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Is it OK to Add Cytomel T3 but NOT adjust Synthroid T4 and Hair Loss / Breakage Questions Related to adding Cytomel T3?
My Doctor Prescribed T3 today….(Cytomel). He said to take 5 mg 1x per day. He did not reduce my Synthroid, which has been 100MCG for the past 5 months (lowered form 133 mcg on 6/21/11).
Based on what I read, I feel as though my doctor should have reduced my Synthroid to 75 or 88 mcg and given me 10 mg Cytomel 2x per day instead.
I dont know about how I feel about taking the Cytomel without having a lowered Synthroid T4 dose, because I had serious hair breakage on the Synthroid (which has gotten "MILDLY" better because I am taking so many supplements to counteract it)....but I have heard that taking Cytomel, has the same side-effect (ie. Hair Loss/Breakage), if your thyroid is thrown out of balance (?)
I have also read that adding Cytomel T3 can HELP a hair loss / breakage problem, too!! All of this has made me seriously confused.
I cannot risk any more hair loss. Hmmm. NOt sure what I should do here….
My October 9th labs were FT3 (2.5), FT4 (1.57), TSH (1.36)
My November 2nd labs were FT3 (3.0), FT4 (1.67), TSH (.826)
…..Do you think 5 mg of Cytomel is enough? Shouldn’t I lower my Synthroid? I know that adding T3 Cytomel makes your TSH go down anyways. I want my FT4 in the mid-range and my FT3 in the mid-to-high range, based on what I have read as "optimal", although I know a lot of adjusting one's thyroid depends on the side effects and how one feels, first and foremost.
I am interested in similar experiences and also comments about the hair loss/breakage topic and non-adjustment of the T4 upon prescribing T3.
Thanks!! :)
Based on what I read, I feel as though my doctor should have reduced my Synthroid to 75 or 88 mcg and given me 10 mg Cytomel 2x per day instead.
I dont know about how I feel about taking the Cytomel without having a lowered Synthroid T4 dose, because I had serious hair breakage on the Synthroid (which has gotten "MILDLY" better because I am taking so many supplements to counteract it)....but I have heard that taking Cytomel, has the same side-effect (ie. Hair Loss/Breakage), if your thyroid is thrown out of balance (?)
I have also read that adding Cytomel T3 can HELP a hair loss / breakage problem, too!! All of this has made me seriously confused.
I cannot risk any more hair loss. Hmmm. NOt sure what I should do here….
My October 9th labs were FT3 (2.5), FT4 (1.57), TSH (1.36)
My November 2nd labs were FT3 (3.0), FT4 (1.67), TSH (.826)
…..Do you think 5 mg of Cytomel is enough? Shouldn’t I lower my Synthroid? I know that adding T3 Cytomel makes your TSH go down anyways. I want my FT4 in the mid-range and my FT3 in the mid-to-high range, based on what I have read as "optimal", although I know a lot of adjusting one's thyroid depends on the side effects and how one feels, first and foremost.
I am interested in similar experiences and also comments about the hair loss/breakage topic and non-adjustment of the T4 upon prescribing T3.
Thanks!! :)
I am taking 200mcg Levothyroxine for thyroid replacement. My thyroid was ablated back in 2001 with radioactive iodine therapy. Since then I have switched to a 2nd endocrinologist who I have currently been seeing for about 7 years. Dilema: I cannot get my weight under 200#. I walk, I run 5k's, I am on a low-carb 1200 calorie diet, I drink well over 100 ounces of water daily, I do not drink soda's, coffee, tea or alcohol. I have never smoked or drank. I started taking 10,000mcg Biotin to help with the never-ending peeling fingernails and my hair sheds worse than a dog. My DR doesn't understand why at such a large dose of Levothyroxin that I still struggle with weight. I see her every 6 months and it's the same story. I used to be on 325mcg of Levo but she started gradually reducing that amount (because of lab results). Would I benefit weight-wise if I could convince her to switch me to Armour, or at least add Cytomel? I've already been thru menopause 11 years ago (I'm only 53 yrs old), so that is not the reason for my weight issues. Thanks for any and all advice.
My first thought is that your doctor is changing both your T3 and T4 doses in much too big increments. A T4 increase/decrease should be in the range of 12.5-25 mcg at a time, and FT3 should be 2.5-5.
Just as an aside...don't worry about your suppressed TSH. That often happens once people are on meds, especially meds with T3 in them. You will probably pretty much have to ignore TSH (and convince your doctor to do the same).
