# Trying Cytomel...Again



## jenny v (May 6, 2012)

My hyper swing has finally calmed down (my labs are below) and I'm back to my usual "almost there" TSH, good FT4 and low FT3, so my doc has given me the okay to try Cytomel again.

I'm switching from 75mcg of Synthroid to 50mcg of Synthroid and 5mg of Cytomel. I'm starting with one week of 2.5mg of Cytomel, taking half in the morning and half in the afternoon. If that goes well, I'll bump it up to 3.75mg for a week and then the full 5mg after that.

For those of you who split your T3 dose, when do you take your doses? In the morning and afternoon, morning and evening, morning and night?

My November 2012 labs were:
TSH: 1.91 (range .4-4.5)
FT4: 1.45 (range .8-1.8)
FT3: 3.1 (range 2-4.4)

My January 24, 2013 labs were:
TSH: .008 (range .4-4.5)
FT4: 2.06 (range .82-1.77)
FT3: 4.7 (range 2-4.4)

My March 13, 2013 labs are:
TSH: 1.74 (range .4-4.5)
FT4: 1.45 (range .8-1.8)
FT3: 2.9 (range 2-4.4)


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## CA-Lynn (Apr 29, 2010)

If the Synthroid worked, why rock the boat and juggle the meds and doses to include to Cytomel?


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## jenny v (May 6, 2012)

Because the Synthroid doesn't help raise my FT3 at all and I still have lingering hypo symptoms the doc thinks the Cytomel will address.


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## Andros (Aug 26, 2009)

jenny v said:


> My hyper swing has finally calmed down (my labs are below) and I'm back to my usual "almost there" TSH, good FT4 and low FT3, so my doc has given me the okay to try Cytomel again.
> 
> I'm switching from 75mcg of Synthroid to 50mcg of Synthroid and 5mg of Cytomel. I'm starting with one week of 2.5mg of Cytomel, taking half in the morning and half in the afternoon. If that goes well, I'll bump it up to 3.75mg for a week and then the full 5mg after that.
> 
> ...


This is great and I like the slow approach here w/ the titration process. Hopefully others will respond to your question as I don't take Cytomel although when Armour was off the market I had to for about 18 months. At that time, I just took a single dose in the morning but then I was already acclimated to the T3 in the Armour.


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## bluesmom (Aug 11, 2012)

I'm starting cytomel tomorrow so I'm no help to you... sorry! I was about to ask a very similar question so I'm hoping you get some responses. I was taking 75mcg synthroid and, over 6 months, watched my ft4 rise and my ft3 stay put at just under half the range. 
I saw a new endo last week who suggested cytomel (before I even got a chance to urge him to consider it)! Anyhow, I've dropped down to 50mcg synthroid for the past 5 days and will start the 5mg cytomel in the morning. I was thinking I'd take half then and half around lunchtime but now I'm thinking about starting out with 2.5mg per day for a week as you're doing.
I'll be so curious to see how it goes for you this time as I read your thread from last time and am hoping neither one of us experiences the ugly side effects!
Best wishes to you,
Carolyn


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## smelliebellie (Oct 14, 2012)

ive actually been taking 50 mcg of synthroid and 5 mcg of cytomel together in the am, empty stomach. I dont split my doses up. I figured you're taking it very slowly since you had a hyper flare. I wonder if you have low ferritin, b12, or cortisol that prevented you from feeling good the first time you tried t3. Hopefully this time around itll help


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## jenny v (May 6, 2012)

Thanks for all of the advice!

Carolyn, the first time I tried Cytomel I was in the middle of a hyper swing (although I wasn't aware of it until after I started the Cytomel) so it just didn't work well. I usually have decent FT4 and TSH, but my FT3 just stays stuck below the midpoint of the range no matter what. I'm hoping easing into the Cytomel this time will work and help get rid of my lingering hypo symptoms (fatigue, coldness and difficulty losing weight). Let me know how it goes for you, too!

smelliebellie, I surprisingly have excellent numbers in my B12, ferritin, cortisol and Vitamin D levels (the D really shocked me since I am so pale I will burst into flames in direct sunlight - LOL!). I think my Hashi's was just swinging hyper the last time I tried Cytomel, so it didn't work.


