Looks like part of my post went missing. Here are the full labs:
Thyroflex - 150
TSH 1.98
FT4 1.35 (.9-1.7)
FT3 3.3 (1.8-4.6)
RT3 17.7 (8-25)
TG Antibody

not sure what's happening here! Let's try this one more time!
Thyroflex - 150
TSH 1.98
FT4 1.35 (.9-1.7)
FT3 3.3 (1.8-4.6)
RT3 17.7 (8-25)
TG Antibody less than 10 (less than 115)
TPO Antibody 7.5 (less than 35)

I've been diagnosed with Adrenal Fatigue and Estrogen Dominance. I'm taking supplements and Bioidentical Hormone creams for those issues. I also have low iron and B12. Will be adding those supplements.
I was prescribed 25mcg of Cytomel and took that this morning. I'm feeling rather anxious and have higher heart rate today. I'm thinking my problems are more the adrenals and sex hormones.
Is my functional provider right in starting thyroid meds?
Any advice is appreciated!

This site has a maddening bug! When you use a less than or greater than sign it will cut off your post!

Ok, so let me start with your breakdown:

Free T4
Range:0.900 -1.700
Result: 1.350
Percent of range: 56.25%
Free T3
Range: 1.800 -4.600
Result: 3.300
Percent of range: 53.57%
TSH 1.98

I can tell you that *most* people feel well with a Free T4 of 60-100% of range or slightly over the top of the range and a Free T3 of 50-100% of range. So, you're lowish on the Free T4 side and iffy-ish on the Free T3 side. Combine that with a TSH above 1 (where *most* people feel well is 1 or below), it shows you have a sluggish thyroid. Which, obviously, your HCP has identified. Combine that with estrogen dominance and adrenal fatigue and you have a hot mess!

But, it sounds like your HCP is approaching it correctly. With adrenal fatigue/failure you don't want to tackle thyroid disease with drugs (free t4 mostly) without addressing adrenal fatigue first (cortef, hydrocortisone, etc). And with estrogen dominance, progesterone is usually rx'd (in my case anyway). So, hopefully with an adjustment here or there, you'll eventually get to a point where you can add T4 IF IT'S NEEDED. Some people report feeling great on T3 only meds. The one thing to watch out for is feeling "wired and tired". If that happens, it's most likely under treatment of T4 or under treatment of adrenals.

Good luck and keep us posted!

PS It's not uncommon to feel a tad worse before you feel better when starting thyroid meds (it's the worst kept secret in the medical biz, but nobody tells us this). Feeling anxious and well...like your body is waking up (with tons of coffee) isn't unusual.

When to worry: If, after a few days (7-10) for T3 meds, you don't feel that you've adjusted and have worsening symptoms...call someone. For t4, it takes a few weeks to adjust, but if you have worsening symptoms that just don't ever let up - have your adrenals tested.

We have one member here who white-knuckled his way to perfect thyroid numbers....only to find out he had an adrenal problem (adrenal failure) addison's disease...it was NOT a pretty picture and he'd be the first to tell you that. But, on the up side, his thyroid levels were fabulous! And once he addressed his adrenals, he could live his life again.

Thanks for the reply MButterfly! I called the clinic and told them how I was feeling. I was told to stop the Cytomel for now and they suggested some natural supplements to calm my system. I had previoulsy purchased their PM calming supplements and those are helping me sleep better along with the Progesterone cream. In fact with the supplements, hormone cream and vitamins I've been taking the past couple of weeks I've started to feel more like myself again. I was told to stay off the Cytomel until the anxiousness subsides and then to start up again at half the dose. I'll update how I'm doing when I start of the Cytomel again.

Ok, that's a LOT of cytomel to start with imho.... like jumping in with 100 mcg of sythroid but with even more punch.
I get jumpy when they increase mine by 5 mcg too much..
Glad they are 1/2ing your dose and I would suggest you go with split dosing, say 5 mcg am and then add 5 in the evening and then if you need it add more to the am. T3 doesn't last long in our systems, so multiple doses a day are generally helpful, or you get a roller coaster effect.
Don't take this experience as a given for a lower dose.
Also wondering why they aren't giving you ANY t4? Aren't they concerned your body will forget how to convert? kind of different...

Nina nailed it. I can't imagine taking 25mcg of Cytomel - especially all at once!

*Most* people are started on FIVE mcg of cytomel to start and they usually half it - one half in the am/one half in the afternoon (around lunch time). Remember: T3 is waaaay more powerful than t4. But, you need both at an optimal level to feel healthy.

I think Nina's absolutely right. And I WOULD ask for a lower dosage and why the doc isn't starting you on T4.

Now, some docs DO want to optimize T3 before T4, but it's not the norm.

Nice catch Nina! I totally missed the dosage.... (having some issues here)

More info on balancing your thyroid:
http://www.dailystrength.org/groups/thyroid-resources/discussions/messages/17754063

Yeah I get jumpy with more than or equal to 15mcg jumps, lasts a few days, or if its near my hyper zone it just stays.

i thought the idea was to go slow and to take your vitals, ie blood pressure and temperature, pulse etc a few times at least a day.

are you taking any T4 meds as well?

I was told they wanted to start on just t3 for one month because of my reverse t3 was above 15 (17.7). Then I was to start on NP Thyroid. I also have very low progesterone and adrenal fatigue that I'm treating. I've decided that since I'm starting to feel better with the bio identical hormones and the adrenal supplements that I'm going to get those back up to normal and see where my thyroid is at. From the research I've done these issues are all connected. I feel I'm doing too much at once to my body, so I'm going to go slow with adding more. I'm sleeping great now and that was my main battle. Appreciate all of your comments! If you have any other suggestions please send them my way!

Oh I feel for you. Ive been living with this 10 years.

I too am about to start T3 only get my RT3 down.

Do you have to take your temps and blood pressure etc?

I recommend personally spreading the T3 out, dont quote me Im not your doc. But one reason sometimes they give a big dose in the morning is to get the circadian rhythm of cortisol working. But that doesnt sound like whats going on here.

Id ring and advise them if its making you anxious or gives you heart palps. I know it would me for sure.

Do you take pain killers by any chance? Do you have anxiety or any emotional stress? Have you had your liver tested? How is your b12, selenium, D3, zinc, iron? Do you take digestion medication?

Hi,
I had to jump into this discussion. It seems like a few if not many are using progesterone. My doctor recommended this to me since I never sleep well. How much percentage of cream is everyone on? What is the starting point for it and do you do it every day of the month. I think I may have estrogen dominance. I am on Climara patch 0.5 for many years.
Thank u,
Fran

I don't know about the others, but I take a progesterone pill once a day. The cream never worked for me.