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Old 01-31-2013, 07:24 PM   #1
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need an honest opinion regarding cytomel

Lots of posters here believed I should stick with the 50mcg of synthroid and see how i do for six weeks and get bloodwork done. recap, the 50 mcg of synthroid was prescribed by my endocrinologist who believed i shouldnt have upped to 50 mcg but let me since I explained to her that i STILL wasnt feeling well despite my RECENT labs this month taken at 10 am (tsh 1.13 (0.3-3), free t3 3.15 (2.5-3.9) free t4 0.95 (0.58-1.64) reverse t3 364 (90-350)) . this endocrinologist is NOT open to natural hormone or cytomel, not even UPPING my last dose which was 37.5 mcg of synthroid because she didnt want my tsh to go out of range!! HELLO,?! SHE put me on synthroid 25 mcg EVEN WHEN my labs were in range..

anyway, i went to my naturopathic dr that deals with my gut issues, iron, vitamin d levels and has history of treating hashimotos patients and he suggested adding some t3 into my synthroid. that would mean 5 mg a day. and he suggested to cut back on the 50 synthroid and if i had to, take 2.5 mg cyto in the morning and 2.5 mg of cyto in the afternoon. I am scared to feel bad, or hyper. I start work next week and according to some here i converted well in december ft3 3.75 (2.5-3.9) but that was taken at 11 am.

my only sole purpose of considering t3 is from what ive learned.
will taking t3 help clear my high reverse t3 and improve my symptoms?

thanks for your advice in advance

Last edited by Administrator; 02-02-2013 at 10:10 PM.

 
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Old 02-01-2013, 10:32 AM   #2
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Re: need an honest opinion regarding cytomel

Message received.

Would it be possible for you to post a recap of your thyroid labs from before and after starting meds? Include the date, meds dose size and the length of time you were taking the dose. Include all thyroid labs like antibodies, etc...

 
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Old 02-01-2013, 09:10 PM   #3
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Re: need an honest opinion regarding cytomel

Quote:
Originally Posted by telus View Post
Message received.

Would it be possible for you to post a recap of your thyroid labs from before and after starting meds? Include the date, meds dose size and the length of time you were taking the dose. Include all thyroid labs like antibodies, etc...
two weeks before starting synthroid 25 mcg in october
tpo 933 (<60)
tsh 1.64 (0.3-3)
free t3 3.24 (2.5-3.9)
free t4 1.00 (0.58-1.64)
reverse t3 369 (90-350)
TG antibodies 212 (<60)
thyroglobulin 25.9 (<60)

december 6 weeks after synthroid 25 mcg
tsh 0.69 (0.3-3)
free t3 3.75 (2.5-3.9) -- was going to switch to armor 15 mg but others on this board advised to give synthroid a chance and that i would feel extremely hyper if i did so
free t4 0.81 (0.58-1.64)

upped to 37 mcg

mid january 6 weeks after synthroid 37 mcg
tsh1.13 (0.3-3)
free t3 3.15 (2.5-3.9)
free t4 0.95 (0.58-1.64)
tPO 1224 (<60)
TG antibodies 201 (<60)
vitamin d 66 (20-49)
reverse t3 364 (90-350)

just started 50 mcg of synthroid this week. every time i increased, i tolerated it well. others say its because i feel hypo thats why i don't experience the hyper symptoms that people go through when they up their meds. OR my adrenals are in great shape since not being able to tolerate meds can be adrenal (low cortisol related) recap: i take selenium, vitamin d3, magnesium, adaptocrine support, probiotics, and fish oil daily

any suggestions?

 
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Old 02-02-2013, 05:32 PM   #4
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Re: need an honest opinion regarding cytomel

Hi fresnogirl, I was put on natural thyroid while still on thyroxine and told to taper down thyroxine and increase NT. I too had a high RT3 (464) I gradually eased off thyroxine completely and was on 2 grains (1am and 1pm) along with most of the supplements you are on. My RT3 has gone down to 260 despite there still being t4 in the natural thyroid.
I will admit that even on 3 grains now I am still not there but have seen improvements. Though I have adrenal fatigue which I think is causing some hiccups with my thyroid treatment. I start acupuncture for that next week along with supplements. My cortisol remains low. I think I will be able to reduce the 3 grains once the adrenals heal but having t3 along with T4 in my natural thyroid has helped and has most definitely reduced my RT 3, I did not at any stage feel hyper in fact for a while I thought I was on a placebo as I felt no different, then slowly I saw improvements, I would consider reducing your t4 and introducing T3 into your treatment, I think it is good advice but you have to be the one to decide if it is right for you.

