# Newbie with Lab questions...



## HOODLE (May 7, 2012)

Hello! I have hypo and hashi's. I have all of a sudden started gaining weight rapidly. My Dr ran a slew of tests and my said my thyroid was off again. She started me on Cytomel 25mcg. It made me sick so it was dropped to the 5mcg. Even that made me feel headache nausea and just strange. I even tried taking just half the pill. She is sending me to an Endo again. Currently I take 125 of synthroid.
here are my labs..I Appreciate input..Thank you!
TSH...............(RANGE .48-5.90).....ME 3.29
FREE T4..........(RANGE .8-1.7)........ME 1.0
T3 FREE..........(RANGE 2.6-4.4).......ME 2.1
THYROID PEROX AB..)RANGE 0-9.0) ..ME 321.5
THYROGLOBILIN AB..(RANGE 0-20.0)..ME 599.0


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## lainey (Aug 26, 2010)

Not everyone tolerates T3 medications well, and starting at 25 mcg of Cytomel is a huge dose. You can go off it, give it some time to clear your system (a week) and try again at the low dose (1/2 5mcg pill) to see if you can work back into it.

Your numbers leave a lot of room for improvement--did you discuss increasing the synthroid? That would lower the TSH, raise the T4 and the T3 concurrently.


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## HOODLE (May 7, 2012)

No she did not mention that.. We just went from 100 to 112 to 125 as I could not go from 100 to 125 as it was to much of a jump...this was about 9 months ago. Where should the TSH be when you say room for improvement can you please explain. All I ever get is "normal" from my Dr till the T3 showed low. Is that extremely low? Also what do the anti bodies mean. Has them for several years.

Thanks so much!!:hugs:


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## lainey (Aug 26, 2010)

Well she will tell you "normal" as long as you fall under the lab range--which at 5.9 is quite high for TSH--more modern ranges go to 3.0 for example.

Many people feel better with a TSH of around 1.0. You are still quite a ways away from that, and with your low Free T4 and T3 values, really are not in immediate danger of being over medicated. A small increase to 137 might change things, for example.

All the antibodies mean is that your thyroid disease is autoimmune in nature. They are generally not influenced by the treatment with thyroid hormone, but some people report more symptoms as they wax and wane. There are quite a few reasons people may become hypothyroid--they can be born hypothyroid, or develop it due to surgery or due to treatment for hyperthyroidism or can simply have their thyroid stop functioning, but not necessarily due to autoimmune attack.


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## Andros (Aug 26, 2009)

HOODLE said:


> Hello! I have hypo and hashi's. I have all of a sudden started gaining weight rapidly. My Dr ran a slew of tests and my said my thyroid was off again. She started me on Cytomel 25mcg. It made me sick so it was dropped to the 5mcg. Even that made me feel headache nausea and just strange. I even tried taking just half the pill. She is sending me to an Endo again. Currently I take 125 of synthroid.
> here are my labs..I Appreciate input..Thank you!
> TSH...............(RANGE .48-5.90).....ME 3.29
> FREE T4..........(RANGE .8-1.7)........ME 1.0
> ...












Wow! You "certainly" need the Cytomel but truly, you should have been started on only 5 mcg. and then have it increased every 6 weeks or so as needed. It is powerful stuff.

Were you also still taking the Synthroid w/the Cytomel?

Have you had and ultra-sound? Whit such high TPO and Thyroglobulin Ab, it is a good idea because cancer needs to be ruled out. Or in, as the case may be.

cancer TPO and thyroglobulin
http://onlinelibrary.wiley.com/doi/10.1111/j.1699-0463.1994.tb04888.x/abstract
http://www.wikigenes.org/e/gene/e/7173.html

Understanding Thyroglobulin Ab.
http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html


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## HOODLE (May 7, 2012)

