# 6 week labs after starting 5 mg cytomel, I am a little disappointed....



## millironk (Jun 22, 2015)

6 weeks ago I was seen by a new doctor that agreed to prescribe me a low dose of cytomel. 62 years old , 40 plus years of diagnosed hypothroid, and fighting not feeling well, and told repeatedly nothing is wrong. Labs before the Cytomel:

TSH 0.852 (.5 to 5 ref)

Free T4 1.06 (.8 as the low end 2.8 upper)

Free T3 2.0 (2.3 as the low end 4.3 upper).

New labs came back (6 weeks on 5mg of cytomel)

TSH-- 0.274

Free t4 -- 1.05

Free t3-- 2.3

Doctor now wants to lower my Synthroid from 125 to 112 and says my Free t3 is now normal so no change in the cytomel dosage. I feel just as poorly as I have before. Any one else been in this situation? My T3' have been around 2.3 to 2.5 for the past 6 years of testing. (no other test other than TSH was done on me for the rest of the years I have been sick. I do believe I COULD (and deserve to try to feel better!


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## joplin1975 (Jul 21, 2011)

Did your doc say why s/he wanted to lower your Synthroid? You should really be upping your Cytomel...


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## millironk (Jun 22, 2015)

I agree that a higher cytomel dose would be what I would want to try.....He is thinking that the TSH dropped too much. what I have read is that the TSH always drops when someone is adding T3. I am waiting for him to call me back with a decision.


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## joplin1975 (Jul 21, 2011)

Yup, that's correct - TSH will always drop more drastically on t3 than without t3.

You need to get that free t3 number up in order to feel better.


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## Lovlkn (Dec 20, 2009)

> Doctor now wants to lower my Synthroid from 125 to 112 and says my Free t3 is now normal so no change in the cytomel dosage.


 ?? Why did he say? Due to the drop in TSH?

You need to find a new doctor.

Your FT-4 and FT-3 should be approaching 1/2 closer to 3/4 of ranges.


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## jenny v (May 6, 2012)

I think it might be mentioned on the drug insert that comes with the Cytomel boxes (it might not come when the pharmacy puts it into your pill bottle) that T3 drugs lower or even suppress TSH (NDT meds do the same thing, it's a side effect of T3 meds). If your doc won't test FT3 or doesn't want to increase your Cytomel I would definitely push back and also being to search for a new doc. You don't feel well, your FT3 is in the bottom of the range and they need to take your symptoms into account.


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## millironk (Jun 22, 2015)

thanks for all the helpful replies....I DID stand my ground with the nurse that called. She spoke with my doctor and he then agreed to try staying with my 125 Synthroid and upping the Cytomel to 25 mg per day. Retest in 6 weeks.

Any advice on upping the Cytomel dosage? Do I change all in one day or slowly up it by 5 or more over the course of a few days. I have a bottle of 5mg pills now and my next refill will be the 25's, so I can spread the 5's out, before going to the split 25. thanks


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## Lovlkn (Dec 20, 2009)

> upping the Cytomel to 25 mg per day


WOW!!! That is way way way too much of an increase based on your situation.

125mcg levothyroxine and 25mcg Cytomel is simply a huge amount of thyroid hormone replacement.

If it were me - I would take 2 - 5mcg pills daily to see if I had any hyper symptoms such as heart palps or heart rate increase for at least 1-2 weeks. You might consider refilling your existing 5mcg pill prescription and definitely ease into the dose, although, I feel that 25mcg daily is too much.

Honestly, to me it sounds like they made a mistake and actually meant to increase your dose to 2 , 5mcg pills daily.


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## millironk (Jun 22, 2015)

Thank you for the great reply.....I will check with the nurse again. I had already decided to slowly up the dosage. Being on t4 only replacement for 42 years, I have been through every hypo symptom you could have. basically I have dealt with not feeling well almost all of my life. I don't want to feel worse.


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## millironk (Jun 22, 2015)

am I seeing many places that the starting dosage of Cytomel is 25mcg? I am glad my physician was conservative.


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## Lovlkn (Dec 20, 2009)

You may be misninterpreting that as that starting it without any levothyroxine.


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## millironk (Jun 22, 2015)

I understand....thanks. I will go up slowly this weekend and contact the office on Monday. Many years ago an Endo i saw explained to me that I could cut my Synthroid dose on my own by taking 1/2 of a tablet 1 day a week and a full tablet the other 6 days. Doing the math now if I did that with the 125 synthroid then I would settle into 116 mcg as the average. This would be getting closer to the 112 . Have anyone done this?


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## jenny v (May 6, 2012)

Depending on the size of the 25mcg pills, you could also try cutting them in half. You're going from 5mcg to a higher dose, right? Half of the 25mcg pill would be 12.5, so that's a reasonable increase from 5. Plus, you get the bonus of 2 doses in one pill, so you're saving money, lol!


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## millironk (Jun 22, 2015)

I have been splitting my 5mcg tablets into 2 doses. I will certainly do the same with the 25's. thanks


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## Sabrina (Aug 30, 2016)

I am on levothyroxine and liothyronine (generic cytomel). Since taking T3 is putting the active hormone right into your body for immediate use, and some people have reactions when tarting to take it, I started slowly and built up over time. I was able to to bring my FT3 from the bottom of the range up to almost the top with 22.5mcg daily, dosed 7.5mcg every 5-6 hours 3x daily. That works very well for me. I had to lower my levothyroxine to help address a reverse T3 issue so I need a bit more cytomel than I otherwise would, but no matter what, I don't convert well so I will always have to take it.

Keep us posted on how it goes! And yes, taking T3 or NDT can suppress TSH so the lab isn't very reliable anymore. I think my last lab for TSH was .02. Super low, but my other labs - plus how I feel, is good.


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## millironk (Jun 22, 2015)

My doctor will not order a reverse t3 for some reason...I have a lab retest in early Oct..If I push him for the test will the reverse t3 be of any use now that I had been on Cytomel for 12 weeks? Thanks


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## Lovlkn (Dec 20, 2009)

millironk said:


> I have been splitting my 5mcg tablets into 2 doses. I will certainly do the same with the 25's. thanks


2.5mcg to 12.5mcg is still a HUGE increase.

Your levothyroxine will definitely need to be lowered with such a high dose.

If you have any elevation of heart rate or feel anxious you should reduce to the lower dosage and call your doctor.


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## millironk (Jun 22, 2015)

Thank you for your response Lovlkn.....I checked with the adjustment of cytomel and the doctor did up it from 5 to 25mcg. I have 5mcg tablets and I have gone from 5mcg to 7and a half, to 10mcgs and today will do 12 and a half today. This has been over the course of 6 days. I have not had any hyper type issues. blood pressure remains at my usual low of about 95/50 with a RHRate of around 45. I love the support from you and others on the forum.


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