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  • FT3 and FT4 lower after Cytomel Added

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    Old 05-14-2013, 12:08 PM   #1
    LisaKatrina
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    Question Advice needed - FT3 and FT4 lower after Cytomel Added

    I am hoping for some advice prior to my doctor's appointment tomorrow Friday May 17. For the past year, I was taking 112 mcg Synthroid only, then this spring, my Endocrinologist adjusted the dosage from 112mcg down to 100mcg, then added 5mcg of Cytomel once per day. (I take it at 3PM). We were hoping to raise my Free T 3 levels.

    We gave that two months, and just had my FT3 and FT4 tests redone.

    Here are the before/after stats:

    Prior to adding Cytomel:

    TSH 0.67
    Free T 4 1.77 Range (.78-2.19)
    Free T 3 3.2 Range (2.8-5.3)

    After adding Cytomel:

    TSH 0.80
    Free T 4 0.9 Range (.78-2.19)
    Free T 3 2.98 Range (2.8-5.3)

    These results aren't a major shift, but at best it hasn't helped and I see an opposite trend from what I wanted to happen. The only good thing that has come of it is I feel more clear headed and seem to have more energy in the afternoon from taking the Cytomel. I am really tired in the mornings, though, even after a full night's sleep. The Endo recommended staying on this new dosage.

    My family doctor handled my thyroid issues for years and did a good job - he sent me to this Endo last year after I had some bad hormonal side effects from being on a birth control pill for 6 months. I called and got an appointment with him for Friday.

    My question is, should I talk to him about upping my Synthroid back to 112mcg and adding a second dose of Cytomel in the morning when I take the Synthroid, or should I get rid of the Cytomel all together and see if he can give me an even higher dose of the Synthroid only? I do have about a 2 month supply of the Synthroid at 112 mcg left at home, as my mail-order pharmacy had just sent me a new bottle before my dosage was lowered.

    Any advice you can give would be greatly appreciated.

    Last edited by LisaKatrina; 05-16-2013 at 08:24 AM. Reason: Clarity

     
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    Old 05-16-2013, 08:25 AM   #2
    LisaKatrina
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    Re: Advice needed - FT3 and FT4 lower after Cytomel Added

    Hoping to get some feedback before my appointment tomorrow! Thanks!

     
    Old 05-16-2013, 09:09 AM   #3
    midwest1
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    Re: Advice needed - FT3 and FT4 lower after Cytomel Added

    I think you should be getting a steady supply of Cytomel all day, not just in the afternoon. Five mcgs in the a.m. and 5 mcgs p.m. would be a reasonable starting point. Plus, I don't think your Synthroid should have been lowered to accomodate such a small dose of Cytomel.

    When a T3 replacement (Cytomel or natural thyroid) is taken, free T4 will often fall. This is because natural conversion of T4 to T3 is slowed due to the increased FT3 blood level. Many people (including me) are fine despite a slightly lower FT4 level; others are not. It takes trial and error to figure that out.

    I would want to attempt getting a doctor - whichever one - to increase your Cytomel to 5 mcgs twice daily and leaving your Synthroid at 100 mcgs for the time being and see where that goes. If free T4 continues to stay below lab median and you continue having symptoms, then an increase of Synthroid would be justified.

    Hope that helps. Good luck at the doc's!
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    Old 05-17-2013, 07:08 AM   #4
    Heckofagal
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    Re: FT3 and FT4 lower after Cytomel Added

    As always, i agree with Midwest. It would have been best to leave your synthroid dose and add the cytomel, but you can't go back and change that. Looks like you still have room for improvement on both the Free T3 and FreeT4 levels but I would advise only making 1 change at a time.

     
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