Current Labs

[snwbnemama]

I posted recently that my doctor was happy to try me on Cytomel when I told him I'd like to try it.  Here are my labs just before he added the Cytomel (I snuck the Free T3 lab onto the lab slip as he doesn't normally order it, I don't know why?).  I was taking 100mcg Synthroid daily.

5-9-13
TSH .56   RANGE .4-4.5
THYROXINE, FREE, DIRECT (T4 Free) 1.0  RANGE .8-1.8
FREE T3 3.0  RANGE 2.3-4.2
VITIMIN D 43    RANGE 30-100

He said they look better than my last ones which were:

2-28-13
TSH .85   RANGE .4-4.5
THYROXINE, FREE, DIRECT (T4 Free) .9  RANGE .8-1.8
VITIMIN D 23    RANGE 30-100


Anyways, I was just wondering what you guys think of my labs from 5-9-13, do they seem ideal?  I was still having a terrible time waking up and the afternoon slump around 2-4pm.  That's why I asked about trying Cytomel.  So, he has adjusted my meds to 88mcg Synthroid + 5mcg Cytomel.  So, far....I do feel better.  The past few days infact, I haven't been *as* tired in the afternoon.

[goolarra]

I didn't catch that he'd reduced your Synthroid when he added the Cytomel...I wish he hadn't done that, too.  

Your FT4 is only in the lower quarter of the range now, so it's likely to go down a little with the decrease.  FT3 should improve.

Since you have central hypo, your TSH is useless.  Hopefully, he's not going by that.

If you are increased beyond 5 mcg of Cytomel, think about splitting your dose and taking half in the morning with your Synthroid and the second half later in the day.  You can play with exact timing to see what works best for you.  Though some people can take it later, most prefer to take the second dose before about 3:00 (on a "normal" sleep schedule) so it doesn't affect sleep.

Do you have labs again in 4-6 weeks?

[snwbnemama]

oh, and no I don't split the cytomel....he wants me to take it in the am w/ my synthroid, for now.

He had me taking a Mega dose of Vit D for 6 weeks and now I take 1000 IU daily.  Don't know why he didn't tell me to increase that, because you're right, I'm barely in range.  

[snwbnemama]

Thanks.  I don't understand why doctors like to get you barely functioning instead of in those ranges you mentioned.  He acted like those labs were ideal.  That bugs me especially since I was still complaining of being so tired in the morning and afternoon.  I guess I should just be happy that he was willing to try the Cytomel....I had hoped he would just add it in addition to what I was taking though and not reduce the Synthroid.  we'll see how the next labs look.  I will keep in mind the 1.3 range for T4 and that my T3 should also be higher.  Very interested in how the Cytomel addition will show on the labwork.

[goolarra]

Your labs have improved, though only very slightly.  FT4 often has to be about midrange (1.3 on your range).  Yours just went from 0.9 to 1.0, which is better, but still not good.

Your FT3, which should be upper half of range, unfortunately was not run in February, but it's still very low now.

The same goes for vitamin D...an improvement, but quite a ways to go.

I think the addition of Cytomel was a good move.  Cytomel is much faster acting than T4, so you are likely to feel its effects sooner.  I know those tablets are teeny, but do you split your Cytomel into two half doses?

[snwbnemama]

I guess I should remind that I am Central Hypothyroid.  Also, finally had my Pituitary MRI done and nothing was found :)  My next labs will include Cortisol levels as I haven't had them checked yet and I've been wondering about possible Adrenal Insufficiency.