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Cytomel and Water Retention

Hi All,

I'm new here. Quick info regarding my stats: I'm a 29 year old man. Have been taking Synthroid since I was diagnosed Hypothyroid (6 years). In that time I have never felt quite right, but over the last 8 months everything went haywire. I've gained close to 20 pounds, my levels are all over the place, and my dosage has been upped three times (125 to 137 to 150). The last thing I tried was a switch to Armour, which nearly took me down. I felt worse than I ever have. I switched back to Synthroid 150, and haven't felt well since. I feel Hypo again.  

My last set of labs were:

TSH    3.590    (0.450 - 4.500)
FT4     1.71      (0.82 - 1.77)
FT3     3.2        (2.0-4.4)

What on earth is going on with my levels? I tried Cytomel, and it actually caused weight gain through water retention. I honestly don't know what to do. I feel like my doctors are stumped as well. I could really use some help, because I'm getting really depressed with all this. I've lost all my energy and drive.

Thanks,
HypoGuy
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1756321 tn?1547095325
I too worsened drastically on Armour. I talked about this on another answer if you are interested in that.

http://www.medhelp.org/posts/Thyroid-Disorders/Is-anyone-here-taking-more-than-5-grain-NDT/show/2277875

Do you have Hashimoto's thyroiditis?
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Avatar universal
Interesting. Thank you for your comment. I guess Armour just doesn't agree with all of us? Too bad, because I had heard such great things.

I believe I do have Hashimoto's Thyroiditis, but I'm not even sure how that changes treatment. I'm pretty sure I'm having an attack now, but I don't know what to do. The doctors are next to useless. It'll be another month before I can get in. How does treatment change for Hashi's?

Also, anyone have any ideas on the Cytomel weight gain connection?

Thanks!
HypoMan
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Avatar universal
Your FT4 is actually quite a bit on the high side.  It's 94% of range, and that's high of the 50% guideline.  FT3 is right at 50% of range, and the guideline for FT3 is 50+%.  

TSH is a little high.  AACE recommended many years ago that TSH range be changed to 0.3-3.0.  Your lab, as with most, has bee slow to make that change.

Have you considered testing RT3 (reverse T3)?  FT4 is converted to both FT3 and RT3.  However, RT3 is inert.  Sometimes, when FT4 levels are very high, it will trigger a reaction in which more FT4 is converted to RT3, rather than FT3.  One theory is that FT3 and RT3 compete for docking space in cell receptors, and RT3 can block FT3 from getting in.

How long did you try Cytomel for?  How much were you taking?  Same questions for Armour.  
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Avatar universal
Thanks for the response. I feel like I'm taking too much T4, but the TSH is confusing the doctors.

I took Cytomel 5mcg for about two months. Gained 15 pounds in that time. I only took Amour for 2 weeks -- had a horrible reaction to it, and had to stop. I was truly bedridden for the first time in my life. I think it was because I switched straight to it without any titrating. I also think losing the Synthroid was a shock. I wonder if a mix of Synthroid and Armour could help. I've read about that before. It's not as common, but it's safe and effective for some people.
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Avatar universal
What was your horrible reaction to Armour?  Symptoms?  It can be challenging to switch from a T4 only med (Synthroid) to Armour (both T3 and T4 with a high T3 component).  T4 is very slow acting and remains in your system for weeks.  T3 is very fast acting and hits your system almost immediately.  So, if you go directing from straight T4 to Armour, you experience a double whammy for a while.

You certainly gave Cytomel an adequate try.

Some people mix T4 and Armour with success.  The high T3 content in Armour can make it difficult to maintain a high enough FT4 without getting FT3 too high.

Unfortunately, most doctors put way too much stock in TSH, ignoring FT3 and FT4 and symptoms.  

Do you think your doctor would test RT3 on request?  
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Avatar universal
My reaction to Armour was odd -- quite the opposite of what I would expect. I didn't feel hyper at all, no fast heartbeat, no anxiety, no energy. It's like the T3 wasn't even there. I became extremely fatigued, to the point where it was an effort to even move. I don't know how else to explain it, it honestly felt like I was shutting down.

I think my doctor would run RT3 if I asked. What would be the protocol if I had high RT3?

Thanks!
HypoGuy
Helpful - 0
1756321 tn?1547095325
You too might have issues with pancreatic enzymes due to not enough stomach acid. And you need an adequate amount of stomach acid to absorb nutrients.  An easy stomach acid home test I posted on another link...

http://www.medhelp.org/posts/Vitamins--Supplements/vitamin-mineral-absorption-and-anxiety/show/1723371

An article that is really indepth on RT3 is from Tired Thyroid: Reverse T3: Side Effects of T3-only (or Why You Need T4 Too). When I read this sentence this made all other RT3 websites talking about blocked receptors a bit dodgy lol: "If the hyperthyroid state causes high reverse T3 levels, and reverse T3 really "clogged" receptors, then no one could ever be hyperthyroid." :)

This info below is from Sensible Alternative Thyroid Clinic.  If you do have gluten intolerance one of the signs of this is vertical wrinkles on the finger pads. Interesting eh? My fingerpads are smooth but I'm not surprised about that. I do have lactose intolerance though.

