# Appointment tomorrow Need Advice



## LadyDi (Apr 28, 2012)

Tomorrow I have an appointment with Doctor #3, after two OB/GYN's and now a Family Practice Doctor in the hopes she will either a-have some knowledge about Hypothyroidism or b-refer me to an Endocrinologist. I've tried unsuccessfully to get into see an Endocrinologist and in this area(500 square miles) you have to have a Physician referral. Even offered to pay cash but that didn't work. After a year of this I am getting very frustrated. I'v posted all over the place here so I'm going to post my latest labs that my last Doctor felt were great. He put me on all kinds of supplements and said I should be good. 
TSH 4.19 mIU/L Reference Range or 20 years 0.40-4.50
T4 FREE 1.3 0.8 - 1.8 ng/dL
T3 TOTAL 94 76-181 ng/dL
T3 UPTAKE 29 22-35 %
T4 TOTAL (THYROXINE) 10.6 H 4.8-10.4 mcg/dL

Everyone tries to tell me to just not think about it but I'm honestly sick and tired of feeling sick and tired. I'm on .75 mcg Synthroid and have been at this level since October of last year. Everytime the doctor increased it I initially felt better but then I'm back to feeling awful. I am going to elaborate more on the physical issues and not the weight problem as I find most doctors who aren't in the know think we all eat too much and don't exercise and are looking for a short cut to weight loss.

Truthfully I know alot depends on whether this Doctor believes my labs are good and if that's the case then I know I"m toast I'm running out of time, I'm supposed to start a new job and if I don't soon get someone to listen to me I'm going to scream. Any advice would be appreciated as well as any good thoughts and prayers.


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## Andros (Aug 26, 2009)

LadyDi said:


> Tomorrow I have an appointment with Doctor #3, after two OB/GYN's and now a Family Practice Doctor in the hopes she will either a-have some knowledge about Hypothyroidism or b-refer me to an Endocrinologist. I've tried unsuccessfully to get into see an Endocrinologist and in this area(500 square miles) you have to have a Physician referral. Even offered to pay cash but that didn't work. After a year of this I am getting very frustrated. I'v posted all over the place here so I'm going to post my latest labs that my last Doctor felt were great. He put me on all kinds of supplements and said I should be good.
> TSH 4.19 mIU/L Reference Range or 20 years 0.40-4.50
> T4 FREE 1.3 0.8 - 1.8 ng/dL
> T3 TOTAL 94 76-181 ng/dL
> ...


Prayers by all means; ditto on the thoughts.

TSH is waaaaaaaaaaaaaaaaay to high. You are hypo. However, try to get the doc to run the FREES not the Totals.

Here is info that may help.

TSH ref. range
http://www.endocrinetoday.com/view.aspx?rid=28716

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.

Dr. Mercola (FREES)
http://www.mercola.com/Article/hypothyroid/diagnosis_comp.htm
Dr. Woliner
http://www.thyroid-info.com/articles/freet3woliner.htm

Most of us feel best w/TSH @ 1.0 or less and the FREES @ about 75% or the range give or take a wee bit either way.

Will be waiting to hear and I pray that you get good news.


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## LadyDi (Apr 28, 2012)

Met with this new Doctor and I really really like her, very nice compassionate and she agrees my levels are not what they should be. She put me on Cytomel and said we would check my levels in 8 weeks. I was shocked when I picked up my prescription that she prescribed 25 mcg once a day. Wow, that's alot isn't it? I broke the pill in quarters and took a quarter this morning. Opinions? Advice?


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## Andros (Aug 26, 2009)

LadyDi said:


> Met with this new Doctor and I really really like her, very nice compassionate and she agrees my levels are not what they should be. She put me on Cytomel and said we would check my levels in 8 weeks. I was shocked when I picked up my prescription that she prescribed 25 mcg once a day. Wow, that's alot isn't it? I broke the pill in quarters and took a quarter this morning. Opinions? Advice?


That is a hefty dose!!! Your instincts are right on. Do the quarters for about a week and see how you feel, then go up to 1/2..............stay on that for a couple of weeks and get labs.

That is my humble and very very experienced advice.

Bless your heart! But......................I think you found "the" doc! So hang in there and always tell her what you are doing. Keep the communication lines open.

Just say you were a little scared and thought going slo mo was a better option for you.

Yay!

Please let us know how you are feeling on a day to day basis. I know that I personally will be very interested.


