Question about synthroid & T3 compound???

[loretta38]

Ok - so as I am reading on this board - I keep hearing people talking about taking synthroid and then another drug for your T3 or T4 compound. I just got my lab results back and they only told me that my tsh was at 2.49 which is on the high end of normal. But is there something I need to be asking my doctor about when I see him on the 26th of April. I mean I have no thyroid now and if I am needing something else - shouldn't the doctor have me on it? Haven't seen him since surgery on the 29th of March - so I just want to be prepared when I do see him. Will have new blood test run on the 20th. Then see him on the 26th. So what is this other medicine I hear people talking about - any advice would be awesome.

[ErinBeth]

Originally Posted by loretta38;2***578

Ok - so as I am reading on this board - I keep hearing people talking about taking synthroid and then another drug for your T3 or T4 compound. I just got my lab results back and they only told me that my tsh was at 2.49 which is on the high end of normal. But is there something I need to be asking my doctor about when I see him on the 26th of April. I mean I have no thyroid now and if I am needing something else - shouldn't the doctor have me on it? Haven't seen him since surgery on the 29th of March - so I just want to be prepared when I do see him. Will have new blood test run on the 20th. Then see him on the 26th. So what is this other medicine I hear people talking about - any advice would be awesome.

Loretta, I don't recall the details of your story, but I know I benefited from an increase in my Levothroid (T4) when my TSH was at 2.7. I benefited from an increase when my TSH was at 1.9. I benefited from an increase when my TSH was at 1.7. My journey is ongoing.

It may be one or both of us may eventually want to add some T3, but I don't think you or I are quite there yet.

I plan to get as close to a TSH of 1 as my T4 med will allow and my doc is recommending that. Once there, if I have lingering symptoms, I will then as for the "frees" labs, Free T4 and Free T3. If there is room to tweak a bit more with either T4 or T3, I will probably ask to try that. Carefully, given what I have read here.

You may want to keep that in mind if indicated in the future, but I would suggest you try to get T4 increased until you reach that TSH around 1 first. Why? Because, if your body proves capable of converting T4 to T3 itself once you have enough free T4, it will do that at a more appropriate rate than you could trying to guess at it by adding the T3 yourself.

Additionally, Cytomel (a synthetic T3) is more expensive than T4. I know I would rather have my body create the T3 itself if at all possible. I need to give it a good try first to see if it can, anyway.

[ThyroidShmyroid]

Ok, I'll try my hand at answering this. The usual disclaimer here: I'm not a medical doctor, consult a doctor before any change in meds, blah blah blah ...

Ok good, glad we got that out of the way.

A healthy thyroid produces both T4 (thyroxin) and T3 (triiodothyronine). However, it only produces about 1/5 as much T3 as it does T4. The T4 by itself is not used directly - it is converted in other parts of the body (sorry don't know exactly where or how) into T3, in which form it is useful to tissues in your body.

Synthroid is a T4 only drug. There are others ... Cytomel is a T3 only drug. Again, there are other brands.

So when people discuss taking T4 they are really talking about taking their Synthroid pill, or Unithroid, or any other T4-only drug. When people talk about taking their T3, they are really talking about taking their Cytomel (or some equivalent brand). Same thing.

Some drugs, such as Armour (dessicated thryoid extract) contain both T3 and T4.

Modern medical theory says that when the thyroid fails (hypothyroidism), all that's needed is to replace the T4 (even though your thyroid produces T3 as well) since the T4 gets converted to T3 anyway. In other words, the fact that your thryoid produces T3 doesn't really matter, since tissues can draw as much T3 as they need by converting T4, so replacing T3 is not considered necessary. Several medical studies demonstrate that adding T3 does not help the patient feel any better. However, some patients strongly feel that they DO feel better with T3 added, despite what the studies say.

I can't comment on the efficacy of T3 since I have never taken it. I can say that I have many frustrating symptoms that have cropped up about a year after I was diagnosed with Hashimotos, and that I suspect that there is more to the story than modern medical science understands.

Loretta38, I hope this at least partially answered your question, sorry if I am telling you stuff that you already know.

If anyone wants to clarify or correct, please go ahead ...

[loretta38]

Thanks guys - that helps me understand. So - I just need an increase in my synthroid and wait until I get to 1.0-1.5 and then see if that is something I need to add. Everything just gets so confusing - I hate not knowing when I go to the doctor - I always want to be as prepared as possible. Trusted them for too long to just "believe anything" told to me by a doctor. But thanks - that is why everyone here is so awesome!!!!!!!!!!!!1

[Red Maple]

Loretta, IMO the very best way to understand thyroid disorders, diseases, surgeries, is to educate yourself. You certainly are trying to do that using this board and there are many experts here to guide you. However, each of us has our own opinions, preferences of doctor speciality, preferences of medications or thyroid hormone supplements; probably the best way to educate yourself (along with the real life stories here) is a visit to your local public library. You will find many books on thyroid disorders of all varieties, treatments, various medications and virtually a wealth of information. You can then put that information into the prespective your own individual case.

Many of us here recommend the book "Thyroid for Dummies" as a starting place. I found my first copy at my local library, found it so very helpful, that I went out and bought my own copy. I have lived with a thyroid disorder for nearly 5 years now, and still refer to my copy often. This book helped me a lot to understand the thyroid hormones T4 and T3, thier function in the body, and the benefit you can receive from them. Most people start out with a T4 only medication such a synthroid. T4 only medications are the most widely prescribed thyroid supplement in the world. Many, many people do very well on it all by itself. Some have need to supplement T3 in addition to T4; but you won't know if you need T3 until you have given the T4 only medication a real shot at resolving your needs.

You probably have already found many reputable web sites from medical organizations to help you also understand the various medications available. Each brand of thyroid hormone supplement medication also usually has a web site for better understanding about dosing, side effects, or other things you may be concerned about.

You probably also have thought of making a list of questions to ask your doctor when you see him. I have found my list invaluable when I visit the doctor. I have a tendancy to forget to mention information I would like to have when in the doctor's office. My doctor has been my very best source of information, (providing I don't forget to ask...) and has always been very willing to explain anything to help me to understand my disorder. The more information I have, the better I am able to be a partner with my doctor in my care.

Best of luck to you and I hope to see more of you around the board--of course I'll be expecting to hear how great your are feeling! Welcome to the board, you have found friends!