Effective strategies for addressing the autoimmune aspect of Thyroid disease include:

Avoid wheat.
Selenium to reduce autoimmunity.
Correct vitamin D deficiency
Improve gut flora
Reduce stress
Correct underlying adrenal issue, such as DHEA or cortisol imbalance.
Correct oestrogen dominance. Consider using Natural progesterone.
Detoxify mercury and other toxins. (Testing for mercury toxicity is available at Sensible-Alternative Clinic).
Supplement selenium to lower thyroid antibodies. Also helps with conversion of T4 to T3.
Correct an iron deficiency.
Herbal medicine Bupleurum, Turmeric, Rehmannia and others.

Other Naturopathic treatments for thyroid.

Herbal medicines Withania or Coleus to increase production of thyroid hormone. (See Best Herbs for Women article.)
Iodine (not kelp) but in LOW dose. Use with caution in Hashimoto's disease.
Amino acid tyrosine which is the building block for thyroid hormone.
N-acetyl cysteine to detoxify
Vitamin B6 and Vitamin A to improve function of the thyroid gland.
Selenium and zinc to ensure conversion of T4 to T3.
Coconut milk/ coconut oil provides medium chain fatty acids to normalise gut flora and stimulate metabolic rate.
Exercise
Sleep
Thyroid hormone supplements."
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Avatar universal
Interesting reaction.  Did you have labs run by any chance?  I wonder if for some reason you weren't absorbing the Armour.  

If you have RT3 tested, be sure they test FT3 on the same blood draw.  RT3 numbers per se are fairly meaningless.  It's the FT3 to RT3 ratio that's important.  

What would the protocol be for high RT3?  That's the $64k question.  The article Red refers to from tired thyroid is an interesting perspective.  Many people are still sticking to the theory that RT3 blocks receptors (the tired thyroid article says that in an experiment in vitro, this did not happen).  Aside from the RT3 that's in Armour, all RT3 comes from conversion from FT4.  So, the theory goes, eliminate the T4, take T3 only, and the RT3 will eventually clear.  The tired thyroid article offers other suggestions, depending on why your RT3 is elevated to begin with.

Another theory is that the FT3:RT3 ratio is the best measure we currently have of tissue thyroid levels.    
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Avatar universal
Great info goolarra! I'll be looking into the above -- thanks.

Here's an interesting update -- I ran out of my Synthroid 150mcgs because I'm waiting for a new prescription to get called in. Anyway, I had to resort to taking a few of my leftover Synthroid 137mcgs for three days. Here's the interesting part: my water weight fell off! About six pounds melted away after the second day. Unfortunately, by the third day my aches and pains were back with a vengeance, along with headache and depression. I got my prescription refilled, and have been taking the 150mcgs again for the two days. Low and behold, I'm puffy again! The water retention is back!

Why could this be? What's going on here? It was so nice to lose that extra weight, and its very discouraging to have it come back just like that. Thoughts?

Thanks,
HypoGuy
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Avatar universal
I'm thinking of the fillers in the tablets.  Synthroid is color coded according to strength, so each dose has slightly different inactive ingredients, including dyes.  Dropping down 13 mcg per day for just three days would hardly effect your hormone levels, so we really have to look for something faster acting to explain your water retention coming and going.

You could try a few things.  Synthroid 50 mcg tablets are white...no dyes.  You could try taking three of those for a few days to see what happens.  You could ask your doctor to switch brands, perhaps to Levoxyl, for example.  Of course, Levoxyl has its own fillers, but they're different from Synthroid's.  You could try Tirosint, which is a gelcap with very few fillers and hypoallergenic (also has recently gotten VERY expensive).  
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Avatar universal
Thanks goolarra. I tried the 50mcg Synthroid route for about a month. It didn't seem to change much, and my insurance wouldn't cover it when prescribed that way. My doctor did mention Tirosint, but I'm nervous to start switching all around. I guess I do need to try something. Still scared from my Armour experience.
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Avatar universal
I was starting to think I was crazy?? I've been on cytomel a year and a half . Started at 10 up to 50 which I decided against however I've been puffy and weight gain ever since. I thought t3 helps you loose weight. I don't have a thyroid but I'm afraid to go off since it's helped my depression yet gaining weights kinda making me depressed again?? Ugh
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Avatar universal
You've take from 10 to 50 mcg of Cytomel?  Were you taking T4 at the same time?  

Do you have recent labs and reference ranges to post?
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Avatar universal
just wondering have you had your VitD checked also ferritin and B12 from what i learned on this forem, most of us that are hypo will be very low in all these vit, and if so this could mess with the absorbsion of the thyroid hormone, if you did have these test done, alot of times doctors will say your fine meaning your in the range even if it is in the very low range, you want to be in the higher range, if you had them done please post them with there ranges. And if you havn't had these tests done, I'd incourage you to do so. take care, I'm sorry your having to go thru all this,
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Avatar universal
I realize this is an old post but thought I should mention this anyway. Have you been tested for Hashimotos/autoimmune thyroiditis? Anti thyroglobulin and anti-TPO antibodies would show if you have autoimmune thyroid disease. If that is the case, it could be a reason why you were fine for many years on the medication but eventually symptoms worsened. That would happen if you have the autoimmune component that is not being addressed. There is a lot of information online about Hashimotos, and various treatment options for it (primarily lifestyle changes related to diet, stress, etc.) just a thought I wanted to share. Hope you are doing better at this point!
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649848 tn?1534633700
COMMUNITY LEADER
HypoGuy is no longer active on the forum, so it's unlikely you will get a response to your comments.
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