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Ask Dr. D. Love Your Own Question

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17525
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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My 85 year old mother is taking Eltroxin for an underactive

Customer Question

My 85 year old mother is taking Eltroxin for an underactive thyroid. From what I have read Armour is better for this condition. She is on several medications for arthritis. But I suspect she is suffering from several of the negative side effects of Eltroxin. Also, I am not confident that her GP is monitoring her blood regularly, to check the correct dosage of Eltroxin is being perscribed? I am wondering if she should switch to Armour?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
Hello from JustAnswer.

There are a couple of different issues in this situation.

It is not a true statement that everyone with hypothyroidism will do better on Armour thyroid. Most people do well on a thyroid replacement pill that contains only levothyroxine, or T4, such as the Eltroxin. However, there are a group of people that subjectively do better on a thyroid replacement pill that contains both T4 and T3, such as Armour thyroid. If someone is still having typical hypothyroid symptoms while taking the Eltroxin, it is a reasonable option to consider Armour thyroid replacement to see if it is more effective.

There also is a potential issue regarding the goal of the thyroid blood tests. In most people, they will do well when the thyroid replacement dose is sufficient to lower the TSH into the normal range. However, there is evidence that some people do better with a slightly more aggressive treatment, and achieving a TSH that is low in the normal range, such as around 0.5 - 1.0. So, if the TSH is in the middle or upper portion of the normal range and she is still having hypothyroid symptoms, it also would be reasonable to consider a higher dose of thyroid replacement (of whichever drug is being used) to achieve a TSH in the lower portion of the normal range.

The frequency of monitoring thyroid blood tests depends upon the individual patient and the level of control of symptoms and stability over time. In someone with many years of good control of symptoms on a stable dose of thyroid replacement, the thyroid blood tests do not need to be checked as often, usually only 1-2 times per year. However, in someone with poor control of symptoms or a need for frequent adjustment of doses, it would be appropriate to monitor the thyroid blood tests more often, about 3-4 times per year, and about 6 weeks after any change in dose.

Many primary care physicians are comfortable in dealing with thyroid replacement for most people with hypothyroidism. However, if someone is still having symptoms despite the best management by their primary care physician, it would be appropriate to seek consultation with an Endocrinologist, who would be better able to consider these other options.

If I can provide any further information, please let me know.

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