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## surge (Aug 15, 2012)

Not really related, but I had to respond: about the vitamin D, pale people can actually get their vitamin D from the sun-- provided you live in a place where it is occasionally sunny, unlike New Hampshire these days! The darker skinned you are, the harder it is for you to absorb vitamin D via the skin. Finally, a benefit to the paleness, no?

I'm thinking of adding Cytomel, so I'll be following this post to see how it goes...


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## bigfoot (May 13, 2011)

jenny v said:


> For those of you who split your T3 dose, when do you take your doses? In the morning and afternoon, morning and evening, morning and night?


When I was taking Cytomel I tried to space it out and, like you, split up the doses between morning and afternoon. Because T3 has a half-life of about 3-4 hours, you might be the kind of person who really notices the "bonk" as it wears out. Or it might not even be a speedbump.


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## smelliebellie (Oct 14, 2012)

Whats your ferritin? Anything from 70-80 is considered optimal. Did you do a 24 hour saliva cortisol test? I hope it helps!!!  Crossing fingers for you.


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## jenny v (May 6, 2012)

I'm on day 4 of Cytomel, taking 2.5 mg, half in the morning with my Synthroid and half around 1pm. So far, so good! I had one minor episode of racing heart/jittery-ness but I popped a beta blocker and was good to go. I'm bumping the Cytomel up to 3.75 mg next week and then the full 5 mg after that.

Does anyone know if you're supposed to take the dose on an empty stomach an hour before you eat, like with Synthroid? I do that in the morning but my afternoon dose is usually right after lunch and I wasn't sure if I needed to wait another hour after my meal before taking it.


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## Octavia (Aug 1, 2011)

My doc did not give me any instructions when I started Cytomel a few months ago. I take one 5mg pill in the morning with my Synthroid, and that's it.

I suspect you might absorb your afternoon dose better on an empty stomach...but just be consistent, whatever you do.

I'm not sure it's really necessary to split your doses like you're doing. According to what I've read, the half-life is over 2 days.

According to drugs.com:

_Since liothyronine sodium (T3) is not firmly bound to serum protein, it is readily available to body tissues. The onset of activity of liothyronine sodium is rapid, occurring within a few hours. Maximum pharmacologic response occurs within 2 or 3 days, providing early clinical response. The biological half-life is about 2-1/2 days.

T3 is almost totally absorbed, 95 percent in 4 hours. The hormones contained in the natural preparations are absorbed in a manner similar to the synthetic hormones._


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## bluesmom (Aug 11, 2012)

Andros posted a great link about Free T3 under the thread "Is she a poor converter" on the Lab Results Board - sorry, don't know how to share links. That article gave me the impression that because Free T3 is fairly fast-acting and doesn't have to attempt to convert like Free T4, it may not matter whether or not you take cytomel with food.
I'm on day 3 of taking 2.5mg cytomel with synthroid in the a.m. I had a much faster than usual pulse awhile after taking it the second day but then felt pretty good the rest of the day. I'm very sensitive to medications and can swing hyper so have very much appreciated you sharing your journey!
Thanks,
Carolyn


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## jenny v (May 6, 2012)

Glad you are having success so far, Carolyn!

I'm on day 5 of 2.5mg of Cytomel and so far, so good. On Sunday I will be bumping it up to 3.75mg (taking a half pill in the morning and half of a half in the afternoon) and doing that for a week.

A few questions for those of you with Cytomel experience:

1. I am splitting the dose since I read you can get a bump of energy after you take it and feel a drop off in the afternoon, but I've never felt those things at all. Do you think I should just take the whole dose in the morning with my Synthroid on an empty stomach? After reading Octavia's post, I'm wondering if I should.

2. How long did it take for you to notice any differences in your symptoms? I wasn't sure if I should expect to wait the 6-8 weeks like I do with Synthroid or if I would feel any differences faster.


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## Octavia (Aug 1, 2011)

jenny...don't just take my word for it. I'm no expert on this at all. I've only been taking Cytomel since very late December. Doc started me on 5mg and no instructions, so I asked the pharmacist, and he said go ahead and take them together (the Cytomel and Synthroid).

