Graves' Disease Support Group
Graves-Basedow disease is a medical disorder that may manifest several different conditions including hyperthyroidism (over activity of thyroid hormone production), infiltrative exophthalmos (protruberance of one or both eyes and associated problems) and infiltrative dermopathy (a skin condition usually of the lower extremities). This disorder is the most common cause of...
So, long story short... I have been on Synthroid since my TT in 2010... added T3 (Cytomel) last year and felt AWESOME until 6 months later I got an excruiating headache like a migraine that would not go away. Endo took me off of the Cytomel suspecting that was the culprit and a week later- the headache vanished.... Three months after that, I started to drag my butt again and felt sluggish... I asked for Armour and he asked to try the Cytomel again so I obliged.... to every other day. Perfect again. But was worried that the headache from hell would return again. Went to my PCP and she refused to put me on Armour because my TSH was "too low" but according to my Endo- it was low because of the T3 I was taking. Went to my GYN who also deals with endocrinology patients and she happily prescribed Armour to me. I was elated! Fearful but elated! I skipped one day of my Synthroid (as I was taking at night) and started the Armour the next morning. Was taking Synthroid 112 mcg at bedtime and Cytomel 5 mcg every morning. She prescribed Armour 90 mg (1 1/2 grain). Day 1- took it 6 am, 2 pm, and 10 pm... stayed up ALL NIGHT with hot flashes. Day 2... 6 am, 10 am... skipped 2 pm.... due to HOT FLASH GALORE all day... what the heck? I thought Armour was like gold to thyroid patients? Is this normal? has anyone else experienced this? Here are my last two labs:
Date: 12/28/2012
Free T4: 1.21 (range 0.82-1.77)
Free T3: 2.2 (range 2.0-4.4)
TSH: 1.440 (range 0.450-4.500)
Note: I felt terrible in December- palps, extra tired all the time. Was not on T3.
Date: 3/15/2013
Free T4: 1.54 (same range)
Free T3: 3.3 (same range)
TSH: 0.243 L (same range)
Note: Felt better but still dragging my butt in the mornings taking the Synthroid at bedtime and T3 in the mornings. Endo stated TSH is low due to T3 suppressing it and refused to switch me to Armour til my TSH came up. How can it when I take T3?
Any advice, suggestions, and sympathy appreciated :).
Date: 12/28/2012
Free T4: 1.21 (range 0.82-1.77)
Free T3: 2.2 (range 2.0-4.4)
TSH: 1.440 (range 0.450-4.500)
Note: I felt terrible in December- palps, extra tired all the time. Was not on T3.
Date: 3/15/2013
Free T4: 1.54 (same range)
Free T3: 3.3 (same range)
TSH: 0.243 L (same range)
Note: Felt better but still dragging my butt in the mornings taking the Synthroid at bedtime and T3 in the mornings. Endo stated TSH is low due to T3 suppressing it and refused to switch me to Armour til my TSH came up. How can it when I take T3?
Any advice, suggestions, and sympathy appreciated :).
I have been having horrid hypO symptoms since before I was taken off methimazole early in December. I took myself off the MMI as soon as I had the blood work done, and in my follow up appointment the Endo commended me for doing the right thing, but has refused to supplement me, even though my Free T3 has been hoovering just above and below the bottom of the range since December.
Enough of myself, though. Personally, I think labs don't lie, but symptoms matter a lot as well. Doctors like to diagnose and treat by the TSH because the thyroid hormones fluctuate too much, especially the Free T3. I have requested monthly lab reports because I can never catch my FT3 fluctuating as much as my TSH. I also think my symptoms are mostly Hypothyroid. Symptoms may arise from having your hormones fluctuate too much, so changes to your supplements should be a more gradual thing.
Your labs seem to be:
Too low in the FT3 in December, about the bottom 10% of the range when it should probably be in the upper third of the range. In March it rose to almost the midpoint. The Cytomel is replacement FT3 and this is the hormone that is the most active in the body, probably relating the most to your symptoms. It also has a short half-life and a patient is usually told to take half in the morning and half 12 hours later. I don't really know, but I would think a person needs less when they are sleeping. Armour is comes from a pig's thyroid, hence, "natural" but it is higher in T3 replacement than in T4 for what humans need. It isn't for everyone, but many people do better on it.
Your FT4 was in the bottom half of the range in December and in the upper half of the range in March. Levothyroxine replaces that. So does Armour to a lesser extent. If doing Armour, I would think you would need a little Levothyroxine for a proper balance with the T3, but no supplemental T3 at the same time.
I would think Synthroid (levothyroxine) is always best taken in the morning a half an hour before eating. Whether Cytomel can be taken with food or not, I don't know, but I think the dose should be divided into two parts. I would think the first dose should be taken fairly early in the morning and the second dose about 8-10 hours later so you have some time for it to get lower in your system before trying to sleep and to avoid "night sweats". It is important to know that there can be an interaction between female hormones and the thyroid. [Whether this includes the thyroid hormones themselves or just the gland, I'm not sure.]
For me, migraines were mostly related to bone loss and bone loss can be related to the thyroid. If I get a migraine, just a few minutes in sunlight causes it to go away. I also get migraines if there is anything I am lacking that will help bones: Calcium, dietary vitamin D, Magnesium, Manganese, and also Fosamax, the pill I take for Osteopenia.
Whatever the causes of your symptoms may be, I think it is best to know what your thyroid hormone levels are when you are at your best, and aim to be in that portion of the normal range consistently while being treated for other conditions that may arise.