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Old 06-17-2006, 12:56 PM   #1
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Question Does taking Cytomel decrease your T4 levels? Meep..Midwest??

Just wondering about this, ever since I started taking Cytomel. My Dr. reduced my Levothroid dosage, to accomadate taking the added T3, but it appears my T4 levels have dropped, quite a bit...from 1.6 to 1.2. (range is .8-1.7) I knew it as I started get the ol' fun, (pain) symptoms back again...and hair fallout, etc. Ugh...not pretty.

Would you suggest that I increase my Levothroid, (maybe only by .12 mcg's) or increase my T3, (the Cytomel), by 5 mcg's. (That's what she's prescribed in the first place, was 5 mcg's 2 x a day,...but that much gave me severe headaches...and I mean severe...every waking moment, so I reduced it to 5mcg 1x per day.) I wonder if I had taken the 10 mcg's, would it have kept my T4 levels up?? I see my endo on Monday, and would like to tell her what I'd like to do. ... She's really not very good...but she'll work with me though.

So, what do you think....raise T3, or raise T4?? I really need my T4 near the top to feel right. It was 1.6 before I started the Cytomel. Please,....someone help??

Thank you in advance! : )
Deda

EDIT to add: I forgot this. My T3 level is still about just a little over the midrange, and my TSH is 1.8. That's what worries me...that she'll say it's all fine...but I will argue that point with her, I assure you. I really didn't feel well until that TSH was at least ALL the way down to a 1. Thanks for reading all of this...

Last edited by Deda; 06-17-2006 at 01:16 PM. Reason: forgot to add other levels

 
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Old 06-17-2006, 06:12 PM   #2
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Re: Does taking Cytomel decrease your T4 levels? Meep..Midwest??

Well 5mcg of Cytomel is equal to .25mcg of Levothroid. I found that I cannot go by what the doctors recommend. I added Cytomel on my own to go along with my Synthroid T4 and have felt much better. I did cut down my Synthroid from ,125 to .50mcg and added .5mcg of Cytomel. I will do this for a while and up the dose slowly. I just experimented with the combination until I felt good. I always took the least amount early in the morning when I am experimented with dosages. Then if I don't get side effects in a few hours, I take a litttle more. Sounds crazy, I know, but after 12 years of doctors increasing my T4 medicine, and I still didn't feel good, I decided to take matters into my own hands since my doctors would not give me Cytomel. If the amount of Cytomel is giving you a headache, then cut the dose in half and allow your body to get use to it.

 
Old 06-17-2006, 06:14 PM   #3
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Re: Does taking Cytomel decrease your T4 levels? Meep..Midwest??

I don't like to recommend amounts, Deda. But I do know that T3 drugs often will keep T4 levels a bit low and out of balance with T3. Even for myself on Armour, my T3 is way higher than my T4, but my MD doesn't like to prescribe additional T4, so there ya go.

I would say you should increase the T4, but I can't say by how much. I hope you'll be able to work it out with your MD, though. Just tell her, "I felt better when my FT4 was "X" high. I'd like to try to get it back there again." Can't hurt. Maybe she'll listen.

 
Old 06-18-2006, 01:09 AM   #4
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Re: Does taking Cytomel decrease your T4 levels? Meep..Midwest??

Quote:
Originally Posted by Deda
my T4 levels have dropped, quite a bit...from 1.6 to 1.2. (range is .8-1.7)...

Would you suggest that I increase my Levothroid, (maybe only by .12 mcg's) or increase my T3, (the Cytomel), by 5 mcg's.
We'll get there...

Quote:
(That's what she's prescribed in the first place, was 5 mcg's 2 x a day,...but that much gave me severe headaches...and I mean severe...every waking moment, so I reduced it to 5mcg 1x per day.)
Your doc is wise to have dosed it twice a day, but I think a more appropriate starting dose would have been 1/2 of a 5mcg pill twice a day, with an increase later if needed. (T3 is stable in your blood after only a week, and Cytomel can be adjusted often until you are where you need to be T3-wise)

Quote:
I wonder if I had taken the 10 mcg's, would it have kept my T4 levels up??
Two possible answers here:

1. If you no longer have a thyroid gland, the Cytomel would have had negligible effect on T4 levels, no matter how much if it you took.

2. You said your TSH is still 1.8. If you still have a thyroid gland, TSH tells your thyroid gland to produce T4. Since the Cytomel drops your TSH, your T4 would also drop, so increasing to 10mcg in this case would very likely have caused your T4 to drop even more.

Quote:
I see my endo on Monday, and would like to tell her what I'd like to do. ... She's really not very good...but she'll work with me though.
THAT is great to hear! I love it when a doctor will work with a patient on feeling better. You have a docotr who is in it to help you. Keep this one and be thankful!