I know others here have split their doses under the same assumption you stated. But I'm honestly not sure it's warranted. My understanding of what half-life means tells me it's not necessary to split the dose. It's interesting that you haven't noticed an increase in energy, as that seems to support the idea of not splitting the dose. Curious to hear from others. As I said, I'm no expert on this!


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## jenny v (May 6, 2012)

Octavia, have you noticed any improvements or changes with the Cytomel?

I've bumped my dose up to the whole pill now (5mg) and I'm still splitting the dose, half in the am and half around 1pm or so (an hour after I've eaten lunch). I honestly still don't feel a bump of energy or a drop off and if that continues now that I'm on the whole pill, I'm just going to start taking the whole thing in the morning. It's kind of a pain to bring the pill to work with me and remember to take it after lunch!


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## Andros (Aug 26, 2009)

jenny v said:


> Octavia, have you noticed any improvements or changes with the Cytomel?
> 
> I've bumped my dose up to the whole pill now (5mg) and I'm still splitting the dose, half in the am and half around 1pm or so (an hour after I've eaten lunch). I honestly still don't feel a bump of energy or a drop off and if that continues now that I'm on the whole pill, I'm just going to start taking the whole thing in the morning. It's kind of a pain to bring the pill to work with me and remember to take it after lunch!


My sentiments; precisely!!! Don't worry; it will stabilize with taking it in the morning only.


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## Octavia (Aug 1, 2011)

I think I'm a bit better, but could use an increase. I've been on 5 mg since very late December. I'm a bit overdue for labs...and I was supposed to get them done this morning, but we got a foot of snow yesterday, so...well...I didn't get my labs done. Made an appt for Wednesday instead.


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## jenny v (May 6, 2012)

Octavia, a little foot of snow kept you from your appointment?? :tongue0013: I'm just messing with you! I'm in Texas and anything over an inch completely paralyzes the city, everything shuts down (it's kind of awesome!).

I'm on day 10 of Cytomel, up the the full dose now and I haven't noticed anything different except for one weird thing--I'm ravenously hungry all the time lately. Is this a side effect anyone else has had? I could eat all day long if I let myself.


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## Octavia (Aug 1, 2011)

Jenny, in all honesty, it wasn't the foot of snow that kept me from going. I kind of forgot that I had the appointment (can I blame that on the snow?), and I took my meds first thing in the morning. Of course, 30 seconds after swallowing them, I remembered I had a lab appointment, but it was too late. I try to be consistent and always get my labwork done early in the morning before taking my meds, so I didn't want to break my own rule!

I, too, am hungrier than the average bear. But my metabolism doesn't keep up, so I have to be careful not to overeat.


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## jenny v (May 6, 2012)

I'm just messing with you, Octavia! I think a foot of snow would have me holed up for a few days, praying the electricity stayed on and I had enough food in the house to not have to leave until it all melted.

I'm usually never this hungry (which is good since I'm usually hypo and have a sluggish metabolism as it is), so I can't figure out if it's the Cytomel or not (is 10 days enough to have an effect on my system?). I'm eating my usual 1200-1300 calories and usual meals, haven't changed anything there, but I'm getting crazy hungry again about 30 minutes after I eat. It would be nice if this is the Cytomel at work and my metabolism is kicking into gear again (I could stand to lose some weight), but I guess I'll have to wait and see.


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## Octavia (Aug 1, 2011)

It's funny you say that...I am often hungry shortly after eating. It makes absolutely no sense. It's like a mix between hunger and lack of "satisfaction," as if I ate something sweet, but should have had something salty, or vice versa. No sense at all!

Oh, believe me - a foot of snow would normally shut things down around here. But this time, I think we were all so irritated about it, we were not about to let the snow win! There wasn't even the normal panicked trips to the store to get bread, milk, and eggs. (Why those are the "emergency staples" is beyond me...I just wanted to make sure we had enough toilet paper for a couple of days!) We are ready for spring in a really bad way!


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## jenny v (May 6, 2012)

I'm up to a full pill now (5mg) and still splitting the dose, but I think I'm just going to start taking the whole pill in the morning with my Synthroid. I've only had 2 or 3 instances of a racing heart, which were pretty mild, and an extra dose of beta blockers took care of those easily. Plus, it's a pain in the butt to take the tiny half of a pill with me to work every day (I'm so lazy!).

