Should I take a T3 supplement Cytomel?

[Rasta15]

I have felt miserable for months and my thyroid has been up and down.  My last tests were TSH .46 (range .34-3.50  T4 1.1 (range .5-1.6), and T3 free 2.9 below 2.5 is consider low.  I have never needed a t3 suppl. in the past 7 years of my disorder.  Does anyone have any experience?  Would this help me get some energy?  I feel so tired, cold feet, achy.  

[gimel]

You're very welcome.  The more I learn about thyroid problems, it seems the more there is to learn about.  we all learn a lot from other members and of course we have all had our own experiences, plus there is so much available on the net.

From your description it's likely that your horrible night was related to reducing your HRT.  I am assuming that you made no change to your thyroid meds.

If your new endo will treat your symptoms by adjusting  FT3 and FT4 levels without being constrained by resultant TSH levels, then you will be in good hands.  So start with testing for FT3 and and the other tests I mentioned above, just to put those to bed, or find out if they are a contributor.

[Rasta15]

Hi,

Thanks again for all your input.  How do you know so much?  Have you been studying thyroid?  So I have another question.  Yesterday I reduce my HRT, this is why the dr. wanted to wait two weeks before I start the cytomel, and last night I had a horrible night.  I have reduced before with no effects, but last night was different.  I don't know if it was hormone related or thyroid or a 24 hour bug.  I had extreme body aches, felt feverish, chills and then got hot.  I never actually took my temp., but I took some advil, out of tylenol, and finally felt a little better.  This am, no fever, back a little achy but nothing else.  I know what hot flashes feel like and have not had any since being on HRT.  If it is hormone related I am not sure how long it will take my body to adjust to the new dose.  If it thyroid related is waiting the two weeks a good idea?  I seem to be sensitive to reduction of estrogen.  I assume my body will adjust to both the HRT and thyroid.  It is frustrating feeling this way and I have never had an issue with my thyroid being out of whack.  I can say I normally am tired, but I have two five year old that I account for that.  Maybe I needed T3 help and did not know it.  They usually only measured the T4 and TSH.  My new endo. does go off symp.  I just don't have a lot of patience when it comes to feeling lousy.  Any input is appreciated.  Thanks

[gimel]

With those symptoms and FT4 I'd say hypo.  As I stated above, it is not at all uncommon to have a low TSH result when taking meds, yet still have lingering hypo symptoms.  You are hyper only if you have hyper symptoms, not just because TSH is low.  You need to get your doctor to understand this and increase your FT 4 level into the upper part of the range.  If your body is converting T4 to T3 adequately this will also increase your FT3 level and FT3 is the most important thyroid hormone.  It is four times as active as FT4, plus FT3 correlates best with hypo symptoms.  

Even if they don't believe in T3 medication, you should insist on testing for FT3, due to its importance and my expectation is that your FT3 will be in the lower third of its range.  Personally I think I would start working on your current doctor by giving him copies of everything you can find on the internet that references the importance of testing and adjusting FT3 and FT4, to alleviate symptoms, without being constrained by resultant TSH levels.  

In view of your long standing problem with being hypo, I would also suggest that you consider testing for adrenal function, Vitamins B12 and D, and ferritin.  All of these can be contributors and need to be checked out.

I also think that I would look around where you are to see if you can find a good thyroid doctor that will treat your symptoms in the above manner.  I've found that you can almost always evaluate a potential doctor by calling the office and saying that you are looking for a good thyroid doctor , but you have a few questions you'd like to ask one of the nurses first.  Then ask the nurse if the doctor is willing to treat a patient for hypo symptoms by testing and adjusting FT3 and FT4, with whatever medication is required to alleviate those symptoms, without being constrained by resultant TSH levels.  Also ask if the doctor is willing to prescribe meds other than T4.  If the answer to either is no, then keep looking.

[liya8]

Greetings

Been hypo thyroid since I was about 16 years old.  Now 57.

Feeling a bit dispondent as my TSH is 0.26 and the range is 0.17 -  4.3
Free T 3 was not tested this time but the last time it was 4.0
F T4 is 10.5 range 7.7 - 16.2

My voice is hoarse
body aches
Constantly feel cold - hands and feet feel cold
From time to time I start sweating a lot and then feel very cold again
when eat Carbs feel clammy and shaky afterwards
have swelling in my lower legs and my eyes are puffy at times red and feet itchy and dry.
Dry nails and hair

Here in Hong Kong they do not believe in T3 medication and also looks at TSH and feels testing for Free T3 is not a need.

The only other option I have is to go to Manila in the Philippines where a naturapath can treat with other Thyroid supplementation.