I have to say that your doctor's ranges for FT3 and FT4 are much more reasonable than the usual lab ranges.
i don't understand her logic, though. Your FT3 is at 4.64, a little high according to the lab range, but right on target according to your doctor's range. However, you are having a few hyper symptoms though some hypo symptoms still persist at a reduced intensity (is that a correct summary of how you feel?). Your FT4 is at 1.12, not too far from her 1.3 target.
If I were you, I'd be more inclined to want to drop my T3 intake just enough to stop the hyper symptoms...something like 5 mcg. I'm a big believer in only changing one thing at a time if possible so you can really isolate and evaluate what that does. My guess is that you're getting very close to an optimal dose for you. You might have to add a little more T4, too (I'd want my doctor to add about 12.5 mcg to start). If you decrease the T3 first, since its effects will show in your blood work in a couple of weeks, you can evaluate what that's done (see if the hyper symptoms go away) and see if you still think you need to add some T4.
50 mcg changes in T4 and 10 mcg changes in T3 are much too big. Your doctor will having you bouncing back and forth from hypo to hyper on those changes.
Just as an aside...don't worry about your suppressed TSH. That often happens once people are on meds, especially meds with T3 in them. You will probably pretty much have to ignore TSH (and convince your doctor to do the same).
I have to say that your doctor's ranges for FT3 and FT4 are much more reasonable than the usual lab ranges.
i don't understand her logic, though. Your FT3 is at 4.64, a little high according to the lab range, but right on target according to your doctor's range. However, you are having a few hyper symptoms though some hypo symptoms still persist at a reduced intensity (is that a correct summary of how you feel?). Your FT4 is at 1.12, not too far from her 1.3 target.
If I were you, I'd be more inclined to want to drop my T3 intake just enough to stop the hyper symptoms...something like 5 mcg. I'm a big believer in only changing one thing at a time if possible so you can really isolate and evaluate what that does. My guess is that you're getting very close to an optimal dose for you. You might have to add a little more T4, too (I'd want my doctor to add about 12.5 mcg to start). If you decrease the T3 first, since its effects will show in your blood work in a couple of weeks, you can evaluate what that's done (see if the hyper symptoms go away) and see if you still think you need to add some T4.
50 mcg changes in T4 and 10 mcg changes in T3 are much too big. Your doctor will having you bouncing back and forth from hypo to hyper on those changes.
Didn't know where else to post this and you seem to know a lot....
I was diagnosed as hypothyroid in March of this year and my levels were:
FT3- 2.64 and FT4- 1.25...low, but not terrible. I was put on Armour Thyroid and after a few months of persisting symptoms (tired, weight gain) I stopped taking them cold turkey per another doctor's advice who said I didn't have a thyroid issue.
Flash forward to October and I was still experiencing weight gain (was 117lbs in Feb and am now up to between 128 and 134), tired, hair loss, dry skin, puffy face, etc. Cortisol levels normal, have gluten allergy but endoscope showed no celiac, very low vitamin D, vitamin B levels good. Was put back on thyroid meds....this time Levothyroxine 50mcg and Liothyronine 10mcg. After 2 months, symptoms hardly improved so dosage was increased to Levo 100mcg and Lio 20mcg. Energy levels had been much better but still gaining weight though it seemed to slow down...hair loss still, but that slowed down as well. Started having rapid heart beat and other signs of hyper. Got levels retested a couple weeks ago and they are now FT3- 4.64 FT4- 1.12 TSH 0.020
Any thoughts on what could be happening? Doc now wants to decrease Lio back down to 10mcg and increase Levo to 150mcg. Does this all sound right? I feel like maybe I have an adrenal issue but Cortisol (morning only was tested) was normal.
The FT3 level range printed on the lab is 1.50-4.10 but the doc has had written she likes to see them at 3.5-5.0 (mine was 2.64 to start and is now 4.64)
FT4 printed range is 0.89-1.76 doc wants them at 1.3-2.0 mine was 1.25 to start and is now 1.12.
My most recent Vitamin D level was 17...lower part of the range is 25. My level 17 was while taking 10,000 (yes 10,000) iu of vitamin D3/day.
Haven't had glucose or any other tests besides morning cortisol.
I was diagnosed as hypothyroid in March of this year and my levels were:
FT3- 2.64 and FT4- 1.25...low, but not terrible. I was put on Armour Thyroid and after a few months of persisting symptoms (tired, weight gain) I stopped taking them cold turkey per another doctor's advice who said I didn't have a thyroid issue.
