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High T3 lab after taking cytomel an synthroid
Ok, my T3 (that's all it said, not free T3 or anything) was over twice the high limit (taking 25mcg the last 6 months) and my synthroid dose was 100. My tsh was0.006 and Im Hashi. My doctor wants to lower my T3 dose. I feel fine. What should I do and does anyone else have this high a t3 after taking cytomel? Actually, I haven't even been taking my full dose for a while now of Cytomel because it's so darn expensive. Help, please...
COMMUNITY LEADER
Whenever T4 and T3 don't have "Free" or "F" attached to them, they will be total; that's why we ask for clarification when we see only "T4" or "T3".
My insurance always pays for my FT3, so hopefully, yours will, too.
"I guess no one has ever asked them for the free version before. That's just sad..." Yes, it is sad, because most people don't know to ask for Free T3; in fact, many people don't even know there is such a thing as T3, either free or total. The saddest part is that we even have to ask -- doctors should be testing the frees automatically, without us having to ask/insist/beg, etc. Yep, that's just sad!!
My insurance always pays for my FT3, so hopefully, yours will, too.
"I guess no one has ever asked them for the free version before. That's just sad..." Yes, it is sad, because most people don't know to ask for Free T3; in fact, many people don't even know there is such a thing as T3, either free or total. The saddest part is that we even have to ask -- doctors should be testing the frees automatically, without us having to ask/insist/beg, etc. Yep, that's just sad!!
They are going to re-test today. I HOPE my insurance will pay for it.They only keep the blood for 5 days and it is past time. The nurse said they had it in their computer as T3, so that's where the problem lies. I guess no one has ever asked them for the free version before. That's just sad...
COMMUNITY LEADER
I don't know where you are, or your circumstances, but some labs won't run FT3 *and* some doctors refuse to order it, no matter what; so are you sure your doctor specified FT3 and not just T3? You could call the lab and ask them to check the lab order; that would tell you who messed up. I think the labs also keep the blood for a period of time, so if it hasn't been too long, you might still get the test.
Then again, maybe your insurance company won't pay for FT3.
Iron supplement would raise your ferritin level, but you should talk to your doctor regarding the dosage. Be sure to eat plenty of iron rich foods, such as meats, green leafy vegetables, beans, nuts, whole grains, beets, etc.
Then again, maybe your insurance company won't pay for FT3.
Iron supplement would raise your ferritin level, but you should talk to your doctor regarding the dosage. Be sure to eat plenty of iron rich foods, such as meats, green leafy vegetables, beans, nuts, whole grains, beets, etc.
You know what? I rechecked the lab report and it DOES NOT state FREE T3..they ran the same darn test instead of the requested one. Can you believe that? either the doctor was careless in her orders to the lab here or the lab where it was sent didnt read the code right. Great. Sure glad I went to all that trouble for nothing...
As for raising ferritin levels, can you suggest the best way to do that? A regular iron supplement?
Thanks so much!
As for raising ferritin levels, can you suggest the best way to do that? A regular iron supplement?
Thanks so much!
COMMUNITY LEADER
Some people are comfortable at lower FT3 and FT4 levels, so you really don't need to change your thyroid dosage at all, unless you have symptoms.
COMMUNITY LEADER
Are you sure that FT3 is "really" FT3? Does the lab report specifically say Free T3 or FT3? It really looks more like result/range for Total T3. Please verify that.
That said, with a "little help from my friends", the RT3 doesn't really appear to be an issue, because it's only 35% of its range, while your FT3 (if that's what it is) is at 55%.
Synthroid is a T4 med, so in order to raise FT4 you would need to increase the synthroid and assume that there will be some conversion, which will, in turn raise FT3; however, keep in mind that an increase in T4 med takes at least 4-6 weeks to reach full potential in your system. You should then retest after 6 weeks and see where your levels are. Cytomel is at T3-only med and will do nothing to bring up FT4 levels.
Make only one change at a time or you won't know what actually helped/hindered.
Do you eat a lot foods that are rich in vitamin B12? Those would be meat, dairy, eggs, etc. It would seem that you don't have Pernicious Anemia. Like I said B12 is not toxic.
Bring your Ferritn levels up and see if that helps.
That said, with a "little help from my friends", the RT3 doesn't really appear to be an issue, because it's only 35% of its range, while your FT3 (if that's what it is) is at 55%.
Synthroid is a T4 med, so in order to raise FT4 you would need to increase the synthroid and assume that there will be some conversion, which will, in turn raise FT3; however, keep in mind that an increase in T4 med takes at least 4-6 weeks to reach full potential in your system. You should then retest after 6 weeks and see where your levels are. Cytomel is at T3-only med and will do nothing to bring up FT4 levels.
Make only one change at a time or you won't know what actually helped/hindered.
Do you eat a lot foods that are rich in vitamin B12? Those would be meat, dairy, eggs, etc. It would seem that you don't have Pernicious Anemia. Like I said B12 is not toxic.