I am on 100mcg of LThyroxin on even days of the month and7 5mcg on the other days
Any advice will help.

I am not sure if I am Hypo or Hyper

[gimel]

The very best indicators for thyroid problems are symptoms, along with the levels of the biologically active thyroid hormones, FT3 and FT4.  In my opinion the reference ranges for FT3 and FT4 are too broad.  These ranges have never been corrected like was done for TSH over 6 years ago when its data base was purged of suspect hypo patients and the range was significantly narrowed.  If this same thing were done for the Frees, my experience with statistical analysis leads me to believe that their ranges would look more like the upper half of the current ranges.  I believe this is why we hear from so many members that have FT3 and FT4 in the lower half of the range and their doctor pronounces them as "normal", yet they continue to have hypo symptoms.

Here is a good link for you to read through.

http://www.hormonerestoration.com/Thyroid.html

So I am encouraged that your doctor is adding T3 to your meds, even though TSH is close to the low end of the range.  that's why I added the comment not to let the doctor get overly concerned with the TSH level.  When you are on thyroid meds it is not at all uncommon for the TSH to be suppressed below the range limit, with no hyper symptoms.

[Rasta15]

I would start cytomel on the Jan 27th and then re-test Feb. 24th.  So you think my levels are more consistent with hypo.?  or are you going based off symptoms?  I am still confused.

[gimel]

That's a good starting dose.  The reason I asked is that sometimes doctors will prescribe too much to start and the patient has a reaction  to it.  Much better to start slow and increase as needed.
When are you scheduled for testing again to see the effect of the Cytomel on FT3 level?  

[Rasta15]

Hi,

I believe it is 5 mcg 2x a day.  He said if I start having hyper sym. to reduce to one a day.    I have been tested for both Vit. B12 and D.  I have had a cortisol test and that was normal as well.  However, my testerone is low of normal. He said that may be some of my fatigue too.  I don't understand this whole thyroid thing.  I am trying to learn, but it seems so backwards and confusing.  Thanks for answering.  I am having a hard time trying to trust the dr.'s and I don't like taking med's.  

[gimel]

In my opinion the best way to treat a hypo patient is to test and adjust the levels of the actual, biologically active thyroid hormones (FT3 and FT4) with whatever type meication is required to alleviate symptoms, without being constrained by resultant RSH results.  Relief of symptoms should be all important.  Frequently this requires that FT3 is in the upper part of its range and FT4 is at least midpoint of its range, as yours already is.  So prescribing some T3 med is good directionally.  Hopefully since your doctor is at least testing for FT3 and FT4, then he will be agreeable to treating you for your symptoms, in this way.

If the doctor should get concerned about low TSH results, and want to reduce your meds, you should be aware that a low TSH  is the frequent result of being on thyroid medication.  A TSH below even the low limit of the range does not mean you are hyper, unless it is accompanied by hyper symptoms.  

How much cytomel has the doctor prescribed?  The doctor is right on with his direction that if the additional T3 does not improve your symptoms, then ther are additional tests that should be considered, including Vitamins B12 and D, ferritin, and
adrenal function.

[Rasta15]

Hi,

I have misplaced my last blood test results with the FT3 results.  I was going off of memory for the ones I posted.  I am confident they are right, but just did not remember the FT3 range.  

I was diag. with graves in 2003 and had RAI.  Since then I have been on .112 of generic lev.  In Sept. I went of birth control pill that I was only on for 6 weeks.  It screwed up my system and I have not been the same since.  After a ton of testing, a lot has been ruled out.  However, my thyroid still appears to be low of normal.  I am working with an endo. who reduced my lev. to .100 and took me off generic.  That was a month ago and I still feel those same symptoms.  However, I did just have my ovaries removed and I am on HRT.  So I had another dropped or adjustment in estrogen.  I know this can effect my thyroid.  My endo. said give my system 2 weeks and if I don't feel better to try the cytomel 2x a day and see if that helps.  Next course of action is adrendal tests, etc.  

I had my thyroid checked every month b/t sept. and dec.  one min. my tsh is 2.1 and then it is .64 or .46.  My t4 has been bt 1.0- 1.6.  This is mid range of normal I know, but my Ft3 has been borderline low.  In the afternoon I feel so leth. and tired, but at night I get a burst of energy.  I have never felt like this before.  I am a huge athlete and have been grounded by this.  

[gimel]

You did not post the ref. range for the FT3 result, but if it is similar to those I am familiar with, then a FT3 of 2.9 along with hypo type symptoms are indicators of still being somewhat hypo.  Are you on medication now?  If so, was any cause previously identified for being hypo and needing medication?  Also, when you say your thyroid has been up and down, what were the test results that were the basis for that belief?