Quote:
So, what do you think....raise T3, or raise T4?? I really need my T4 near the top to feel right. It was 1.6 before I started the Cytomel. Please,....someone help??
Quote:
EDIT to add: I forgot this. My T3 level is still about just a little over the midrange, and my TSH is 1.8. That's what worries me...that she'll say it's all fine...but I will argue that point with her, I assure you. I really didn't feel well until that TSH was at least ALL the way down to a 1. Thanks for reading all of this...
OK, lets get this all in one place and make some sense of it:

Free T4 - 1.2 (range is .8-1.7) and you need it higher to feel well.
T3 - just above mid range and you probably need it a little higher
TSH - 1.8 Though TSH is variable, yours is still a little elevated... Your pituitary is trying to tell your thyroid that you need at least a tiny bit more T3 and T4.

Since increasing T4 cAN also increase T3, and you have already stated that taking more T3 gave you a headache, then lets work on T4. I would ask for an increase to the next higher dose of T4 (usually about 12mcg more, like you said) and stay on it for 6 weeks before re-testing. Meanwhile, start splitting your Cytomel tablets and take half in the morning, upon rising and half in the early afternoon (about 8 hours later). You will be more even, energy-wise and it will have less impact on your TSH this way, too.

Next, take 50-100mcg of Selenium a day. This will help your body convert the T4 you are taking to T3 more efficiently, letting your body decide when you need more T3.

What should you expect from this change? My estimation is that at your next blood draw, 6 weeks after you make the changes I recommend, your Free T4 will have risen a little--probably not as much as you like, but it is better to sneak up on the proper levels than to overshoot and have to back-track. I know from my experience that can be frustrating. Your Free T3 will also probably rise a little due to the better conversion. Once you get these blood results in you may need to repeat this process (nudge T4 dose a little, wait 6 weeks, and test again), but that will be over 6 weeks away and we'll cross that bridge when we get there.

Meanwhile, keep in mind that you should NOT take your meds within 8 hours of having your blood drawn if you are getting Free T3 and Free T4 labs done. During that time, your levels of Free T3 and Free T4 are artificially elevated due to taking the pill(s), until the proteins in your blood have time to bind with them and stabilize the levels. Many docs think Free T3 and Free T4 blood tests are unreliable and sporadic, because they haven't been taught what you just read.
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Last edited by Meep; 06-18-2006 at 01:14 AM.

 
Old 06-18-2006, 03:24 AM   #5
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Re: Does taking Cytomel decrease your T4 levels? Meep..Midwest??

Thank you ALL for your advice and encouragement. (you are all terrific people!)

rstarre...glad to hear that you're feelin better. That's amazing that you're feeling okay with such a large reduction in your Synthroid....this thyroid balancing is so individualized it isn't funny....really tricky..huh? Thanks..and good luck!

Midwest,..thanks! Yep, when I was on Armour (only), my Dr. wouldn't give me any T4 either....I know it could've helped. I had the same problem, the low T4 and my T3 was up near the top. Unfortunately for me, I felt terrible. (T4 never went above 1.0, as any increase in dose over 90 mg. made me hyper on T3 levels) Thank you for your reply too.

Meep...thank you. That was so interesting, yet pretty easy to decipher as well. I think I am going to ask for the next dose up on the Levo...T4., which would be 125 mcg. I don't see how she would deny me that, as my FT4 is low enough. Thanks for the great advice, and taking the time. I wish I could just print out your message and just give it to her and say..."here...this is what Meep thinks I should do" ha ha....ever think about becoming a thyroid Dr? (You would've made a good one!) Thank you!

Have a great Sunday,..all of you...and cross your fingers I get my way on Monday...

Deda

 
Old 06-18-2006, 11:33 PM   #6
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Re: Does taking Cytomel decrease your T4 levels? Meep..Midwest??

LOL Thanks, Deda! Sometime I think I aspire to a career in medicine, but it woudl take motivation I don't have right now, and many MANY years. My high school education gets me by in my current life, med school, then residency, WOW! Makes me tired thinking of it.
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Old 06-19-2006, 09:00 PM   #7
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Re: Does taking Cytomel decrease your T4 levels? Meep..Midwest??

Well Meep, ..your high school did you pretty well!

Just to let you all know the results of my endo appt today....just as I thought, as soon as I walked in, after asking how I was feeling, and I answered really not that great....some hypo symptos have returned.. She said, "well, your levels look great". I told her, (just as you suggested, midwest), "Well, for ME they're not great"...and went on to tell her how I HAVE to have my Free T4 levels up near the top...(the last labs T4 was 1.1), that I just feel terrible unless it's way up there....

And she was so cool about it! She said we still had enough wiggle room there to go back on the 125 mcg, (up from 112), and stick to the 5 mcg Cytomel, taken as 2.5 in the AM and 2.5 in the afternoon. She said as long as I stayed within the lab ranges...that kinda worries me tho...but we'll cross that bridge if I come to it later. Anyway, our TSH lab range starts at 0.2. Hope it doesn't go below that...we'll see. Go back in 8 weeks for new labs and then see her again. She didn't know that I already started this dose, 125, a few days ago already.

Thanks for all you help and suggestions...
Deda

 
Old 06-20-2006, 01:09 AM   #8
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Re: Does taking Cytomel decrease your T4 levels? Meep..Midwest??

*HUG* glad it went so well... Keep us posted on how you are feeling!
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