# Free T4 Levels on Cytomel



## bitedust (Aug 30, 2017)

My first post here and wanted some help with my free t4 levels. I have low normal Free T4 and keep reading that levels should be around midrange however I am on both levoxyl 137/150 alternating and cytomel 7.5mcg and recently tried to go up to just 150mcg of levoxyl and had bad anxiety and blood pressure went up. I feel better back on 137/150 but that even is starting to feel like it's to much.

Free t4 1.2 values 0.8 - 1.6

Free t3 333 values 222-383

Free t4 is with the 150mcg levoxyl only.

Thanks


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## joplin1975 (Jul 21, 2011)

Your free t4 level will stay suppressed if you take any kind of T3 med or medication with T3 in it. So, the idea of getting your free t4 to midrange is only valuable if you are on a t4-only routine.


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## bitedust (Aug 30, 2017)

joplin1975 said:


> Your free t4 level will stay suppressed if you take any kind of T3 med or medication with T3 in it. So, the idea of getting your free t4 to midrange is only valuable if you are on a t4-only routine.


Joplin1975, that makes sense to me, I just wasn't sure why some are saying different, It just makes things confusing. So how would one best dose or what range would you say free t4 should fall in if I am also on cytomel.

Thanks


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## joplin1975 (Jul 21, 2011)

Don't pay attention to it. Focus on getting your free t3 at the 50%-75% range and go from there.


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## bitedust (Aug 30, 2017)

joplin1975 said:


> Don't pay attention to it. Focus on getting your free t3 at the 50%-75% range and go from there.


I hear what you are saying but I'm wondering if there would be any reason to lower ft4 based on symptoms. I learned going up on t4 made me feel very anxious and raised my blood pressure. I found out the hard way.


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## joplin1975 (Jul 21, 2011)

Sure. If you aren't converting free t4 to free t3, then the t4 builds up in your system and causes hyper symptoms. It might make sense just to stick with 137 and see how you feel.

Part of dosing depends on labs, but you also have to track how you feel, too.


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## bitedust (Aug 30, 2017)

joplin1975 said:


> Sure. If you aren't converting free t4 to free t3, then the t4 builds up in your system and causes hyper symptoms. It might make sense just to stick with 137 and see how you feel.
> 
> Part of dosing depends on labs, but you also have to track how you feel, too.


I really appreciate your help. I was thinking of sticking to just 137 myself and see how I feel. When is the best time to do labs, I usually wait until the next morning to test taking cytomel after, but wouldn't that give a false level because how do you know how high your free t3 levels peak during the day.


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## joplin1975 (Jul 21, 2011)

No, you're correct. Have your blood draw first thing in the morning and take your meds afterwards. T3 peaks two hours after you take the meds.


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## bitedust (Aug 30, 2017)

joplin1975 said:


> No, you're correct. Have your blood draw first thing in the morning and take your meds afterwards. T3 peaks two hours after you take the meds.


Wouldn't taking t3 after blood test show a false low? How would you know how high the t3 peaks during the day.


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## joplin1975 (Jul 21, 2011)

It might show it slightly low. But you can make a decision about an increase based on how you feel.

The flip side, though, is that if you take cytomel before your blood draw, you are almost guaranteed a hyper result. The "hyper" result basically shows results for what amounts to ~2 hours per day. After those initial two hours, things change. So the idea is that you'll want to base your dosing decisions on a blood work result that more accurately reflects the other 22 hours of your day.

It's admittedly not perfect, but nothing with the thyroid is!


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## Lovlkn (Dec 20, 2009)

> I am on both levoxyl 137/150 alternating and cytomel 7.5mcg and recently tried to go up to just 150mcg of levoxyl and had bad anxiety and blood pressure went up. I feel better back on 137/150 but that even is starting to feel like it's to much.
> 
> Free t4 1.2 values 0.8 - 1.6
> 
> ...


So you were not taking Cytomel at this lab? Can you please clarify?

Your FT-3 is in decent range ((302-342)) ((1/2-3/4 of range))

Your FT-4 is at 1/2 range ((1.2-1.4)) ((1/2-3/4 of range))

If it were me - I would test Ferritin, D and b-12 levels to see if that's why you are symptomatic with these labs. Being low in all or any seems to have an effect on alot of people posting here.

When I added Cytomel my FT-4 initally went up and I needed to reduce my Levothyroxine. Over time I was able to return to the original dose. Addressing my low ferritin may have been the reason I struggled adjusting to Cytomel initally.


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## bitedust (Aug 30, 2017)

I went down to 137 and up to 15mcg of cytomel and feel fatigued. I read that t3 will clear out cortisol which makes you feel tired. My knees hurt a little more although I have bad knees and my mind is not as sharp. I wonder if I need to alternate 137/150 again and stay at 10 with cytomel.

I notice my cortisol gets high and causes anxiety, increases my heart rate and bp. I find the sea salt knocks out the cortisol pretty quickly. I also get occasional heart palps I notice when cortisol is to high.


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## bitedust (Aug 30, 2017)

Lovlkn said:


> So you were not taking Cytomel at this lab? Can you please clarify?
> 
> Your FT-3 is in decent range ((302-342)) ((1/2-3/4 of range))
> 
> ...


I took cytomel before the test. I need to get ferritin tested. thanks


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## bitedust (Aug 30, 2017)

joplin1975 said:


> It might show it slightly low. But you can make a decision about an increase based on how you feel.
> 
> The flip side, though, is that if you take cytomel before your blood draw, you are almost guaranteed a hyper result. The "hyper" result basically shows results for what amounts to ~2 hours per day. After those initial two hours, things change. So the idea is that you'll want to base your dosing decisions on a blood work result that more accurately reflects the other 22 hours of your day.
> 
> It's admittedly not perfect, but nothing with the thyroid is!


I miss my functioning thyroid....lol


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## Lovlkn (Dec 20, 2009)

Be consistent with your lab's. If you lab early - don;t take your med's and if you lab mid day make sure you have 6+ hours after your last dose. Try to lab same time every lab with or without taking your med's.

That I have found is the only way to figure out dosing.


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