is about to give up because my testing doesn’t add up to my symptoms. Any ideas?
I have been taking NDT for years. But after Nature-throid was recalled, this past year have tried 2 other NDTs and after 6 weeks or so started getting hyper symptoms. Saliva tested my hormones/cortisol and cortisol is high in morning. Now my doctor wants to be put me on Levothyroxine so it can be better “regulated.” I don’t know what to do. I’m so sensitive to everything and I don’t want to get hyper symptoms. Advice? Thanks.
Hi Laura,
Please see these articles 🙂
https://www.restartmed.com/is-ndt-still-working-are-thyroid-groups-safe-interview-with-janie-bowthorpe/
https://www.restartmed.com/thyroid-medications-that-work/
Hello. I recently switched from Unithroid to Armour. I started out with 15mg once per day for 4 weeks and it brought my TSH down from 7 to 4. Then I was raised to 30 mg once per day for 4 weeks and it brought my TSH to a 5 (kind of weird that it increased). So now I started taking 45mg (30 + 15) and I started noticing after a couple of days that I am always feeling hot and sweaty, and my hair is falling out. So I am thinking that I am now taking too much. I will talk to my doctor about this. I should ask my doctor if this indicates that I need to stay with the 30mg dosage and maybe a couple times a week increase the dosage by 15mg and see if this will lower the TSH? or Maybe I wasn’t on the 30mg long enough? or Maybe I should have stayed with the 15mg and increased it to 30mg a couple times per week. Any thoughts on how I should approach this with my doctor?
Hi!
I’ve been reading your articles for a very long time. I had RAI in 2015 and have been on levo ever since. I was up to 150mcg a day with a 5 mcg supplement of cytomel which did help. I had Graves’ disease before the RAI.
Recently I found a functional medicine doctor who was willing to journey with me through compounded thyroid. I am also pregnant so I was hesitant to make this switch but even on 150 levo I was really not doing well and pretty desperate to change something.
I started compounded in 11/2021. I’ve been self dosing now for 6 weeks and I am up to 2 grains every 4 hours (4-5 times a day). I read that you said people shouldn’t take more than 4 grains total in a day… I’m doubling that. I’m very familiar with t4 vs t3 symptoms and I’m a little sensitive to the t3 but I feel like I’m not getting enough t4. I also feel like my body is trying to figure out what to do with this t3 lol. Today I started 3 grains this morning and wanted to see if it lasts any longer than 4 hours or if I feel better. Taking 4-5 doses while pregnant is hard with eating . Anyways, wanted to hear your thoughts on this high a dose but split. I only have palpitations when I miss a dose, then when I take the dose it cures any headache or heart rate change. Thought that was weird but it’s true time and time again.
Hi Rachel,
Dosing based solely on your symptoms is generally not a good idea. Thyroid medication takes weeks (6+ weeks in some instances) to take effect in the body so adjusting your dose prior to waiting this length of time will only make the picture more confusing. I wouldn’t make any drastic changes to your dosing schedule, especially while pregnant, unless absolutely necessary.
How long after Armour Thyroid can I drink lemon water? Also, how long after Armour Thyroid to eat and take supplements? Thank you so much for your help!
Hi Didi,
Please see this article for more information! https://www.restartmed.com/how-to-take-your-thyroid-medication/
Hello, my doctor advised me NOT to take my Armour the morning of my blood tests, which is what I normally do. T4 and T3 have been in normal range in the past, but that is at at least a 24-hour interval after my previous morning’s Armour is taken. Recently I had my T4 and T3 levels tested on the same day that I took my morning Armour, say 5 hours after taking it. And my T3 was too high.
I had been crashing on and off for the last few months. After I saw the results I decreased my dose from 180 to 120 and immediately felt better, more energy, no crash.
My question is how long after dosing should you take your blood tests? I had been doing it 24 hours+ and may have been doing that wrong.
Hi Alexandra,
Please see this post which outlines how to take your thyroid medication before your lab tests: https://www.restartmed.com/thyroid-testing/
I’ve been on synthroid for several years at 200mcg but still never gotten my TSH below 6 and still suffer from hypothyroid symptoms. I switched docs to try and get improvements and was put on 60mcg of AT to start. I have all the standard T3 sensitivity reactions that you describe. I was given T3 by my previous doc and had horrible side effects so intense I ended up in the ER thinking I was having a heart attack. On AT the side effects aren’t as intense but are the same. Hopefully they will lessen in the next few weeks? Will this ever improve?
