cytomel vs Armour

[dessie111]

Hi Doctor
Well I just had my labs done and my TSH is great at 1.55, my Free T4 is 1.0 which is great but my Free T3 is still sitting at 227, I am on syn 50mcg and cytomel 7.5, doc started me on cytomel at 2.5 and doing small increaese monthly, but my Free T3 is not moving it has been between 200-227 everytime even on the cytomel??  Doc can't really explain it??  Can you??

He decided to switch me to armour today 1grain daily to see if my body responds to that??  He thinks everybodies body is different and responds to differnt things, so thinks we should just give it a try??  HMMM I don't know?  What are your thoughts on that, vs just increaseing my cytomel??  I bodyfat percent keeps going up, so it is obvious I need my Free t3 to kick into gear, has ordered a reverse T3 as well to see what is going on with that??  That test is not very common, what will it show??

[Mark Lupo, M.D.]

The T3 level will rise for several hours after the cytomel dose.  If the blood is drawn before the dose, the T3 will be low again.  

We usually don't use T3 levels to guide dosing because it is such a short acting medication and the levels must be interpreted in light of the time of dose.

Really it is a matter of symptomatic improvement -- ie, do you feel any better with the cytomel?  From a lab standpoint, the TSH is still the most important clinically.

Reverse T3 is not helpful to manage patients.

The body fat is not likely to change with thyroid dose titrations.....it will change with the proven scientific concept of taking in less calories than you burn off.  

[blancita]

The problem with the last part of your statement is that, if your metabolism is working very slowly because of your thyroid or otherwise, you could be eating 500 calories and still taking in more than you burn.  We would agree that eating 500 calories per day just to not take in more than one is burning is not the answer either.  Obviously fixing the metabolism is the answer, and in some cases the metabolism is repaired through adjustment of the dose of right thryoid meds.

[dessie111]

gosh you are so right?  that is my issue, I love working out and exercising and tend to be a chronic dieter to stay lean year around and I think I have screwed up my metabolism, for me to loose weight or bodyfat I literally have to drop my food intake to about 700 calories and have it consist of just protein and fat??  And Dr. Lupo does not believe or think the free t3 has anything to do with fat loss or weight loss because of the science behind calorie in calorie out, but not everyone is the same--some where along the way I have really slowed my metabolism down and would like to know how to repair it and there has to be some correlation between the Free T3 levels--He says that they don't usually treat based on those numbers because of the cytomel being short lived, so then I would think you would go by the level when not on the cytomel which is LOW--???