Flash forward to October and I was still experiencing weight gain (was 117lbs in Feb and am now up to between 128 and 134), tired, hair loss, dry skin, puffy face, etc. Cortisol levels normal, have gluten allergy but endoscope showed no celiac, very low vitamin D, vitamin B levels good. Was put back on thyroid meds....this time Levothyroxine 50mcg and Liothyronine 10mcg. After 2 months, symptoms hardly improved so dosage was increased to Levo 100mcg and Lio 20mcg. Energy levels had been much better but still gaining weight though it seemed to slow down...hair loss still, but that slowed down as well. Started having rapid heart beat and other signs of hyper. Got levels retested a couple weeks ago and they are now FT3- 4.64 FT4- 1.12 TSH 0.020
Any thoughts on what could be happening? Doc now wants to decrease Lio back down to 10mcg and increase Levo to 150mcg. Does this all sound right? I feel like maybe I have an adrenal issue but Cortisol (morning only was tested) was normal.
The FT3 level range printed on the lab is 1.50-4.10 but the doc has had written she likes to see them at 3.5-5.0 (mine was 2.64 to start and is now 4.64)
FT4 printed range is 0.89-1.76 doc wants them at 1.3-2.0 mine was 1.25 to start and is now 1.12.
My most recent Vitamin D level was 17...lower part of the range is 25. My level 17 was while taking 10,000 (yes 10,000) iu of vitamin D3/day.
Haven't had glucose or any other tests besides morning cortisol.
Very confusing labs as they relate to meds and symptoms...
On 12/2/11, your Synthroid dose remained the same (100), your Cytomel dose was raised to 20 from 10, yet by 12/29/11 your T3 had taken a nosedive (from 3.4 to 2.6), and you felt better. FT4 had come up to 0.88 from 0.55.
On 6/19/12, you were still feeling well with labs that had hardly changed since 12/29. Your doctor raised your Synthroid to 112, keeping Cytomel the same.
By 10/10/12, you felt the worst ever, although FT3 had remained exactly the same. FT4, however had fallen a lot (20% of range) on an INcrease in Synthroid.
So, how to explain all these contradictions???
It's possible that you are losing thyroid function continually. If your thyroid is producing less and less as time goes on, it could explain the drop in FT4 despite the increase in Synthroid. Your meds increases aren't keeping up with the loss of thyroid function.
You've felt well before with FT3 in the 2.6-2.8 range, but it would seem that you start not feeling well when your FT4 goes below somewhere around 0.8. That's not far from where you are right now.
If I were you, I think I'd ask the doctor for a slight Synthroid increase, probably in the vicinity of 13 mcg, bringing you to 125. For the time being, I wouldn't change the Cytomel. Whether you feel well or not, I'd retest in 4-5 weeks to see what effect the increase has had on your labs. You can then re-evaluate symptoms and go from there. It appears your condition is changing too fast at the moment to let 4 months go by without having labs, especially after a change in meds. You should always have labs 4-5 weeks after a change to evaluate your response to it.
On 12/2/11, your Synthroid dose remained the same (100), your Cytomel dose was raised to 20 from 10, yet by 12/29/11 your T3 had taken a nosedive (from 3.4 to 2.6), and you felt better. FT4 had come up to 0.88 from 0.55.
On 6/19/12, you were still feeling well with labs that had hardly changed since 12/29. Your doctor raised your Synthroid to 112, keeping Cytomel the same.
By 10/10/12, you felt the worst ever, although FT3 had remained exactly the same. FT4, however had fallen a lot (20% of range) on an INcrease in Synthroid.
So, how to explain all these contradictions???
It's possible that you are losing thyroid function continually. If your thyroid is producing less and less as time goes on, it could explain the drop in FT4 despite the increase in Synthroid. Your meds increases aren't keeping up with the loss of thyroid function.
You've felt well before with FT3 in the 2.6-2.8 range, but it would seem that you start not feeling well when your FT4 goes below somewhere around 0.8. That's not far from where you are right now.
If I were you, I think I'd ask the doctor for a slight Synthroid increase, probably in the vicinity of 13 mcg, bringing you to 125. For the time being, I wouldn't change the Cytomel. Whether you feel well or not, I'd retest in 4-5 weeks to see what effect the increase has had on your labs. You can then re-evaluate symptoms and go from there. It appears your condition is changing too fast at the moment to let 4 months go by without having labs, especially after a change in meds. You should always have labs 4-5 weeks after a change to evaluate your response to it.
