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Going to try Cytomel but is the dose too high?
I am on Synthroid currently 125 and my labs "look" normal as usual. Well, I tried a new endo since I still live with all hypo symptoms and asked for Cytomel with Synthroid. He reluctantly agreed to give it a try. He has prescribed lowering my Synthroid to 100 and adding Cytomel 5 b.i.d. for a total dose of 10. I think that seems a little high? My labs are: TSH 1.68. FT4 1.06. Total T4 9.7. Total T3 0.88. Total T3 uptake 37%. I do not know if Cytomel will help or not, but I am willing to try it versus living with the symptoms forever and ever....If not, I guess it is a life of "happy" Synthroid and symptoms!
I did post to the physician forum but I know they are probably extremely busy so I thought I would ask for opinions from actual people with hypo symptoms using these medications. Thanks!
I did post to the physician forum but I know they are probably extremely busy so I thought I would ask for opinions from actual people with hypo symptoms using these medications. Thanks!
Do you have recent FT3, FT4 and TSH labs to post (include reference ranges since these vary lab to lab so have to come from your own lab report)?
Do you know why your doctor put you on Cytomel only? T3-only meds are seldom used on a permanent basis, but sometimes used to treat metabolic disturbances on a temporary basis. How do you take your Cytomel? That is a huge dose of Cytomel, BTW. Since T3 is roughly fout times more potent than T4, 100 mcg T3 is equivalent to about 400 mcg of T4.
We need to balance both T3 and T4 to feel well. I'd like to see labs, but I'm betting you're overmedicated on T3 and starving for T4.
What's P-Thyroid?
Do you know why your doctor put you on Cytomel only? T3-only meds are seldom used on a permanent basis, but sometimes used to treat metabolic disturbances on a temporary basis. How do you take your Cytomel? That is a huge dose of Cytomel, BTW. Since T3 is roughly fout times more potent than T4, 100 mcg T3 is equivalent to about 400 mcg of T4.
We need to balance both T3 and T4 to feel well. I'd like to see labs, but I'm betting you're overmedicated on T3 and starving for T4.
What's P-Thyroid?
In Sept of 2010 I started to see this new internal medicince doctor for my thyroid. I sought other treatment because I knew that my gaining weight and unstable thyroid symptoms I could no longer tolerate. He started me on P-Thyroid in Oct and did well. I wasn't losing weight but, felt good. Then in Feb 2011, I had a bad reaction to P-thyroid and suffered a set back with my thyroid treatment. I had swelling in my legs, hands, feet (retaining water) My doctor took me off of that and then put me on 100mcg of Cytomel.
I felt good, started losing weight again which really made me happy. I had been on synthroid for 4 years with only gaining weight and couldn't lose a pound with 100% efforts. My doctor then did the saliva test for my adrenal glands because of continued symptoms, tests came back and here were the results. 5.3 (range 7.0-10.0), 1.7 (range 3.0-6.0), 2.3 (range 2.0-4.0), 1.1 (range <1.5). As you can see I am a little low in the morning and low again in the mid morning.
So, I am now on 100 mcg of Cytomel, 5mg of Hydrocortisone and I feel horrible. I have severe muscle fatigue, shortness of breath when walking, I get tired standing from the floor and my left hip has been hurting something terrible.
I see my doctor next week and even when I was on synthroid I never felt this bad. I could at least exercise, but my biggest complaint was I could not lose weight, even on the 1200 calories a day and even did the one where you eat 1800 a day to burn off fat.
I didn't notice these symptoms until going on the cytomel. Any thoughts???
I felt good, started losing weight again which really made me happy. I had been on synthroid for 4 years with only gaining weight and couldn't lose a pound with 100% efforts. My doctor then did the saliva test for my adrenal glands because of continued symptoms, tests came back and here were the results. 5.3 (range 7.0-10.0), 1.7 (range 3.0-6.0), 2.3 (range 2.0-4.0), 1.1 (range <1.5). As you can see I am a little low in the morning and low again in the mid morning.
So, I am now on 100 mcg of Cytomel, 5mg of Hydrocortisone and I feel horrible. I have severe muscle fatigue, shortness of breath when walking, I get tired standing from the floor and my left hip has been hurting something terrible.
I see my doctor next week and even when I was on synthroid I never felt this bad. I could at least exercise, but my biggest complaint was I could not lose weight, even on the 1200 calories a day and even did the one where you eat 1800 a day to burn off fat.
I didn't notice these symptoms until going on the cytomel. Any thoughts???
Yes, you don't know how many times I've wished I could write prescriptions!
Your FT4 is just a little below midpoint of the range, and midrange is the rule of thumb for FT4, so it looks good.
I wouldn't cut the Synthroid in half. You're right that that would be too big a decrease. I think it would be a good idea to start out at 5 mcg. It's always better to be a little bit conservative with changes. At 5 mcg you can see how you feel on it and minimize the possibility of feeling hyper from too much, too fast. You can work your way up to the 10 mcg after a couple of weeks if your symptoms persist. It's hard to know what to do without FT3 results. Your TT3 looks quite low, but FT3 and TT3 don't always correlate.
I think you have a good thought...start out at half and see how it goes.
Your FT4 is just a little below midpoint of the range, and midrange is the rule of thumb for FT4, so it looks good.
I wouldn't cut the Synthroid in half. You're right that that would be too big a decrease. I think it would be a good idea to start out at 5 mcg. It's always better to be a little bit conservative with changes. At 5 mcg you can see how you feel on it and minimize the possibility of feeling hyper from too much, too fast. You can work your way up to the 10 mcg after a couple of weeks if your symptoms persist. It's hard to know what to do without FT3 results. Your TT3 looks quite low, but FT3 and TT3 don't always correlate.
I think you have a good thought...start out at half and see how it goes.
He does not believe in FT3, only Total T3 and that is 0.88 and I did not get the range for that, but in looking online see it is around 0.8 - 2.0. The FT4 is 1.06 with reference of 0.58 - 1.64. I guess I could start out with only 5 mcg of the Cytomel and see how it goes...unless I cut my 125 Synthroid in half but that would be too low I think. Wish we could write out own Rx :)
Cytomel is roughly four times more potent than Synthroid. So, when you add in 10 mcg of Cytomel, you should lower Synthroid by approximately 40 mcg IF you want your overall dose to remain about the same.
Did your doctor test FT3 before adding the Cytomel? What are the ranges on your FT4 and TT3? These vary from lab to lab and have to come from your own lab report.
Did your doctor test FT3 before adding the Cytomel? What are the ranges on your FT4 and TT3? These vary from lab to lab and have to come from your own lab report.
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