# New labs done...need help on what to do.



## malenda_jane (Mar 14, 2014)

I was diagnosed with hypothyroidism in May of 2009 and started T4 medication. (Within the last year or two did I learn it was Hashimotos) Even though my labs came back normal after being on the medication for a while I still didn't feel good. I found a new doctor who is great and was willing to look at more then just TSH. Here are my results: The first results are from the endo she sent me too in March that said that I was fine. The second ones are the recent ones and I haven't been to see her about them yet.

3/12/14-TSH 0.862 range 0.340 - 5.600
Free T4 1.03 range 0.5-1.5
Free T3 2.90 range 2.5-3.9

10/07/14-TSH 1.02 range 0.34-4.82
Free T4 1.28 range 0.78-2.19
Free T3 2.64 range 2.77-5.27

My question is do I add a little T3 to the 75mcg of T4 I take or drop the T4 down to 50mcg and add T3? Or do I not bother with T3 and increase the T4 which still seems a little low to me? Everything seemed fine until a couple of years ago and that is when the hypo symptoms got worse. My hair started falling out and I am tired all the time. I am just frustrated and just want to feel better.


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## Octavia (Aug 1, 2011)

You definitely have some wiggle room in your Free T4. If these were my results, I would push for adding T3 without decreasing my T4 drug.


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## malenda_jane (Mar 14, 2014)

Would just increasing my T4 be a bad idea? Would it bring up my Free T3 levels too? I am just a little afraid of T3...back in March I tried 5mcg for about a week and I did not feel good. I am willing to give it another try...maybe I didn't give it enough time to have my body adjust. Also I was taking another medication at the time with lots of side effects. If I do decide to add the T3 do I just take it once a day or split it up?


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## Octavia (Aug 1, 2011)

I am assuming, based on your lab results above, that you are not converting T4 to T3 well enough. If that's the case, you could add T4 to the point that your Free T4 becomes too high, while your Free T3 is still struggling to be in range, or is still at the bottom of the range.

Unlike several others here, I had zero issues adding Cytomel to my Synthroid about a year ago. But I know some posters here had difficulty adjusting. Some stuck with it and things leveled out. Maybe some of those people will be along to comment.

Since you tried 5 mcg not too long ago, maybe another approach is in order. Your idea of splitting the pill is a good one. Maybe you could start with 2.5 mcg daily, then ease your way up to 5 mcg over the course of several weeks.


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## Lovlkn (Dec 20, 2009)

malenda_jane said:


> Would just increasing my T4 be a bad idea? Would it bring up my Free T3 levels too? I am just a little afraid of T3...back in March I tried 5mcg for about a week and I did not feel good. I am willing to give it another try...maybe I didn't give it enough time to have my body adjust. Also I was taking another medication at the time with lots of side effects. If I do decide to add the T3 do I just take it once a day or split it up?


Sometimes it can take awhile to adjust to. I broke my 5mcg pill into 4 pieces and took a crumb every 4 hours or so. I gave up due to anxiety while trying to adjust but the fatigue of a low FT-3 make me try again. It is baby steps while finding a dose that might be optimal. I now take 12/5mcg of Cytomel in addition to 125mcg of Unithroid. After my TT I took 125mcg of Unithroid and the doctor always told me my labs looked "good" - sigh. I started out with 5mcg of Cytomel.

I think you might want to ask for a lower dose of T-4 or break a pill in 1/2 and take 1/2 pill one day of the week, you can always go back to the full dose once you've adjusted to the Cytomel

I call Cytomel TNT - it's definitely explosive so be careful. It does such a good job once your body adjusts.


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## Andros (Aug 26, 2009)

If your new doctor is willing to Rx a small amount of Cytomel (5 mcgs.), try that but don't lower the med you are taking for T4. That amount would eventually be about right because as you continue to add T3; a 4 to 1 (cytomel) ratio would be the goal. And more importantly, how do you feel!


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## ifthespiritmovesme (Jan 8, 2014)

I added Cytomel to my Levothyroxine in May - 15 mcg, then upped it to 25 mcg in August. No trouble adjusting, and it has made a WORLD off difference in the way I feel.


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## Prudence (Oct 30, 2012)

malenda_jane said:


> ...back in March I tried 5mcg for about a week and I did not feel good. I am willing to give it another try...maybe I didn't give it enough time to have my body adjust. Also I was taking another medication at the time with lots of side effects. If I do decide to add the T3 do I just take it once a day or split it up?


Were you taking the full 5 at once, one time a day, I take it? It may be easier to split it in half, or even quarter it to start. Some people do better adjusting very slow, some can handle the full dose.


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## malenda_jane (Mar 14, 2014)

Yes I was taking the full 5mcg at once in the morning. I do think it's worth another try for sure. Last time I only took it for a week so I feel like I need to give it another try. This time I will start with 2.5mcg and split it into two doses. How far apart do you usually take it?


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## Lovlkn (Dec 20, 2009)

I take one upon waking and one 6 hours later


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## malenda_jane (Mar 14, 2014)

Ok so I have another question...how the heck do you split a 5mcg pill evenly? I am suppose to start with 2.5mcg and stay on that for 2 months and see where my labs are after that. But every pill I have tried to split breaks really unevenly. It wouldn't be a problem if I was taking the full 5mcg in a day because its spread out over a day and it adds up the the 5mcg. But I am splitting them every day and only taking half a day. One half is significantly bigger then the other. I have tried scoring it before I cut it and it still doesn't work. Is it ok it I get a bigger dose one day and not so much the next day?


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## malenda_jane (Mar 14, 2014)

OK so I have my labs and I am more confused then ever. I go see my doctor on Monday so I am not sure what she is going to do.

12/18/14

TSH 0.25 (0.34-4.82)

Free T4 0.95 (0.78-2.19)

Free T3 2.77 (2.77-5.27)

Reverse T3 17 (9.2-24.1)

Vit D 44.6 (30-100)

Medication adjusted from 75mcg t4 and 5mcg t3 to 50mcg t4 and 12.5 mcg t3

Vitamin D increased from 1000 to 5000 iu...doctor wants it in the 70s.

2/23/15

TSH 2.10 (0.34-4.82)

Free T4 0.72 (0.78-2.19)

Free T3 2.52 (2.77-5.27)

Reverse T3 6.8 (9.2-24.1)

I felt worse at first but then I started to feel a little better. About a couple weeks ago is when I noticed my hair loss slowed way down and I just generally felt better. If I could use a word to describe it I would say I felt brighter. I have been losing my hair for about 2.5 years so I was really happy to see that slow down.

But I also noticed that I started to get more constipated and I started sleeping more and I have gained some weight. I also started to get this squeezing feeling in my throat like my thyroid was working hard to make hormone. I have had the squeezing feeling before and it was when my TSH went up to 3.6. Now with the new labs I am really confused. Why have I been feeling better if my TSH went up and my frees dropped? Was it the vitamin D? I would love some input I am totally lost.


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## Octavia (Aug 1, 2011)

I'm not sure if I can really answer your question, but what I can tell you is based on the lab results you posted for February, you are hypothyroid--both your Free T3 and Free T4 are below range.


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