I had a biopsy a few years ago for a nodule that was benign. I started back on the Cytomel with my 125.of synthroid today. Only took half of a 5mcg. Will work my way up..How long do you think on the 1/2 of the 5 before trying to increase. I dont want to feel yucky again. Why do I respond that way when it is something I need? Would a higher dose of Synthroid help the Free T3 or do I need the cytomel too? I had not idea that the TSH was to go the other way... I thought the "higher" the number the better:ashamed0002:


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## Andros (Aug 26, 2009)

HOODLE said:


> I had a biopsy a few years ago for a nodule that was benign. I started back on the Cytomel with my 125.of synthroid today. Only took half of a 5mcg. Will work my way up..How long do you think on the 1/2 of the 5 before trying to increase. I dont want to feel yucky again. Why do I respond that way when it is something I need? Would a higher dose of Synthroid help the Free T3 or do I need the cytomel too? I had not idea that the TSH was to go the other way... I thought the "higher" the number the better:ashamed0002:


If I were doing this, I would stay on the 2.5 mcg. for at least 10 days and then I would add to that 2.5 mcg. of Cytomel for another 10 days, do this one more time for a total of 30 days which should place you @ 7.5 mcg of Cytomel and go get a FREE T3 test to see where you are at w/this.

You will feel even yuckier if you overdose on Cytomel and end up in the ER. Consider this.

If you do get the FREE T3 test, we need the ranges w/ the results as different labs use different ranges.


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## HOODLE (May 7, 2012)

My regular DR upped my Synthroid to 137mcg and to stay on the cytomel. They cytomel does not seem to be affecting me negatively now. Still on the 2.5. BUT upping the synthroid had made me more tired..?? is that possible and if so WHY??


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## Lovlkn (Dec 20, 2009)

I posted this on the other thread you began on the newbe section and want to add that 25mcg of Cytomel is HUGE to take along with your current Synthroid does.

I also noticed all the changing you have done on your meds - bad idea. You need to go back to your original Synthroid dose you were taking with the labs you posted and ease into Cytomel - like 2.5mcg 1 time a day then 2.5 mcg 2x a day and retest. Taking a full 25mcg daily and increasing your Synthroid is likely to make you hyper - very hyper.



> FT-4 mid range is 1.25 you are at 1 - Under-medicated
> 
> FT-3 mid range 3.5 you ate at 2.1 - Under-medicated
> 
> ...


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## HOODLE (May 7, 2012)

Thank you for all the replies. SOOO...if I upped my Synthroid that would be bad? I thought my TSH ect were to "high" and my FT3 t low. Will the Cytomel help the TSH too? I have not take the Cytomel since Satuday to see if the nausea ect get better. Why is this so complicated. and the pounds just keep stacking on no matter how hard I work out or diet :scared0015:
If I stay at 125 of the synthroid (my origional dose) and SLOWLY add the cytomel what can I expect from my labs?? I do feel much more emotional/depressed with out the cytomel if it is possible to notice in 2 days.


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## Andros (Aug 26, 2009)

HOODLE said:


> Thank you for all the replies. SOOO...if I upped my Synthroid that would be bad? I thought my TSH ect were to "high" and my FT3 t low. Will the Cytomel help the TSH too? I have not take the Cytomel since Satuday to see if the nausea ect get better. Why is this so complicated. and the pounds just keep stacking on no matter how hard I work out or diet :scared0015:
> If I stay at 125 of the synthroid (my origional dose) and SLOWLY add the cytomel what can I expect from my labs?? I do feel much more emotional/depressed with out the cytomel if it is possible to notice in 2 days.


When adding Cytomel to the mix, most doctors lower the Synthroid. To raise it make you sick. I have seen this for years. Many patients just "insist" that their FT4 should be high also. This is wrong. FT3 is your active hormone and that Cytomel should be titrated upward if needed every 8 weeks or so.

Most that take T3 are on about 88 mcg of T4 and that is sufficient. The ratio is supposed to be 4 (T4) to 1(T3)


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## HOODLE (May 7, 2012)

Thanks for the info. If I go back down to my 125mcg and take the cytomel 2.5mcg I still get nausea ect. It helps my mood though. I am miserable. I dont see the new endo for 2 more weeks. I think i will stick with just the synthroid until I see him. Will upping my synthroid WITHOUT the Cytomel help my T3?? Is my TSH in need of more synthroid?? Thank you all for input!