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## LadyDi (Apr 28, 2012)

Aww thanks so much Andros, you have no idea how much I appreciate your support and your wealth of experience. She recommended Selenium and Vitamin B in addition to everything the other Doctor recommended. Muti vitamin daily, Fish Oil twice a day, Folic Acid, Vitamin D 10,000 daily for two months til my levels rise, baby aspirin once a day. I will certainly let you know how I'm feeling. I was just so pleased this Doctor acknowledged my levels were off. The only thing she didn't really agree with TSH levels around 1, she said 2 should be good enough. So, we'll see how things progress and most importantly how I feel. I would be thrilled at this point to get even close to 2. Hard to believe I even functioned with TSH at 10.47. Oh and she told me there were other lab tests he should have run that she will do next time. I am so relieved.


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## Andros (Aug 26, 2009)

LadyDi said:


> Aww thanks so much Andros, you have no idea how much I appreciate your support and your wealth of experience. She recommended Selenium and Vitamin B in addition to everything the other Doctor recommended. Muti vitamin daily, Fish Oil twice a day, Folic Acid, Vitamin D 10,000 daily for two months til my levels rise, baby aspirin once a day. I will certainly let you know how I'm feeling. I was just so pleased this Doctor acknowledged my levels were off. The only thing she didn't really agree with TSH levels around 1, she said 2 should be good enough. So, we'll see how things progress and most importantly how I feel. I would be thrilled at this point to get even close to 2. Hard to believe I even functioned with TSH at 10.47. Oh and she told me there were other lab tests he should have run that she will do next time. I am so relieved.


I am impressed w/ the supplement regimen. This is good. When the time comes, you may have to get her to learn how important the FREES are instead of the TSH. We will cross that bridge when we come to it.

Sounds like you have a real "keeper" here. I am soooooooooooooooooooo glad.


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## LadyDi (Apr 28, 2012)

Andros, not sure if this is all in my head or not. I took a quarter of the Cytomel 25 mcg pill and went shopping with a friend, I felt like I had more energy and I was also sweating for the first time in a long time. Of course it was in the 90's here but I truly can't remember the last time I sweated and that's including when I work out. Could this possibly be the turn around for me?


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## Andros (Aug 26, 2009)

LadyDi said:


> Andros, not sure if this is all in my head or not. I took a quarter of the Cytomel 25 mcg pill and went shopping with a friend, I felt like I had more energy and I was also sweating for the first time in a long time. Of course it was in the 90's here but I truly can't remember the last time I sweated and that's including when I work out. Could this possibly be the turn around for me?


Yes; the toxins are coming out. I had the same situation. I did not perspire for years and years. When I started Armour, I started to perspire. Thank goodness.

And......................I was working out hard myself at the gym and still do.


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## LadyDi (Apr 28, 2012)

So it's been 5 days since I started the Cytomel and I have to say I feel great. Still only taking the 1/4 of the 25 mcg pill but I already feel so much better. I notice in the afternoon it wears off and I'm feeling a little tired but I'm still able to work out every evening. I am truly optomistic for the first time in a long time.


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## Andros (Aug 26, 2009)

LadyDi said:


> So it's been 5 days since I started the Cytomel and I have to say I feel great. Still only taking the 1/4 of the 25 mcg pill but I already feel so much better. I notice in the afternoon it wears off and I'm feeling a little tired but I'm still able to work out every evening. I am truly optomistic for the first time in a long time.


At this point, consider taking another 1/4 at about 2 or 3 in the afternoon.

What time do you take the first dose and what time do you go to bed?

You "sound" better!!! Thank God!


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## teri2280 (Feb 7, 2012)

Congrats to you LadyDi!!! I've been following your post for a couple days, as I was curious, but I too noticed the "greatness" of Cytomel. I have to admit that I'm slightly jealous, though. (But in a good way, of course.) I just went off Cytomel in prep for RAI, and my endo, when questioned about how good I felt while I was on it, told me it was all in my head. After about 4 days with zero meds, I'm 99.9% sure it wasn't just in my head.

Did your doc originally run your free t4 on his/her own, or did you pressure him/her to do it? In 3 months of seeing an endo, I've never had frees run, and am starting to think I'm having trouble converting the t4 to t3, since I felt so much better on Cytomel. I'll admit that this will be a test for my fam doc to order rather than the endo, as he'll actually listen to me and believe that I felt better on the Cyto.


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## LadyDi (Apr 28, 2012)

Andros, Yesterday I wasn't thinking and took a half instead of a quarter and quite honestly I didn't notice too much difference. I take my pill anywhere from 7 to 8 in the morning, depending on what time I get up. Yesterday I had a zillion errands to run and I felt wonderful. Today I will take another quarter around 2 or 3 this afternoon. Besides the energy I notice I am perspiring. Never thought I would be happy about that but for so long I couldn't do this. I could actually sit on the beach in the middle of July, temps in the 100's and I couldn't even perspire. 6 mile bike rides and I still wasn't perspiring. No wonder I couldn't lose any weight.

