It's Stella--just to lazy to do the sign up thing.

My story: diagnosed with type 1 diabetes 11/04. Shock--thought it might be a thyroid issue since some of the symptoms are similar and I have a family history. Anyway, part of the blood tests to do diagnosis showed a low normal (10% of range) T4, low normal (30% of range) T3, fairly normal TSH--but elevated TPO antibodies. Getting the diabetes under control was priority one.

But once I did that and still had fatigue, weight gain, dry skin, etc., I asked about treating the thyroid. The TSH had gone up to 3.93 by this time, so the endo agreed and started me on the lowest dosage of Synthroid. I gained 9 lbs. in 4 weeks.

She raised it to 75 mcg. and later at my request added 15 mg of Armour. My most recent levels were: TSH .66, T3 3.35 (55% of range), T4 1.11 (31% of range). Symptoms were pretty much unresolved with the exception of the AM fatigue--I take my meds @ 6 am and then chill out until 7 am. It's easier to get out of bed these days.

Even with those test results I was able to get her to up the dosage to 100 mcg of Unithroid (switched for several reasons) and staying with 15 mg of Armour. I seem to be converting T4 to T3 pretty well, so I don't know that I need more than that. I do have issues with joint/muscle pain/stiffness that I never had prior to medication. If it doesn't resolve, I may consider asking for another 15 mg of Armour and take one pill in the AM and the other before dinner.

The regimen I am on is a 98%/2% combo recommended by Dr. Ken Blanchard:

http://www.enotalone.com/article/3531.html

It makes sense to me--especially since I don't have a conversion problem.

Dr. Ridha Arem, author of The Thyroid Solution advocates 6-10 mcg of T3 added to the T4 dosage. You may already know this but each 15 mg of Armour contains 9 mcg of T4 and 2.25 mcg of T3. It's an 80/20 split. The human body is more like 93/7 so the additional T3 cause be a bit much for many people to handle.

Regarding your pituitary gland--it may not actually be "broken" but it's definitely not used to the amount of T3 that is coming into your system now. It senses the hormone and says "Enough. Shut down." Your metabolic system setpoint may be lower from having decreased (and lower than necessary) thyroid hormone in your system. Point is, you're healthy when you FEEL healthy not when your pituitary gland says you are.

If the lower dosage isn't quite cutting it for you and your doctor is squeamish about raising you back up, ask her to add a bit of T4. It should bring your T4 up without suppressing your TSH.