Hypothyroidism Support Group

I started on levothyroxine in March of last year and, after dealing with the titration process, was doing well from last fall forward.

Then, in January of this year, some minor hypo symptoms developed.

At the time, I was taking 75mcg levo and, my FreeT4 level was in the upper third of the range but, my FreeT3 level had dropped to mid-range.

I had already learned that I need both my FreeT4 and FreeT3 levels at least in the upper third of the range (and still feel good with both at the top of the range).

So, my doctor started me on 5mcg Cytomel.

Now, after my doctor added Cytomel, I had the common experience of my FreeT4 level decreasing (it's a biochemical thing).

It took 4 levo dose increases to restore my FreeT4 level.

Adding Cytomel only makes sense if your FreeT4 level is in an appropriate place (upper half/upper third of the range) and your FreeT3 level is lagging behind.

This indicates a problem with converting the T4 storage hormone in your levo into T3, the active hormone.

There's a chance you just might need an increase in your levo dose. 50mcg is a pretty small dose....in fact, it's a common starting dose.

And, "shady abnormal" doesn't sound good.

Is your doctor just looking at your TSH? Thyroid-savvy doctors know to look at the actual thyroid hormone levels - FreeT4 and FreeT3 for dosing rather than pituitary hormone TSH.

And, thyroid-savvy doctors will adjust the patient's dose until their FreeT4/T3 levels are similar to those that healthy people would have - FreeT4 towards the higher end of the range and FreeT3 above mid-range.

This is documented in thyroid textbooks but, it does seem like many doctors were sleeping through thyroid class.

How about sharing some recent labs? And, why doesn't your doctor want to change your dose?

Quite honestly, a doctor that doesn't want to increase a levo dose will most likely not be interested in Rx'g Cytomel.

Oh, almost forgot to mention, I am currently taking alternating doses of 112/125mcg levo....and 5 mcg liothyronine (generic Cytomel) and I'm symptom-free.

Truly, age, weight and height don't have much to do with whatever dose a person takes. We take whatever dose we need to optimize our levels....and then maintain those optimal levels.