# Thankfully I didn't have to fire my endo



## CMantz (Jun 4, 2010)

I had my first follow up with my endo post TT which was on 8/24. I have been wondering what my latest test results would be and what he would suggest. I was wondering if I would have to start looking for a new doctor...but actually I think he passed and I am going to keep him for now...

Previous labs
Surgeon ran labs on 9/15 after being on 100 mcg synthroid for two weeks post TT
TSH .02 (.3-5.5)
Ft3 1.7 (2-4.2)
Ft4 1.2 (.9-1.8)
surgeon wanted me to stop synthroid for 4 days and restart as he thought i was still hyper...obviously ONLY looking at my TSH. I did not agree and thus did not stop taking meds. I did add 200 mg of selenium to help with conversion.

Recent labs on 10/25
TSH .025 (.45-4.5)
Ft3 1.5 (2-4.4)
Ft4 1.48 (.82-1.77)

Endo immediately suggested adding 10 mcg of cytomel and to cut back to 75 mcg of synthroid and retest in 2 weeks.

What is interesting though is that this endo was only going to run TSH and FT4 but I requested the nurse add FT3 which she did. And it is probably a good thing I requested it because apparently I have issues with conversion and I wouldn't have even known it with out the FT3. And what was even more shocking was my endo isn't even going to run TSH the next time.

FINALLY a doctor that isn't all about the T*S*H!!!! hugs4


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## Andros (Aug 26, 2009)

CMantz said:


> I had my first follow up with my endo post TT which was on 8/24. I have been wondering what my latest test results would be and what he would suggest. I was wondering if I would have to start looking for a new doctor...but actually I think he passed and I am going to keep him for now...
> 
> Previous labs
> Surgeon ran labs on 9/15 after being on 100 mcg synthroid for two weeks post TT
> ...


Thank goodness but I cannot help but wonder what would happen if you were not informed.

Yeah, FT3 in the basement. May I make a suggestion? About the Cytomel? I won't wait for your answer though. I suggest that you start on 5 mcgs. at first for a couple of weeks. It is most powerful. A lot of folks don't realize that. And I am very very glad your doc Rx'd it for you instead of leaving you crimping along. Selenium is good but it is not the total answer. As you know.

That is correct; at a certain point, TSH is no longer relevant. Nor will the FT4 be really as taking any form of T3 depresses that as well. Expect to see the FT4 below mid-range and do know that this is normal and natural.

Are you on the Cytomel yet? If so,are you feeling good? Let us know.


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## CMantz (Jun 4, 2010)

I started the cytomel on Saturday. I did jump in with the 10mcg dose and haven't had any issues...actually haven't even noticed a difference. I did ask the doctor about splitting up the dose...5 mcg in the morning and the remainder mid afternoon. His advice was to take it all in the morning because he worried about me not being able to sleep but I think he thought I was suggesting taking it morning and evening.

Anyway today I took 5mcg in the am and will take the other after lunch and see if that helps the afternoon yawns.

Thank you for the info on the cytomel suppressing T4...I did not know that. Does that mean that I would need to add more synthroid to compensate? He reduced my synthroid because he thought FT4 was a little high but was that smart since he was adding the cytomel? At least I go back for labs in two weeks to see where I am heading.


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## Andros (Aug 26, 2009)

CMantz said:


> I started the cytomel on Saturday. I did jump in with the 10mcg dose and haven't had any issues...actually haven't even noticed a difference. I did ask the doctor about splitting up the dose...5 mcg in the morning and the remainder mid afternoon. His advice was to take it all in the morning because he worried about me not being able to sleep but I think he thought I was suggesting taking it morning and evening.
> 
> Anyway today I took 5mcg in the am and will take the other after lunch and see if that helps the afternoon yawns.
> 
> Thank you for the info on the cytomel suppressing T4...I did not know that. Does that mean that I would need to add more synthroid to compensate? He reduced my synthroid because he thought FT4 was a little high but was that smart since he was adding the cytomel? At least I go back for labs in two weeks to see where I am heading.


From what I have observed over the years, increasing the thyroxine to get the FT4 up renders the patient to be very very sick. After all, the T4 is not going to convert because there is no need for it too w/ the addition of the T3 (Cytomel) to the regimen. T3 is your active hormone.

Glad you could take the 10 mcgs. straight on. This is rare but everyone has a different system and metabolism.

I also think that it should be taken in the mornings as the doc suggests. It builds up in 3 days so as long as you take it in a timely fashion, you won't run out of steam.

Unless you are running a marathon! Which you may end up doing!

I for one, will be most anxious to see your labs and ranges in about 2 weeks if you care to share.


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## CMantz (Jun 4, 2010)

Thanks for your reply. I will be sure to post labs when I get them.
And BTW...I am not a guy


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## Andros (Aug 26, 2009)

CMantz said:


> Thanks for your reply. I will be sure to post labs when I get them.
> And BTW...I am not a guy


Oh, my gosh. Please accept my apology!! Lord have mercy!! I do wish we had little gender icons, it would so helpful to me.

Thank you for getting that straightened out!!! You are a good sport.

And yes, keep us informed. I do want to see those labs of yours.

Hugs..........


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## CMantz (Jun 4, 2010)

No worries.....


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## CMantz (Jun 4, 2010)

Previous labs on 10/25 were:
Ft3 1.5 (2-4.4)
Ft4 1.48 (.82-1.77)
Dr. dropped Synthroid from 100 mcg to 75 mcg and added 10 mcg Cytomel and requested new labs in 2 weeks.

Current labs are:
FT3 2.1 (2.0 - 4.4)
FT4 1.04 (.82-1.77)
Dr wants me to continue with 75 mcg of Synthroid but up the Cytomel to 15 mcg daily and retest before the end of the year.


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## Andros (Aug 26, 2009)

CMantz said:


> Previous labs on 10/25 were:
> Ft3 1.5 (2-4.4)
> Ft4 1.48 (.82-1.77)
> Dr. dropped Synthroid from 100 mcg to 75 mcg and added 10 mcg Cytomel and requested new labs in 2 weeks.
> ...


Well, the FT3 certainly is better but gosh; it makes me wonder if you are asorbing your Cytomel as well as you should be.

Do you have IBS or anything like that? Your doc is on it though and does not hesitate to titrate as needed and that is a very good thing.

Good to hear from you. How are you feeling in general? Certainly much better w/ the FT3 coming up?


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## CMantz (Jun 4, 2010)

No IBS. I have been taking the Cytomel in the morning w/ my Synthroid on a empty stomach and don't usually eat or drink anything for about 1 hr.

As far as feeling better...I think I am feeling better. Moods seem to be more stable. Not quite as tired in the afternoon as before. I seem to be tolerating the T3 as I am not having any hyper symptoms.

Where do I want my FT3 to ultimately level off?


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## Andros (Aug 26, 2009)

CMantz said:


> No IBS. I have been taking the Cytomel in the morning w/ my Synthroid on a empty stomach and don't usually eat or drink anything for about 1 hr.
> 
> As far as feeling better...I think I am feeling better. Moods seem to be more stable. Not quite as tired in the afternoon as before. I seem to be tolerating the T3 as I am not having any hyper symptoms.
> 
> Where do I want my FT3 to ultimately level off?


Everyone one is so different. However in all my years of this stuff, I have come to the conclusion that most of us do well w/TSH really low (like below 1.0) and the FT3 about half-way above the mid-range of your lab range for FT3 or higher.

It depends on how active you are.

I am so glad to hear you are doing so well thus far. This is the best ever news!


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