Adding T3

[zachslp]

I've been hypothyroid for 25 years (I'm 36)and for most of the time on Synthroid or Levoxyl, with my dosages increasing over the years to 200 mcg.  Looking back, I think I have "settled" for always being tired, mildly depressed, and with cold intolerance, even though my TSH has been "normal".  This summer, my PCP tested my TSH, found it to be low (.274)and said she needed to lower my meds to 175 mcg.  After about 3 weeks on this dose, I noticed an increase in my fatigue, depression, and other symptoms.  At 6 weeks, I was retested and found that my TSH hadn't changed and so I was lowered again to 150 mcg.  The symptoms worsened and so I (for the first time ever) began researching online and through books to find out what I can do.
I have found through research that some people have success with starting on Cytomel (T3) to aid in improving symptoms and maintaining a normal TSH.
My question(s): 1.Are PCP's educated enough re: Cytomel and/or Armour or should I only go to an endocrinolgist (haven't had luck with them in the past)? 2.It's been 4 weeks since my last test... do I have to wait 2 more wks (6 wks total) until retesting TSH and possibly starting Cytomel, or can I begin Cytomel trials now?  3. Any info re: Cytomel and/or Armour and it's cost?
Thank you!

[jillepr]

A related discussion, Should I ask to try T3 added to Synthroid was started.

[pattyg]

Hopefully a doctor can help me out here.  I recently went to a doctor after doing a saliva test.  It showed testostrone was alittle low, progesterone high and estrogen good.  He gave me a shot of testostrone which gave me alot of energy but increased facial hair (dark)!!!  Will this go away?  Also I ask what dose of shot it was 50mg. (although I saw a bottle there that said 100mg on it)..Only lasted approx 2 wks.  but now afraid to do it again because of the hair.  Also he changed my levoyll to armour and today I feel like my arms and legs want to go numb..Not sure what to do or if it really is the armour that's making me feel that way.  Should I have been tapered off my levoyll?  I've been taking 88mcg for years.  He orginally prescribed 90mg of armour, but after research from the pharmacist and the computer I beleive it only should be 45mg.  Need help...feeling crudy again.  thanks for any help.

[kanawah]

The use of synthetic T4 "just don't work".

Your body (thyroid) makes T1, T2, T3, T4, and Calcitonin.

The synthetic T4 only meds are exactly that T4 only.  Desiccated thyroid (Armour, etc) has all 5 parts.

The TSH worshipers will keep you severely under medicated.  If you receive an adequate dose of thyroid, your TSH will be suppressed.  You will also feel better than you have in many years.

Drop into the "Stop the thyroid madness" web site
<< http://www.stopthethyroidmadness.com/index.html >>
They have a lot of good information.

Also check out the NaturalThyroidHormone group on Yahoo.

[Julie65]

Those are good questions!  Armour is a prescription-only med.  And a DO is a Doctor of Osteopathy.  Same training and qualifications as an MD, but they focus more on the interaction between organ systems and on how your lifestyle affects your health.  They are "regular doctors" and show up on your health plan listings along with everyone else.  I think a DO is a particularly good choice when your thyroid symptoms persist despite treatment with levothyroxine.

[zachslp]

Sorry to seem dumb... what is a D.O.?  Also, I assume you need the prescription for Armour at Sams Club?  Hope these aren't too stupid questions!

[Julie65]

Hi - I was a lot like you.  Bloodwork said normal but I still felt depressed, tired, etc.  I switched to Armour from Synthroid several months ago and feel way better!  Still get tired (although not as bad) and the depression completely resolved.  Only problem I've had is that now I feel a little jumpy sometimes - but it's well worth it.  (Probably that high T3/T4 ratio Dr. Mark mentioned.)  Armour is a lot cheaper than Synthroid.  I pay cash for it at Sam's Club and it's about $15 for a 90-day supply.  As for endo's vs. PCP's - it all depends on the doctor.  You might try a D.O. instead of an M.D.  Same training, but a different philosophy.  My D.O. does a much better job with my thyroid issues than the endo I went to.  Good luck!

[Mark Lupo, M.D.]

1) depends on the PCP (and the endo) -- I would try adding some cytomel or simply let your TSH be 0.25 or greater on the higher dose of T4.
2) Wait 6 weeks in general but adding T3 now that you are on a lower T4 dose for 4 weeks is likely okay -- I usually start with 5mcg in am and again at 2-3pm
3) Armour is cheaper I believe, but harder to regulate in some patients and contains a much higher T3/T4 ratio than most humans need.