Hi Terry,
Have you checked for gut-related issues that may be preventing your thyroid medication from getting absorbed?
I have hashimotos thyroiditis. Considered to have subclinical hypothyroidism. I have all the classic symptoms.
6/20/22 labs: TSH=3.92, T3=3.3, T4=1.2
Started 15mg of Armour 7/1/22.
8/8/22 labs: TSH=2.75, T3=3.7, T4=.83
Increased armour by 7.5mg and within 5 days started having a racing heart, sweats, fatigue.
8/31/22 labs: TSH=2.73, T3=3.5, T4=1.1
Cut back down and feeling somewhat better. Still have some heart racing, fatigue and sweats.
At all doses, my symptoms have improved but not 100%. I’m also perimenopausal.
I’ve received conflicting recommendations from a few doctors. One dr believes I shouldn’t take Armour at all. Or if I insisted, that I should add T4 (levothyroxine) only to the armour 15mg.
I’m very confused.
Hi Kristen,
Have you asked your doctor why they don’t want you to take Armour thyroid? Their response will tell you a lot about whether or not you should listen to that person.
I love your newsletters. It has helped me convince me NP to take a different approach.
I take Armour (was taking at 90mg and felt fine). I had no problems staying at my normal weight.
But, then my NP decided too high (I had no signs of hyperthyroidism)
–I am not sensitive to T3
–I do have MTHFR C677+ and A1298C (single genes)
–My TSH was slightly below range (which I have read that this is okay with NDT)
I am now on 60mg, which I am experiencing some hair loss, a tiny bit of fatigue, plus now having to watch diet to not gain (which I did gain 3 pounds and can’t get off – goes straight to abdomen)
I convinced her to take me up to around 70mg. Will be taking the PROPER labs for thyroid in Dec. I was able to convince her of the correct labs, yay!
Hi Sue,
Glad to hear it! It sounds like you are on the right track. Just be sure to also keep track of other hormones like insulin, leptin, and cortisol in addition to your thyroid. Those hormones can contribute to some of the lingering symptoms you are experiencing.
Hi Dr. Childs,
This is an amazing site! I am so glad I found you!
I had a Thyroidectomy (cancer) March 29, 2022. I was on Levothyroxine, and had EXTREME chest spasms and anxiety. I switched to Armour in July (60mg). I felt great. No chest pain or anxiety. I became Hypo so my endo bumped me to 90. I started to get slight palpitations. I was tested after a month, and my TSH went down to 9. He bumped me up again to 105 on Nov 16. After a month, I was tested and am now at 105. I have the palpitations now. My TSH is at .482. I am great otherwise. These palpitations are all day long. My endo does not want to lower me. My question is, do you think I will get acclimated over time? Should I split my does through the day? Right now I take the 105 at 6 am all at once. Any advice would be so greatly appreciated. THANKS!!
Hi Donna,
It’s possible that you will get acclimated but I usually don’t find that to be the case. Those who are sensitive to thyroid medications tend to remain sensitive. And, yes, you could definitely try splitting up your dose and taking it multiple times per day as that does work for some people.
I apparently have an undersized thyroid. Always a little heavy but I can gain 3 lbs overnight and take a week to get off. Taking Armour 180 and I feel like it isn’t working anymore. 59 y. o. I am seriously at a loss. Docs don’t dose me right. TSH really high and T4 were really low.
Hi Leslie,
I think you will find these thyroid weight loss patient case studies helpful as you evaluate your own situation:
https://www.restartmed.com/weight-loss-naturethroid/
https://www.restartmed.com/weight-loss-hypothyroidism-success/
https://www.restartmed.com/diabetes-reversed/
https://www.restartmed.com/thyroid-weight-loss/
https://www.restartmed.com/victoza-weight-loss/
https://www.restartmed.com/adding-t3-ndt/
I currently take 2.5 grains but seem to have to increase my dose every 8 months or less and don’t seem to be able to settle. This has been going on for 4 years now. I’m at my wits end with the ever returning constipation.