Bring your Ferritn levels up and see if that helps.
So does the low T4 suggest I need to up my synthroid? or my cytomel? I find this all so confusing...I am not even taking any B12..don't know what the high number is all about there...
Thanks for your response!
Thanks for your response!
COMMUNITY LEADER
In my opinion, your doctor reacted ONLY to the low TSH.... FT3 and FT4 warrant change, but not what she wants........ FT4 is actually below range, while FT3 is only at 55%.
I'm sorry to say that I'm not well versed on the RT3, but I know it has more to do with the ratio of FT3/RT3 than the actual result, so it looks like there might be an issue there.
B12 is water soluble and there is no known toxicity, but if you're taking supplements, you could stop if your levels are twice the high end. Wish I could get my levels up there; I'd be going "zoom, zoom" all the time... lol
You should supplement to bring up your ferritin level.
With Hashi, you will need periodic adjustments to thyroid med until your thyroid no longer produces hormones. You may already be at that point, but you'll know when your FT3/FT4 levels remain stable for a period of time, with no symptoms.
I'm sorry to say that I'm not well versed on the RT3, but I know it has more to do with the ratio of FT3/RT3 than the actual result, so it looks like there might be an issue there.
B12 is water soluble and there is no known toxicity, but if you're taking supplements, you could stop if your levels are twice the high end. Wish I could get my levels up there; I'd be going "zoom, zoom" all the time... lol
You should supplement to bring up your ferritin level.
With Hashi, you will need periodic adjustments to thyroid med until your thyroid no longer produces hormones. You may already be at that point, but you'll know when your FT3/FT4 levels remain stable for a period of time, with no symptoms.
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ok, here's my updated labs and restatement of my question...
I had a t4 and t3 plus tsh lab done last month with my tsh being .0006 and my t3 being double the high end. Doctor wanted to decrease my 25 mcg of cytomel and leave my 100mcg of t4 alone. I had her agree to first do a free t3, freet4 and rt3 test first. it came back as follows:
t4, free (direct) 0.92L (limits 0.93-1.60 ng/dl)
t3 free 131 (limits 71-180 ng/dl)
Reverse T3, serum 20.7 (limits 13.5-34.2)
I' have slightly low ferritin level and very high B12 levels, like double the high end.....
does any of this suggest a course of action? Doctor agreed to leave my t3 dose alone...Oh, and I have Hashis and am 19 yrs old been on thyroid meds for a few years due to weight gain...What do you think?
ok, here's my updated labs and restatement of my question...
I had a t4 and t3 plus tsh lab done last month with my tsh being .0006 and my t3 being double the high end. Doctor wanted to decrease my 25 mcg of cytomel and leave my 100mcg of t4 alone. I had her agree to first do a free t3, freet4 and rt3 test first. it came back as follows:
t4, free (direct) 0.92L (limits 0.93-1.60 ng/dl)
t3 free 131 (limits 71-180 ng/dl)
Reverse T3, serum 20.7 (limits 13.5-34.2)
I' have slightly low ferritin level and very high B12 levels, like double the high end.....
does any of this suggest a course of action? Doctor agreed to leave my t3 dose alone...Oh, and I have Hashis and am 19 yrs old been on thyroid meds for a few years due to weight gain...What do you think?
COMMUNITY LEADER
I'd have to move from your neck of the woods, because your doctor would kill me, with my < 0.01 TSH and low FT3/FT4. She'd be taking away my medication to bring up TSH, while FT4 and FT4 would keep going down. Actually, had a doctor who did that, and I, literally, thought he was going to kill me.
COMMUNITY LEADER
Well, I know she only believes in TSH, but I keep hoping for something more!! LOL
Oh you humor me with the "what test did she order"...
She only belives in TSH.....
The mega dose was added too the OTC Vit D. Funny part is I had no symptoms of being over medicated on Vit D..
I will keepn you updated on the test results.
She only belives in TSH.....
The mega dose was added too the OTC Vit D. Funny part is I had no symptoms of being over medicated on Vit D..
I will keepn you updated on the test results.
COMMUNITY LEADER
"My vit d level was over 300 when she put me on the regime of 50,000 once per week & 2000 OTC daily." 300 was before she put you on the mega dose, plus daily, or after? I'm assuming (yeah, I know what that means.... lol) that was after.......
Seems that she really went overboard, didn't she? Usually, if a weekly "mega dose" is prescribed, there is no additional daily supplementation required. That would be 50,000 + 14,000 (7 days X 2,000 IU) for a total of 64,000/week......... wow!!
Do you know which thyroid tests she did? Hopefully, both FT3 and FT4!!
Please post results/ranges when you get them.
Seems that she really went overboard, didn't she? Usually, if a weekly "mega dose" is prescribed, there is no additional daily supplementation required. That would be 50,000 + 14,000 (7 days X 2,000 IU) for a total of 64,000/week......... wow!!
