This is partially and update, and partially a request for feedback!
My thyroid doctor determined high reverse T3, small amount of antibodies, and generally low range T3 and T4, TSH varied high to low. Gradually switched from synthroid to cytomel only, and after much better t3/reverse t3 ratio, added synthroid.
I'm taking 25mcg cytomel (half in AM, half in afternoon), and 25 mcg Synthroid. I don't have my recent labs, however my TSH was around 2, T3 in the top of the range and T4 in the very bottom of the range. Reverse T3 ratio was perfect. This was not much different from my labs on cytomel-only taken 2 months prior, and I feel better with the small amount of synthroid. Until a month ago, I was taking 20 mcg of Cytomel, but insurance changed and taking four 5 mcg pills a day was significantly more expensive than one 25 mcg a day. The doctor was cautiously okay with this.
My problem is that I now seem to be having some symptoms of over-replacement - hot when others are cold, am now underweight, hyperactive and a little anxious/obsessive. BUT I am feeling even more awake and capable than ever - I think and learn better, sleep soundly, can't recall the last temper tantrum.
I'm in the middle of switching bipolar medicine to one less effective but without the side effects of weight gain and fatigue, and decided to stop refilling my antipsychotic medicine. I'm not sure what symptoms there could be from all of this, but the antipsychotic is what I suspect caused the anxiety/obsessions.
Is it better to keep my T4 levels so low since I had reverse T3 problems? The doctor wasn't thrilled by it, but also didn't want to double the synthroid dose by moving up to 50 mcg. Other than feeling sad frequently there's no more mental symptoms of low thyroid, just physical symptoms. I started a new job in a new city which could be the cause. Things aren't bad right now, but something doesn't seem right. I fear telling my thyroid doctor because in a way I feel better and don't want the medicine decreased, and I fear telling the psychiatrist because she'll say I'm "manic" and I don't want that medicine increased!!