I go in to do labs in 2 weeks; my endo wants me to do them sooner than usual, only 4 weeks after I've started Cytomel, just to make sure I'm not swinging hyper again.


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## jenny v (May 6, 2012)

I've been on the 50mcg of Synthroid and 5 mg of Cytomel for almost 5 weeks now and my endo had me do labs yesterday just to make sure I'm not swinging hyper the way I did the last time I tried it.

My November 2012 labs (75mcg of Synthroid) were:
TSH: 1.91 (range .4-4.5)
FT4: 1.45 (range .8-1.8)
FT3: 3.1 (range 2-4.4)

My January 24, 2013 labs (50mcg of Synthroid and a week of 5mg of Cytomel) were:
TSH: .008 (range .4-4.5)
FT4: 2.06 (range .82-1.77)
FT3: 4.7 (range 2-4.4)

My March 13, 2013 labs (back on 75mcg of Synthroid) were:
TSH: 1.74 (range .4-4.5)
FT4: 1.45 (range .8-1.8)
FT3: 2.9 (range 2-4.4)

My April 17, 2013 labs (50mcg of Synthroid and 5mg of Cytomel) are:
TSH: 4.92 (range .4-4.5)
FT4: 1.19 (range .82-1.77)
FT3: 3.1 (range 2-4.4)

Grrrr, it seems like I've swung hypo again!! I'm waiting for the endo to call me back, but I can't believe I'm hypo again because I've had quite a few "hyper" symptoms lately (mainly weight loss, insomnia, racing heart and feeling hot). I'm thinking we need to bump up my Synthroid dose to help my FT4 and TSH; my FT3 is rising, which is good, since I don't think I can take any increase of Cytomel (I accidentally took a double dose one day and felt like a hummingbird for a few hours).


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## Lovlkn (Dec 20, 2009)

I'm late to this thread and will tell you my experience.

Jenny- I find when my hunger is intense I am usually going hyper.

I have been on 12.5mg of Cytomel for several years. It took me 2 tries to get adjusted. I gave up after the first attempt and was hypo for several years because of it.

I run low to no TSH while on Cytomel - my Free's have been unusually hypo aka mid to lower range for the last 2 years when doing labs - although I do not usually feel hypo, my TSH is nil. I have increased my calcium intake considerably over this time and wonder if I have been getting some absorbtin issues because of that.

I take my Cytomel 5mcg before I get out of bed and as early as 5:30 a.m.

My 2nd dose I try to take 6 hours from the 1st dose and my 3rd and final dose which is 1/2 a pill around 3-4p.m. I have always understood the 1/2 life to be around 6 hours.

I definitely feel the jolt 2 hours after taking it and my afternoon dose can create some

I generally feel much better being on Cytomel - I find myself cutting back on my dose when feeling wired or anxious and in times of extreme stress. I have a benzo on hand to help with anxiety caused by Cytomel at times.


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## jenny v (May 6, 2012)

Thanks, Lovlkn! I seriously thought I might be hyper up until my labs came back and showed hypo--I had all of my usual hyper symptoms (insomnia, feeling hot, losing a few pounds), but I guess they are hypo symptoms now, too.

I'm getting a little frustrated with all of this lately! It's like I get close to feeling good and then I swing into hypo or hyper land all over again. It's exhausting. Plus, my endo is out until Monday so I haven't heard yet what she wants me to do dosage-wise.


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## Andros (Aug 26, 2009)

jenny v said:


> I've been on the 50mcg of Synthroid and 5 mg of Cytomel for almost 5 weeks now and my endo had me do labs yesterday just to make sure I'm not swinging hyper the way I did the last time I tried it.
> 
> My November 2012 labs (75mcg of Synthroid) were:
> TSH: 1.91 (range .4-4.5)
> ...


You could stand 2.5 mcgs. of Cytomel added to your 5 mcgs.. Your FREE T3 is below the mid-range of 3.2. Most of us feel best when it is above the mid-range @ about 75% of the range given by your lab.

