- Armour thyroid dosing is highly individualized, and the average dose falls between 1 grain (60 mg) and 2 grains (120 mg) per day, though some patients need more or less.
- Many patients are underdosed when converting from levothyroxine to Armour thyroid, which is a common reason they continue to feel poorly after switching medications.
- The best way to find your optimal Armour thyroid dose is through a combination of lab testing and closely monitoring your symptoms rather than relying on labs alone.
- Sensitive individuals may need to start at doses lower than 1 grain, while resistant individuals may require doses higher than 2 grains to feel their best.
- Several factors influence the dose you need, including your body weight, the severity of your thyroid condition, and how well your body converts T4 to T3.
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.
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 that 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 NP thyroid and Adthyza (as of this writing, Nature-throid and WP Thyroid are not available).
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 NP Thyroid 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
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.
Hi Dr Childs, my GP has prescribed different amounts of Armour for different days: Mon, Wed, Fri, Sun at 60 mg and the other 3 days at 90 mg. Is this a correct way to dose me, or should she raise me by the same increments every day when she is trying to raise my levels? Thank you so much for being available. I appreciate you!
Hi Allie,
There really isn’t a “correct” way to take thyroid medication as I’ve seen some of the most bizarre routines work. It’s more about what works for your body, so if that dosing schedule is helping you feel better, then it’s good enough. If it isn’t, that’s another story.
How can we possibly take desiccated thyroid three times a day, always on an empty stomach? First thing in the morning is doable, but I can’t figure out how to take a second (or third) dose at lunch or mid-afternoon, but still have it be at least an hour before and after any food or caffeine or other mineral supplements. I could manage if I did some intermittent fasting, but I believe fasting and low-carb dieting is part of why I have developed hypothyroidism.
Hi Lisa,
You don’t have to take it 3 times per day, but if you wanted to, it’s not that difficult. It only takes your stomach about 2 hours to empty after a meal, so there are plenty of opportunities throughout the day to fit it in. That said, it may not even be necessary for most people, it just can sometimes provide additional benefits if taken this way.
Hello Dr. Childs,
I am in a bit of a pickle right now and desperately need some advice. I switched to Armour in 2022 from 50mg of levothyroxine originally given in 2016 at the weight of 145 pounds ( I am 5’7″). After 8 years and 4 surgeries later, still on 50mg of levo, I went up to 195 pounds and that is when I asked to see an endocrinologist who switched me to the Armour even though my tests were normal. She put me on and kept me on 60mcg – I was very sick for about 3 weeks, but when it kicked in – life was good. Fast forward to the end of 2024, where a U/S of the Thyroid rebieles that I had two very small TR4 nodules with calcifications in my upper left thyroid gland and on my Isthmus. I have a family history of thyroid carcinoma, however my endocrinologist said they were too small for fine needle aspiration and said we will check it again in a year. I have a very complex medical history and I am always the 2-5% person who may get some negative outcome than the normal population. Keeping this in mind, I have had trouble with swallowing and getting things stuck in my throat – as well as pain and tenderness on the left side lower throat. I ended up getting another U/S thyroid 6 weeks later ordered by my ENT – the nodules had gotten denser and slightly bigger as well as my left lobe being 1cm bigger. At this point my endocrinologist did blood tests and My T3 has doubled. I also went down in weight by 10lbs. I was losing hair rapidly, irritated ,palpations the whole thing, so my endocrinologist lowered my Armour to 30mcg and reorder blood work in 6 weeks.I have done that and my T3 is back exactly where it was before the spike – however I feel horrible. The palpations have subsides somewhat but my hair loss is ongoing – extreme hair loss. Now the next step was to do an iodine uptake test but only if the T3 was high on the next set of tests ( obviously to see if it is the nodules that were causing the spike). So here is the issue I am having, on the lower dose I feel like I am moving through mud, extreme fatigue and brain fog ( which I already struggle with due to my autoimmune disease Bechets) – I am still losing hair, I still have some palpations, and my T3 went back to the exact ( and I mean exact) level of 3.6, my TSH and T4 have stayed the same – do you think the first set of blood tests with the spike in T3 was a lab error? Does my loss of 10lbs warrent that much of a difference as to effect my T3 ( which is what my endocrinologist believes was the issue )? Should I take the iodine uptake test anyway? And considering my family history of thyroid carcinoma ( my 39 years old cousin just had surgery and her nodules were found to be malignant), combined with my nodules being rated as TR4, is it possible that my endocrinologist is not seeing the picture clearly?
The palpations and the extreme hair loss is very disconcerting – combined with a lower dose of Armour resulting in the exact previous blood test Numbers when things were “normal” yet I feel horrible ( and we only went down by 15mcg) – just doesn’t make sense to me? Does it it make sense to you? I would love to know your thoughts? I am due to see a new endocrinologist – but cannot be seen until the end of May – pretty sure I will be bald by then… Thank you for reading this if you made it this far. I hope to hear back, sincerely – Cynthia
Hello Dr. Childs,
I’ve been taking 180 mg of Armour for the past few years with a low TSH (I’m s/p thyroidectomy after thyroid cancer in 2009), and normal T4 and T3. Over the past 9 months my TSH has steadily risen, my T4 is now low, and my T3 is very low normal.
I’m now experiencing symptoms of hypothyroidism.
My PCP considered increasing the dose, but I worried that I had already hit the max dose.
Should I be worried?
Thank you!
Hi Charlene,
You are on a fairly high dose already, though not the highest I’ve ever seen. It would be worth exploring other potential causes of hypothyroid symptoms before automatically assuming your current symptoms are related to your thyroid. Plenty of medical conditions can cause hypothyroid-esque like symptoms that will not go away with further increasing of your thyroid medication: https://www.restartmed.com/medical-conditions-that-mimic-hypothyroidism/
Hi Dr. Childs,
My thyroid was removed 2 years ago due to a goiter and I was on Synthroid 137. After watching you and researching some of my symptoms, I requested to go to Armor. My doctor reluctantly gave 2 Armor pills ( 1-60mg and 1-15mg). It’s been 32 days and I have more energy and mental clarity but heavy heart palpitations and hair is falling out. Was tested last week TSH 2.29, T4 low .08, T3 3.1. I was told T4 is normally low on Armor. Am I on the wrong dosage or is there a supplement that you offer that can help me optimize my thyroid health?