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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Cytomel, Armour, or neither?
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.
Cytomel, Armour, or neither?
by Bananie22, Jul 01, 2006 12:00AM
Hello~
I will give a brief history.
I have Hashi's...had half my thyroid removed mid May of this year due to large nodule and scar tissue. Had blood work done last week and last month.
TSH (last month) 1.37 (this month) 1.65
FT4 (last month) 1.25 (this month) 1.46
FT3 (last month) 2.6 (this month) 2.7
I'm on 137 Levothyroxine (also take 200 mcg selenium) and my endo upped me to 150 yesterday after this last round of tests. What I want is to either add Cytomel (and lower my Levo dose) or go on Armour. He's against that saying there are too many variables (I don't have any idea what that means). Do I have a case to argue for Cytomel or Armour with these numbers? I know the FT3 is on the lower end of normal, but falls within the normal range...but so does a TSH of 5 and I felt lousy at that. I have hypo symptoms again...I was feeling well briefly...but the last couple of weeks I've had puffy eyes, swollen feet and hands...ankle and knee pain...muscle aches in general. I've had these symptoms before when I was hypo so I'm aware of what they are now. Is there any advice you could give me to convince my doc to switch me over? We have a great relationship so talking to him is easy...I just want to be as informed as possible.
Thank you!
I will give a brief history.
I have Hashi's...had half my thyroid removed mid May of this year due to large nodule and scar tissue. Had blood work done last week and last month.
TSH (last month) 1.37 (this month) 1.65
FT4 (last month) 1.25 (this month) 1.46
FT3 (last month) 2.6 (this month) 2.7
I'm on 137 Levothyroxine (also take 200 mcg selenium) and my endo upped me to 150 yesterday after this last round of tests. What I want is to either add Cytomel (and lower my Levo dose) or go on Armour. He's against that saying there are too many variables (I don't have any idea what that means). Do I have a case to argue for Cytomel or Armour with these numbers? I know the FT3 is on the lower end of normal, but falls within the normal range...but so does a TSH of 5 and I felt lousy at that. I have hypo symptoms again...I was feeling well briefly...but the last couple of weeks I've had puffy eyes, swollen feet and hands...ankle and knee pain...muscle aches in general. I've had these symptoms before when I was hypo so I'm aware of what they are now. Is there any advice you could give me to convince my doc to switch me over? We have a great relationship so talking to him is easy...I just want to be as informed as possible.
Thank you!
Doctor's Answer
by Mark Lupo, M.D., Jul 03, 2006 12:00AM
, Jul 03, 2006 12:00AM
There is no medical study supporting the use of T4 & T3 combo treatment however some of the studies concluded that some patients felt better on the combo -- this coincides wwith my clinical experience. I feel cytomel gives more control that armour and it is my first choice in approaching patients with combo treatment. Usually the cytomel is 2x/day and the synthroid or levoxyl is once a day and must be lowered a bit to accomodate the cytomel.
Member Comments (3)
by Bananie22, Jul 03, 2006 12:00AM
To: Doc
I know you don't respond to posts you've already answered, but I do hope you read this. I just wanted to thank you for your response...I did get the Cytomel (2.5 once a day then after a month 2.5 twice a day). My endo thought it was very admirable that you donated your time for this site and commended you for it. I thought you should know. Thank you again and Happy 4th of July!
by Mark Lupo, M.D., Jul 05, 2006 12:00AM
, Jul 05, 2006 12:00AM
thanks
