Worried about hair loss

[millie808]

Hello,
I'm 35 female and have been treated for hypothyroidism for 10 years. For the past few years, I've been taking 75 mcg of Synthroid and 25 mcg of Cytomel. Back in March, I made a drastic change to my diet and lost 10 lbs in 2 months after switching to the Paleo diet. I was feeling great but would wake up super early which I attributed to paleo.
I had my bi-annual thyroid checkup and my doctor said I was on too much meds due to my weight loss and reduced me to a half Cytomel and 100 mcg Synthoid. Got tested again after 6 weeks and was told I was slightly high but could stay at that level. However I was feeling awful on that (really tired) so I talked to my doctor and agreed to going back to 25mcg Cytomel/75 mcg Synthroid. It's been 3 weeks and while my energy level is back (and waking up early too) my hair is falling out like crazy. It started after my first dosage change so it's been over 2 months now and my hair is really thinning out. I'm supposed to get retested in 2 weeks. Does this hair loss make any sense to you? I don't know what to do anymore!

[goolarra]

I really do need to see the ranges to see where you fall.  Could you either call your doctor and ask them to read you the ranges or call the lab for the same?

[millie808]

I was tested again at my doctors lab this time (so a week later) and got these results:
TSH: 0.044
FT4: 1.03
FT3: 7.51

I don't know the ranges for this lab. I was given the results over the phone. My doctor instructed that I stay on the 75mcg of Synthroid but cut the 25mcg of Cytomel in half. What do you think?

As for the hair loss, I think it was due to me going off the pill 2 months ago. I'm going back on asap.

[goolarra]

It is possible, but it's unusual.  Some people are comfortable very low in the range, few are happy below range, where you are, and most need to be around midrange.  We don't know what your FT3 is doing, and that could very likely be causing your wired feelings.  FT3 should be tested every time blood is drawn for all of us.  However, once you take T3 meds, it becomes crucial.  Can you imagine a diabetic trying to adjust insulin dose without testing blood glucose?  That's exactly what your doctor is doing if he's not testing FT3.    

[millie808]

I do feel a little wired and I wake up super early in the morning on my own which is very unusual for me.

Is it possible to be hyper with low T4?

[goolarra]

Your FT4 is very low in the range, as you mentioned.  You're not hyper unless you have hyper symptoms.  Do you?  T3 meds often suppress TSH, making it a uselesstest.  That's why it's so important to test FT3, especially when you're taking T3.

You've only lost 10 lbs.  That could be enough that you'd want to reduce your dose a little, but cutting it in half seems drastic.

T3U, despite its name, is an indirect measure of T4.  It's considered a fairly obsolete and useless test.  You really have to find out what your FT3 is doing.

[millie808]

So I got my latest results:

TSH: 0.024 ulU/ml (range is 0.27-4.20)
Free T4: 0.919 ng/dl (range is 0.93-1.7)
I don't have the T3 yet but it sounds like they did the T3 uptake vs free T3.

Currently I'm on 75 mcg of Synthroid and 25 mcg of cytomel. It was my dose for years when I weighed 130-135 lbs. I'm now 125 lbs.

It looks like I'm hyper but with still low T4. I'm also losing a ton of hair and I'm really concerned about that.

I'm talking to my endo today but I'm concerned he will just cut the Cytomel in half.

[goolarra]

That was a pretty drastic change in Cytomel.  You only lost 10 lbs, and he cut your Cytomel in half.  Hair loss is often the last symptom to go away.  The body heals the more crucial systems first.  Hair loss is reactive and often has more to do with what was going on a month or six weeks ago than what is happening today.  

Is your doctor testing FREE T3 and FREE T4?  Please post labs and reference ranges from before he reduced your meds if you have them.