Hi Suzanne,
Please see this article for more information which explains why it’s not uncommon for thyroid dosing to change regularly: https://www.restartmed.com/you-cant-stay-on-the-same-thyroid-medication-dose-forever/
Hi Dr. Childs,
I appreciate the detailed information in this article. I had a total thyroidectomy in 2009. I was prescribed Synthroid 175 mcg (adjusting doses based on TSH only) by itself for many years and then began experiencing hypothyroid symptoms. My Synthroid was then decreased to 88mcg (once per day) in combination with Armour Thyroid 30 mg (three times per day). I’ve been on this new combination for 3 months and feel worse. I’m seeing a new Dr now in hopes of a med change to feel better. How do you feel about the Synthroid and Armour Thyroid combination?
Thank you for your continued support in helping so many thyroid patients!
Carly McKee
Hi Carly,
In general, I’m not a huge fan of NDT plus levothyroxine/Synthroid combinations because they just seem redundant. Armour thyroid still contains plenty of T4 so that should usually cover your T4 needs and if you felt like you needed more T3 then adding Cytomel to Armour thyroid is usually the smarter option. Having said that, if it’s working for you then you can certainly keep using it, I just feel there are better options for most people.
Hi Dr Childs
My most recent labs are puzzling for me and my Dr. , a little back round, I have been on 150 +/- mcg Armor for almost 15 years after a total thyroidectomy. My levels are generally well controlled and usually fairly easily corrected.
TSH 4.580 (HI)
T4 5.5 (OK)
T4 FREE .90 (OK)
T3 182 (HI)
T3 FREE 4,6 (HI)
I feel like i am slightly overdosed, but truthfully, my symptoms are similar whether over or under.
My Labs were taken a few hours after my morning (only) dose.
I am wondering why my TSH is High but my two T3’s are also high, this is not customary for me…
I would appreciate your insight and I definitely appreciate your page and your time. Thanks, Norm Turner
Hi Norm,
I would recommend reading this article for more information on how to get accurate thyroid lab tests. The way you mentioned you had your labs drawn indicates that they are probably not very accurate which means that making decisions based on those results is not ideal: https://www.restartmed.com/thyroid-testing/
Hi Dr Childs, I am having trouble taking Armour for hypothyroidism. On the 15th day of taking 60 mg of Armour I am overwhelmed with chronic nausea. This does not happen when I’m taking 30 mg of Armour. But I was not getting the positive effects at 30 mg so my doctor increased my dose to 60 mg. I am currently taking 60 mg of NP thyroid but I do not feel any low thyroid symptom relief from this medication. Have you found other patients that struggle from nausea when taking Armour at higher doses? Do you have any recommendations for me with regards to taking Armour more successfully? I have tried taking 30 mg in the morning and 30 mg in afternoon but the nausea still appeared on the 15th day.
Thank you.
Hi Laura,
Not extreme nausea, no, but I have seen stomach pain. In the medication and supplement realm, you can usually solve the problem of nausea by simply taking your med/supplements with food. That is not ideal with thyroid medication, but there may be a place for it if it means controlling your symptoms. That’s something you’d need to think about and discuss with your doctor, though.
I am confused and getting fustrated. In one place you recommend taking Armour Thyroid at 7 a.m. and again 5 hours later. Another place you recommend taking it at night. I take 75mg./day. i divide it into 45 and 30 mg. doses. But, I am confused about when to take these 2 doses. If I take it at night and again in the morning, i am putting at least 12 hours apart. I would appreciate clarification on what is best. Thank you for clarification.
Hi Debi,
Can you please share where it was stated that people should take Armour thyroid at 7am and then again 5 hours later? I don’t recall ever saying that but if you can point me to where you read that, I can provide context on what I was trying to say.
I think this refers to splitting doses, from your article above…..
Let’s use an example:
Suppose that you are taking 2 grains of Armour thyroid per day.
Let’s also suppose that you are someone who is experiencing palpitations and flushing about 30-60 minutes after you take your medication.
You decide to alter how you take your medicine and split your dose into 2 divided doses.
You would proceed by taking 1 grain (60mg) first thing in the morning around 7:00 am (on an empty stomach).
Following that dose, you would take another 1 grain (60mg) around noon (on an empty stomach).
