Trying to find right balance between Synthroid and Cytomel

[jen26059]

I am about 115 lbs and (I had RAI year ago for Graves) and recently my TSH was .62 and my FT4 was in upper portion of the range but I still felt bad fatigue on 125mcg Synthroid (my doctor didn't do a FT3 test so I don't know.)  I'm now on 75mcg Synthroid and 5mcg cytomel 2x/day and I feel better in that I do have more energy and my brain works much better now and I can speak and read much better, but I also feel hyper symptoms like I'm on a small amount of some bad, low-grade speed drug - I just feel racing and anxious like there's a tiny electrical current running through my body, mild diherrea, fidgety, can't relax, worsened insomnia.

Like I said, my fatigue, which was my main remaining problem, is helped a lot and everything is better with T3 but I still feel the fatigue very strongly at times, and I don't completely like the way I feel; I feel kind of strung out.  

Is it possible I'm on too much cytomel?  Does cytomel or T3 always give this electrical feeling?  What would probably be a good dose of Synthroid/Cytomel given that I felt hypo before and possibly hyper now?  Is it reasonably possible to find a good does or not feel either hypo or hyper?

[jen26059]

Thanks for posting - the other medication I'm on is Lamictal, which may give me the electrical feeling, but that feeling seems to be going away, at least for now.  Now I feel pretty good for most of the day but my energy takes a severe dive around 8:30, maybe because the T3 has worn off.  I wonder why Armour would give a smoother feeling?  Is the T3 more constant?  Sorry if I sound silly with all these changing symptoms; I feel kind of like a yo-yo - it seems like I'm riding waves and I can't really tell where I'm at, that my symptoms are changing a lot and that they're contradictory, too!

[mshypo]

I have tried Cytomel before and also felt that "wired" feeling with it.  I use the word "harsh" on the body to describe it.  I use Armour which has T3 in it (as well as T4 and the other thyroid hormones) and find it to be a very "smooth" feeling...I never feel that "wired" feeling with it.  I think also, that some docs use time-released T3 which i think comes from a compounding pharmacy.  So maybe you could try Armour or the time-released T3.  

[HashiMan]

Do you mind my asking if they have you on an antidepressant? My reason is because some people while adjusting to those like the prozac and paxil, while experience what they term electric zaps. Research was done on this phenomenom several years ago out of concern these zaps might be causing patients damage in the electrical part of the nervous system but was determined that it does not. They did find it happens to large percent of people on these. Might be something to rule out for you.

[Mark Lupo, M.D.]

There is no single dose or ratio that fits everyone - sometimes I dose 2.5mcg 2x/day if there are hyper symptoms but improvement in other ways.  The electrical sensation is odd.  Trial and error with t4/t3 combo is important -- sounds like you need less t3 - if that is the case then increase the t4 to compensate