It's really too bad your doctor isn't checking your FreeT3 level. The "plain" T3 test you had done checks T3 that is bound to proteins and not usable by the body.

*Maybe* your FreeT3 level is elevated like your T3 level is.....since there's a test to measure usable hormone, I don't understand why doctors choose to guess.

You *could* be on too much Cytomel so, the slow and steady approach would mean lowering your dose by 2.5mcg/day.

Even though we don't use TSH for dosing purposes, your TSH is higher than someone optimally medicated on any form of T3 might have. That tells us one/both of your thyroid hormone levels is too low for you.

And, without a doubt, your FT4 is way too low - it's near the bottom end of the range.

Now, decreasing your Cytomel dose will lower your FT3 level but, with less exogenous T3, your body could very well use more of your T4 for conversion to T3. So, lowering your Cytomel dose could actually cause your FT4 level to decrease.

When a patient has FT4 below mid-range, most doctors would increase the Synthroid dose by 25mcg - I think you might want to discuss that with your doctor as well. You might find the need for another dose increase down the line but, 25mcg is really the largest increase anyone should try at one time.

Slow and steady wins the race.

For whatever it's worth, Armour isn't hard to regulate. However, there's no guarantees that Armour will work for you - some people have trouble with the cellulose used as a filler and just don't absorb it properly. In addition, you might find that you need to take some Synthroid with the Armour to balance your FT4/FT3 levels.

That said, since you are responding to Synthroid/Cytomel and "just" need better labs, the dose adjustments I suggested seem to make more sense.

I'm glad the doctor is willing to try something new.

Best of luck to you moving forward - please keep us posted!

Thank you for getting back to me so quickly. I am so busy with work, school and my three teenagers I can't get on here. I am glad she will switch it and we can see what happens. I don't get why she didn't run the free T3 either? I am going to ask her to next time.

I get anxious and hot after meds and then tired. I explained this to her and she said she is willing to try and see what happens. That is the good news. I have to try to stick with one doctor after the 7or 8 that I tried. I do like one but it's a four hour wait and it's in a bad area near NYC so I hate to go back there. Last time a homeless man wanted money and was screaming at cars while they were at a light. NOT FUN!
You are amazing and thanks for always helping me and others on this site! It's greatly appreciated. :)

Happy to help.

I can't remember if you're doing this already but, please know that Cytomel is best taken in divided doses since it has a short half-life.

Most of us taking Cytomel divide the daily dose into two/day.....one in the morning and the other about 6 hours later (and never later than 3PM).

Since you will most likely be going down to 10mcg, taking 5mcg in the AM and the other 5mcg 6 hours later could help with any hyper symptoms after the dose and prevent an afternoon crash.

The more consistent you are with dose timing, the better you'll feel.

CD - Because of you I demanded a T3 test. I'm waiting for results now. To my surprise, my doctor thinks it's a good idea to switch out my dosage to synthroid/cytomel combo or armour depending on what T3 test show. Will post results for you later.

@MButterfly

Great news!! (reading this stuff makes me happy :)

If you are doing well on Synthroid, it might be easier to add Cytomel if your labs show the need.

While many people do well on Armour, some have trouble absorbing it due to the cellulose used as a filler. And, others need a higher FreeT4 level than what Armour can usually provide.
(since Armour is made from porcine thyroid that has a larger proportion of T3 than T4 compared to human thyroid, people taking it will have a FreeT3 level that is proportionately higher in the range than their FreeT4 level - most people are fine with this....those who aren't usually add a small amount of T4 in the form of Synthroid).

Just so you know, I'm leaving for vacation on Sunday and won't be back until 8/20.....hope you're able to post your labs before then.

Without a doubt, you will reap the benefits from being proactive with your care.

@MButterfly

Great news!! (reading this stuff makes me happy :)

If you are doing well on Synthroid, it might be easier to add Cytomel if your labs show the need.

While many people do well on Armour, some have trouble absorbing it due to the cellulose used as a filler. And, others need a higher FreeT4 level than what Armour can usually provide.
(since Armour is made from porcine thyroid that has a larger proportion of T3 than T4 compared to human thyroid, people taking it will have a FreeT3 level that is proportionately higher in the range than their FreeT4 level - most people are fine with this....those who aren't usually add a small amount of T4 in the form of Synthroid).