Following this regimen, you would still take your total dose of 2 grains each day but they would be split by at least 5 hours.
This may allow you to stay on your same dose while mitigating completely the side effects of heart palpitations and flushing.
You can also split this further and take your dose in 3 divided doses if …
Hi K Stewart,
Ahh, thank you for that reference.
Yes, all I was trying to point out there is that there are multiple ways to take any given thyroid medication. I believe the misunderstanding comes from the assumption that there is a best way to take thyroid medication, but that isn’t the case at all. Instead, there are several different variants that all have the potential to work and it’s up to the individual to determine which works best for them using trial and error.
I was on Levothyroxine for years and finally went to an endocrinologist begging to try something new as I felt horrible. He switched me to Armour after I said my cousin felt so much better on it. What a difference Armour makes for me. I do not have a thyroid, so when we finally found my dose it was 120mg. After a few years of feeling better, I actively tried to lose weight, something that I could never accomplish on Levothyroxine. I ended up losing 60 pounds in 5 months. I was thrilled, but then my TSH started running low (.04). We figured it was the weight loss, so my doctor dropped me to 90mg +15 mg. TSH still running low (.08). My doctor then dropped me to 90mg and my TSH went high (7.64). I’m back on 90mg + 15mg and just had my blood draw and my TSH was .3. There are no lower doses than 15mg. Do I split the 15 mg in half and try that? My endocrinologist dropped my insurance and I have been doing this with my general practitioner and she is not a fan of Armour, so I am grasping at straws to convince her to stay on it. Any help is so appreciated. Thank you for doing this for people.
Hi Jeannine! I had a similar thing happen to me while taking Tirosint. My TSH was unexplainably low- yet I had zero hyperthyroid symptoms. I can’t remember which article I read- but I found out that high doses of Biotin can affect TSH and artificially lower it. I checked my supplements and sure enough I had been taking a high dose. I stopped and when I had my labs checked again my TSH was in the normal range. Hope this helps!
I really enjoy your articles and am learning so much from you! I started my thyroid journey after receiving immunotherapy treatments which completely burned out my thyroid. I was initially hyper and then swung to hypo very quickly and had worked up to 125 mcg of levothyroxine. As my dosage increased, my symptoms got worse. My doctor switched me to Unithroid and I got severely ill. Long story short, I did some research and asked to switch to Armour. I was a different person within days! After 3 weeks on Armour however, some of my symptoms are reappearing though not as severe. Recent bloodwork indicates that I’m hypo again (TSH 8.55). Side effects are tingling in hands and feet, throat ‘fullness’ and some hoarseness, fatigue, muscle pain and palpitations. I am going to ask for an adjustment.
Throughout this journey, my cortisol has been within range at times but very low. How would this effect my hypothyroidism and being on Armour? Thank you for being such a great resource of information to so many.
I just made the switch from 112mg of levothyroxine&10mg of Liothyronine to 90mg of Armour Thyroid. I just got my labs back after being on Armour Thyroid for 60 days. It did freak me out. My TSH is 10.300 and my T4,free (direct) 0.66, T3, free 2.8 . I had radiation on my thyroid 31 years ago and have never had labs like that. It will be interesting to see what dosage my doctor increase me to.
Thank-You for all your information. It has been very helpful and encouraging
Hello, just read this article and I am intrigued. Curious to know if you could further explain T3 sensitivity?
I’ve been on Armour Thyroid for years, and I am taking roughly 112 average per week. TSH decreased, FT3 increased, but FT4 is low and slightly under range …always! Everyone keeps saying I need more based on number but I feel hyper if I increase? Why does the FT4 drop in some?
Hi Laura,
You can learn more about T3 sensitivity here: https://www.restartmed.com/thyroid-hormone-resistance/
Hi Dr. Child’s
Do you know the exact composition of Armour Thyroid now? 12/20/23. It has changed in some ways and I wonder if all the important enzymes and other thyroid molecules are still in it. I’ve taken it for 20+ years and am very familiar with its “look” and “aroma “ both that have changed
Hi Julie,
I haven’t looked up its exact formulation recently but I’ll make a note to check it out when I have time.
