# New here- Trying to understand



## Penny84 (Jul 15, 2015)

Hi Everyone!

I am new here and appreciate the wealth of information I have already come across. A little background on me: I am 31 year old female, no children, diagnosed Hypothyroid in 2013 when I finally convinced my primary physician to test me.

At that time my labs came back as :

TSH 29.04 Range 0.34 - 5.50uIU/mL

Free T4 0.67 .0580 - 1.640ng/dl

T3 uptake 40% range 32.0-48.4%

Thyroid Ultrasound showed nothing.

She started me on 25mcg of Synthroid and 60 days later new labs showed:

TSH 2.38 Range 0.34 - 5.50uIU/mL

Free T4 1.05 Range 0.580 - 1.640ng/dl

9 months after taking 25mcg synthroid and new labs showed:

TSH 1.45 Range 0.34 - 5.50uIU/mL

Free Thyroxine 6.8 Range 5.9-13.1

T3 Uptake Ratio 40.4 range 32.0-48.4%

T4 Total 6.7 Range 6.1 - 12.2 ug/dL

So as you can tell, she never consistently tested me for the same things, with the exception of TSH. I also continued to experience symptoms and was constantly told that it takes a long time for symptoms to go away. For a while I accepted this. At the beginning of this year I moved to a different state and found my symptoms becoming worse than ever. Here is what I am experiencing:

Fatigue- always tired, exhausted. Exercise, eating right and sleep have not helped.

Increased sensitivity to cold - so very cold, even on hot summer days my hands and feet are like ice cubes

Constipation

Dry skin

Unexplained weight gain - 15lbs in 6 weeks

Puffy face

Muscle weakness

Muscle aches, tenderness and stiffness

Pain, stiffness or swelling in your joints

Irregular menstrual periods

Thinning hair and hair loss

Depression and Anxiety

Impaired memory - cognitive ability is horrible. I can't remember anything, I have a hard time paying attention and retaining new information. I feel like I am in a constant fog.

So I decided to go to a health and wellness clinic that advertised treating thyroid issues as one of their specialties. I figured worse case I would have new lab results and have to find someone else to see me. I had an appointment a week ago and just did a follow up yesterday. I will say so far I am impressed because this is the first doctor who has ever suggested trying Armour or something other than synthroid.

New lab results are:

TSH 1.170 uIU/mL Range 0.450-4.500

Free T4 1.23 ng/dL Range .82-1.77 ng/dL

Reverse T3 18.0 ng/dL Range 9.2 - 24.1 ng/dL

Thyroxine Binding Globulin 13 ug/mL Range 9.2 -24.1 ng/dL

Thyroid Peroxidase TPOAb 153 IU/mL reference 0-34 IU/mL

Triiodothyronine 2.2 pg/mL reference 2.0 -4.4 pg/mL

He immediately pointed out the TPOAb and then started talking about Thyrotropin-releasing hormone and Thyroid conversion issues. Unfortunately, I am having a hard time remember all the details. I put a call in to his office and waiting for him to call me back.

He decided that a good course of action would be to take me off synthroid and put me on Cytomel, 25 mcg for 30 days. I take 1/2 at 6 am and the other 1/2 at 2pm. After 30 days he wants to move me to Armour.

I will say I am very excited to try Armour. I just want to feel normal again, whatever that might be.

Does anyone have any input on what might be going on with me? Easy to read links? Experience with Cytomel or Armour?


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## Lovlkn (Dec 20, 2009)

> Triiodothyronine 2.2 pg/mL reference 2.0 -4.4 pg/mL


This is the FT-3 test and based on this it appears your doctor is trying to address.

Now, how he is addressing is a bit odd. A better way to do it would have been to immediately switch you to Armour or add say 5mcg Cytomel to your existing 25mcg of Synthroid which is a low dose. I'm honestly amazed how small a dose made such a change in your TSH and your FT-4 level which I might point out at the last test they ran was not even at 1/2 of range. Most on this board feel best somewhere 1/2 -3/4 of range.

My concern for you is that T3 only medications such as Cytomel can pack quite a punch and some people ( me) need to ease into them to avoid cardiac and hyper symptoms. I would suggest you break the pill into 4 pieces and take 2 pieces 6 hours apart for a few days and if you don;t have any hyper symptoms, add a 3rd piece for a few days and then the 4th piece. If you don't have symptoms then try splitting the pill in 1/2 and take the pieces 6 hours apart. If you have any issues you need to call your doctor immediately and stop the Cytomel until you hear back from him. 25mcg Cytomel is quite a hefty dose, especially since you were taking only 25mcg of Synthroid. I speak from my personal experiences with Cytomel - hopefully you won't have any issues - just be aware.


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## Octavia (Aug 1, 2011)

I completely agree with what Lovlkn has said above. Starting out on 25 mcg of Cytomel is a HUGE dose. Huge.


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## webster2 (May 19, 2011)

I agree 25 mcg of T3 is a whopper of a dose.


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## jenny v (May 6, 2012)

Plus, your reverse T3 is on the high-ish side of the range. 25mcg of T3 is going to shoot that up even higher and keep you from feeling better.


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## Penny84 (Jul 15, 2015)

Lovlkn,

Thank you for all of the easy to understand information. You are right he is trying to address the FT-3 and get me somewhere between 3.8-4.4. He also is also worried about a possible conversion issue and thinks I might feel better if we can address the RT3 too. Which is why he did not move me straight to armour.

Side note: Am I the only one that finds RT3 confusing? I've been researching it for a few days and I think I am more confused than before.

Everything I had read and everyone I have asked says the same thing, "25mcg of Cytomel is a high dose". I asked him about this and he was not concerned as long as I am not having any serious side effects. However, I have noticed a few strange things and I can't help but wonder if it's the cytomel. I have noticed approximately 4-5 hours after taking it I feel out of it, kind of in a daze and irritable. I have a lot of gas and belching within minutes after eating. I have to use the restroom frequently but have not experienced diarrhea. I have noticed some positive side effects; I don't feel like I am in a brain fog, my memory has improved, overall I feel happier and I am sleeping like a baby.

However, due to the weird slump 4-5 hours after taking the cytomel I am going to take your advice, split it up and take it every 6 hours. I think I am getting too much at once and that's what I am experiencing


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## jenny v (May 6, 2012)

Splitting up the dose would probably be a good thing--T3 burns off faster than T4 so it helps to spread it throughout the day to maintain your energy levels. Just don't take it too close to bed because it could keep you up all night. I take my last dose between 1-2pm every day.


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## Penny84 (Jul 15, 2015)

Thanks Jenny V.! Surprisingly, I did not think about the fact that it could keep me up.


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## Andros (Aug 26, 2009)

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/
(Copy and paste into your browser)

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.

Have you had an ultra-sound of your thyroid? If not, you should.

I hope the Cytomel works for you; it should. Since you are not taking any Synthroid, that may not be too high of a dose but then again it could be. Watch out for hyper symptoms.

And most importantly; you need a FREE T3 test.

Welcome and hugs,


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## Penny84 (Jul 15, 2015)

Hi Andros! 

I had an ultrasound and there was nothing significant to report, just a normal healthy looking thyroid. Which is great news for me.

I think this is the FT3 test: Triiodothyronine 2.2 pg/mL reference 2.0 -4.4 pg/mL, is that correct?

Who knew a small gland could be so complicated! Thanks for all your help and the welcome.


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