Just so you know, I'm leaving for vacation on Sunday and won't be back until 8/20.....hope you're able to post your labs before then.

Without a doubt, you will reap the benefits from being proactive with your care.

@MButterfly

Great news!! (reading this stuff makes me happy :)

If you are doing well on Synthroid, it might be easier to add Cytomel if your labs show the need.

While many people do well on Armour, some have trouble absorbing it due to the cellulose used as a filler. And, others need a higher FreeT4 level than what Armour can usually provide.
(since Armour is made from porcine thyroid that has a larger proportion of T3 than T4 compared to human thyroid, people taking it will have a FreeT3 level that is proportionately higher in the range than their FreeT4 level - most people are fine with this....those who aren't usually add a small amount of T4 in the form of Synthroid).

Just so you know, I'm leaving for vacation on Sunday and won't be back until 8/20.....hope you're able to post your labs before then.

Without a doubt, you will reap the benefits from being proactive with your care.

Thanks CD! she wants to try 125 Synthroid and 5 cytomel. I thought she would drop theCytomel to 10 but she went lower. Time will tell

I am not familiar with cytomel. Is it a thyroid med used in conjunction with synthroid/armour thyroid?

Hope you can get your number at a theraputic level soon.

Cytomel is a T3 drug. Your body needs T3 and T4 and basically I was told my body doesn't convert the T4 drug (Synthroid) to T3 so that is why I take Cytomel as well.

Thank you! I have been Hypothyroid for fourteen years. I have one doctor in a very bad area near NYC that would help me but because he is so good you have to wait four hours to see him. His office staff is horrible.

Then I went to another doctor that was know for helping people, yet he was a pervert and he put me 25 Cytomel and 100 Synthroid and I felt like I was ADHD! He also would rub my arm and my leg when I went. So that was another nightmare.

This woman I went to know has to be the seventh or eighth Endocrinologist I have been to and she seem open minded.

Good luck to you too and you should ask your doctor about the T3. Let me put it to you this way, my doctor thought I was a nut case and I was getting my period every two weeks. He sent me to a woman doctor and she sent me back to him and told me to tell him that it was my thryroid and he need to up my medication! Two months of hell and I can not believe for the life of me that these doctors rather look at labs and not the person.
CD is an expert of this and really helped me, yet I don't get on here much. I want to thank everyone for their help. I wish everyone a doctor with an open mind and heart! :)

GOOD LUCK!

I also wanted to add the I am allergic to a lot of medications. That's why i looked back to two years ago and thought I gained ten pounds when he increased the Cytomel. Most people lose weight and I thought I was nuts!

The other day I was swollen, hot, and seeing blurry so I had to contact my doctor. I also can't think straight half the time.

CD, I would cut the pill in halp and take it in the morning and afternood and just would swell for some reason? Have a great vacation and I'm thankful I caught you before you went.
:)

cute1

Since you don't have a FreeT3 result to guide you, who knows if 10 or 5mcg Cytomel is appropriate? The fact that you've had issues after your dose is a sign that it's too high.

Without a doubt, you need a Synthroid dose increase so, I'm glad you got one.

Since your FreeT4 level does need to come up a lot and, via conversion, your FreeT3 level might increase as a result of the Synthroid dose increase, 5mcg Cytomel might be OK.

I hope you'll be getting labs in 6wks....8 wks. tops.

Then you can look at your labs and ask your doctor to make reasonable dose adjustments based upon them.

You will probably need some more finetuning but, at least you're headed in the right direction.

Best of luck to you moving forward - please keep us posted!

Hi cute1,
I was just dropped to 5 mcg of Cytomel because I was having insomnia. I also take Levoxyl 50 mcg.

It does seem to help.. My last TSH was 0.4 which is a bit on the low side.

Dropping the Cytomel from 10 mcg to 5 mcg seems to be helping.

I thought I read somewhere that dosage in the summer should be lower but this is the first time I've experienced this.

Thanks Bronx,

I just couldn't think straight and would swell up and I knew something was wrong. I then back tracked in my mind and realized when I started to gain weight I was but on 25 Cytome and then reduced to 12.5 a day. Then kept lowering the T4 Synthroid and I would swell and get very hot after taking both medications. I split the doses and it helped but I would still swell. I guess time will tell...
I wish you luck as well. I hope you are feeling well.