Hi all! First of all I have to say how great it's been to have found this board. I finally don't feel so alone in this crazy hypothryroid world I live in!! :-) I heard about cytomel and asked my doc about it and she said she could change me when she sees what my bloodwork says. I take 250mcg of synthroid right now. I was under the impression that I would take both the synthroid and cytomel together, but she said no only one. Does this sound right to you guys? Isn't one a t3 and one a t4 and don't I need both? I just don't know what to ask for and we all know we can't rely on them to help without a push! Any info would be greatly appreciated.

Thanks, Lin

Welcome, Lin. You are correct: Synthroid is a T4-only med, and Cytomel is a T3-only med. Our bodies typically need both because they are absorbed in different areas, but during the metabolism process T4 breaks down to form T3 (and then to T2 and T1 I believe, though these forms of the hormone aren't tested).

Adjustments to T4 meds take about 6-8 weeks to fully assimilate in our body. But T3 meds (considered "fast-acting") are more readily absorbed and more easily used up as well. Because of this, T3-only therapy sometimes produces symptoms of Hyper when you first take your dose, and then Hypo later in the day when you've used it up. Most people split the dose throughout the day to minimize this problem.

With Hypo patients with low T3 levels, some doctors prescribe T4-only meds, with the belief that increasing the doseage will provide the body with the T3 it needs. It works for some; others need to supplement their bodies with additional T3 -- combination therapy (Synthroid + Cytomel) works best for these folks. Still others are on T3-only meds. This protocol is typically followed for those with Wilson's Syndrome (where the body is producing Reverse T3).

Ask your doctor to test your blood levels for (at a minimum) Free T3, Free T4, Reverse T3, TSH, and Thyroid Antibodies. The Free T3/T4 levels will show how much of the hormone is available to the body for use -- other blood tests include the hormone that's bound to proteins and is sometimes an inaccurate depiction of what's going on.

Thyroid antibodies are interesting because antibody-related thyroiditis (including Hashimoto's) may cause fluctuations in your blood levels, particularly the TSH, and may also cause your symptoms to flare up sometimes as Hypo, Hyper or a combination of both.

Medications are typically prescribed according to the protocol about which the doctor has the most knowledge. This is generally a pretty good idea, as the patient is more likely to receive relief from something the doc has experience with, but there are cases where new methods are necessary. Your doc may not be familiar with T4/T3 combination therapy and, as such, is less comfortable with the idea. But T3-only can be difficult to manage at times.

If you've not yet had a chance, read through our Information Archive thread. It includes symptoms lists, notes about various tests and what they mean, thyroiditis and antibodies, supplements that may be helpful (such as Vitamin B-complex, Selenium and Maca), questions to ask doctors, and much more.

Information Archive thread http://www.healthboards.com/ubb/Forum118/HTML/000005.html


Let us know what happens.

Thanks for all the info!! I followed the link you provided too and WOW!! What a load of knowledge! I feel so much better about talking with my doc now. I will keep you posted.

Hi all. I got my labs back and was wondering if you all could tell me what they mean. My TSH came back 11.09, My free t4 was 1.1, my t3 was 180. My Doc is going to start me on armour. Is this a t4/t3 drug? I'm not too familiar with it, I've only heard it mentioned. Anybody have any comments on this? Do you think this new drug will help? Any posts appreciated.

Hi mommy20boy

TSH 11.09 is very high, meaning you are definitely hypothyroid!

You need to post your lab ranges, too, in regard to the T3 and free T4.

Armour is a t4/t3 natural hormone, not a "drug".
I am on Armour, and it works very well for many people. It is a good idea to note and write down symptoms, if any, as you try this. We are all different.



[This message has been edited by Tree Frog (edited 11-22-2002).]

thanks for the reply, tree frog. I don't know the lab ranges for the free t4, the range for the t3 is 60-181. I'm wondering why I'm so high. I really thought it would be low because my symptoms are so severe..fatigue, swelling, weight gain, moody, hair loss, etc. I have been fighting for help for 14 yrs and slowly putting on like 10-15 lbs a year. I am now so overweight despite my dieting and exercise. I so hope this armour will help.

The Armour should definitely start you on a return to good health. It is a "whole gland" medication that provides a more complete form of thyroid hormone than would Cytomel or Synthroid alone. The Information Archive thread above includes a table with equivalent doses of the various thyroid meds, in case you want to compare it to your 250 mcg of Synthroid. Armour dosage is typically increased slowly, to give the body a chance to assimilate it.

The blood tests are kind of counterintuitive, because TSH goes up when our other levels go down, and vice-versa:

When the TSH (Thyroid Stimulating Hormone) is HIGH, it means that the brain is trying to stimulate more production of hormone because the amounts of T3 and T4 hormone in your blood are LOW, and you are HYPO (need more hormone).

Hi mommy20boy,

Please be sure to get copies of all lab tresults for your own records. It really helps if you have to change doctors or need to talk about a possible dose change!

Thanks for the info and suggestions. My doc started me on 120mg of Armour. I've been on it for 5 days. I'll let you know if(when) it helps! I will also get copies of my labs--good advice.

Thanks!! Lin