Do you know which thyroid tests she did? Hopefully, both FT3 and FT4!!
Please post results/ranges when you get them.
I was taking OTC vit D, but my endo took me off it as well about 4 months ago due to toxcicity (sp?) My vit d level was over 300 when she put me on the regime of 50,000 once per week & 2000 OTC daily.
This past Wed was the first time she has tested my thyroid & vit d, I won't know the results until next week when I go in to see her.
This past Wed was the first time she has tested my thyroid & vit d, I won't know the results until next week when I go in to see her.
COMMUNITY LEADER
If you think your muscles aches are related to vitamin D, you can always supplement OTC and see if helps.
Hard to tell what the labs really are on the T3.
You have not actually been taking it lately. I can say one way or another with T3, my endo will not even talk about it.....ONLY T4 & TSH....
I just had lab work done this morning for TSH & vit d. I have a feeling she will TRY to lower my Synthroid from 175mcg to 150mcg. I say that only because when she put me on 175mcg 3 weeks later she tested and it came back at .36, so I can only imagine getting the full effect of the dose 6 months later...
The only symptoms I have are muscle aches but I believe that is due to her taking me off Vid D completely..
You have not actually been taking it lately. I can say one way or another with T3, my endo will not even talk about it.....ONLY T4 & TSH....
I just had lab work done this morning for TSH & vit d. I have a feeling she will TRY to lower my Synthroid from 175mcg to 150mcg. I say that only because when she put me on 175mcg 3 weeks later she tested and it came back at .36, so I can only imagine getting the full effect of the dose 6 months later...
The only symptoms I have are muscle aches but I believe that is due to her taking me off Vid D completely..
COMMUNITY LEADER
Both Armour and ERFA are desiccated porcine medications - derived from pig thyroid. ERFA is a Canadian drug. Both are T3/T4 combo, and have much more T3 than the body normally produces. If your FT3 levels are so high on 25 mcg of cytomel, I'd have to wonder if desiccated would be right for you, because of the high T3 content.
If the muscle cramps were your main symptom and they went away with 10 mcg cytomel, why were you raised to such a high dose? It seems that you could have gotten by with much less.
If the muscle cramps were your main symptom and they went away with 10 mcg cytomel, why were you raised to such a high dose? It seems that you could have gotten by with much less.
Thanks so much..I will look in to Armour, but have not heard of ERFA...I also got the doctor to order more labs for the FT3 and FT4 as a condition to possibly lowering my dosage.I'd love to go with the generic T3 but may try a different manufacturer and see if that does better. I was getting muscle cramps in my legs (charley horses..painful!) and they stopped when I went to the Cytomel. And this was on the lower starting dose of 10mcg...half at night and half in the morning...
Hi, Barb, Thanks for your response! I was wondering if you had any difference when taking brand vs generic? And if the generic is working well for you with no side effects, can you tell me the manufacturer?
My doctor is an idiot. I know that but she's the only one who would even prescribe cytomel. i tried the generic first and was having side effects and no good symptom relief, so tried brand name and it was as different as night and day. I ask for free t3 and T4 but they refuse to oder them apparently. All they know is total. I dont have a copy of results yet. I was just called and toled they want to reduce the dosage because my t3 was over 300.
COMMUNITY LEADER
Can you please post actual results so we can get a better idea of what's going on? Reference ranges vary lab to lab, so have to be posted with the results.
If the lab report only said T3, then that was most likely total T3 and a huge amount of that would be bound by protein and unusable. You really need to get a Free T3, because that's what's actually available for use by the individual cells.
Are you also getting T4 labs? Are they FT4 or TT4? Total labs for both T3 and T4 are obsolete and of little value; basically a waste of money, when they can test for the frees and tell you exactly what's happening.
25 mcg of T3 med is quite a lot, but if you feel well, who cares?
Not sure where you are, or where you get your T3 med....... I'm on a generic T3 and the cost is minimal, but even when I was on brand cytomel, it wasn't that expensive; you might want to think about switching to generic vs brand.
If the lab report only said T3, then that was most likely total T3 and a huge amount of that would be bound by protein and unusable. You really need to get a Free T3, because that's what's actually available for use by the individual cells.
Are you also getting T4 labs? Are they FT4 or TT4? Total labs for both T3 and T4 are obsolete and of little value; basically a waste of money, when they can test for the frees and tell you exactly what's happening.
25 mcg of T3 med is quite a lot, but if you feel well, who cares?
Not sure where you are, or where you get your T3 med....... I'm on a generic T3 and the cost is minimal, but even when I was on brand cytomel, it wasn't that expensive; you might want to think about switching to generic vs brand.
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Total T3 really tells us nothing, because we have no idea how much of that is bound by protein and unusable. Same goes for T4.
You might try pre-interviewing doctors to find one that test for FT3 and FT4, as well as prescribe all types of medication, including, T3 and T3/T4 combos, such as Armour, ERFA, etc.