Terri this new doctor used my old labs from my other doctor and after I am on the Cytomel for 2 months she is going to run new labs. She said there were different test my old doctor should have run and mentioned Frees so I'm assuming she'll run them in June when I go back. At this point I will do anything to stay on the Cytomel. I feel that much better and I started feeling better immediately. Hope you are able to find a doctor that listens to you.


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## Andros (Aug 26, 2009)

LadyDi said:


> Andros, Yesterday I wasn't thinking and took a half instead of a quarter and quite honestly I didn't notice too much difference. I take my pill anywhere from 7 to 8 in the morning, depending on what time I get up. Yesterday I had a zillion errands to run and I felt wonderful. Today I will take another quarter around 2 or 3 this afternoon. Besides the energy I notice I am perspiring. Never thought I would be happy about that but for so long I couldn't do this. I could actually sit on the beach in the middle of July, temps in the 100's and I couldn't even perspire. 6 mile bike rides and I still wasn't perspiring. No wonder I couldn't lose any weight.
> 
> Terri this new doctor used my old labs from my other doctor and after I am on the Cytomel for 2 months she is going to run new labs. She said there were different test my old doctor should have run and mentioned Frees so I'm assuming she'll run them in June when I go back. At this point I will do anything to stay on the Cytomel. I feel that much better and I started feeling better immediately. Hope you are able to find a doctor that listens to you.


If you can go w/the half in the morning that is better. Mainly because most of us forget to take the one in the afternoon and it won't make any difference in so far as the longevity of the T3.

The main criteria is to take it in a timely and consistent manner.

We are all so happy for you!!! T3 is life sustaining so now I hope you have a life!


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## LadyDi (Apr 28, 2012)

Thanks so much Andros. I can always count on you !!! I was thinking last night, if I feel this great on a half .25 mcg I wonder what I would feel like on the full dosage but I really don't want to do anything to compromise how great I feel unless you think I should.


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## Andros (Aug 26, 2009)

LadyDi said:


> Thanks so much Andros. I can always count on you !!! I was thinking last night, if I feel this great on a half .25 mcg I wonder what I would feel like on the full dosage but I really don't want to do anything to compromise how great I feel unless you think I should.


Just stay the course and go with slow but sure titration. Your body needs the proper time to adjust. You are doing fine to increase by small increments every few weeks or so.

You will get to the top and the caveat is you will stay on top. If you go too fast, you could crash and burn.

Getting labs, especially the FREE T3 every 8 weeks for a while is very important. Once you stabilize, FREE T3 every quarter "if" patient is clinically hyper but if patient is thriving and seems fine, it is not necessary.


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## LadyDi (Apr 28, 2012)

Thanks again Andros, I knew that's what you would say. Slow and steady wins this race. Think I'm going to stay where I am for a little while. It's only a week since I started the Cytomel. I feel way too good to do anything that will cause me to crash and burn.


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## LadyDi (Apr 28, 2012)

Just thought I would post an update. I am now on the full .25 mcg of Cytomel and the .75 mcg of Synthroid (been on this for over a year). I probably don't feel as great as I did when I first was put on the Cytomel but I believe that's because I'm just doing too much LOL. I have tons of energy and I'm taking advantage of that new found energy. I go back to the doctor in another month. Believe it or not I'm actually losing weight. Eating pretty much the same things as I've been eating for the last year or so but now the weight is coming off. I truly believe the Cytomel has helped me alot !!!


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## Andros (Aug 26, 2009)

LadyDi said:


> Just thought I would post an update. I am now on the full .25 mcg of Cytomel and the .75 mcg of Synthroid (been on this for over a year). I probably don't feel as great as I did when I first was put on the Cytomel but I believe that's because I'm just doing too much LOL. I have tons of energy and I'm taking advantage of that new found energy. I go back to the doctor in another month. Believe it or not I'm actually losing weight. Eating pretty much the same things as I've been eating for the last year or so but now the weight is coming off. I truly believe the Cytomel has helped me alot !!!


Excellent!! Don't tamper w/ a thing. If you lose a lot of weight, you may have to re-evaluate but probably not if you STAY active.

Remember......................................it is normal for anyone to feel tired at times; especially at the end of the day. I think we have a tendency to forget that!

Thanks for the wonderful update!


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