Exogenous T3 lowers your T4 and FT4 and really, that should not be tampered with as you only need a little T4 for peripheral deoiodination.

http://en.wikipedia.org/wiki/Iodothyronine_deiodinase


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## jenny v (May 6, 2012)

Andros, do you think my endo will/should bump up my Synthroid a bit to compensate for the lower FT4 and higher TSH? I wasn't surprised my FT3 rose but I was very surprised my TSH shot up so much and my FT4 dropped quite a bit. I went from 75mcg of Synthroid to 50mcg of Synthroid and 5mg of Cytomel.

This is a totally new area for me so I appreciate the advice!


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## Lovlkn (Dec 20, 2009)

jenny v said:


> Andros, do you think my endo will/should bump up my Synthroid a bit to compensate for the lower FT4 and higher TSH? I wasn't surprised my FT3 rose but I was very surprised my TSH shot up so much and my FT4 dropped quite a bit. I went from 75mcg of Synthroid to 50mcg of Synthroid and 5mg of Cytomel.
> 
> This is a totally new area for me so I appreciate the advice!


If it were me I would add back some Synthroid before increasing the Cytomel. Try taking 75mcg 3 days a week M-W-F, your body will adjust to the medications - I still have days where I feel a bit hyper so I reduce my last dose of Cytomel which is only 1/2 pill down to 1/4.

I bet your hyper feelings are the higher FT-3. Your body will adjust to these over time,


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## I DClaire (Jul 31, 2011)

I'm sorry, I took the slow bus to school - sometimes I think I understand about Cytomel, sometimes not so much.

What rationale prompts taking Cytomel? My husband's cousin takes only Cytomel.

My test results are pretty good but I am miserably lethargic all day. I honestly feel better this time of night than I feel all day.

I have experienced something unique two times that makes me believe I need something besides either Armour or Synthroid and that is I stopped taking Synthroid on 12/22/11 and started taking Armour the next day. For one entire day I felt 100% like myself...then that feeling vaporized.

A little over a year later, having serious side effects with Armour, I stopped taking it on 2/20/13 and went back on Synthroid the next day. AGAIN, for one entire day I felt totally normal, I wasn't hypo, I wasn't hyper, I felt normal...then, poof, that was the end of that.

Is it pure coincidence that having a little Synthroid in my system when I took the Armour made me feel normal OR having a little Armour in my system when I started taking Synthroid made me feel normal?

I read somewhere, maybe on FB recently, about people taking Armour and Synthroid...yet my endocrinologist looked dumbfounded when I told her what I'd read.

People may think I'm totally lost in space but I KNOW how I felt and I felt like myself. I do not feel like myself with either Armour or Synthroid - I feel like something is missing. I feel O.K. but, as God is my witness, I do not feel like myself!

Is there a test to determine if someone needs Cytomel? How does a doctor decide a patient needs Cytomel? About all I ever get lab orders for is T3 Free, T4 Free and TSH.

For a long time I honestly was terribly discouraged and frustrated because I KNOW I do not feel whole - now, feeling better on the Synthroid but still not like myself, I'm going to pursue this until I get more satisfaction.


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## Lovlkn (Dec 20, 2009)

Cytomel is indicated when a person taking a T-4 only medication does not have FT-3 in mid range or higher.

Symptoms are similar to what you describe - mid day fatigue.

After checking ferritin, D and B-12 if your FT-3 is mid range or lower Cytomel in my opinion would be worth a try. Mid day fatigue can also be caused by diet - eat a protein and see if that helps.

It took me 2 tries to be able to take it - it's very powerful stuff and definitely a medication I "feel". I am in sales and wonder if I should talk to ppl some days after my noon/1 dose because I get a boost so strong around 2 hours after taking it, I almost feel hyper with the extra adrenaline of the idea of walking into an office where I do not have business relationships set up.

Who knows? Maybe that's anxiety caused by the Cytomel - I just have learned to deal with it - although sometimes ppl ask if I had a cup of coffee - a very large cup before entering their office - LOL

Funny thing is I do not have this feeling in the morning after my cup of coffee and my Cytomel.


