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Can overreplacement of synthroid and cytomel cause worsening symptoms?
I am on 150 mcg Synthroid and 12.5 mcg generic cytomel and my doctor thinks that I have too much medication, which is lowering my labs and creating worsening symptoms. I have cold intolerance, my hair is falling out, severe constipation, I am fatigued, and I still have all of the hypo symtoms so I am confused. Here are my labs:
TSH: <.01 range= .40-5.0 uIU/mL
Free T3: 2.4 range 1.7-3.7 pg/mL
Free T4: 1.1 range 0.7-1.5 ng/dL
I also had a pituitary MRI done which was completely normal. My blood pressure is 98/60, pulse is always around 60 bpm. I feel that I may need an increase in my meds, but my doctor wants to decrease them. I am concerned that by decreasing these medications, that my symptoms will get worse, not better.
Has this happened to anyone else?
TSH: <.01 range= .40-5.0 uIU/mL
Free T3: 2.4 range 1.7-3.7 pg/mL
Free T4: 1.1 range 0.7-1.5 ng/dL
I also had a pituitary MRI done which was completely normal. My blood pressure is 98/60, pulse is always around 60 bpm. I feel that I may need an increase in my meds, but my doctor wants to decrease them. I am concerned that by decreasing these medications, that my symptoms will get worse, not better.
Has this happened to anyone else?
Thank you for this information. I have a call into my doctor to discuss this further.
Thank you for the response. I forgot to add that my dosage has been increased gradually over the past 8 1/2 years. My previous doctor (who left) would slowly increase my Synthroid. I've been on 12.5 mcg of generic cytomel for at least 5 years. The previous doctor didn't want to increase the cytomel because my synthroid dose was already "quite high". I don't think that I've ever had my Reverse T3 checked. I'll talk to my doctor about this right away.
Thanks again.
Thanks again.
Question:
Was this a starting dose of BOTH the T3 and T3 medications? Or have you been on them awhile and have worked up to those dosage levels.
REason I ask is that if you went from zero to 150mcg T4 and 12.5 mcg T3 most people that would SHOCK the system and you would feel worse. And in fact some would respond with Hyper and overmedicated symptoms.
Also when starting from zero and adding Thyroid meds in for the first time many people will temporarily feel worse as your body attempts to adjust to the thyroid and balance things out. This is why it is always best to start low dosages and work up slowly.
But from the sounds of this. YOur Dr is FREAKED out by the Low TSH. Not realizing that the vast majority of people who are on Thyroid meds especially T3 meds (Cytomel) and especially with moderate dosage of T3 like you have will almost assuradly suppress TSH. Rendering TSH worthless test and should be ignored.
Most people target to feel well to have BOTH of the following:
1) Free T4 to be MIDDLE of the range or a bit higher (50% or so) and you are testing at exactly 50%
2) Free T3 to be 50% to 67% of the range (upper half to upper 1/3 of the range) you are testing at a measly 35% of the range.
Your symptoms might suggest a slight increase in T3.
But again if you went from zero to the dosage you are on now, I would suggest you cool things down and be patient. If you had been on the dose or worked up to the dose, then I would agree that your cytomel could be increased.
Have you ever had your reverse T3 checked? I ask this because reverse is useless. And comes from the conversion of T4 into T3. With that much FT4 it would seem that very little is being converted into T3. This would suggest that it is either being converted to Reverse T3 or not being converted much at all. The only real way to determine this would be to have the Reverse T3 tested.
Just some thoughts to consider.
Was this a starting dose of BOTH the T3 and T3 medications? Or have you been on them awhile and have worked up to those dosage levels.
REason I ask is that if you went from zero to 150mcg T4 and 12.5 mcg T3 most people that would SHOCK the system and you would feel worse. And in fact some would respond with Hyper and overmedicated symptoms.
Also when starting from zero and adding Thyroid meds in for the first time many people will temporarily feel worse as your body attempts to adjust to the thyroid and balance things out. This is why it is always best to start low dosages and work up slowly.
But from the sounds of this. YOur Dr is FREAKED out by the Low TSH. Not realizing that the vast majority of people who are on Thyroid meds especially T3 meds (Cytomel) and especially with moderate dosage of T3 like you have will almost assuradly suppress TSH. Rendering TSH worthless test and should be ignored.
Most people target to feel well to have BOTH of the following:
1) Free T4 to be MIDDLE of the range or a bit higher (50% or so) and you are testing at exactly 50%
2) Free T3 to be 50% to 67% of the range (upper half to upper 1/3 of the range) you are testing at a measly 35% of the range.
Your symptoms might suggest a slight increase in T3.
But again if you went from zero to the dosage you are on now, I would suggest you cool things down and be patient. If you had been on the dose or worked up to the dose, then I would agree that your cytomel could be increased.
Have you ever had your reverse T3 checked? I ask this because reverse is useless. And comes from the conversion of T4 into T3. With that much FT4 it would seem that very little is being converted into T3. This would suggest that it is either being converted to Reverse T3 or not being converted much at all. The only real way to determine this would be to have the Reverse T3 tested.
Just some thoughts to consider.
COMMUNITY LEADER
It appears that your doctor is going only by your TSH, which is obviously suppressed, but that's not unusual, considering that you're on a T3 thyroid replacement med.
Your FT4 is right at mid range, indicating that you don't need an increase in your T4 med; however, your FT3 is only at 35% of its range... rule of thumb is for FT3 to be in the upper half to upper third of its range. Rule of thumb is where most of us find that we feel best.
FT3 is the hormone that's used by the individual cells and in view of the low FT3, it appears that you could use an increase in your T3 med. You might try going up to 15 mcg/day and see if that helps, but most likely, you'll need a bit more than that.
Additionally, T3 meds are best split into multiple doses each do... for instance, I'm on 10 mcg T3 and I take 5 mcg in the morning, with my T4 med and 5 mcg just before noon. That keeps the T3 steady in your blood all day, so you aren't getting a "blast" in the morning when you first take it, then nothing when it wears off a few hours later.
Your FT4 is right at mid range, indicating that you don't need an increase in your T4 med; however, your FT3 is only at 35% of its range... rule of thumb is for FT3 to be in the upper half to upper third of its range. Rule of thumb is where most of us find that we feel best.
FT3 is the hormone that's used by the individual cells and in view of the low FT3, it appears that you could use an increase in your T3 med. You might try going up to 15 mcg/day and see if that helps, but most likely, you'll need a bit more than that.
Additionally, T3 meds are best split into multiple doses each do... for instance, I'm on 10 mcg T3 and I take 5 mcg in the morning, with my T4 med and 5 mcg just before noon. That keeps the T3 steady in your blood all day, so you aren't getting a "blast" in the morning when you first take it, then nothing when it wears off a few hours later.
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