pmgamer18
Well-known member
I asked Dr. Marianco at a Men's Health Forum I am a member at this Dr. is great he takes time out of his busy life to answer Questions for free. He is at this site doing research on low Hormones and Depression he believes most problems with Depression are caused by Adrenal Fatigue, Thyroid and low Hormones like us men with low Testosterone.
Here is a cut & paste on his reply to me.
Phil
marianco thanks again I picked up my Armour yesterday and my Dr. gave me 15mgs. to take once a day. I told him I had been taking some my wife had left over that was 1 grain 60 mgs. he told me this is to strong to start with. I know this maybe putting you on the spot but what dose do you start with. I can't see doing this low a dose for 7 weeks then test to see if I need more. I just feel to dam good to lower it.
Dr. Marisnco's reply sounds like most of what is said here and at Stop The Thyroid Madness.
The dose range for Armour thyroid varies between 15 mg to 300 mg a day - generally in two divided doses since T3 may last only 8 hours.
If a person has heart problems, then the usual top dose is 120 mg a day. There is a risk of atrial fibrillation from high T3 levels when a person has heart problems such as having had a heart attack. It is possible to go higher but one needs a lot of thinking and deliberation about the risks involved and whether or not it is worth it. T3 does have some anti-arrhythmic property - reducing the risk for ventricular tacchycardia - a frequently fatal irregular heart beat.
One can gauge the dosing by how much faster the heart beats compared to baseline. If the resting heart beats more than 10 beats more per minute compared to baseline, than the increase in dose may be too high and too fast. If the resting heartbeat goes past 100 beats per minute, then the dose may be too high. If there is significant anxiety or if the heart rate is fast because blood pressure is low, etc., then using the pulse as a gauge in treatment may be more difficult and other signs and symptoms may be then used to measure response to treatment.
Ramping up too fast can exacerbate adrenal fatigue - which risks worsening the person's overall condition. Then it is important to pull back on the dose, allowing time for the body to get use to a dosage level (say about 2-4 weeks), before trying again to increase the dose.
Most people tolerate starting at 30 mg of Armour Thyroid a day (about 1/2 a grain). If in good health otherwise, many tolerate starting at 60 mg a day. If the person is fragile in health or has significant adrenal fatigue, then I may start at 15 mg a day. Then I may ramp up in dose by 15 mg or 30 mg every 2 weeks as tolerated (i.e. so long as significant symptoms of hyperthyroidism do not show up), to an initial plateau of 60 mg before getting lab tests, then if needed, gradually increasing the dose every 2 weeks to 120 mg a day. If signs of excessive dose shows up, I have the patient reduce the dose. If the person is fragile in health, a slower ramp up may be needed. If reasonably safe and needed, ramping up to higher doses is done at a more gradual pace - e.g. changes occurring once a month.
I try to be flexible about it, giving the patient some leeway to decide what is a tolerable and effective dose for him or herself, while keeping in mind the boundaries of safety. I usually give instructions and a flexible dose to allow this.
Patients can monitor their blood pressure and pulse to help determine the dosing of thyroid hormone. Blood pressure may be reduced if hypothyroidism has contributed to hyperthyroidism. Blood pressure may be low if adrenal fatigue is worsened. The pulse helps determine if a hyperthyroid state is present.
It is more important to pay attention to the signs and symptoms of hypothyroidism (and of hyperthyroidism if the dose is too high)during the dose adjustments than the lab tests. This is particularly true when a person has hypothyroid signs and symptoms and has normal baseline thyroid levels (e.g. mitochondrial disease).
The signs and symptoms of hypothyroidism - such as dry skin, lack of energy, cold intolerance, etc. - should go away as an appropriate dose is reached.
Interactions with other neurotransmitters and hormones need to be attended to. For example, thyroid hormone increases serotonin production. If the patient is on an SSRI, then signs of excessive serotonin levels (such as restlessness or agitation) may occur. The SSRI may need to be then reduced. If the patient loses weight, then thyroid levels may be reduced. The dose of Armour Thyroid may then need to be increased. Should adrenal fatigue show up, then it should be treated simultaneously with thyroid hormone treatment.
__________________
Any statement I make on this site is for educational purposes only and is subject to change. It does not constitute medical advice, does not substitute for proper medical evaluation from physician, does not create a doctor/patient relationship or liability. If you would like medical advice, you will have to make an appointment. Thank you.