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## I DClaire (Jul 31, 2011)

Thanks for the information. I'm numb at the moment - struggling to absorb anything after a family pet (my nephew's little dog) died this morning.

Last night I fell asleep with my currest test results in my thoughts, trying to understand why my endocrinologist said for me to lower my weekly intake of Synthroid from 137 mcg every day to that same dosage six days but half of it on Sundays.

What am I missing? My T4 Free was 1.4 (Range 0.8-1.5). My T3 Free was 3.1 (Range 2.0-3.6). TSH was .013 (Range 0.37-4.55).

I would think those numbers were perfect considering I had a tiny papillary cancer. I thought the object was to keep the TSH low while keeping the other two values in normal range?

I feel like I'm braindead at the moment.


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## Lovlkn (Dec 20, 2009)

I DClaire said:


> Thanks for the information. I'm numb at the moment - struggling to absorb anything after a family pet (my nephew's little dog) died this morning.
> 
> Last night I fell asleep with my currest test results in my thoughts, trying to understand why my endocrinologist said for me to lower my weekly intake of Synthroid from 137 mcg every day to that same dosage six days but half of it on Sundays.
> 
> ...


Your doctor probably saw your FT-4 approaching high range. I don;t think dropping 1/2 a pill is going to make a HUGE difference but it may be enough to keep your FT-4 from going over high range.

I feel like crap when my FT-4 is that high - I'm just saying this because i know you do not feel well. Slightly over Mid range FT-4 and FT-3 is always my goal.


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## I DClaire (Jul 31, 2011)

Lovlkn said:


> Your doctor probably saw your FT-4 approaching high range. I don;t think dropping 1/2 a pill is going to make a HUGE difference but it may be enough to keep your FT-4 from going over high range.
> 
> I feel like crap when my FT-4 is that high - I'm just saying this because i know you do not feel well. Slightly over Mid range FT-4 and FT-3 is always my goal.


I had a neat experience yesterday afternoon. A pair of cardinals seem oddly fascinated by our patio so I decided I'd go to the pet store and buy them a bag of seeds I know cardinals love. I was intently studying all the different products when my endocrinologist, her mother and her two little sons showed-up. While the two boys tried to convince their grandmother to buy them something, my doctor and I had the best visit ever!

She remembered my latest test results perfectly. I told her I'll never understand my test results, that usually what I think is good is really bad and what looks bad to me is usually good! :anim_63:

She said my TSH was too low. She said tweaking my Synthroid down just a touch might make my TSH go up a little bit and I thought she said she'd like for it to be mid-range. It's a hundred miles from mid-range at this point - .013 (Range being 0.37-4.55)

I wanted to ask if my TSH changed, wouldn't my apparently perfect T4 Free and T3 Free results also change but her children wanted her attention and we'd already visited for probably 30 minutes.

I like my endocrinologist so very much and I know she has been concerned about me and is determined to get me to the optimum level with the tests. I just, for the life of me, cannot understand thyroid test results!

This afternoon, looking back at all my test results, I noticed my T4 Free is EXACTLY the same now that it was the first three months after my surgery when I was on 125 mcg Synthroid. My T3 Free is higher now than it was then. My TSH was extremely low at that time and is even lower now.


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## jenny v (May 6, 2012)

> She said my TSH was too low. She said tweaking my Synthroid down just a touch might make my TSH go up a little bit and I thought she said she'd like for it to be mid-range.


 Whoa, I hope she didn't say mid-range! You definitely don't want your TSH to be in the middle of the range, esp. since you had cancer. She probably (hopefully) wants it to be closer to 1.0 and for your FT4 to go down a smidge since you're pushing hyper territory there.

Heard back from my endo and we're going to raise my Synthroid a bit to compensate for my high TSH and FT4 dropping. I'm staying with 5mg of Cytomel and bumping up from 50mcg of Synthroid to 60mcg. We'll see if this works!

I had a weird weekend, my heart rate went bananas a few times at night, but it wasn't anything a beta blocker couldn't control. But it felt like my thyroid swelled up for a few days and I could feel my pulse throbbing in it and kept choking randomly on food and water. It's down a little today so I'm going to give it a few days and see if it continues or not. Thyroids are the weirdest glands! LOL.


