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hair loss, weight gain
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hair loss, weight gain

A few endos looked at bloodwork and says my thyroid function is fine.  However, another endo tells me these dr's. are 30 years behind the times, and that I have a sluggish thyroid, so he put me on cytomel.  

The other endos tell me that I need to get off the ctyomel immediately as it causes heart problems and osteoporosis in menopausal women.  The endo that put me on cytomel told me that these endos were full of sh**!! And that he himself has been on cytomel for years, so why would he put himself on a drug that risks his heart?

I am torn as to who is right here.  I will say that I haven't been able to lose weight (and keep gaining), have lost a lot of hair, tired all of the time, terrible insomnia,  sometimes body temp is 96-97 range, sometimes it is 98 range.

While on the cytomel, I was losing weight, about 5-6 pounds per week, (lost 23 pounds and was thrilled with this!) had energy, and was able to sleep through the night, which has been a rarity the last few years, and my boyfriend says I don't snore anymore!!  I told the endos this that told me to get off the cytomel, that I was feeling so much better, etc. and they still said to get off of it immediately.

I went off  the cytomel because of these doctor's warnings about heart problems long term.  The weight all came back, I am even heavier now even with dieting and exercise,  and my hair is getting very, very thin where I can actually see bald spots.  My sleeping is terrible, I'm snoring again, and very, very depressed.

I just this week decided to start taking the ctyomel, and I'm losing the weight again and feeling better, along with sleeping soundly.  So, I'm going to stay with it since I feel so much better.

My questions is this:  which endo dr. should I believe here, and can cytomel damage my heart long term?  Also, with being on it, will the hair loss be reversed, as this is devastating for me.

Thanks for any advice here.
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Avatar_m_tn
That is an awful story--this tale of the dueling endos.  First of all, based only on your symptoms and your low temperature , it does sound like you are hypo t.  This needs to be confirmed by specifically testing for free T3 and free T4, along with TSH.  Has this ever been done for you?   If so, please post the data and that will be very useful to us.  

The next question is , Why did the doc choose to prescribe cytomel only?   There are usually much better choices, including a T4 type such as synthroid, or a T4/T3 type such as Armour thyroid, or under some conditions, a T3 type such as Cytomel,along with a T4  source.

I have no idea where that opinion that cytomel would cause  heart problems and osteoporosis.  That supposedly is a concern if your TSH is suppressed below the low range limit and stays there for a long while.  Even then this opinion is disputed by studies that were inconclusive and could not prove those assumptions.  

At any rate, there is no need to go there.  If they will test  your free T3 and free T4 and
prescribe the type of med needed to get your free T3 into the upper part of its range, and properly balanced with free T4, without exceeding the low limit for TSH, then you'll be in what I call the "sweet spot".  Unless there are other concerns we don't know about, that should alleviate your symptoms, and bring your temperature up close to the optimal of 98.6, and  make you a healthy and happy lady.
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Avatar_f_tn
Hi,

Thanks for the informative response re the debate that I've had with "the battle of the endos"...lol...

My TSH is 2.82
My T3 is 118
My T4 is 6.8

Also, estradiol was extremely low at 14, along with vitamin d at 17 (which I am now supplementing the d), but don't want hormone replacement therapy as my mom died at 51 with breast cancer and my sister died at 64 with stomach cancer (I'm 48).

Not sure why the endo put me on just the cytomel and did not know to ask at the time.
He also put me on prescription vitamin d, along with phentermine for weight loss, so I'm not sure if it is the phentermine or cytomel that makes me lose the weight (or combo of the two), but either way, it works for me.  6 lbs just this week, so I'm so very optimisitc because I don't eat much junk food and watch caloric intake and have been exercising 3-4 times a week, and can't lose weight at all, so it is very defeating to work out with no results.

Anyway, just curious to know if you are in the medical field as you were so informative, which I really appreciate!

Also, will the cytomel help with the hair loss over time?

Thanks so much!

Poppies101

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Avatar_f_tn
Hi,

An added note to my last memo is that my insulin levels are on the low end at 11.2

Thanks again,

Poppies101
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Avatar_m_tn
The only thing I know about thyroid is from my own struggles over the years, along with what I pick up from internet sources, including our very knowledgeable forum members.  From your thyroid test numbers, I can see why there could have been differing opinions about the need for medication.  Still not sure why the endo who chose medication prescribed Cytomel, rather that the more usual approach of using one of the T4 meds.  
Also, realize that your  total T4 and total T3 tend to the low side and your TSH is at the high end of the range.  If your test was done late in the day, that is when the TSH level is lower than earlier in the day.  Also, if you were taking Cytomel at the time of these test data, I have read that thyroid meds. can affect the result.  The idea here being that it is better to have blood drawn for thyroid testing early in the morning without having taken any thyroid meds. yet.  

At any rate you still need to get a free T3, free T4 and another TSH test done, under the best conditions as I have described.  With these results, along with your symptoms and your temperature results, I think your apparent hypo t condition will become much clearer.  Then you will need a doc to prescribe med. to get you into the "sweet spot" and I think you will notice a big difference in your life.  As for hair regrowth, I'm not aware of anything that would preclude that, once your meds. are straightened out.

Keep in mind that you may have to find a new doctor who understands thyroid issues.  Even though you have gone to two already, you obviously haven't had any luck with them so far.    
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Avatar_f_tn
Hi,

Thanks for the reply.

All of the bloodwork was done in the a.m. and I was not on any thyroid meds at this point, so the readings were not altered by any meds.

I think it is  a good idea, however, to repeat the tests as it has been 6 months, although now the tests will be altered since I started back on the cytomel this past week.

Do you know if the hair loss will improve once the problem is stabilized?  This has been devastating for me, as it is noticeable.

Thanks again.

poppies101
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Avatar_m_tn
I'm not suggesting you get a rerun of the same tests.  Instead of total T3 and total T4 you need free T3 and free T4, to know where you really are.  I would also want to know why the doc chose Cytomel only.   In your situation, my choice would probably be Armour thyroid, which is a combination of both T4 and T3,  Then I would consider adding a T3 type med., such as Cytomel, only as required to get the free T3 into the upper part of its range.  
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Avatar_f_tn
Hi,

You and I exchanged a few emails re "battle of the endos" in which an endo put me on cytomel and two other endos said to get off it immediately for reasons of heart damage and osteoporosis, and in which they disagreed with the doc stating I was hypothyroid since bloodwork showed "normal" range.

I took your advice and went in for more thorough testing re hypothyroid debate.  As of 12/11/2007, my 3rd generation tsh was 2.43.  Hmmm...I asked the dr. to do a full panel of indepth thyroid testing, and it looks like this is the only test he ordered re thyroid.  

The test was done about 12:00 (noon...only time I could break free), but I was not on any meds at the time as I wanted a true reading without any influence from drugs.

Also, triglycerides were up to 154, ldl at 148, hdl at 63, total cholesterol at 242, chol/hdlc ratio at 3.8.

Dr's office asked me to continue with cytomel.  I didn't speak with the dr. directly, so I was not able to ask for T3 and T4 supplementation.  I will be seeing him within 3 months, but have continued again with cytomel this week, along with vitamin d supplementation.

Thanks again.

Poppies101
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