 
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Old 02-05-2013, 10:48 PM   #5
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Re: need an honest opinion regarding cytomel

Hi Fresno. Sorry I didn't get back to you earlier.

This is what I would consider to be normal for you:
TSH 1.41
FT4 1.04
FT3 2.88
RT3 220

So in comparison to normal, your labs are:
TSH 1.13 (low)
FT4 0.95 (low by 9%)
FT3 3.15 (high by 9%)
RT3 364 (high by 65%)

OK, there are three things of note in your labs.
1. RT3 is extremely high
2. Even though you were taking only 37 mcg of T4, your FT4 and FT3 are nearly at or above normal.
3. Your ratio of FT3 to FT4 is very high for someone taking T4 only.

So what is causing these 3 things to happen? It appears that your own thyroid is releasing a lot of thyroid hormone. So much so that your RT3 is highly elevated.

(Now please remember I am not a doctor.) there are two possibilities: hashi or Hashitoxicosis.

IF YOU HAVE HASHITOXICOSIS
I see from one of your posts in October that you had a TSI test of 89. I do not know how to interpret this. If you have Hashitoxicosis, then I can't really help.

IF YOU HAVE HASHI -
At this point I would like to recommend that you go back and read Surfing4answer's post above. She switched from T4 to natural desiccated thyroid (NDT) and is showing improvement.

Because you can swing between hypo and hyper, your labs are not reliable for making dosing decisions. You have to go by symptoms. If you raise your thyroid meds high enough (but not too high), it will sometimes stop the antibody attack and lower your antibodies. NDT seems to this better than T4 only.

But the key is that you have to raise your thyroid meds up to a "full replacement dose". A usual minimum full replacement dose is around 3 grains of NDT, and you will notice that is where Surfer is now at. Another key thing is to move up thru the doses fairly rapidly, going by symptoms, not labs. Usually you start at one grain and raise it 1/2 grain every two weeks. You slow down between 2-3 grains.

Well, I hope I have helped a bit. Good luck...

 
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Old 02-06-2013, 02:46 PM   #6
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Re: need an honest opinion regarding cytomel

Quote:
Originally Posted by telus View Post
Hi Fresno. Sorry I didn't get back to you earlier.

This is what I would consider to be normal for you:
TSH 1.41
FT4 1.04
FT3 2.88
RT3 220

So in comparison to normal, your labs are:
TSH 1.13 (low)
FT4 0.95 (low by 9%)
FT3 3.15 (high by 9%)
RT3 364 (high by 65%)

OK, there are three things of note in your labs.
1. RT3 is extremely high
2. Even though you were taking only 37 mcg of T4, your FT4 and FT3 are nearly at or above normal.
3. Your ratio of FT3 to FT4 is very high for someone taking T4 only.

So what is causing these 3 things to happen? It appears that your own thyroid is releasing a lot of thyroid hormone. So much so that your RT3 is highly elevated.

(Now please remember I am not a doctor.) there are two possibilities: hashi or Hashitoxicosis.

IF YOU HAVE HASHITOXICOSIS
I see from one of your posts in October that you had a TSI test of 89. I do not know how to interpret this. If you have Hashitoxicosis, then I can't really help.

IF YOU HAVE HASHI -
At this point I would like to recommend that you go back and read Surfing4answer's post above. She switched from T4 to natural desiccated thyroid (NDT) and is showing improvement.

Because you can swing between hypo and hyper, your labs are not reliable for making dosing decisions. You have to go by symptoms. If you raise your thyroid meds high enough (but not too high), it will sometimes stop the antibody attack and lower your antibodies. NDT seems to this better than T4 only.

But the key is that you have to raise your thyroid meds up to a "full replacement dose". A usual minimum full replacement dose is around 3 grains of NDT, and you will notice that is where Surfer is now at. Another key thing is to move up thru the doses fairly rapidly, going by symptoms, not labs. Usually you start at one grain and raise it 1/2 grain every two weeks. You slow down between 2-3 grains.

Well, I hope I have helped a bit. Good luck...
telus,
thanks for your reply. i dont swing from hypo to hyper anymore. im mostly hypo and have been since October. fatigued, achy, and hair fallling out like crazy. And, you are right. My rt3 is ridiculously high meaning either a t3 or t3/t4 combo will help clear it out.

my only gripe is STARTING over again and ramping up my dose. like im starting from square 1, even though i want synthroid to work. my dr suggested adding the t3 of cytomel to my meds and decreasing on the t4 to see if it would help improve symptoms. so, based on you and surfer's recommendations, idk what to do at this point. either start on t3 cytomel to see if it helps. or just take armour and ramp up my dose like you suggested! i do feel better now, than i did in october but i am just afraid of feeling hyper symptoms like some feel when they take t3. i just need to stop being a baby about it! telus, are you on NDT too? and did u ever take synthroid before?

