Hypothyroidism Diagnosis? Synthroid/ Cytomel Dosing Quesitons

[aerlyn02]

Hello,

I've been struggling with gastrointestinal issues (celiac disease) for the past 8 months and these are my thyroid test results - I was diagnosed with hypothyroidism and have been put on some medications, but what I'm worried about whether I actually need them or not…. I had one endo tell me I should stop them, that my numbers never qualified me for the diagnosis of hypothyroidism… symptoms of extreme tiredness, toxic feelings, muscle aches, nausea, indigestion, constipation/ diarrhea, etc etc

Looks like it is possible I have gallstones as well - waiting for the test results there. So its possible malbsorption of key nutrients & lack of iodine caused a decrease in my fT3?

Going on the Cytomel did help my digestion a bit and give me some more energy but for the most part I just feel tired all the time - even when I take cytomel, doesn't really give me much energy at all.

My doc just prescribed some synthroid because my ft4 is now really low….

Should I come off these synthetic thyroid meeds? My goal is to NOT be on them! How do I safely taper off of the thyroid meds and still maintain thyroid function naturally - with adrenal support and iodine perhaps?

Should I wait to come off them until my gastrointestinal issues are resolved? I feel like the thyroid meds are not really helping my gastro issues though…

Have been negative for hasimoto's antibodies, ultrasound of thyroid is fine, progesterone was found to be really low so I'm on Rx compounded progesterone at night. Pituatary tumor has been ruled out

Since being on the cytomel, my periods have started again (after being gone for out 7 months) but they are erratic and often come 2x a month now

Any advice on my thyroid numbers would be much appreciated -

[Mark Lupo, M.D.]

looks like the only abnormal lab prior to meds was slightly low free T3 (not very accurate test)-- along w/ nl US and neg antibodies, would not think you need any thyroid meds.  You need to talk to your doctor about stopping/coming off meds though - I cannot give specific advice like that in this forum.

[aerlyn02]

Hello,

Thank you for the response. I did most my results in the comments section because I was unable to put it all in the original post. Do you have any further suggestions based on the below test results?

The issue I'm having now, is that since starting the Synthroid 25mg with 2x cyotmel a day, I'm having chronic diarrhea... do my most recent thyroid numbers indicated I've gone hyperthyroid and the cytomel is just excabating things?



HISTORICAL NUMBERS:

12/20/11

TSH 0.99
fT4 0.90
fT3 2.00

2/14/12

TSH 0.87
fT4 1.00
fT3 1.90

3/28/12

TSH 0.96
fT4 1.10
fT3 2.10

5/3/12

TSH 1.7
fT4 1.1
ft3 2.0

--> introduction of cytomel 5/19 (marked decrease in TSH and fT4)

6/4

TSH 1.46
fT4 0.8
fT3 2.9

7/10

TSH 0.47
fT4 0.5
fT3 3.1

8/15

TSH 0.51
fT4 0.5
fT3 3.1


DOSING:

Dec '11 - end of April '12: nothing but natural over the counter thyroid extracts as support - no iodine

May 6th-12th: 50mg armor --> ramped up to 100mg too fast and became violently ill

May 13-19th: No armor

May 19th - June 9: 5MG 2X DAILY CYTOMEL

June 9 - present: 5 MG 3x Daily cytomel

Just prescribed 25mg synthroid to add - haven't started yet. Am also taking Rx digestive enzymes, probiotics and other natural remedies to support my stomach

I'm just exhausted and sick to my stomach all the time and no one can figure out what's wrong - have just started taking bile salts and that really helps some of my stomach issues, again leads me to believe this is gallbladder/ gallstone issues

I recently did an iodine patch test and it disappeared within 4 hours … possible I'm just iodine deficient? possible anemic too?

Have done a heavy metal urine test and have extremely elevated levels of mercury - recently started DMPS

I have had many other tests done, so if you have questions, post and I'm happy to provide more of my results

Should I take synthroid? and continue or stop the cytomel? Should I just stop all of the meds and see if things will straighten themselves out on their own - appreciate the help and input

[Mark Lupo, M.D.]

You did not give your test results, but in general, if normal US and negative antibodies, the risk of permanent hypothyroidism is lower so tapering off under medical supervision may be appropriate.  However if you have documented celiac sprue, then the hypothyroidism may be autoimmune and not testing out that way (negative antibodies) and the hypothyroidism may be lifelong.  In general, we do not use T3 therapy by itself, we combine w/ T4 (ie cytomel in low doses - 5mcg 1-2x/day along w/ Synthroid or other T4 product).  These are bio-identical products which are synthetically produced and are usually more consistent/reliable than "natural" options.

[aerlyn02]

HISTORICAL NUMBERS:

12/20/11

TSH 0.99
fT4 0.90
fT3 2.00

2/14/12

TSH 0.87
fT4 1.00
fT3 1.90

3/28/12

TSH 0.96
fT4 1.10
fT3 2.10

5/3/12

TSH 1.7
fT4 1.1
ft3 2.0

--> introduction of cytomel 5/19 (marked decrease in TSH and fT4)

6/4

TSH 1.46
fT4 0.8
fT3 2.9

7/10

TSH 0.47
fT4 0.5
fT3 3.1

8/15

TSH 0.51
fT4 0.5
fT3 3.1


DOSING:

Dec '11 - end of April '12: nothing but natural over the counter thyroid extracts as support - no iodine

May 6th-12th: 50mg armor --> ramped up to 100mg too fast and became violently ill

May 13-19th: No armor

May 19th - June 9: 5MG 2X DAILY CYTOMEL

June 9 - present: 5 MG 3x Daily cytomel

Just prescribed 25mg synthroid to add - haven't started yet. Am also taking Rx digestive enzymes, probiotics and other natural remedies to support my stomach

I'm just exhausted and sick to my stomach all the time and no one can figure out what's wrong - have just started taking bile salts and that really helps some of my stomach issues, again leads me to believe this is gallbladder/ gallstone issues

I recently did an iodine patch test and it disappeared within 4 hours … possible I'm just iodine deficient? possible anemic too?

Have done a heavy metal urine test and have extremely elevated levels of mercury - recently started DMPS

I have had many other tests done, so if you have questions, post and I'm happy to provide more of my results

Should I take synthroid? and continue or stop the cytomel? Should I just stop all of the meds and see if things will straighten themselves out on their own - appreciate the help and input