How can we monitor the results of treatment if the blood tests are inadequate to the job? We do this by how the person feels, whether or not the thyroid symptoms and signs have improved or disappeared, whether or not symptoms of an overactive thyroid gland have developed, and by monitoring the basal body temperature.

Generally, the dosage of Armour thyroid is best started at a low dose, with a gradual increase every week or two, until the optimal therapeutic dosage is reached. It may take four to six weeks at the optimal dosage to feel the full therapeutic benefits. In my practice, I generally start the patient on 1/4 grain or 15 milligrams daily. Every week or two, I increase the dosage by 1/4 grain per day until 1 to 2 grains daily are reached. Usually, the optimal dosage is in this range, provided that the patient is doing the other adjunctive necessary things, which I will discuss in a moment. Occasionally, the dosage may need to be 2 and a half grains daily or more. Full therapeutic benefits many not be fully realized for months and the basal temperatures may not come up to normal for a year or more. The dosage for infants is usually 1/8 to 1/4 grain daily and from one to six years old, the dosage is usually 1/4 grain. From 7 years to puberty, 1/2 grain is usually used, but it may need to be increased.

Special Cases: Recent Heart Attacks and Weak Adrenal Function
There are a few special cases that needs to be discussed in the context of this treatment. If a person has recently had a heart attack, treatment should not begin for at least two months following the heart attack. After that, the protocol discussed above can be used.

If a person has evidence of weak adrenal function, the adrenal gland problem must be treated first or simultaneous to the thyroid treatment. The reason for this is that hydrocortisone is necessary for the conversion of T4 to the active T3. If the weak adrenal is not addressed, the patient may actually feel worse and/or develop symptoms of an overactive thyroid gland, such as palpitations, a rapid heart beat and increased sweating. Clues to low adrenal functioning include a low blood pressure (less than 120/80), allergies, asthma, breathing difficulties, skin problems (such as acne, eczema, psoriasis, lupus, dry flaky skin), joint or muscle pains, as in arthritis, and emotional problems, such as mood swings, weeping, fears and phobias. Using low physiologic doses of hydrocortisone along with Armour Thyroid, when the patient shows evidence of both low adrenal and low thyroid function, will help to assure the desired results.

Problems in Converting T4 to the T3 Hormone
The conversion of the relatively inactive T4 to the active T3 thyroid hormone is an important process. As mentioned previously, frequently low thyroid function is not due to the low production of thyroxine, T4, by the thyroid, but due to the failure of conversion of T4 to T3 by peripheral tissues. What nutrients are necessary to help with this conversion? In addition to sufficient quantities of cortisol, iron, zinc, copper and selenium are necessary for this conversion. Deficiencies of any of these minerals can prevent the conversion T4 to T3 and should be corrected if present. Sufficient protein and especially the amino acid, tyrosine, and iodine are necessary to make T4 in the thyroid gland.

Another approach to the problem of conversion failure of T4 to T3 has been proposed by a young physician, Dennis Wilson. He has found that the body often adapts to various stressful situations by switching to a conservative mode in order to preserve energy. For example, when a famine occurs, an excellent adaptive change that the body can make in order to use less energy because food calories are unavailable, is to stop converting T4 to T3. However, this response appears to occur to a wide variety of stressors and sometimes this mode is not reversed, even after the stress is removed. This can lead to all of the symptoms and signs of a low thyroid that I have been discussing.