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## I DClaire (Jul 31, 2011)

jenny v said:


> Thyroids are the weirdest glands! LOL.


Those could be the truest five words ever written! :anim_63:

I may have dreamed this but I think I read somewhere online that a normal thyroid only produces something like 1/4 teaspoon of hormone every year or something like that. I need to backtrack and check on that little tidbit.

Do you suppose we're going through all this to replicate 1/4 teaspoon of thyroid hormone??? :ashamed0003:


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## jenny v (May 6, 2012)

I'm back with more labs and confusing symptoms, lol! I've been on the raised dose of 60mcg of Synthroid and 5mcg of Cytomel for over 2 months now and I'm not feeling any better. My labs have gotten better than they were in April, but I'm actually feeling worse! I have been gaining weight hand over foot the last few weeks (without changing my diet or exercise level), I fall asleep on the couch around 8:30 every night, and now I'm having these weird feelings in my neck (it feels swollen and hard to swallow, although I can't see a difference when I look in the mirror). I go back to the endo next week, but I imagine she'll think I'm nuts when I complain about my symptoms and yet my labs look somewhat decent.

My January 24, 2013 labs (50mcg of Synthroid and a week of 5mcg of Cytomel) were:
TSH: .008 (range .4-4.5)
FT4: 2.06 (range .82-1.77)
FT3: 4.7 (range 2-4.4)

My March 13, 2013 labs (75mcg of Synthroid) were:
TSH: 1.74 (range .4-4.5)
FT4: 1.45 (range .8-1.8)
FT3: 2.9 (range 2-4.4)

My April 17, 2013 labs (50mcg of Synthroid and 5mcg of Cytomel) were:
TSH: 4.92 (range .4-4.5)
FT4: 1.19 (range .82-1.77)
FT3: 3.1 (range 2-4.4)

My June 5, 2013 labs (60mcg of Synthroid and 5mcg of Cytomel) are:
TSH: 2.91 (range .4-4.5)
FT4: 1.45 (range .82-1.77)
FT3: 3.2 (range 2.4.4)


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## Lovlkn (Dec 20, 2009)

> Do you suppose we're going through all this to replicate 1/4 teaspoon of thyroid hormone???


Yes.

I have my dosage dialed down to a variable of 1/4 Cytomel weekly. Sometimes if I take it -I get hyper, sometimes I feel low so I add it. When I feel out of sorts and hyper all I back off that tiny 1/4 pill a week and things get better in a week or so.

Mental? Maybe - I think it's good to know your body and have decided it's not always my thyroid causing my issues.

People get into issues when they continually change doses and medications.

I have been taking the same dose of Unithroid and Cytomel for almost 3 years.

Sometimes - I feel poorly but look to causes other than my thyroid.

IDC, you are 3/4 range of FT-4. For many, that is perfect. For me I would be anxious. A 3/4 range FT-3 for me would again = cause anxiety - we are all different. It comes down to how you "feel" and what your labs say. If you disagree with your doctor , you have control - speak up or do as you please ;-) I used to disagree with my doctors - they still run labs and labs vary, it's the nature of this wonderful journey of thyroid dysfunction.


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## Lovlkn (Dec 20, 2009)

jenny v said:


> I'm back with more labs and confusing symptoms, lol! I've been on the raised dose of 60mcg of Synthroid and 5mcg of Cytomel for over 2 months now and I'm not feeling any better. My labs have gotten better than they were in April, but I'm actually feeling worse! I have been gaining weight hand over foot the last few weeks (without changing my diet or exercise level), I fall asleep on the couch around 8:30 every night, and now I'm having these weird feelings in my neck (it feels swollen and hard to swallow, although I can't see a difference when I look in the mirror). I go back to the endo next week, but I imagine she'll think I'm nuts when I complain about my symptoms and yet my labs look somewhat decent.
> 
> My January 24, 2013 labs (50mcg of Synthroid and a week of 5mcg of Cytomel) were:
> TSH: .008 (range .4-4.5)
> ...


Your labs are all over the place. You must feel like crap? Moving thyroid levels can make you feel horrible.

Do you by chance have a running list of labs longer than from just January 2013? If you post them all on one post , I'd like to take a look.

