Aa
NEED LAB WORK HELP!! HASHIMOTOS .......
I don't really know where to start but am desperate for help. I am 39 years old and a mother of 4. I live in a small town in Wyoming that has ONE endo who is NOT efficient or knowledgeable. The only other Endo is over 100 miles so now I am seeing just a local "GP". I was diagnosed with Hashimotos about 4 years ago by an Endo in Phoenix. Now we live in a small town and seems no doctors are up on the Thyroid better yet "Hashimotos Disease". I started seeing the "GP" about 8 weeks ago when he did the initial bloodwork. He called me with these results:
Free T3 - 2.62
Free T4 - 1.10
TSH, 3rd Gen- 6.78
At the time of my visit I begged him to help me with the lousy way I felt. I have severe joint paint all over, VERY tired and sluggish, dry skin very short temper and was having CONSTANTLY rupturing fibroid cysts (which I have been told can be linked to hypothyroidism). At the time I had the above bloodwork done I was on 100mcg Levoxyl ONLY.
During the conversation with my "GP" via phone about the above bloodwork he advised that he needed to increase my levoxyl to 125mcg. I then asked him about taking "Cytomel" since I had heard such great stories. He said sure I will call it in for you. My pharmacist was shocked at the massive dose of "Cytomel" to start. The "GP" prescribed 125mcg levoxyl and 25mg Cytomel which was apparently a massive dose for the fact that I just took 100mcg levoxyl previously. I found out the hard way because I almost had a true heart attach the first day. My heart was racing like crazy. It took me a week to try the cytomel again. I felt like I was going to have to figure out what doses I needed to take on my own because my doctor was obviously unfamiliar as to thyroid doses. I called him back the next week and told him I wanted to stay on 100mcg of Levoxyl along with the Cytomel...he agreed. I still knew not to take the full 25mg of cytomel after the last weeks experience so I began taking 100mcg levoxyl and 1/4 of a 25mg cytomel pill (I cut it 4 ways) once a day for a week then went up to a half pill a day for a week and so on till I got to 25mg of CYTOMEL safely. I took this dose (25mg cytomel and 100mcg of levoxyl) for about a month and felt much better.. Joint pain was gone, fibroid cysts stop rupturing, hair and nails were growing and I definately had energy. There were 2 main concerns though. First, sometimes I felt like I had so much energy that I couldn't do ANYTHING if that makes any since. I felt like I was overwhelmed and in a whirlwind quite often. I wasn't losing ANY weight as I had heard people on Cytomel do and last..I was noticing I was very short and ILL tempered. I just don't think my dose was ever correct.
Now as of today April 24th, my doc called me back with my new and most recent bloodwork which I had done 3 days ago and advises me to STOP the cytomel cause my T3 is off the charts and my TSH isn't even on the charts. He said thats bad and no more Cytomel for me. Told me only Levoxyl from now on. WHY?? I felt so much better with it. Isn't there a happy medium? A dose that can make me feel human again without the edginess and short /ill temper? I have battled this thyroid problem way too long and it's like I am screaming and no one hears me. PLEASE GIVE ME DOSAGE ADVICE ON MY CYTOMEL AND LEVOXYL ACCORDING TO THE RECENT LABS (LISTED BELOW). My doctor has finally agreed today to let me have 5mg Cytomel daily and 125mg levoxyl according to my bloodwork. IS THIS RIGHT? I just don't have much faith in him anymore unfortunately. I have 4 kids who need their mother back to normal............any help is VERY much appreciated.
Here is the bloodwork I got back today:
T3- 6.03 (yes! thats correct)
TSH- .01
T4- 1.25
compared to my bloodwork at top of this post it is a big difference.
Free T3 - 2.62
Free T4 - 1.10
TSH, 3rd Gen- 6.78
At the time of my visit I begged him to help me with the lousy way I felt. I have severe joint paint all over, VERY tired and sluggish, dry skin very short temper and was having CONSTANTLY rupturing fibroid cysts (which I have been told can be linked to hypothyroidism). At the time I had the above bloodwork done I was on 100mcg Levoxyl ONLY.
