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Old 12-30-2010, 02:25 PM   #1
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Need Help with Labs/Adding cytomel

Hi folks--Here are my latest labs and I am currently on 100mcg synthroid.

tsh- 3.02 ; range .34-5.6
free t3- 2.6; 2.2-4.3
free t4- 1.29; .57-1.25

I tried 2.5mcg cytomel a few years back and couldn't tolerate it. But...my new dr. has now said maybe I should try some cytomel.

I am going to try 2.5mcg cytomel again and hope this time it agrees with me and I don't get overly anxious . I will split the dose taking one early am and one early afternoon.

Does anyone know with adding the 2.5mcg cytomel how much should my synthroid 100mcg be reduced. I have bone loss already and do not want to go hyper either so I want to be conservative.

I have read that t3 is 4x as potent as t4....
so 2.5mcg cytomel should equal 10 mcg synthroid...Right?

And , then I could decrease my 100mcg a day synthroid by about 10 or 12 mcg a day right?

Can anyone tell me if this sounds about right on the numbers???? Yes, my dr. could do the numbers but...I have had drs. go too far and push me into hyper..I don't want that again.
Azuree

Last edited by azuree; 12-30-2010 at 02:36 PM. Reason: my oops

 
Old 12-30-2010, 02:44 PM   #2
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Re: Need Help with Labs/Adding cytomel

Well- the first thing I see is the lab ranges are not right. Your TSH should be no higher than 2.5 or you will by hypo- some people are hypo once their TSH goes over 2.0. I went hypo when my TSH went over 2.5. Your doctor is clearly using outdated lab ranges. You're still hypothyroid at 3.02. Both your FT4 and FT3 appear on the low side, as well.

As to T3 being more potent than T4- it doesn't exactly work that way. T4 is converted to T3 in the body, T3 is what the body needs. If your body has a conversion disorder and you don't do well at converting T4 to T3, then adding T3 either through Cytomel or by switching to a desiccated natural thyroid might be appropriate. I have heard, anecdotally, that people who switch from Synthroid to one of the desiccated thryroids have sometimes lowered their overall dosage because the presence of T3 in the pill makes the need for T4 less. If Cytomel disagrees with you, you might consider trying one of the natural desiccated versions such as Armour, Erfa, Naturethroid, Westhroid. I just take a generic version offered at my Naturopath's office called "Thryoid USP" which is ridiculously cheap ($16.50 a month for 1-1/2 grains a day) and according to my doctor has never been re-compounded the way some of the other ones have.

If you peruse the thyroid board and read some of the posts, you'll find there are some people on here that have a lot of experience dealing with hypothyroidism. Additionally, there are some really good books out there. The one book that helped me the most in understanding my disease (I have Hashimoto's Thyroiditis) was "Overcoming Thyroid Disorders" by Dr. David Brownstein, MD. There are also books and a website by Mary J Shomon and she has some excellent advice and resources. And since diet is a biggie - particularly if you have Hashi's (which you don't say if you do or not) one of the best books I read on revamping my diet was "The Anti-Inflammation Diet and Recipe Book" by Dr. Jessica Black, ND.

Everyone's different, and thyroid particularly seems to be very individual, so I recommend reading as much as you can here and elsewhere so you can figure out what works best for you.

Good luck!

Last edited by EagleRiverDee; 12-30-2010 at 02:59 PM.

 
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Old 12-30-2010, 02:53 PM   #3
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Re: Need Help with Labs/Adding cytomel

EagleRiver--Thank you for all that helpful info. Those are the lab ranges at a major clinic in a large metro area. My dr. didn't set those levels. My dr. and I would be fine with my tsh at around 2--that is where I feel better.
Yes, I do have hashi's.
Azuree

 
Old 12-30-2010, 09:15 PM   #4
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Re: Need Help with Labs/Adding cytomel

It's clear you aren't converting T4 very well. Because your FT3 is so very low and your FT4 is above-range, it is a good idea to slightly reduce the Synthroid when you start the Cytomel. And yes, exogenous T3 is 4 times the strength of the same amount of T4. Just roughly guessing... You could reduce Synthroid to 88 mcgs and see how that goes.

Your FT4 level may naturally fall some after you've been on Cytomel for awhile. That would ensure the safety of your bone health. But if it doesn't fall back to no more than 75% of its range, you could further reduce the Synthroid dose to facilitate that change.

 
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Old 12-30-2010, 09:51 PM   #5
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Re: Need Help with Labs/Adding cytomel

Midwest--Thanks for your input. I appreciate your looking over my numbers. As I said, I had a rough time with just 2.5mcg's when I tried that before...but it sure looks like I need to do something as the gap is so wide between my free t's.
Do you think that 2.5mcg's could actually make much of a difference in my very low free t3? I guess I shall find out in about a month...but, just wondering if you had a thought about whether the amount I am adding is just too inconsequential to do anything at all.
Thanks again.
Azuree

 
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