Re: It's me again I have a ?..
Sounds like your doctor is a gem!
You may want to ask your doc, but I believe it's actually <B>not</B> in your best interest to take both Cytomel (T3) and Synthroid when you are determining your initial dosage requirement. Doubling up would be more likely to put you in a spiral of symptoms:
The T3/Cytomel is "short-acting" and needs to be taken twice a day. So, it would bring your levels up to "normal" for several hours and then slowly decrease throughout the day. In the meantime, your T4/Synthroid slowly builds up in your body over time (it takes 4-6 weeks to assimilate completely). So, while your Cytomel was cycling up and down, your Synthroid would be slowly building up the thyroid hormone levels in your body. You'd probably spiral through Hypo and Hyper symptoms throughout the day. Plus, it would be difficult to determine your proper dosage of Synthroid alone. (If you were taking both Cytomel and Synthroid, you'd have to take both until you were Hyperthyroid, then phase out the Cytomel, wait a week or so for its full metabolization, and then increase the Synthroid until balanced. That's two waiting periods for wellness.)
At any rate, it would actually take a lot longer than just ramping up the Synthroid itself over time. But, remember, each dosage adjustment takes 4-6 weeks to assimilate in your body (and it may take a couple of months before you notice a status quo of your symptoms and can determine if the dosage is too low or too high).
If you become very uncomfortable before your start your meds and really need to alleviate your symptoms quickly, I suppose you could take Cytomel alone to address your symptoms and then STOP the Cytomel and start Synthroid. This way you would have some thyroid hormone in your blood stream but wouldn't be stacking your meds, as it were. But I don't know if this approach will really be necessary or if your doctor would be willing to do it. I found the time before starting my meds a bit uncomfortable, but it was livable. And I knew it was temporary.
And even though it takes a while to fully assimilate in your body, you will probably notice some improvement as early as the first couple of weeks of medication, even if you're taking only Synthroid. You just won't feel 100% until everything is balanced. But realize, feeling "normal" may take six months to a year or two, and still requires a close watch for the return of any symptoms that could indicate a medication adjustment is needed. It's a long process.
Once you're on the meds, expect blood tests every 2-3 months until you stabilize, and then every 6 months to a year thereafter. Doctor's orders vary, but they typically take Free T3, Free T4, TSH, and Calcium for the first several tests following surgery. After you stabilize, your doc may only want to take Free T4 and TSH, but if you can get him to do Free T3 as well it will give you a better picture of what's going on in your body.