During the conversation with my "GP" via phone about the above bloodwork he advised that he needed to increase my levoxyl to 125mcg. I then asked him about taking "Cytomel" since I had heard such great stories. He said sure I will call it in for you. My pharmacist was shocked at the massive dose of "Cytomel" to start. The "GP" prescribed 125mcg levoxyl and 25mg Cytomel which was apparently a massive dose for the fact that I just took 100mcg levoxyl previously. I found out the hard way because I almost had a true heart attach the first day. My heart was racing like crazy. It took me a week to try the cytomel again. I felt like I was going to have to figure out what doses I needed to take on my own because my doctor was obviously unfamiliar as to thyroid doses. I called him back the next week and told him I wanted to stay on 100mcg of Levoxyl along with the Cytomel...he agreed. I still knew not to take the full 25mg of cytomel after the last weeks experience so I began taking 100mcg levoxyl and 1/4 of a 25mg cytomel pill (I cut it 4 ways) once a day for a week then went up to a half pill a day for a week and so on till I got to 25mg of CYTOMEL safely. I took this dose (25mg cytomel and 100mcg of levoxyl) for about a month and felt much better.. Joint pain was gone, fibroid cysts stop rupturing, hair and nails were growing and I definately had energy. There were 2 main concerns though. First, sometimes I felt like I had so much energy that I couldn't do ANYTHING if that makes any since. I felt like I was overwhelmed and in a whirlwind quite often. I wasn't losing ANY weight as I had heard people on Cytomel do and last..I was noticing I was very short and ILL tempered. I just don't think my dose was ever correct.
Now as of today April 24th, my doc called me back with my new and most recent bloodwork which I had done 3 days ago and advises me to STOP the cytomel cause my T3 is off the charts and my TSH isn't even on the charts. He said thats bad and no more Cytomel for me. Told me only Levoxyl from now on. WHY?? I felt so much better with it. Isn't there a happy medium? A dose that can make me feel human again without the edginess and short /ill temper? I have battled this thyroid problem way too long and it's like I am screaming and no one hears me. PLEASE GIVE ME DOSAGE ADVICE ON MY CYTOMEL AND LEVOXYL ACCORDING TO THE RECENT LABS (LISTED BELOW). My doctor has finally agreed today to let me have 5mg Cytomel daily and 125mg levoxyl according to my bloodwork. IS THIS RIGHT? I just don't have much faith in him anymore unfortunately. I have 4 kids who need their mother back to normal............any help is VERY much appreciated.
Here is the bloodwork I got back today:
T3- 6.03 (yes! thats correct)
TSH- .01
T4- 1.25
compared to my bloodwork at top of this post it is a big difference.
I am on the other side of the fence with this thought. I agree with all of the above that the 25mcg of Cytomel was maybe too much all at once, but I am not horribly concerned over your readings off the labs. Especially with your GP not dropping your T4 Levo med down a bit prior to scripting you the Cytomel.
Personally - I think you should have been dropped to a lower amount of Levo while trying the Cytomel and the Cytomel should have been scripted to you to start at 5mcgs 2x's a day which would have given you the 10mcgs a day, I think you were probably in a medical induced hyper situation , but I don't believe you were nearing any thyroid storming due to the overmedicated T4 levo med - not the Cytomel.
It sounds to be, you are in the same situation so many thyroid patients are in with their doctors basing everything on a TSH level instead of looking at everything together. You recieved tests that ranged your "stored" hormones and not the "free" levels that really tell what is going on. Stored levels or straight T3 and T4 labs should be ran - but the FREE's are very important when you are dosing meds for relief of symptoms.
This is how I see it - as personal opinion. I think your levels were probably starting to level out for you on the Cytomel with your Free T3 - If you were relieved of the symptoms while on Cytomel of joint pain and the other things that were bothering you that your thyroid was causing, the Cytomel was doing what it should do. The only thing was you probably had to much Free T3 going through at once not necessarily from Cytomel - but the over conversion of T4 into T3 with the Levo - adding the Cytomel.
What time of day did you take your test? Did you take your T3 Cytomel prior to getting your labs done? This make a difference if the Cytomel was in your system prior to the lab.
You see, T4 meds needs to convert Free T4 hormone into Free T3. The Free T3 is the hormone that stabilizes you with thyroid symptoms and metobolism. Direct T3 as Cytomel - is a quick absorbed dose - but short lived within the system. so to stabilize on this type of med you need small dosages split through the day to achieve stability and it must be done in slow - small dosages. You eventually can climb up a bit until you find the right dosage to remain stable.
I agree your doctor does not seem to understand thyroid - or how to control the situation with medication. I hope this endo you plan on seeing sees things differently, but many find that until you find a doctor that looks at your symptoms and blends the labs with your overall health, they get caught up in a catch 22 of misery.
If I were you, I would start researching Free T3 hormone. Start learning the benefits of what this hormones can do to relieve thyroid issues. Learn about the correct way to get the Hashimoto in remission first before trying to level out on hypothyroid symptoms. Hashimoto is a horrible situation when those antibodies are raging and labs can be totally inconsistant when these are raging in full force.
Personally , I think that if your GP would have dropped your Levo to around a .75mcg and adding 10mcg Cytomel - 2 times a day - you would of been alot better off and probably would have not spiked hyper at all.
Personally - I think you should have been dropped to a lower amount of Levo while trying the Cytomel and the Cytomel should have been scripted to you to start at 5mcgs 2x's a day which would have given you the 10mcgs a day, I think you were probably in a medical induced hyper situation , but I don't believe you were nearing any thyroid storming due to the overmedicated T4 levo med - not the Cytomel.
