Unstable TSH level

[Beth1009]

Hello,

The last time my TSH level was withing "normal" range was 11-22-06.

From 2006 to Feb 2008, I was on Armor Thyroid.  The last dose was 3.5 grains.  My TSH kept going up with each dose increase.  The Endo I was seeing didn't know why.

I left that Endo & now see MD who has me on 25 mcg Cytomel 3x daily.

My TSH as of yesterday's blood draw is 25.75.  My FT4 is .39 (.61-1.76 range) and FT3 is 3.2 (2.3-4.2 range).

Is my TSH eratic because of Hashimotos?

I won't take Synthroid again.  I've been on it twice (for about 2 years each time) and it has always made me feel physically sick.  Armor I tolerated but my TSH kept increasing & my Endo was against increasing dosage yet again.  Cytomel makes me feel wonderful but again TSH is high.

What is going on & what can I do to correct it?  Is it possible to combine Armor & Cytomel?

I'd appreciate any suggestions you may have.

[Beth1009]

Thank you Dr. Lupo.  My Dr. now has me on 1 grain Armour 2x per day in addition to 25 mcg Cytomel 3x per day.

I'm being very careful now to wait an hour after taking meds b/4 I eat.

Thank you again.

[Mark Lupo, M.D.]

You likely have a problem absorbing the medication or are taking it not on an empty stomach or w/ meds/supplements/foods that decrease the efficacy.

Usually T4 alone is the standard of care.  Straight T3 (cytomel) is not recommended for long-term replacement but is sometimes used.  Would prefer a combination of levothyroxine and cytomel.

T3 can be over-stimulating so even with a high TSH there can be periods of excess stimulation to the heart causing heart palpitations and dangerous rhythm disturbances -- talk to your doctor if this happens.