 
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Old 02-06-2013, 05:42 PM   #7
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Re: need an honest opinion regarding cytomel

Hey fresnogirl - how long have you been taking selenium? We're you taking it before you started the Synthroid?

Surfung4answers - are you on selenium? Do you think that might have helped reduce your RT3?

I was taking it at one point and should have documented when. I did not think it was helping much so when it ran out I did not buy more (and have NO idea when that was) and my last bloodwork showed a big jump in my RT3.

 
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Old 02-06-2013, 08:29 PM   #8
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Re: need an honest opinion regarding cytomel

Quote:
Originally Posted by Heckofagal View Post
Hey fresnogirl - how long have you been taking selenium? We're you taking it before you started the Synthroid?

Surfung4answers - are you on selenium? Do you think that might have helped reduce your RT3?

I was taking it at one point and should have documented when. I did not think it was helping much so when it ran out I did not buy more (and have NO idea when that was) and my last bloodwork showed a big jump in my RT3.
I only take selenium in the form of Brazil nuts and not every day so I don't think this affected my RT3 to be honest!
If I cut back on iron supplements I see a downward spiral on symptoms but haven't had RT3 checked this time as it had been at perfect range on 2 previous tests. Don't think that helps you much though!

 
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Old 02-07-2013, 10:36 AM   #9
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Re: need an honest opinion regarding cytomel

Fresnogirl Feb 7, 2013

I was on synthroid (only) for many years. I was always slightly hypo but didn't know it. Finally I got too hypo and got SVT. I finally woke up and started to research thyroid stuff. Long story short, I switched over to synthroid and slow release T3. I now have my labs where I want then, and SVT seems to be petering out. If the SVT does not quit I am going to switch over to NDT; in Canada we get ERFA Thyroid. Actually I wish that I had gone straight to ERFA, but I guess we all live and learn.

In your shoes I would definitely go to NDT. I am not a believer at all in going to straight T3. I think you could spend a lot of time on that and get nowhere except more problems.

I don't think you would really be starting over if you switch to Armour - it would be more like a natural progression. In fact it would be kinda like what your doc suggested - adding some T3 to what you were taking!

You were just on 37 mcg T4.
1 grain Armour = 60 mg Armour = 38 mcg T4 + 9 mcg T3
1.5 grains = 90 mg = 57 T4 + 14 T3
2 grains = 120mg = 76 T4 + 18 T3
2.5 grains = 95 mg = 95 T4 + 23 T3
3 grains = 180 mg = 114 T4 + 27 T3

Fresno - I do not think you need to worry about the meds making you go hyper. Take note that Surfing4 did not have any hyper episodes when she switched over. Check out how other people take Armour - for instance split the dose morning and night.

good luck...

 
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Old 02-07-2013, 03:59 PM   #10
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Re: need an honest opinion regarding cytomel

Hi Fresno, Telus is right, changing to NDT is pretty much the same as introducing synthetic T3. Probably my only reason for using NDT is that I prefer trying to go as natural as possible and I am allergic to coatings on certain tablets which I do not get with NDT.
I changed over slowly, 1/2 grain with .75mcg thyroxine, then 1 grain taken as half doses morning and afternoon with .50 thyroxine in a.m.. Then 1 1/2 grains with .25 2 grains with no thyroxine taken one morning and one p.m.
I then went to 2 1/2 grains but only for a few days before increasing to 3, this was the only time I noticed anything odd. My heart rate increased to 90 BPM from 70 but my B.P. was still 110/75, there were no ther symptoms at all and I eased back and raised again a bit later. I think there should be approx two weeks between NDT increases form what I have read and I upped too quickly. Fast heart rate disappeared.

Probably my only issue is that part of my monthly cycle is totally dominated by hypo issues regardless of current dosage and that confuses myself and my doc, we are currently trialing an additional increase for that time and scaling back again when I get into the next stage of it. And adrenals are most likely still playing their part in reducing effectiveness of NDT.

I still think you should give it a go, if you are still quite hypo it is very unlikely you will get hyper from it. If you do try NDT following the correct protocol for increasing is a good idea as increasing too fast is almost as wrong as increasing too slowly!

