Lab Results Help

[mudkme83]

Free T-3 261 (210-440)pg/dl
T-3 total 98   (97-219) ng/dl
Free T-4 2.3  (.8-2.7)


These labs i just got were from when i was on .50 levo. Now im on .75 and feel a bit hyper.My doctor did not have these results yet when he increased my dosage.Any ideas of where i should be dosage wise?. Do i need cytomel?

[laura1967]

Get a pill splitter from drug store....you will probably end up splitting dosage. 25mcgs of cytomel all at once is a lot....be prepared for possible palps and hyper feeling. Your T3 level was low and it is going to hit you at a running pace the first few days you take it. I would ask the dr if you can split the dosage, or I would just do it on my own.
You are right...you have to be your own advocate...they forget us easily from patient to patient...they are human and have to be reminded. Good Job! You kept making the phone calls and kept with it!

[Cynnieb4]

Glad you listened to your body. I am doing okay . I don't know why they just wouldnt let you stay on the armour then???? It seems to me it would be cheaper and save your cash flow from all this mess. I mean after all it is for life. You said you were feeling better on that.

[mudkme83]

.50 of Synthroid and .25mcg of Cytomel.Both in the morning. Just talked to my endo. Seems like they would have split the cytomel up into two dosages.But they didnt.Glad i made the call. If i would have taken .75 of syn. and 2 times a day .25 cytomel i would have probably had a heart attack do doubt. I have  come to learn that you have to take this stuff very seriously and know whats going on because in my case i have been switched like 10 times in 3 months on different things.Well here goes round eleven.

[laura1967]

Good deal! They should habe immediately lowered your levo dosage when they gave you the script for cytomel. Check again on the script for the cytomel. Starting dosage is usually 5mgs two times per day, with lowered dosage of T4 med by 25mcgs I think.
Yes it is nice to hear they are jointly working together to get you better!

[mudkme83]

Well as of last night my endo and GP talked about my situation and decided to add cytomel.The perscripton says cytomel #60 and it says 2s or 25 or something like that.The .75 dosage seemed to kick in yesterday and as i expected i feel really hyper.I was bouncing off the walls last night had very bad anxiety and my mind was in overdrive.Im glad my doctors are working together now to get me better, but i didnt take my levo this morning.I got to have them change my levo down a bit before i add this cytomel or i might have a heart attack.lol.My body seems to respond within a few days and lets me know if the dosage is right or not.Glad to see my doctors are finally starting to care a little more.

[stella5349]

Make sure when you retest it is not on any meds. Try to get as early as possible a blood draw to get a true reading.

Get the Free T3

I would think the soonest you can retest is in about 4 weeks - but six might be better.

Make sure you keep a log of all your symptoms whether relieved to not and start to look at where you feel best.

[Cynnieb4]

How, come he checked you so early?? I am noticing mine kick in three weeks later after switching back??? I think I would wait it out, at least a week or two. Your body will take time to adjust and then you will know. I am sure I am going to be due for an increase but won't know for two weeks. I am definatley hypot lol.

[kitty9309]

I agree with waiting and seeing. I would test again after 6-8 weeks on the levo.

If you feel hyper, I wouldn't dring a lot of caffeine.

[laura1967]

Yes 60mgs of Armour is equivalent to approx 88-100mcgs....I have found the conversion charts to not be real accurate. When I switched from 75mcgs of synthroid I ended up on 75 mgs of armour after starting at 60 as well. I am now on 90mgs and still will probably have room for a little improvement. They are useful for starting dosage.
Unfortunately I think you are going to have to wait the 6 weeks of being on 75 of levo and see where you stand....see if you are converting better. Ask for another free t3 with your next set of labs for your thyroid. If it is still low I would definately ask for Cytomel. It may relieve your symptoms incredibly....or not...I think it will. :)
As AR said....now is the time to wait unfortunately.
Drink lots of caffiene....lol....that always helped me a little bit! LOL

[AR-10]

That sort of changes everything.

60mg of armour is, what? Around 90 or 100mcg of levo?

Not trying to step on Laura's toes. I want to hear her opinion.

Myself, I think you are just going to have to wait and see.

[mudkme83]

That test was done after switching off armour 60mg to levo .50. I was only on the levo for about a week when that test was done. Now ive been on the .75 since friday.

[mudkme83]

Thanks for the comment. This is just what i had thought too. My t4 was right at the borderline but t-3 seemed just a little bit low.

[AR-10]

Before the med increase, your Free T3 was too low, but your Free T4 was good.

Your Free T4 could range from 1.2-2.4 and be considered good.
Maybe 2.5, but that would be the max.

Your Free T3 needs to be at least above midline on the range. Somewhere between 340-390, maybe 410 tops. It MUST be above midline.

So before your dosage change, you had plenty of Free T4, but not enough Free T3. The dosage increase will lower your TSH and probably put your Free T4 too close to or over the top, which will make you feel hyper. Your Free T3 likely wil not rise enough to be theraputic, unless you are lucky.

I hate to say it, but if I were the doctor, and I had those test results before changing your meds, I would have left you at 50mcg and added the smallest dose of Cytomel available.

Just my opinion. I would retest at six weeks, sooner if you start feeling hyper, maybe 3-4 weeks in if you feel it is going the wrong way. I'd go at least four weeks unless you develop heart symptoms that are bothersome.

[laura1967]

Your T3 level is pretty low and your T4 is on the high normal which could mean conversion issue. How long have you been increased to .75?? Don't forget it takes at least 6 weeks for levo to accurately change levels. If it was me I would ask for Cytomel as well as the levo.  It may help you feel better.