# Lab results, To add cytomel or not? Need Help Please



## danadear (Mar 12, 2016)

I've tried Cytomel twice in the past and quit after 2 or 3 months each time because of the extreme hyper symptoms I would get. I have not tried it in a while.

I did report this to my doctor but he didn't offer any suggestions. The doctor, however, still had it in his system that I was taking 5mcg every day so based on the last labs he had the nurse call to tell me he was doubling my dosage of cytomel .I'm not sure if this is good advice for me and would be interested in knowing what others had to say about it. I read I should cut my dose and take it twice a day and build up my dosage? Is this good advice for me? If you have an opinion about my dosage please express it. My doctor is a general doc and I'm not sure if he is very up to date on what I should be doing.

About me:

Female - 46

Diagnosed w/ Hashimoto's in 2003

recent anemia(still recovering)

Ds weight loss surgery in '09(malabsorption procedure)

For last 2 plus months have been following Hashi's diet and taking many associated supplements Feeling somewhat better but still feel like I weigh 1000 lbs, much effort to move my body around (I weigh 154, 5'7") I suppose that is just weakness from low blood pressure. I just can't shake fatigue and generally feel tired and achy much of my day.

Prior to these labs I was taking Levothyroxin 150mcg for prior 12 months

Labs from Quanum *2/20/17 * (*Doctor raised dosage of to 175mcg of Levothyroxin)

t4, free - 1.5 (.8 - 1.8)

TSH - 2.08 (.40 - 4.50)

T3 - 2.3 (2.3 -4.2)

Labs from LabCorp on *4-4-17 ** Doctor lowered dosage back to 150mcg Levothyroxin

TSH - .036 (.450 -4.50)

T4, free 2.13 (.82-1.77)

Labs from Lapcorp 6-23-17 *Doctor wants me to add 10mcg of cytomel(Liothyronine)

TSH - 1.730 (.450 - 4.500)

T3, free 1.9 (2 -4.4)

T3 reverse - 22.9 (9.2 - 24.1)

Thyroid Peroxdase (TPO)ab - 176 (0-34)


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## Lovlkn (Dec 20, 2009)

Your doc is doing the right thing - except, where is the FT-4 lab from 6-23-17.

i for one would not add Cytomel until I had the FT-4 run along with FT-3 drawn at the same time.

There seems to be a trend on this board where low Ferritin ( iron) causes people to struggle adding Cytomel. I had this happen to me and eventually added 10mcg to my already 125mcg levothyroxine dose.

If FT-4 is in too high of range adding Cytomel will make it go higher so that is why you need to know your FT-4 prior to beginning. Also, since your FT-4 was above range awhile back you have some reverse T3 which also makes adding Cytomel more difficult

https://www.healthonelabs.com/tests_offer/buytest/220/


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## jenny v (May 6, 2012)

Yeah, you need to clear out that Reverse T3 before you'll start feeling better. Usually to do that, you drop your T4 meds in half and slowly add in T3 until you start to feel better and the rT3 should clear. Does your doctor want to increase the Cytomel or does he just want you to take 10mcg for the foreseeable future.


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## danadear (Mar 12, 2016)

Lovlkn said:


> Your doc is doing the right thing - except, where is the FT-4 lab from 6-23-17.
> 
> i for one would not add Cytomel until I had the FT-4 run along with FT-3 drawn at the same time.
> 
> ...


I'm not sure where my T4 results are. I have to call LabCorp on Monday because according to their website t4 is suppose to be included in a thyroid cascade profile. At this point I'm not sure if it is doctor or lab error. It is going to make me angry if they don't have them though.


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## danadear (Mar 12, 2016)

jenny v said:


> Yeah, you need to clear out that Reverse T3 before you'll start feeling better. Usually to do that, you drop your T4 meds in half and slowly add in T3 until you start to feel better and the rT3 should clear. Does your doctor want to increase the Cytomel or does he just want you to take 10mcg for the foreseeable future.


I appreciate the insight and I don't doubt this is correct however, if I had the source of this information it would be helpful. Did you learn this from your doctor or is it in writing somewhere?

Yes, my doctor just wants me to add cytomel for the foreseeable future. He is by no means a "top doc". I really am trying to learn this stuff on my own and I want to learn what's best for me however it can be difficult when you don't know how you are going to feel from day to day.


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## jenny v (May 6, 2012)

The rT3 clear out with Cytomel is what my doctor is doing, but there should be documentation or information on it somewhere (she's good but I doubt she came up with this on her own, lol).


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