Dr Childs,
I have seen a lot of your information and find it very useful. I started on 1 grain of NDT for 9 weeks, had a blood test which showed T4 and T3 actually lower than before I started but TSH reduced. Then moved to 2 grains for the last 3 months and still feel very hypothyroid.
My belief is that the T3 component is strongly suppressive of TSH, and that low doses of NDT will effectively remove as much or more thyroid hormones from the body than will be added in. For this reason both STTM and the thyroid patients handbook suggest starting at one grain NDT and increasing by 1/2 grain every 2 weeks until reaching 2 grains. At that point having a blood test and slowing down to let T4 levels catch up. Of course if any problems occur during this process then back off and investigate. In my case I expect my starting TSH of 5.0 to be down below 1 and maybe approaching zero by the time my dosage is optimal. This implies that my entire thyroid output will have been shut down and I will be existing on NDT thyroid alone. I think it also implies that it didn’t matter what TSH I had started on because whatever my thyroid output was it will have gone.
Incidentally I am still having hypothyroid symptoms, being in the process of building up NDT. However my history of Hypothyroidism reflects very many facets of what you are saying in your talks. So in brief have been out of TSH range for 15 years, once diagnosed hypothyroid but treatment not followed up as my next test was in range. Complained to doctors about badly aching legs, and had lots of tests done. Did my own tests 4 years ago and TSH was around 5 . Told by doctor would not treat for hypo as TSH not over 10! (UK NHS). Own test again last year. Again TSH around 5, again DR refusing thyroid treatment. Looked at my medical record, showed TSH out of range for last 15 years. Went to endocrinologist. She said my thyroid was perfectly normal and I would live longer on low thyroid levels! Saw your video on hypo causing chronic aches and believed every word of it Makes perfect sense that you need to get thyroid right and exercise vigorously to reset you muscles. (In fact I think that exercising hard on low thyroid is what has damaged them in the first place). You suggest 3 grains or so of NDT in that video. Went to a thyroid specialist and said I was hypo. She looked at the numbers and said ‘Of course you are, which of the three treatments do you want’. So I am now in NDT transit and I intend to exercise very hard, as I always have, use a massage gun, and optimise NDT. This should give a very thorough test of your methods.
Hi Phil,
It definitely sounds like you are on the right track! Please note that when treating hypothyroid myopathy, somewhere around 30% or so of thyroid patients need more T3 than what is provided by NDT. Still around 50-70% do well on the T3 doses provided in NDT (which is static) so the chances are in your favor that you will see improvement but I wanted you to be aware that you still may need additional T3 if some symptoms remain. You can get additional T3 by adding Cytomel or liothyronine to your NDT dose if it’s needed.
Dear Dr. Childs,
I have had Hashimoto since 2013 and the only medication my body took to was Armored Thyroid. Since my Endocrinologist retired in 2020 my physician took over the role of checking my blood and prescribing me my thyroid medication. April of 2021 my thyroid TSH went very high and I gained 40 pounds in 2 months and my physician put me on 180mg. Since then its been nothing but back and forth from 120 to 180 and he won’t prescribe me anything in between. This last time he took blood I had a TSH of .005 and he dropped me from 180 to 120 and it felt like my body went into shock. I finally started taking a 120mg pill and a quarter approx. 30mg= 150mg approx. and I feel a lot better. Am I doing the right thing? I do have an Endocrinologist appointment coming up on March 6th (after a 6 month wait, I think there is a shortage of Endocrinologist in the DC area) Since my thyroid has gone Yo-Yo I have has UTI after UTI, depression, and no breaks from Fibromyalgia attacks along with the hair skin and weight problems. It’s been a rough few years.
I am trying to get my TSH down to 0.5 range as you have indicated for weight loss. I have Hashi’s, insulin resistance and a leptin of 86 now down to 77. I am currently on several of you supplements. My endocrinologist was willing to work with me to get my TSH that low. I am now on 90mg of Armour. I just got my labs and my TSH is 0.13. I have an appointment next week to make sure I didn’t become hyper. Obviously that is too low. Wondering what your advice would be? I would imagine she will tell me I have to stay with the 75mg dose which kept my TSH around 2.5. Is that the only option? My health is being held hostage by my weight which is being instigated by my Hashi’s. I need to break the cycle some how and it seems that it has to be with weight loss.