Testing for Thyroid, and when to take medication?

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    Testing for Thyroid, and when to take medication?


    Guys I am having some thyroid testing done (TSH, Free T3, Free T4) and I want to know, should I take my Armour (Combo of T4, T3, T2, T1, etc) the morning of the test before the blood is drawn or wait to take it till after? Thanks.

    Mr.50

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    Are you under the care of a physician and being prescribed this medication?
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    That was my first thought. If not and you get the thyroid test done you will show a hyperthyroid and they will want to give you medicine to bring down your metabolism.
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    Gray area B5150. I was under the care of a physician. He had me on 150mcgs of Synthroid (which was a mainenence dose) but he never measured anything except TSH and I was still symptomatic. Then he had a stroke and retired. At the same time I started back to school for a year and I now only have slightly better then disaster coverage for insurance. Because I will need a new doctor the cost out of pocket for a new Dr.s visit, blood work through the doctor, and follow up will be quite expensive. I was also able to obtain the Armour Thyroid from a reputable online place (no source posting here) and have been taking 2 grains of Armour per day split up into 2 doses throughout the day. I have had one set of blood work from August and now I am going to get another because I do not feel great (not bad but not quite right). I will not be surprised if I have to go to the doctor after the bloodwork and get put back on Synthroid or something else but I want to get this bloodwork done on my own so that I can go to the Doctor with it and try to cut out some of the steps and thus the cost. With that in mind when I go to get the blood drawn I just want to make sure I do not skew the results (especially the Free T3) by taking my Armour the morning of the test. Thanks.

    Mr.50

    Quote Originally Posted by B5150
    Are you under the care of a physician and being prescribed this medication?
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    If you are wanting real results you need to come off the armour. If it's a low dose you shouldn't have much of a problem but if you're dosing a bit more you may want to reschedule your appt so you don't go in there with seriously low thyroid either. My doc referred me to nuclear medicine when mine was off which required me to eat certain foods etc before getting it checked for the final time.
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    Whoops Jayhawkk. Not sure if I was clear, I was put on the Synthroid for what was a purportedly good reason (medical reason) at the time so if we assume now that I am on Thyroid medication for the long haul and just want to make sure I am in the physiological optimal level I would think I need to stay on the replacement dosage I am on, get the blood work done, and determine if the replacement dosage puts my blood values in the optimal range. With that in mind though because of the half life of T3 I want to make sure I do not cause a result that is artificially too high because the first hour or so after taking any preparation containing T3 likely will show a spike in T3 rather then an average value.

    Mr.50

    Quote Originally Posted by Jayhawkk
    If you are wanting real results you need to come off the armour. If it's a low dose you shouldn't have much of a problem but if you're dosing a bit more you may want to reschedule your appt so you don't go in there with seriously low thyroid either. My doc referred me to nuclear medicine when mine was off which required me to eat certain foods etc before getting it checked for the final time.
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    So you're wanting to see where you are with being on this replacement...Gotcha. I would not dose the morning of. I may be missing the mark here(which is known to happen) but with the halflife of t-3 The previous day would be plenty to be in the system.
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    Thanks bro. I think in the past I remembered Dr.D or Dr. John mentioning something to that effect but I could not find it and I want to make sure at least if I am paying the money for the tests I am going ot get reliable results.

    Mr.50

    Quote Originally Posted by Jayhawkk
    So you're wanting to see where you are with being on this replacement...Gotcha. I would not dose the morning of. I may be missing the mark here(which is known to happen) but with the halflife of t-3 The previous day would be plenty to be in the system.
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    My Dr. told me not to take Armour before the blood test and my wifes Dr. told her the same thing.
    Phil
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    Thanks Phil.

    Mr.50

    Quote Originally Posted by pmgamer18
    My Dr. told me not to take Armour before the blood test and my wifes Dr. told her the same thing.
    Phil
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    I agree Dr. John but i thought that because of the absorbtion and half like of the T3 in Armour it might give artificially high results if take too close (or just the right/wrong amount of time) to the time the blood is drawn rather then an average or truely representative value of T3 in the blood for most of the day.

    So are you saying that your reccomendation is to take the Armour in the morning on an empty stomach before going to get the blood drawn?

    Mr.50

    Quote Originally Posted by Dr. John
    Well, let's think this through for a second. Why are we running the test? To find out what current dosing is achieving in the bloodstream.

    So, how can we see how much of the drug is finding its way into the bloodstream if you do not take the drug?

