Thyca and Armour

accsupport7

I was dx with thyroid cancer--papillary with follicular variant 12/05. I had my thyroid removed and a bilateral neck dissection because of nymph node met. 12/06 I had another lymph node removed and am having my 3rd ablation in March. The doctor thinks the 1st ablation didn't do any good because I was VERY sick and didn't keep it down more than a few hours. My last thyroglobulin was 20 but that was before the malignant lymph node was removed in December. I've been reading ALOT lately and find that most oncologists do not recommend Armour because of possibly inconsistent dosages. My oncologist tells me that as long as I am suppressed that it is ok since I feel so good on it. I never really felt ok on synthroid and switched to Armour only 1 month before my original thyca was dx. My question is whether Armour is ok AS LONG AS my TSH is monitored carefully and frequently. I am tested every once so I know it is almost at 0 all the time. Please respond if you have any specific info and if you know how, if at all, Armour affects thyroglobulin levels.

My other question is--I have negative thyroglobulin antibodies and I hear that affects how thyroglobulin levels could be interpreted. Any info on that. Thanks

Rustifox

IF your TSH is monitored very, very frequently - I would want it measured monthly - and it ALWAYS stays at 0, then armour may be fine for you, providing you have no cardiac issues, etc.

It is not considered to be as 'stable' as other Brand Name levothyroxine products on the market, so the critically important thing for you is to make sure your TSH never varies - it needs to be stable, extremely stable with active cancer.

At the same time, I personally would hesitate to use a product that contained pig thyroids, and Armour has had, in past, significant problems with it's stability, so being guaranteed that you have reliable product may be an issue - consistency of always receiving the exact same dose every day is critically important in your situation:
http://thyroid.about.com/b/a/171171.htm

If you had problems with a specific dose of synthroid, there are other "BRAND" names, like Levoxyl, Unithroid, and others that may work better for you - or another alternative is to take the 50mcg dose of synthroid (ie if you take 200mcgs, then take 4 x 50mcgs instead); the 50mcg dose has no dyes, etc - it is the 'purest' form of levothyroxine on the market. Some people do have reactions to the dyes in the various doses, so that might be another option.

Typically, our body produces as much T3 as we need, so Armour is not suggested for us, and many of the best endos are dead set against thyroid cancer patients taking it - but if it truly always makes you feel better, as long as your TSH is ALWAYS checked, and always remains exactly where it should, it is your life... Quality of life becomes very important in the long run.

The comments below are often heard from thyroid cancer treating endo's on this topic:
source: http://www.thyroid-cancer.net/resources/answers.php3
"Q: I just had my thyroid removed because of thyroid cancer, so I will need thyroid medication from now on. I have been reading about the possible shortcomings of thyroxine (T4) for thyroid hormone replacement, and about the use of desiccated (Armour) thyroid as an alternative. What are the facts?

A: For patients who have had thyroidectomy for thyroid cancer, there are two reasons that lifelong thyroid hormone replacement is vital. First, it replaces the thyroid hormone that the gland is no long present to provide. Second, it suppresses the pituitary gland's production of thyroid-stimulating hormone (TSH), which can otherwise promote the regrowth of thyroid cancer. For virtually all patients, thyroxine (T4) is the drug of choice. The normal thyroid itself makes mainly T4, which is then converted to the more active thyroid hormone T3 in target tissues, like the brain, heart, liver, and skin. T4 mimicks this natural process. It also has a stable level in blood and steady tissue action, even when taken just once per day. In contrast medications containing T3, like desiccated thyroid, can cause ups and downs in T3 levels and actions during the course of the day. Because desiccated thyroid also contains T4, which is then converted to more T3, the T3 level is above normal for at least part of the day in most patients. This can sometimes cause nervousness, insomnia, palpitations, tremor and fatigue. In the long-term, it can predispose to bone mineral loss (osteoporosis) and an irregular heart rhythm called atrial fibrillation. There can a temporary use for T3 therapy: when thyroid hormone must be opped for radioiodine scanning and treatment. Its faster offset of action shortens the period of thyroid hormone deficiency. In other settings, thyroxine (T4) is the most stable, effective, and safe form of thyroid hormone replacement. Its conversion to T3 in target tissues also makes it the most "natural" way to replace the function of the missing thyroid gland."

Does Armour affect thyroglobulin? Not to my knowledge - TSH and lack of of T4 do, though... I have to say that in your circumstances, I personally would opt to take T4 - levothyroxine - of any kind (except the generics... not a good idea for you, either) over armour. It is best not to take a generic levothyroxine, either - here is why:
http://www.aace.com/pub/pdf/guidelines/AACE-TES-ATA-ThyroxineProducts.pdf

Lastly, as long as your thyroglobulin antibodies remain negative, then they do not factor in on your thyroglobulin levels at all - if they were positive, it would make thyroglobulin levels less valuable/unreliable as cancer markers in monitoring you. With negative antibodies, the thyroglobulin levels are a 'trustworthy' marker of monitoring your condition, along with I-131 scans, and ultrasound. If your TSH varies, the thyroglobulin levels will vary, too, though... so again, stable TSH is really important to be comparing 'apples to apples' as far as your thyroglobulin levels are concerned.

I'm sorry you are having to deal with such persistent disease, and hope that this 3rd ablation, along with the surgery removing the node will finally put chasing this thyroglobulin behind you, with clear check ups in future. All the best, and hope some of the above might help a bit, information wise. Take care, and again - all the best to you with the March ablation.