# How long is too long for adjustment period to Cytomel increase?



## Rollingsound (Jun 9, 2018)

Hello,

I'm 164lbs 5'11", I've been on 112mcg on Synthroid and 10 mcg of Cytomel for about 8 weeks. About a week and a bit ago we went up to 15mcg of Cytomel. It's been a rough time adjusting to this particular dose increase. Problem is my personal situation has admitedly been a bit more stressful than baseline if you will this past week with travel and commitments, so it's hard to tell what's just normal anxiety and what's the pill. Question is, how long is too long to be feeling the "temporary" symptoms of a dosage increase? one week? 2? I've had a pretty stable and not too high heart rate, but i've been quite anxious and short of breath after doing any pushups or anything strenuous (more than normal). Sleep is fine, I'm actually more tired at the end of the day than I was on the 10 mcg. Had Ferretin and iron labs checked, came back normal. My AM cortisol has always been high and I take a B12 supplement and Vitamin D pills. Any ideas?

Thank you!


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## Lovlkn (Dec 20, 2009)

Welcome to the board!

Do you have lab's you could share prior to your Cytomel dose increase?

Goal is to be close to 3/4 range for both FT-4 and FT-3. If you are over on either it could cause symptoms of being hyper. For me - I have to actually reduce my T3 hormone in the winter months a whopping 2.5mcg a week which makes a huge difference in how I feel and also reflects in my labs. Don't underestimate how small dose changes can affect how you feel


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## Rollingsound (Jun 9, 2018)

Labs before using any cytomel, just on 155mcg Synthroid:

TSH: 0.17 Range: 0.35-5.00

T4 FREE: 24 Range 12-22

T3 FREE: 4.5 Range 3.4-5.9

Labs after being on 112mcg Synthroid and 10mcg Cytomel for 8 weeks:

TSH: 0.41 Range: 0.35-5.00

T4 FREE: 16.8 Range 12-22

T3 FREE: 4.5 Range 3.4-5.9

I've since gone up to 112mcg Synthroid and 15mcg Cytomel, it's been 2 weeks with that dose but I have no labs yet since it's too early. My Free T3 has pretty much always been around 4.5ish even going back a ways to when I was titrating up initially on Synthroid years ago.


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## Lovlkn (Dec 20, 2009)

Rollingsound said:


> Labs before using any cytomel, just on 155mcg Synthroid:
> 
> TSH: 0.17 Range: 0.35-5.00
> 
> ...


I see the issue immediately - ((4.65-5.27)) is 1/2-3/4 of your FT-3 range. Before you added the extra 5mcg of Cytomel you were already at 1/2 of range.

As far as your FT-4 ((17-19.5)) is 1/2-3/4 of your range and you were at 1/2 range.

The first thing I personally would have done as far as dosing is raise your levothyroxine to 125mcg and retest in 6 weeks. Raising Levothyroxine usually will raise FT-3 just a smidge and with you being already at 1/2 of range for FT-3 that's all you really needed -

Taking a full 5mcg dose of cytomel with your current labs is likely pushing you over 3/4 range therefore you are symptomatic.

If you want to stay the course and only increase the T3 hormone then I suggest adding only1/2 a pill daily and retest in 4-6 weeks.


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## Rollingsound (Jun 9, 2018)

Lovlkn said:


> I see the issue immediately - ((4.65-5.27)) is 1/2-3/4 of your FT-3 range. Before you added the extra 5mcg of Cytomel you were already at 1/2 of range.
> 
> As far as your FT-4 ((17-19.5)) is 1/2-3/4 of your range and you were at 1/2 range.
> 
> ...


Thanks for your reply, a side note is that I was having a very hard time with any kind of endurance exercise, strength training was going well and my recovery from that was "normal", but anything more than 30 minutes on the bike and I was wiped out completely. Perhaps that pushed my endo to go towards more of a T3 heavy treatment? I'll need to check.

My bioavailable testosterone was on the low end when I did the test while on 112mcg T4 and 10mcg T3 too, perhaps that may have played a role in going heavier on T3. Again, I'll need to check


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