What antibodies testing have you had?



> My June 5, 2013 labs (60mcg of Synthroid and 5mcg of Cytomel


You should try to stick to this dose for another month or 2 and see what your TSH does.


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## jenny v (May 6, 2012)

Lovlkn, I do feel pretty crappy, but I'm pushing through it. I'm posting a few more labs below, all were on 75mcg of Synthroid. I just can't seem to get stabilized on any one dose, although they aren't hugely wild swings, just enough to make me feel icky. My antibodies were tested back in December 2012 and they were the lowest they've been in a long time: TPO Ab 85 (range 0-34), TRab <0.51 (range 0-1.75), TGab <20 (range 0-40).

I was actually very surprised my latest labs weren't any worse given my neck feels swollen and almost kind of tender; I figured I was having a flare up and my labs would reflect that. Little bugger stumps me every time, lol!

7/13/12
TSH-1.58 (.40-4.5)
FT3-3.1 (2-4.4)
FT4-1.53 (.8-1.8)

9/18/12
TSH-2.58 (.40-4.5)
FT3-3.0 (2-4.4)
FT4-1.17 (.8-1.8)

11/12/12
TSH-1.91 (.40-4.5)
FT3-3.1 (2-4.4)
FT4-1.45 (.8-1.8)


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## Lovlkn (Dec 20, 2009)

jenny v said:


> Lovlkn, I do feel pretty crappy, but I'm pushing through it. I'm posting a few more labs below, all were on 75mcg of Synthroid. I just can't seem to get stabilized on any one dose, although they aren't hugely wild swings, just enough to make me feel icky. My antibodies were tested back in December 2012 and they were the lowest they've been in a long time: TPO Ab 85 (range 0-34), TRab <0.51 (range 0-1.75), TGab <20 (range 0-40).
> 
> I was actually very surprised my latest labs weren't any worse given my neck feels swollen and almost kind of tender; I figured I was having a flare up and my labs would reflect that. Little bugger stumps me every time, lol!
> 
> ...


Try to tough it out on the dose you are currently on.

How long were you on the 75mcg of Synthroid?

Your thyroid is likely dying off - very actively dying off. You will feel fluxuations until it cannot produce any hormone or you have it removed.

If you took your lab history and symptom history to a surgeon they would likely gladly remove it and you could then stabilize on getting your replacement set without any interference from your thyroid which obviously is failing and preventing you from stabilizing or feeling well on replacement now.

Just my thoughts...


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## bigfoot (May 13, 2011)

jenny v said:


> Little bugger stumps me every time, lol!


If only I had a nickel for every time I thought that!


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## jenny v (May 6, 2012)

> Try to tough it out on the dose you are currently on.
> 
> How long were you on the 75mcg of Synthroid?
> 
> ...


 I wish my thyroid could give me a heads up on how long it plans to take to die off!  When I was in my 20's I could have put up with these symptoms, but now that I'm over 30, it's getting harder to tolerate. Or I'm getting wimpy-er, lol!

Lovlkn, I was on the 75 mcg of Synthroid for about 2 years and it was fine until last year when my thyroid started roller coastering on me. I haven't been able to stabilize in over a year now. I've played around with the idea of surgery and my endo is not totally opposed to it, but we've both held back to see if we could get meds to handle it. I'm kind of up in the air now--is this the worse it will get or would it be even harder if it was removed?



> If only I had a nickel for every time I thought that!


 We'd be rich, lol!


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## Lovlkn (Dec 20, 2009)

When I was hyper I gave anti thyroid meds 4.5 years to work. I never stabilized for more than 2-4 months in a row.

My research about ablation was from others personal experiences.

I was tired of my thyroid being out of control so I choose surgery.

Post surgery I was fatigued for about 2.5 years although I did feel better than I did being on anti thyroid medications. My pains and RLS went away, during that time we addressed ferritin deficiency ( which ended up in endometrial ablation), low Vit D. I still do not sleep well but have gone through menopause (not confirmed) and aged 10 years, 40 to 50 post surgery.

I am glad I had surgery.


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## jenny v (May 6, 2012)

Never mind/ moved to labs section.


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