12/2/11 - Taking 100 mcg Synthroid & 10 mcg Cytomel. Felt extremely fatigued. Test results on this date:
12/2/11:
TSH: .58 (range .34 - 5.6)
T4: .55 (range: .58-1.64)
T3: 3.4 (range 2.5-3.9)
12/2/11, doctor raised cytomel to 20 MCG, Synthroid remained 100 mcg.
12/29/11 - taking 100 mcg synthroid & 20 mcg cytomel. Felt good. Test results on this date:
12/29/11:
TSH: .20
T4: .88
T3: 2.6
6/19/12 - when these test were run, i was still on 100 synthroid and 20 cytomel, felt fine:
6/19/12:
TSH: .47
T4: .96
T3: 2.8
6/19/12, However, doctor felt my T4 was too low, and on this date, raised Synthroid to 112 mcg.
10/10/12 - Had now been on 112 Syntrhoid for 4 months, and still 20 cytomel. Felt the worst hypo I've EVER felt, including swollen and painful thyroid when these tests were run, symptoms had been ongoing for about 2 weeks when these test were run:
10/10/12
TSH: .32 (range: .58-1.64)
T4: .76
T3: 2.8
12/2/11:
TSH: .58 (range .34 - 5.6)
T4: .55 (range: .58-1.64)
T3: 3.4 (range 2.5-3.9)
12/2/11, doctor raised cytomel to 20 MCG, Synthroid remained 100 mcg.
12/29/11 - taking 100 mcg synthroid & 20 mcg cytomel. Felt good. Test results on this date:
12/29/11:
TSH: .20
T4: .88
T3: 2.6
6/19/12 - when these test were run, i was still on 100 synthroid and 20 cytomel, felt fine:
6/19/12:
TSH: .47
T4: .96
T3: 2.8
6/19/12, However, doctor felt my T4 was too low, and on this date, raised Synthroid to 112 mcg.
10/10/12 - Had now been on 112 Syntrhoid for 4 months, and still 20 cytomel. Felt the worst hypo I've EVER felt, including swollen and painful thyroid when these tests were run, symptoms had been ongoing for about 2 weeks when these test were run:
10/10/12
TSH: .32 (range: .58-1.64)
T4: .76
T3: 2.8
I'm copying this question from another thread for Bella192 since there seem to be some MH navigation problems going on.
"Goolarra, In your opinion, if I am currently taking 112 mcg of Synthroid and blood tests show positive for the Thyroid Antibodies for Hashimoto's, what would be the new dosage of Sythroid I should try?
I have to hold my doctor's hand and tell her what to look into regarding Thyroid issues, so I want to be prepared with some idea what would be an ideal higher dose to discuss when I see her on Monday."
Dosage is not related to antibodies. Dosage should be based on symptoms first, then FT3, FT4 and TSH, in that order.
Dosage changes should be made in 12.5 to 25 mcg increments. After 4-6 weeks, labs sould be repeated, symptoms re-evaluated and further adjustments made if necessary. We all react differently to meds changes, so it's important to move slowly.
Looking back up to your labs, however, what worries me is the big drop in FT3 from 3.4 to 2.8 despite a 10 mcg INCREASE in T3 meds. This is virtually unheard of, and it makes me wonder if something else isn't going on.
How long after the increase did you start feeling very hypo? How long ago were the prvious labs you posted above?
"Goolarra, In your opinion, if I am currently taking 112 mcg of Synthroid and blood tests show positive for the Thyroid Antibodies for Hashimoto's, what would be the new dosage of Sythroid I should try?
I have to hold my doctor's hand and tell her what to look into regarding Thyroid issues, so I want to be prepared with some idea what would be an ideal higher dose to discuss when I see her on Monday."
Dosage is not related to antibodies. Dosage should be based on symptoms first, then FT3, FT4 and TSH, in that order.
Dosage changes should be made in 12.5 to 25 mcg increments. After 4-6 weeks, labs sould be repeated, symptoms re-evaluated and further adjustments made if necessary. We all react differently to meds changes, so it's important to move slowly.
Looking back up to your labs, however, what worries me is the big drop in FT3 from 3.4 to 2.8 despite a 10 mcg INCREASE in T3 meds. This is virtually unheard of, and it makes me wonder if something else isn't going on.
How long after the increase did you start feeling very hypo? How long ago were the prvious labs you posted above?
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