Lab results low free t4, tsh, t4 index on Cytomel

[worddiva]

Hi guys :)  My doc's office seems very concerned with my recent lab results.

T3 uptake 24 (22-35)

T4 (thyroxine) total free T4 index greater than 0.7 (4.5-12.0)

T4 free .3 (.8-1.8)

On 50 mcg of Cytomel only.   Feel great.   I can actually lose weight.  Used to have goiter... not anymore.   They want me to repeat labs right away.   Should I be worried?

Any info. would be highly appreciated.  :)

[worddiva]

Will do Goola :)   Thanks again.   :)

[goolarra]

I'm 5'6", too, and WISH I was 148!  I got down to 125 about 30 years ago, and to tell you the truth, I didn't look all that good that thin, but 145-150 has always been good for me.  

Taking some T4 would probably help to even things out.  You might also take half your Cytomel in the morning and the other half in the early afternoon to see if it evens out the energy level.

Good luck with the new doctor.  Let me know what his plan is.

[worddiva]

Goola...I am 5'6 148.  Would love to be 129 but I look fine.   Hope I don't gain after he cuts me.  :(  I shouldn't though bc I workout almost everyday.

I take 50 in the am.  I do occasionally get tired in the late afternoon so I bet T4 would help.

[goolarra]

Cytomel really shouldn't be taken for weight loss.  It's okay to take some, along with some T4, but you really should try for a balance between the two.  Also, you are on a pretty high dose.  The increase from 25 to 50 was huge.

After two years on Cytomel, do you have any more weight to lose?  Do you have peaks and valleys in your energy level throughout the day?  How do you take your Cytomel?  Do you split it into more than one dose?  

[worddiva]

Hi goolara :)  Thank you for the info.   I will have my doc order the other tests you suggest.  

I forgot to mention tsh .02 as you might expect.

Two plus years on Cytomel.  Before that   on synthyroid 25 mg with Armour 60 mg. Labs looked ok. Felt decent but couldn't lose weight.   So doc put me on 25 of Cytomel.   Lost weight but then stopped.   Asked for another 25.  He said ok with 1.5 years of refills.  

Then I moved and had to change docs.   I'm so worried he will cut me and then I'll go back to not  being able to lose weight.   :(

All of my other lab work is great...cholesterol,  b12, etc.

[goolarra]

T3 uptake and FTI are considered obsolete tests, of limited usefulness.

Also, you're taking Cytomel (T3), so an FT3 test is an absolute must.  They didn't even test FT3.  T3 uptake is actually a misnomer...it's an indirect measure of T4.  

Your FT4 is very low.  Usually, low FT4 levels will make you feel hypo, unless FT3 levels are quite high.  You're right, low FT4 levels are common on T3-only meds.  Also, T3 meds will suppress TSH.  They should be ordering FT3, FT4 and TSH.

Feeling good is the goal, but Cytomel only on a long term basis is seldom prescribed.  How long have you been on 50 mcg of Cytomel?  What were you on prior?

[worddiva]

Hi Courtney.  Ty for the reply.  They said it was unusual for both tsh and free T4 to be low but I thought that was common on Cytomel?  My doc is not used to treating with Cytomel (It was prescribed by my other doc).

[courtney48]

I would repeat the labs.  More info would be helpful.  Did you ask what their concern was specifically?  What more tests would rule in or out?  Maybe asking a few more questions would help you feel less worried.