 
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Old 02-07-2013, 04:17 PM   #11
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Re: need an honest opinion regarding cytomel

Quote:
Originally Posted by Surfing4answers View Post
Hi Fresno, Telus is right, changing to NDT is pretty much the same as introducing synthetic T3. Probably my only reason for using NDT is that I prefer trying to go as natural as possible and I am allergic to coatings on certain tablets which I do not get with NDT.
I changed over slowly, 1/2 grain with .75mcg thyroxine, then 1 grain taken as half doses morning and afternoon with .50 thyroxine in a.m.. Then 1 1/2 grains with .25 2 grains with no thyroxine taken one morning and one p.m.
I then went to 2 1/2 grains but only for a few days before increasing to 3, this was the only time I noticed anything odd. My heart rate increased to 90 BPM from 70 but my B.P. was still 110/75, there were no ther symptoms at all and I eased back and raised again a bit later. I think there should be approx two weeks between NDT increases form what I have read and I upped too quickly. Fast heart rate disappeared.

Probably my only issue is that part of my monthly cycle is totally dominated by hypo issues regardless of current dosage and that confuses myself and my doc, we are currently trialing an additional increase for that time and scaling back again when I get into the next stage of it. And adrenals are most likely still playing their part in reducing effectiveness of NDT.

I still think you should give it a go, if you are still quite hypo it is very unlikely you will get hyper from it. If you do try NDT following the correct protocol for increasing is a good idea as increasing too fast is almost as wrong as increasing too slowly!

thank you telus and surfing! I APPRECIATE your guidance/advice! now, the only thing is. try the synthetic t3 cytomel? OR try t3/t4 combo of armour. thats my other issue! LOL, see what happens when theres too many docs in my basket! Although, i feel better than i did in october, i just want to hope so bad that synthroid would help (alone). people tell me i just may need to give it more time for my ft3/ft4 ranges to come up. and also, with the high rt3, it could be a hidden infection (which i am currently going to check through a stool kit that my nd gave me) or just by taking t3/ t3/t4 could help solve it.

surfing, what has the NDT helped you with as far as symptoms? you dont feel as hypo as you did a couple months ago? and what ndt do you take? armour or naturethroid or np acella?

heckofagal- i take 200 mcg selenium and its working for me , so far

 
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Old 02-07-2013, 07:29 PM   #12
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Re: need an honest opinion regarding cytomel

Hi fresno, in my own opinion and to my knowledge, though Telus can jump in and correct me as he has greater knowledge! Sythetic T4 and T3 are just that. Natural hormone has calcitonin along with T1 T2 and I think amino acids etc which are all more in line with what our own thyroid should do.
Personally and simply, I think it just covers more options!

It has been said that compounded can be miscalculated and armour has had a recall due to changes in its production but that can be said of synthetic also, like fabric, no batch can really be identical! And sythetic have had several recalls in comparison.

In Australia we have just got compounded dessicated thyroid hormone or tarithroid, they are pretty much the same as far as I know, I was prescribed tarithroid but given compounded. I have had a reduction in pretty much all of my symptoms, leg pain, wrist/arm and jaw, they have gone. Hair loss significant decrease, eyebrows grew back at the ends. My two biggest issues have been brain fog and fatigue. I still have this but it has improved and we are still working on it. The adrenal fatigue and also low iron contributes a lot to those ongoing symptoms.

Do some research and pick what's best for you and then work with your doc. For the results.

 
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Old 02-07-2013, 08:48 PM   #13
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Re: need an honest opinion regarding cytomel

Fresno 7 feb 2013

Hi.
A lot of info has been thrown your way, and I think you might be missing a couple of key points. Maybe go back and re-read all the posts in this thread.

It is probably your antibodies wrecking your thyroid that is causing your thyroid to put out too much thyroid hormone and that raised your RT3. So you need to raise your meds up to a "full replacement dose " so that you shut down your thyroid and try to reduce your antibodies. Evidently NDT is more successful at doing this than T4 only.

If you go to a full replacement dose of T4 only (say 125 - 137 mcg), you risk having to push your FT4 up too high in order to get enough FT3. Again, too much T4 will cause RT3 to go up and this of course will be counterproductive. These are the major reasons people are unhappy on T4.

And Surfer is right, there is other good stuff in NDT.

These are the reasons a lot of people eventually choose NDT.

Fresno - you are still pretty young in your thyroid career and it will certainly help to make things better for you in the future if you make the right decision now. What would really be best is if you could find a doctor who has used NDT; one that you have confidence that he knows what he is talking about. Let's hope that in 20 years from now you will look back and say, "I'm sure glad I took..."

all the best.

 
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