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Old 10-24-2011, 09:34 AM   #1
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Adding Cytomel to Synthroid

Had a total thyroidectomy (no cancer) almost two years ago and am still having adjustment problems. Finally convinced my doctor to add Cytomel (10 mcg.) but she cut my Synthroid by 50% (50 mcg.) Felt pretty good for two weeks but now am getting hypothyroid symptoms again. (My symptoms are mainly digestive in nature: lack of appetite, nausea when I do eat, and fatigue).
Question: For those of you who have added a T3 medication to your T4, was your T4 medication reduced and by how much? My doctor puts a great deal of emphasis on the TSH level, yet I feel best when the TSH level is below range. She calls this subclinical hyperthyroidism, yet I do not have any hyperthyroid symptoms. Any thoughts?

Thanks,
Mary

 
Old 10-24-2011, 10:25 AM   #2
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Re: Adding Cytomel to Synthroid

Quote:
Originally Posted by maryfran33 View Post
Question: For those of you who have added a T3 medication to your T4, was your T4 medication reduced and by how much?
I tried cutting back by 12.5 mcgs (from 175) when added 5 mcgs of T3 and ended up feeling even more hypoT So returned to 175 and a while later added another 5 of T3. I see no reason to decrease T4 if your FT4 isn't particularly high and/or you don't have problems from too high a dose of T4 (I wouldn't put any emphasis on "equivalence" as the body needs both T4 and T3). Your TSH will most likely be suppressed when you're taking a sufficient amount of T4/T3.

Last edited by FinnMaid; 10-24-2011 at 10:26 AM.

 
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Old 10-24-2011, 12:20 PM   #3
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Re: Adding Cytomel to Synthroid

Adding/increasing Cytomel actually causes my fT4 to drop, so I end up needing to increase it as well. My TSH is quite low but my endo says it's not a concern when I'm on thyroid meds. I hope the Cytomel helps!

 
Old 10-24-2011, 04:48 PM   #4
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Re: Adding Cytomel to Synthroid

My doctor kept my levo dose the same when I started Cytomel.

Cytomel got my FreeT3 level to where I needed it to be but, my FreeT4 level dropped in the process (this is not uncommon - it's a biochemical thing). It took 4 levo dose increases to restore my FreeT4 level.

You do not have subclinical hyperthyroidism when you are taking thyroid hormone replacement meds and have a below-range TSH.....if anything, you are optimally medicated.

Per the last sentence of this 2003 article published by the National Institute of Health:

http://www.ncbi.nlm.nih.gov/pubmed/12915350?ordinalpos=1&itool=EntrezSystem 2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pub med_SingleItemSupl.Pubmed_Discovery_RA&l inkpos=4&log$=relatedreviews&logdbfrom=p ubmed

"TSH determination is diagnostically misleading and only free hormone measurements are reliable for thyroid function assessment."

Guess your doctor hasn't kept up with things.

If you have some labs to share (including ranges), we can help you identify where you might need help. Most people need their FreeT4/T3 levels in the upper half/upper third of the range and, most often, this results in low/below-range TSH.
__________________
Graves' 2007...remission 2009....hypo 2010

Last edited by sammy64; 10-24-2011 at 04:53 PM.

 
Old 10-25-2011, 06:45 AM   #5
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Re: Adding Cytomel to Synthroid

Many thanks to all of you who replied regarding adding Cytomel to Synthroid. I will be going to a different endocrinologist next week. Will let you know if I learn anything new.

Mary

 
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