# So many questions about thyroid and medication



## adcardinals (Feb 3, 2014)

I have been on levothyroxine for several years, right now at 75mcg. Throughout this time, other than during pregnancy, my levels were "fine" and no medicaition increases were necessary. All the while I am having extreme difficulty losing weight. I am constantly tired, which could be related to having a toddler and not getting as much sleep as I used to.

My Mom is also a thyroid patient, and struggled with her weight for years. Recently her doctor started her on cytomel plus her levothyroxine. Her weight has dramatically dropped. I am not out for a weight loss pill, but I do strongly believe my inability to lose weight is directly related to the thyroid issues.

Should I request cytomel? Or what about armour? I have no experience taking either. Just so lost at this point and would appreciate some help. Thanks!


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## jenny v (May 6, 2012)

Welcome!

It's hard for any of us to chime in with thoughts on medication without seeing any labs. When adding in Cytomel, you absolutely need to have your Free T3 and Free T4 levels checked before starting. Cytomel is usually added in when a patient isn't converting from FT4 to FT3 well, i.e., your FT3 is usually in the bottom end of the range no matter what your FT4 looks like.

What is your doctor running to check how much levo you need? Do you have copies of your labs, with ranges, that you could share?


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## adcardinals (Feb 3, 2014)

I have called and requested the most recent labs to be faxed to me at work. I have no idea what they specifically test or what the results are. They always just call and say 'things look fine'....so frustrating! I'll respond as soon as I get the labwork. Thanks!


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## jenny v (May 6, 2012)

Definitely get copies of your labs every time you have them done! As a patient, it's your right.

What's "fine" to the doctor, may not be "fine" for your system. With hormones, we're all different and have different levels at which we feel our best. Good luck!


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## adcardinals (Feb 3, 2014)

T4, Free 1.2 ng/dL

T3 Uptake 29

TSH 1.88

I have other lab results (lipid panel, metabolic panel) so if those would be helpful please let me know. Thanks for your help!!


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## Andros (Aug 26, 2009)

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
(Copy and paste into your browser)

http://www.stopthethyroidmadness.com/free-t3/
(Copy and paste into your browser)

Welcome!

Yes; as per jenny v! When you get lab results to post here, please add in the ranges as different labs use different ranges.

The most important test will be the FREE T3. If you are not converting well, that test number will be low. I am furnishing information above.

That test result will be the determining factor as to whether or not you are a candidate for exogenous T3.


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## Andros (Aug 26, 2009)

Your T3 uptake (carrier protein) is low but w/o the range from your lab, I cannot be certain. If it is low; that suggests hypothyroid.


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## adcardinals (Feb 3, 2014)

Sorry, did not think to add the ranges. This is all so confusing and overwhelming!!!

T4, Free 1.2 ng/dL range 0.8-1.8

T3 Uptake 29 range 22-35

TSH 1.88 range 0.40-4.50


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## Andros (Aug 26, 2009)

Good; very good!!! Thanks a bunch and yes; when one is ill, everything is over whelming.

You are definitely hypothyroid. Your T3 uptake is just a tad above the mid-range (28) of your range provided by your lab. Your FREE T4 is also a tad below the mid-range (1.3) and the TSH is a tad high.

This all makes you a "TAD" hypo and this is not a good place.

Most if not all of us like our TSH @ 1.0 or less with the FREES at about 75% of the ranges which are provided by your lab. You are smack dab in the middle of the fence.

Firstly, an increase of your current thyroxine replacement would be the way to go and if this doc won't do it, find one that will. You need fine tuning in the worst of ways. Then if an increase of the Levothyroxine does not get you to the right place and your FREE T3 is in the basement, then yes; time for Cytomel or dessicated thyroid.

This is like dangling a sirloin steak in front of a hungry dog! You are being tortured.


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## jenny v (May 6, 2012)

You definitely need a bump up in your levo, your FT4 level is just barely under the midpoint of the range and most of us like to be in the upper part. I would also request that they run a Free T3 check--if that's low and you don't seem to be converting well, you might need something like Cytomel in addition to your levo.


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## adcardinals (Feb 3, 2014)

I just about cried when I read that the values aren't "fine" as I am always told. What is up with this? I trust my doctor, and she has never really led me astray before. Are doctors just not very educated on thyroid issues? How should I expect her to respond when I question whether the labwork is fine? I don't want her to think I am undermining her as a doctor, but I am really thinking that I might be on to something. I was perusing the stop the thyroid madness page, and saw something about itchy dry skin being a thyroid symptom. I've always had dry skin, but lately, it is out of control. Patchy, and itchy like I am falling apart....

making a doctor appointment ASAP...


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## Madison Marie (Sep 3, 2013)

In all honesty, how your doctor will react depends on your doctor and how you approach the issue. It might help to mention that your mother was put on Cytomel. it is not unreasonable to suggest that your disease course may be similar to your mom's, and so if she needs Cytomel you may also be getting to that point. On the other hand, you may just need a slight boost in T4 for now.

Many doctors have only a rudimentary understanding of thyroid issues and how to manage them. They don't always use the proper testing to evaluate your disease, and they don't always draw the right conclusions from your results. That is why websites such as Stop the Thyroid Madness and other patient forums have formed. Many thyroid patients are not getting relief from the status quo.

However, many do obtain relief from the standard treatment, which is why it is still the standard. The rest of us have to fight for what is best for us. It is a broken system, unfortunately. So don't be afraid to tactfully ask your doctor for what you think you need. If that doesn't work, be prepared to go doctor shopping. Either way, please don't allow yourself to continue feeling badly simply because you don't want to insult your doctor.

Good luck and let us know how the appointment goes!


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## Dolly (Apr 24, 2013)

If your doctor won't listen, maybe go see your Mom's doc.....at least you know that her doc will prescribe T3 if needed.....


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## adcardinals (Feb 3, 2014)

Update....

I am shocked to pieces, but my doctor was willing to at least play around with what I'm on. She keeps saying my labs are perfect, but was willing to let me judge how my symptoms feel. She was leery of Armour--she blamed it on the inconsistency with T3 from pig to pig....I didn't argue with her. She wanted to draw more labs and said we could try a cytomel/levo mix. She said she doubted I would see much difference with weight loss. And if that's the case....she wanted to give me phentermine. LOL. We shall see I guess. Thanks for your advice! Anxious to get labs back in a day or two.


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