--------------------------------------------------------------------------------
Last edited by marianco : Today at 03:33 AM.
Here is a cut & paste on his reply to me.
Phil
marianco thanks again I picked up my Armour yesterday and my Dr. gave me 15mgs. to take once a day. I told him I had been taking some my wife had left over that was 1 grain 60 mgs. he told me this is to strong to start with. I know this maybe putting you on the spot but what dose do you start with. I can't see doing this low a dose for 7 weeks then test to see if I need more. I just feel to dam good to lower it.
Dr. Marisnco's reply sounds like most of what is said here and at Stop The Thyroid Madness.
The dose range for Armour thyroid varies between 15 mg to 300 mg a day - generally in two divided doses since T3 may last only 8 hours.
If a person has heart problems, then the usual top dose is 120 mg a day. There is a risk of atrial fibrillation from high T3 levels when a person has heart problems such as having had a heart attack. It is possible to go higher but one needs a lot of thinking and deliberation about the risks involved and whether or not it is worth it. T3 does have some anti-arrhythmic property - reducing the risk for ventricular tacchycardia - a frequently fatal irregular heart beat.
One can gauge the dosing by how much faster the heart beats compared to baseline. If the resting heart beats more than 10 beats more per minute compared to baseline, than the increase in dose may be too high and too fast. If the resting heartbeat goes past 100 beats per minute, then the dose may be too high. If there is significant anxiety or if the heart rate is fast because blood pressure is low, etc., then using the pulse as a gauge in treatment may be more difficult and other signs and symptoms may be then used to measure response to treatment.
Ramping up too fast can exacerbate adrenal fatigue - which risks worsening the person's overall condition. Then it is important to pull back on the dose, allowing time for the body to get use to a dosage level (say about 2-4 weeks), before trying again to increase the dose.
Most people tolerate starting at 30 mg of Armour Thyroid a day (about 1/2 a grain). If in good health otherwise, many tolerate starting at 60 mg a day. If the person is fragile in health or has significant adrenal fatigue, then I may start at 15 mg a day. Then I may ramp up in dose by 15 mg or 30 mg every 2 weeks as tolerated (i.e. so long as significant symptoms of hyperthyroidism do not show up), to an initial plateau of 60 mg before getting lab tests, then if needed, gradually increasing the dose every 2 weeks to 120 mg a day. If signs of excessive dose shows up, I have the patient reduce the dose. If the person is fragile in health, a slower ramp up may be needed. If reasonably safe and needed, ramping up to higher doses is done at a more gradual pace - e.g. changes occurring once a month.
I try to be flexible about it, giving the patient some leeway to decide what is a tolerable and effective dose for him or herself, while keeping in mind the boundaries of safety. I usually give instructions and a flexible dose to allow this.
Patients can monitor their blood pressure and pulse to help determine the dosing of thyroid hormone. Blood pressure may be reduced if hypothyroidism has contributed to hyperthyroidism. Blood pressure may be low if adrenal fatigue is worsened. The pulse helps determine if a hyperthyroid state is present.
It is more important to pay attention to the signs and symptoms of hypothyroidism (and of hyperthyroidism if the dose is too high)during the dose adjustments than the lab tests. This is particularly true when a person has hypothyroid signs and symptoms and has normal baseline thyroid levels (e.g. mitochondrial disease).
The signs and symptoms of hypothyroidism - such as dry skin, lack of energy, cold intolerance, etc. - should go away as an appropriate dose is reached.
Interactions with other neurotransmitters and hormones need to be attended to. For example, thyroid hormone increases serotonin production. If the patient is on an SSRI, then signs of excessive serotonin levels (such as restlessness or agitation) may occur. The SSRI may need to be then reduced. If the patient loses weight, then thyroid levels may be reduced. The dose of Armour Thyroid may then need to be increased. Should adrenal fatigue show up, then it should be treated simultaneously with thyroid hormone treatment.
__________________
Any statement I make on this site is for educational purposes only and is subject to change. It does not constitute medical advice, does not substitute for proper medical evaluation from physician, does not create a doctor/patient relationship or liability. If you would like medical advice, you will have to make an appointment. Thank you.
--------------------------------------------------------------------------------
Last edited by marianco : Today at 03:33 AM.