cytomel

Not sure where this post will end up.  I recently added Cytomel to my Synthroid.  Previously, I was taking Synthroid 112mcg 6 x weekly.  Dr. reduced to 88 mcg, 7 x and Cytomel 5 mg 2 x daily.  The full 5 mg cause real anxiety and palpatations.  I was told I could split the pill (challenging!  lol) and so far, I am taking only 2.5 approx, once in the am.
Will the anxiety settle down?  I am considering taking Xanax to level out, as I am not feeling so great, with the edginess.

[goolarra]

Do you have labs and ranges to post?

Unless your FT4 was still fairly low, the reduction from 112 mcg 6 x weekly to 88 mcg 7 x (672 to 616, or a reduction of 8 mcg daily) is not nearly enough to compensate for the addition of 10 mcg (as prescribed) of T3.  The rule of thumb is to reduce T4 meds by 20-25 mcg for every 5 mcg T3 added, IF you want overall dose to remain relatively equivalent.  That's because T3 is about 4 times more powerful than T4.

My personal opinion is that you'd be better off trying to get a better balance on your thyroid hormones than adding Xanax to cover symptoms.  

I believe you can get 2.5 mcg Cytomel tablets.  T3 has such a short halflife that it really does have to be taken in more than one dose or you get peaks and valleys in your levels.

[RenKat]

Thanks for the response.  Here are the last labs.  
TSH: 0.57
T4, Free:    1.4
T3, Total: 70
Free T3: 2.8
TP0: 199
TBa: 20

Thus far, I haven't taken the second dose of the Cytomel, thinking to give it a few days to settle down.
I haven't taken the Xanax, but quite honestly, I do not feel right.  I appreciate everyone on this forum, and their most vaulable imput.  Thanks,

[goolarra]

Do you have the ranges on your FT3 and FT4?

One thought:  you might try taking your Cytomel a little later in the morning, after you've had some food.  Cytomel doesn't have the absorption issues that T4 meds have, so you don't have to take it on an empty stomach.  

[RenKat]

Thanks for the reply.  

The FT3 is: 2.8 and the FT4 is: 1.4  
If those are the same as Free T 3 and Free T4.

I will try this, and appreciate the info.  We had a choice, to try this or Armour. I have read conflicting reports on Armour, and oft times, a difficulty obtaining it.  I am scheduled to have labs to recheck in a month.  I am  very curious to see how that goes and will update.  Thanks.  Take care.

[goolarra]

Free T3 is the same as FT3, free T4 is FT4.  Next to your results, on your lab report, there will be a reference ("normal") range.  Ranges vary from lab to lab, so they have to come from your own lab report.  You'll often see people post the result with the range in parentheses after it, e.g.:

FT4  1.4  (0.8-1.8)

Some people do well on Armour.  In fact, some don't do well on synthetics at all and can only take dessicated.  The advantage to synthetics is that the T4 and T3 can be manipulated separately for a dose that is a more custom fit.  Dessicated has a fixed amount of each.  The T3 content is fairly high, and some people can't tolerate that.  There are other brands besides Armour, like NatureThroid and Erfa (Canada).  Since Armour was reformulated a while back, many of our members have gone to these other two with very good results.    .  

[RenKat]

The range on T3 was 2.3 - 4.2
Thanks for the reply.  I guess the plan is give this a bit more time, and then switch to Armour, if neccessary.  Aside from the Hashimotos, and living in Florida, is profuse sweating a side effect?  Seriously, I am like drowing down here!  lol.  

[goolarra]

I used to live in FL (pre thyroid diagnosis) and remember the sweating all too well.  However, heat intolerance can also be a symptom of hyper or overmedication.  Your FT3 is pretty low in the range, so it does look like you should benefit from adding the Cytomel.  FT4 (I'm assuming a range of 0.8-1.8) is a little above midrange, and your TSH is slightly low, indicating that your Synthroid dose might be just a little high.  You might have to ask your doctor to tweak your Synthroid dose down a little more to accomodate the Cytomel.

[RenKat]

Thanks again, g.  I am looking into a move out of here, and heading north.  I have had enough of this heat, as it gets worse for me, each year.  lol.
I have only been on the 88 mcg 1 1/2 weeks from the 112 reduction.  I think you are correct, about the synthroid.  I may skip a day in this dose and In a few days, I will add the additional 2.5 to total the full 5 mg of Cytomel.  I am a long way from the 10 mg he originally ordered.
Despite the initial anxiety, I am noticing that the depression and lethargy that were so acute, are noticablely alleviated, so I won't stop the Cytomel.  I see the doc in about 6 weeks, and will have new labs then.  How is YOUR journey with this complex disorder?  I'd like hear.  Take care. R

[goolarra]

I'm glad to hear you're seeing some positive results.  I know your doctor ordered 10 mcg Cytomel, but bear in mind that many people do well on just 5 mcg.  See how your symptoms go.  If they go away, you might ask your doctor about staying at 5 mcg.  I always think it's a good idea to start out a little lower and increase if necessary.

I'm doing well, thanks.  I've been on a stable dose for over two years now, and I'm feeling good.  I had a very rough first year on meds.  I have a congenital heart defect that thyroid meds really exacerbated, and that was complicated by a pituitary issue that made me look hypo, even when I was hypo.  Once we all accepted that...  It just takes some time.