    Makes dose titration kinda difficult, doesn't it?
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    Quote Originally Posted by Dr. John
    Well, let's think this through for a second. Why are we running the test? To find out what current dosing is achieving in the bloodstream.

    So, how can we see how much of the drug is finding its way into the bloodstream if you do not take the drug?

    Makes dose titration kinda difficult, doesn't it?
    I hear yea but this is what the Dr. wants why I have no Idea maybe they are not as good at reading labs most I am finding are not they for get the test is based on a bell curve. They go by your in the normal range so your OK. We see this all the time guys are low normal on T but there levels are only normal for a man 85 yrs old but to most Dr.'s your in the normal range so you must be Depressed. Here is a good cut & paste on this.

    When’s the last time you went to the doctor and gave a blood sample – that was then sent to a lab? Chances are that lab result came back ‘normal’. Too often, when interpreting lab values, the doctor looks for normal rather than optimal.

    A comparison of values relative to each other yields a great deal of information that would be lost if the values were viewed independently of each other. For example, if the normal height for a man is between 5’3” and 6’ and normal weight is between 130 lbs and 200 lbs., scanning the results column of a lab or other report (for flagged abnormal values) would declare a man who is 5’3” tall weighing 200 lbs to be just as normal as a man 6’ tall weighing 135 lbs. Both are in the ‘normal’ range and therefore would be considered normal. In reality, however, simply looking at a short/obese man next to a tall/thin and a possibly undernourished man would suggest that the two are more than likely not in the same state of health.

    Phil
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    My girlfriend is hypothyroidic and her doctor has her take her Armour before her blood testing in the AM. Doctor told her to do that so the blood work that comes back can determine if you infact need a bump in medication or not.

    When you go in, tell the doc that you already took your Armour pills.
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    Dr. John any chance you can look this one over and point me in the right direction here before I get screwed up blood test results and have to do them over again. Thanks.

    Mr.50

    Quote Originally Posted by Mr.50
    I agree Dr. John but i thought that because of the absorbtion and half like of the T3 in Armour it might give artificially high results if take too close (or just the right/wrong amount of time) to the time the blood is drawn rather then an average or truely representative value of T3 in the blood for most of the day.

    So are you saying that your reccomendation is to take the Armour in the morning on an empty stomach before going to get the blood drawn?

    Mr.50
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    Quote Originally Posted by Dr. John
    What exactly is he testing then? IOW, what question does the lab result answer?

    This strategy makes absolutely no sense. If she is not on the medication, OF COURSE it would like she needs (more) medication.
    She says its so he can make sure that her levels are stable throughout the day, and that enough medicine is actually getting into her bloodstream to help out. This way he knows if he needs to increase the dose or lower it depending on her test results and basal temperature each morning 2 weeks prior to the blood test.

    I think he goes by the temp each morning leading up to see how her levels are without a lot of help, then he wants the blood tests done with her Armour pills for the reason listed above.
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    Those are the tests I ordered Dr. John but what I was really wondering was on the morning of the test (fasting) should I take my Armour, and if so approximately how long before the blood is drawn? Thanks.

    Mr.50

    Quote Originally Posted by Dr. John
    That's the way I do it.

    I run a TSH, fT4 and fT3.
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    Quote Originally Posted by Dr. John
    Well, let's think this through for a second. Why are we running the test? To find out what current dosing is achieving in the bloodstream.

    So, how can we see how much of the drug is finding its way into the bloodstream if you do not take the drug?

    Makes dose titration kinda difficult, doesn't it?


    Armour Thyroid – Frequently Asked Questions
    From Armour Thyroid website
    How and when should I take my Armour® Thyroid?


    ANSWER
    Armour Thyroid should be taken as your doctor or other healthcare professional prescribes. Typically, treatment consists of a specific dose taken daily, usually once in the morning.

    I would reason like this:
    1. Armour Thyroid is taken once every 24 hrs
    2.You want to know (mostly) your FreeT3 level, with T3 having somewhat short half life, its bood level fluctuate.
    3. After taking a pill, assume, your FreeT3 level rises 25% of the time, then stays level 50% of the time and then it lowers for 25% of the time. That is: 6hrs, 12hrs, 6hrs
    4. You want to make a blood draw when FreeT3 is level
    5. Couple days before the blood draw, adjust you Armour Thyroid taking time (plus/minus few hrs) accordingly
    6. You probably won't go wrong with 3hrs (rise), 18hrs (level), 3hrs (lowering), so your window is that much bigger.
    ------------------------------------------
    It would help to know half life of T3 in the body after Armour Thyroid is taken.
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    I am not trying to start anything here but this is a cut & paste from one the biggest Thyriod web sites.