It sounds to be, you are in the same situation so many thyroid patients are in with their doctors basing everything on a TSH level instead of looking at everything together. You recieved tests that ranged your "stored" hormones and not the "free" levels that really tell what is going on. Stored levels or straight T3 and T4 labs should be ran - but the FREE's are very important when you are dosing meds for relief of symptoms.
This is how I see it - as personal opinion. I think your levels were probably starting to level out for you on the Cytomel with your Free T3 - If you were relieved of the symptoms while on Cytomel of joint pain and the other things that were bothering you that your thyroid was causing, the Cytomel was doing what it should do. The only thing was you probably had to much Free T3 going through at once not necessarily from Cytomel - but the over conversion of T4 into T3 with the Levo - adding the Cytomel.
What time of day did you take your test? Did you take your T3 Cytomel prior to getting your labs done? This make a difference if the Cytomel was in your system prior to the lab.
You see, T4 meds needs to convert Free T4 hormone into Free T3. The Free T3 is the hormone that stabilizes you with thyroid symptoms and metobolism. Direct T3 as Cytomel - is a quick absorbed dose - but short lived within the system. so to stabilize on this type of med you need small dosages split through the day to achieve stability and it must be done in slow - small dosages. You eventually can climb up a bit until you find the right dosage to remain stable.
I agree your doctor does not seem to understand thyroid - or how to control the situation with medication. I hope this endo you plan on seeing sees things differently, but many find that until you find a doctor that looks at your symptoms and blends the labs with your overall health, they get caught up in a catch 22 of misery.
If I were you, I would start researching Free T3 hormone. Start learning the benefits of what this hormones can do to relieve thyroid issues. Learn about the correct way to get the Hashimoto in remission first before trying to level out on hypothyroid symptoms. Hashimoto is a horrible situation when those antibodies are raging and labs can be totally inconsistant when these are raging in full force.
Personally , I think that if your GP would have dropped your Levo to around a .75mcg and adding 10mcg Cytomel - 2 times a day - you would of been alot better off and probably would have not spiked hyper at all.
Your welcome, To explain the question regarding T3 and T4, Like I said I am sort of new on the lab results but learning here, In your post you just stated T3 and T4 and I did not know if that was "Free" T's because that is the term used for the actual hormone in your system, I also think this is site is a great asset to anyone with thyroid problems, it helps you understand your situation and lets you know you are not alone. Take Care and Good Luck FTB4
Thanks so much for your advice. I am definately going to make the long drive to see an Endo. I think I will definately stop the Cytomel for atleast a week as well. FTB4, you asked that I post my "free" T3 and T4 levels. Isn't that the same as the "t3 and T4 levels I posted in my first post? I am still trying to catch on to all this bloodwork lingo. Also, the reason he gave me 2 meds is because of course I had to have the levoxyl for the T4 but I wanted the Cytomel since it is straight T3 and my body wasn't converting the T4 to T3 as it should have. I have taken straight T4 (levoxyl) for 6 years now since I first found out I was HYPO. Then 4 years ago after I found out I had HASHI's everything just went to hell for me physically so this year I did a lot of research on cytomel and was very much looking forward to trying it so I could atleast partially function again. Thanks to you BOTH for your input. Like I said before, I feel like I am screaming here in "nowheresville" USA and no one hears me so it's nice to have people who are going through similar situations to talk to...........THANKS AGAIN!!!
I agree, that was a lot of Cytomel to start you on. Also agree it might be worth it to drive to find a decent endo. I think you're doing the right thing by cutting down the Cytomel. With your FT3, I might even stop it for a week, then maybe resume at 1/4 of the 25 mcg. Also, when possible, you should split your Cytomel into two doses...one in the morning, and one perhaps late afternoon. There is a happy medium, but right now the important thing is to get your T3 DOWN. In my opinion, you should stop taking it for at least a week. I've been in the position where I just about prescribed my own meds due to an inept PCP. It anin't pretty, and it's pretty scary. Don't let your T3 get any higher. Good luck.
You are overmedicated, and swinging Hyper, Your TSH should be between 03. and 3.0 and your Free T4 should be between 0.6 to 2.0, These are the references my Endo uses, I am kind of new at this, I was just daignosed with Hashi's in Jan, my TSH was a little over 6.0 I was taking 100 mg Synthoid and my Tsh dropped to 0.078 in six weeks, I don't know why you would need two medications? I would look into the other Endo, even if he is two hours away, you only need to see him every 6 weeks for labs and follow up, You need to reduce the amount of meds you are taking, or you could go into "Thyroid Storm" which is a serious condition, and cause a host of other problems, You need to Post your Free T3 and Free T4, these are your actual hormone levels, The Tsh is just a hormone your pituitary send to your thyroid and does not reflect your thyroid output. Once you post the "FREES" then other members can advise. Good Luck FTB4
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