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## HOODLE (May 7, 2012)

Update...I stopped they cytomel and went to the 137 of synthroid...After 4 days I have not slept the last 2, heart racing and anxiety. I would have thought I could handle it with my TSH so high. Any advice??


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## Andros (Aug 26, 2009)

HOODLE said:


> Update...I stopped they cytomel and went to the 137 of synthroid...After 4 days I have not slept the last 2, heart racing and anxiety. I would have thought I could handle it with my TSH so high. Any advice??


How much Cytomel were you actually taking from the get go?


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## HOODLE (May 7, 2012)

Start of cytomel was 25mcg..after 3 days I was a mess so dropped to 5mcg..after reading on here I was taking 2.5 mcg daily.


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## webster2 (May 19, 2011)

Wow, 25 is a big dose! Hope things go well!


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## Andros (Aug 26, 2009)

HOODLE said:


> Start of cytomel was 25mcg..after 3 days I was a mess so dropped to 5mcg..after reading on here I was taking 2.5 mcg daily.


Yep; not surprised. 25 mcg. all at one time is enough for a horse and maybe even too much for a horse.

Hope you feel better and soon.


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## HOODLE (May 7, 2012)

Thanks everyone! The endo I went to I did not like. Does not even Test T3 and says NO ONE should ever take that poison.....??? He upped my synthroid. I spent 4 days of not sleeping and sweats..I even tried alt the 125 with 137. He said there is no way a jump that small would cause that as well as Does not believe in Armour ect. I think I wasted my money on this Highly respected Dr but I am back to the 125 and taking 2.5 of cytomel and feel better (I think) only been 2 days. I just dont know how to find a new DR! :O( or what I should do before I am 1000lbs and miserble!


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## Andros (Aug 26, 2009)

HOODLE said:


> Thanks everyone! The endo I went to I did not like. Does not even Test T3 and says NO ONE should ever take that poison.....??? He upped my synthroid. I spent 4 days of not sleeping and sweats..I even tried alt the 125 with 137. He said there is no way a jump that small would cause that as well as Does not believe in Armour ect. I think I wasted my money on this Highly respected Dr but I am back to the 125 and taking 2.5 of cytomel and feel better (I think) only been 2 days. I just dont know how to find a new DR! :O( or what I should do before I am 1000lbs and miserble!


You really don't need to find a new doc. You need to have a heart to heart w/the doc that Rx'd the Cytomel. Tell him what you have learned and ask him to work with and most importantly ask him to understand why dosing should be based on your FREE T3; not TSH.

And as you titrate the Cytomel upward via this doc by "only" 2.5 mcgs. each time, it is wise to back down a bit on the Synthroid. The ratio is 4 to 1 which would be like 10 mcg. of T3 to 40 mcg. of Synthrod (T4.)

What do you think of my suggestion?










Get labs every 8 weeks. All you need to get is the FREE T3 which should ultimately be stabilized at about 75% of the range given by your lab.

And a reminder that you need an ultra-sound!


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## HOODLE (May 7, 2012)

I agree. So in terms of the dosage. I am on 125 of synthroid and 2.5 of cytomel. What should my synthroid dose be now and what should it be at 112.5 if is lowered?

Thank you!


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## Andros (Aug 26, 2009)

HOODLE said:


> I agree. So in terms of the dosage. I am on 125 of synthroid and 2.5 of cytomel. What should my synthroid dose be now and what should it be at 112.5 if is lowered?
> 
> Thank you!


When you go up to 5 mcgs., lower Synthroid to about 112.5. Yes........that would be good. Actually that would be excellent and you probably would stay there at the 112.5 for a very long time even if you do end up needing about 20 mcgs. of Cytomel.

My Armour (180 mg., 3 grains) is 114 mcg of T4 and 27 mcg. of T3. 4 to 1 ratio or thereabouts.


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