    We have found it wise NOT to take our Armour before we do our scheduled labs. Why? Because the direct T3 peaks within a few hours after we take our Armour, causing our free T3 to look high and give a false impression of hyper.
    Phil
    Quote Originally Posted by JanSz
    Armour Thyroid – Frequently Asked Questions
    From Armour Thyroid website
    How and when should I take my Armour® Thyroid?


    ANSWER
    Armour Thyroid should be taken as your doctor or other healthcare professional prescribes. Typically, treatment consists of a specific dose taken daily, usually once in the morning.

    I would reason like this:
    1. Armour Thyroid is taken once every 24 hrs
    2.You want to know (mostly) your FreeT3 level, with T3 having somewhat short half life, its bood level fluctuate.
    3. After taking a pill, assume, your FreeT3 level rises 25% of the time, then stays level 50% of the time and then it lowers for 25% of the time. That is: 6hrs, 12hrs, 6hrs
    4. You want to make a blood draw when FreeT3 is level
    5. Couple days before the blood draw, adjust you Armour Thyroid taking time (plus/minus few hrs) accordingly
    6. You probably won't go wrong with 3hrs (rise), 18hrs (level), 3hrs (lowering), so your window is that much bigger.
    ------------------------------------------
    It would help to know half life of T3 in the body after Armour Thyroid is taken.
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    Quote Originally Posted by pmgamer18
    I am not trying to start anything here but this is a cut & paste from one the biggest Thyriod web sites.

    We have found it wise NOT to take our Armour before we do our scheduled labs. Why? Because the direct T3 peaks within a few hours after we take our Armour, causing our free T3 to look high and give a false impression of hyper.
    Phil
    All this may be a splitting hairs.
    If daily FreeT3 variations are large then time of blood testing is important.
    But if it is that important then may be it is also good idea to take Armour Thyroid twice daily to have more steady levels.
    I do not have real info, just guessing.
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    I do take mine twice per day. But I am still wondering if I should take it before the bloodwork or not? I am leaning towards what gammer says and not planning on taking it.

    Mr.50

    Quote Originally Posted by JanSz
    All this may be a splitting hairs.
    If daily FreeT3 variations are large then time of blood testing is important.
    But if it is that important then may be it is also good idea to take Armour Thyroid twice daily to have more steady levels.
    I do not have real info, just guessing.
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    Quote Originally Posted by JanSz
    All this may be a splitting hairs.
    If daily FreeT3 variations are large then time of blood testing is important.
    But if it is that important then may be it is also good idea to take Armour Thyroid twice daily to have more steady levels.
    I do not have real info, just guessing.
    Most of the people at the sites do take there Armour 2 - 3 times a day for this reasion.
    Phil
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    Quote Originally Posted by Dr. John
    I'll start something. LOL.

    My guys tell me when they take the Armour, and I look on the lab report to see when the draw was. Loosely predicting by the PK's of the T3, AND patient response, helps us adjust dose.

    Here's the simple, undeniable point: you cannot dose a drug by lab testing if you did not take the drug!

    This is essential as we rely upon FreeT3 as the most important assay.
    If you say it then in my mind it is true your much better then any Dr. I have ever seen in my life.
    Phil
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    Quote Originally Posted by Dr. John
    If you do that, then T3 will be low, giving the impression of being under-treated.

    Of course, if the doc actujally lifts his/her eyes from the lab printout long enough to ask how the patient is feeling, lots of important info can be garnered.
    Here is my DR. "Well Phil your labs look dam good then I say but I don't feel all the great then the Dr. says you labs don't show this and the beat goes on." They broke the mold after you were born.
    Phil
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    Quote Originally Posted by Dr. John
    Yup. Free T3's half-life is about 7 hours. 7 days for T4/7 hours for T3. Take the Armour first thing in the morning, then again mid-afternoon. Later can keep you up at night.
    Going back to when to draw blood for test;
    basing on 7 hrs T3's half life,
    theoretally,
    I would say 3.5 hours after the Armour Thyroid was taken.
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    Quote Originally Posted by JanSz
    Going back to when to draw blood for test;
    basing on 7 hrs T3's half life,
    theoretally,
    I would say 3.5 hours after the Armour Thyroid was taken.
    I see my Dr. this Tue. and I will ask him how he feels about this again.
    Thanks Phil
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    OK well now I have a plan.

    Mr.50
    Quote Originally Posted by Dr. John
    That would be just fine.
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