Thyroid -Over medicated

[RitaJS]

I'm 54 and have been taking thyroid medication for years - always hypo. My doctor put me on 50 mcg of cytomel and 50mcg synthroid. Then, recently I had my blood work done and results were TSH .05 and Free T4 -.44. My doctor took me off the cytomel today. He seemed confused with my blood work considering I've always been hypo. Could this indicate too much meds or pituitary glad problem. I seem to have brain fog, extremely tired,(at times- my speech is slurred. And I have osteoporosis. I've gained weight, and so tired.

[goolarra]

I agree with Deb that until both your FT3 and FT4 levels are balanced, you are going to find it hard to lose any weight.  You also need to find a doctor who understands thyroid disorders and will do adequate testing.

It is important (very) to lower your Cytomel dose...I didn't realize you were having palpitations.  Splitting the dose will help you to feel better throughout the day, but you also have to reduce the dose.  I'd still like to see what your FT3 levels are at the moment...I think it will be valuable information for you down the line to have that history.

It's also quite possible that once you get your thyroid levels balanced, you won't need some of the other meds you are currently on.  Some of your other symptoms may be more thyroid (or thyroid meds) related than you think.  

Do you have an appointment set up with a new doctor?  

[RitaJS]

Thank you for telling me that thyroid medications can cause heart palpitations - I had no clue. Can I ask you a question - have you had a DEXA Scan?

My blood pressure this week was 112/64  
Heart rate 68

Lab report:
Cholesterol (range 0-200) mine was 179
Triglycerides (range 30-200) mine 31
HDL (range 35-96) mine was 59
LDL (calculated)  114
HDL Risk Factor 3.0

Thank you so much!!!

[RitaJS]

Because I have osteoporosis I had Reclass injection so I wouldn't have to take fosamax, then I have to take 2,000 Calium w/D3 daily and I take a multivitamin, (I was given Adderall XR 15mg to help me focus- I don't take this everyday but it helps me focus and curbs my appetite) and  I take Smarter Focus which is vitamin/mineral  to help with memory and focus  I'm not suppose to take this within 4 hours of my thyroid medications.

Calcium Levels in July 2009 was 9.7 (range 8.5-10.5) prior to Reclass
Calcium Levels April 2010 was 9.4  (range 8.5-10.1)

I was thinking the Adderall was causing the heart palpitations so that is when I started taking the Smarter Focus. (I didn't realize that the thyroid medication could cause palpitations until SmilerDeb mentioned it.  THANK YOU SO MUCH!!!

[RitaJS]

My answer to your weight loss question is yes. I know when I took Cytomel in the past that I would lose weight and have more energy.  

I don't know if this is all in my head but ...yesterday, I took 50mcg of lovothyroxin and cut the cytomel into 3 pieces and took them through out the day. I seem to have more energy last night.

This morning I (on my own) took 1 1/2 true synthroid (75 mcg) and a 3rd of a 25mcg of cytomel.

I found my labs work from last year July
T4 Free     Range (.61-1.12) ng/dl     mine was  0.80
TSH          Range (0.34-5.60) mint Unites/mL  mine was 3.88

Prior to lab work I was on 25mcg of synthroid - he increased it to 50 mcg .

Then in November I was still feeling tired etc. and he put me on 25mcg of cytomel twice a day. My world was much better.  (I just noticed something on the lab report that was overlooked) my doctor wanted me to have  a PTH test? Any comments?

Thank you so much!!!

[Smilerdeb]

I agree with goolarra in rgeards to the dosage of a T3 med......50mg is a LOT with 50mcg of a T4 med....usually the dosage is 4 to 1.
The tsh has crashed low because of the T4 not being an adequate dose.
I know you dont have your FT3 as the Doc hasnt done it and yes, it is irresponsible of the Doc not to do it.
BUT.....if you continue on 50mg of T3 (cytomel) and 50mcg of T4 (Levo) then you are asking for trouble in regards to heart problems.
I'm surprised you havent had palpitations, SVC's etc.
I think your Doc needs to be ducated more on thryoid medication dosing and the thyroid itself.
You would be better taking a lower dose of Cytome (T3)l and a higher dose of Levo (T4).
That way the levels will balance out and then weight loss will happen usually.
By your FT4 being low, you have no hope of losing any weight at all.
Both FT3/FT4 have to be balanced along with TSH to be able to lose that weight.

A 'fallacy' with most people is that if you are HYPER, you lose weight.
It is just that....a FALLACY.
I was Hyper and gained 17 kgs (approx 34 lbs) because my levels were 'out of whack'.

Sorry but my opinion is to see someone who knows what they are talking about.....not a Doc who knows nothing about T3 dosing.

[goolarra]

I think the absolute best thing you can do right now is have your FT3 tested...also TPOab and TGab (the two thyroid antibodies).  I can't even speculate on what your Synthroid/Cytomel ratio should be without seeing that, and, furthermore, your doctor can't either.  If he's had you on 50 mcg of Cytomel and hasn't been testing your FT3, then he's incompetent...period.  That is just plain negligent.

When FT4 is too low, yes, it can cause all the symptoms you mention.  Cytomel doesn't stay in your body for long if not used promptly, so you have to have high enough FT4 levels for conversion to take place.  Otherwise, all the symptoms you mention can happen.  

I think your labs are showing that you are not getting the right BALANCE of thyroid medication, not that you're getting too much.  But, I won't really be able to say that for sure without seeing FT3.  Please, try to get that done.

Were you put on 50 mcg of Cytomel last July because you requested it of your doctor for weight loss?