# What usually tells you that you're hypo (first signs)?



## Endlessness (Oct 5, 2011)

So I've recently stopped taking Cytomel cold turkey because it gave me anxiety/tachycardia after CVS switched manufacturers on me. I had been taking 88 mcg of Synthroid and 5 mcg of Cytomel for about 2-3 years, and originally started taking Cytomel thinking it would help the unexplained fatigue I was struggling with. Since it did not help, and I wanted to cut out Cytomel for a while, I wasn't too upset when my doctor told me to stop it after the tachycardia episodes (130-150 bpm at rest).

However, he wants to "give my body a rest" before going back to my previous Synthroid dose (100 mcg). He told me to do the blood test in 6 weeks, but to come back earlier if I was feeling hypo.

Here is my question to you: What usually clues you in that you're hypo? I've always use "fatigue" as a marker of hypothyroidism in the past, but considering that I'm already struggling with unexplained fatigue, I'm having a hard time figuring out if I need to go in earlier or just tough it out. I do feel more fatigued these days but my unexplained fatigue has been up and down a lot too, so who knows.

Also, I'm wondering if it's normal to feel more fatigue for a while since my body now has to learn to convert the extra T4 into T3 that I abruptly stopped giving it. Should I just wait a little longer, even longer than 6 weeks, or just go straight to my previous Synthroid dose?

More info:

I stopped the Cytomel a little over 3 weeks ago.

Dx Graves Disease at 8 years old, treated with RAI at 15

Last labs (when still taking Cytomel):

TSH: 0.06 uIU/mL (range 0.34 - 4.82)

FT3: 3.50 pg/mL (range 2.3 - 4.2)

FT4: 1.30 ng/dL (range 0.59 - 1.61)


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## Lovlkn (Dec 20, 2009)

Based on your heart rate stopping for a period sounds like a good idea.

How many days are you thinking? Have you considered dose reduction rather than dose elimination?



> Last labs (when still taking Cytomel):
> 
> TSH: 0.06 uIU/mL (range 0.34 - 4.82)
> 
> ...


Most feel best with a FT-4 and FT-3 somewhere between 1/2-3/4 of range which for you is FT-3 ((3.25-3.725)) FT-4 (( 1.11-1.355))

Seeing these range with the range and your lab results - you might consider taking 1/2 less Levothyroxine dose 1 day weekly and continue what Cytomel dose you were on.

I feel extreme anxiety and rapid heart rate when my FT-4 is 3/4 range or over.

It's amazing how reducing 1/2 pill weekly can make a huge difference in how you feel and your lab results. I tweak my doses depending on seasons as going on 15 years with out a thyroid I have identified the pattern.


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## GOLGO13 (Jun 13, 2018)

For me I have a tell. I get a pain in the left side of my back. When I was on a lower amount of levo, it would come quicker in the day. When I was on a higher amount it would take much longer before it came.

So more fatigue would be an indicator to me you are a bit more hypo.

Don't forget this stuff can take a long time to adjust (your body takes time unless you have no thyroid). So you really have to give adjustments some time. I'm not sure how RAI changes the dynamic though. I assume it's not as bad as no thyroid?

I wonder if they should have just lowered the levo vice cutting out the cytomel. I know it's certainly a balance between the two. It will be interesting to see how your numbers change.


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## creepingdeath (Apr 6, 2014)

My 1st sign is extreme nausea in the morning.

It gets more nightmarish the longer the absence of the hormone.

Painful constipation, joint & muscle pain along with hair loss, nerve damage and depression.

That's just a handful of the symptoms associated with thyroid disease.

You slowly end up dying a horrible torturous death over a few months or aquire permanent damage if you do without the hormone long enough.

But then again everyone is different...&#8230;..

"fatigue would be a party compared to the symptoms I've been through"


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## Lovlkn (Dec 20, 2009)

Rapid heart rate , severe insomnia, easily choked w food or saliva and tightened Psoas muscle are my signs of being over medicated.

I tend to run euthyroid or hyper vs being hypo.


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## joplin1975 (Jul 21, 2011)

Constipation (sorry but there it is!) first; obscene amounts of acne second.


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## Endlessness (Oct 5, 2011)

Thanks everyone for the input! It's interesting just how varied the first signs are! I guess it's hard to compare







For now I've been having increased fatigue, daily headaches and lack of appetite.

To answer some of the questions, the reason why we're cutting out Cytomel instead of simply lowering Synthroid is because I haven't seen an improvement on Cytomel despite having good FT3 & FT4 levels, and when I started taking it, I did have tachycardia and palpitations that took a few weeks to resolve. Considering that simply switching manufacturers gave me tachycardia of 130-150 at rest, it felt like it would be better to go back to just Synthroid, which did not give me tachycardia unless I was overmedicated.

I don't know if I'm reacting to the filler or just the slight variation of dosage, but it seems like I'm highly sensitive to T3 and it's not working well for me.

I'm just eager to go back to my previous Synthroid dosage and hopefully stabilize


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## GOLGO13 (Jun 13, 2018)

It would seem that if you were on a combination, it would make sense that you would need more T4 medicine.

That is why I am hesitant to take T3 medicines. But if I never get this stuff working perfect I may try it.


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