Do you think my doctor raised my thyroid meds too much, too soon?

[readyforwhat]

I was diagnosed August 1, 2010 with silent thyroiditis.

My stats are (Range: TSH 0.40 - 4.50 // Free T4 0.8 - 1.8)

08/01/10 TSH 0.03

08/09/10 TSH 0.01

09/23/10 TSH 0.41

10/28/10 TSH 1.36 -- T4 0.96

12/6/10 TSH 3.80 -- T4 0.92

12/28/10 TSH 0.99

02/11/11 TSH 2.45 -- Free T4 1.1
*****PUT ON 25 MCG of SYNTHROID*****

03/28/11 TSH 4.18 -- Free T4 0.9
*****PUT ON 50 MCG of SYNTHROID*****

04/28/11 TSH 0.6 -- Free T4 1.1

06/06/11 TSH 1.23 -- Free T4 1.2

06/14/11 *****PUT ON 25 MCG of SYNTHROID, 5 of CYTOMEL*****

07/07/11 TSH 2.91 -- Free T4 0.9

T3 Uptake 34 (Range 22-35 Percent)

Free T3 2.9 (Range 2.3-4.2 pg/mL)

Ferritin 51 (Range 10-154 ng/mL)

07/14/11 *****PUT ON 50 MCG of SYNTHROID, 10 of CYTOMEL*****

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Do you think it was too much that he basically doubled the dosage all at once?  Yesterday I had some chest anxiety.  I was having a very stressful day, but I don't think my chest should have felt weird.  I DO feel a lot better on this dosage.  I will call him on Monday, but over the weekend I might go down to 50 mcg Synthroid and 5 Cytomel just to play it safe.  

I feel like the doctor is pretty loose with things and I am not sure I am comfortable with that.  He even told me to take 15 mcg Cytomel which I am not doing, so I am not even doing his full recommendation.

Did he raise my meds too much too soon?

[readyforwhat]

Thanks, Barb.  I will definitely go back down to 5 mcg for the weekend.

[readyforwhat]

No, I was doing 5 mcg Cytomel and 50 mcg Synthroid first thing in the morning and then another 5 mcg in the afternoon after 2 or 3 p.m.

[Barb135]

Were you taking that 10 mcg cytomel all at one time?  Most people find that dividing the dose into a couple times/day helps eliminate some of the hyper type symptoms.

I agree that cutting back to 5 mcg cytomel over the weekend is a good idea.  

[readyforwhat]

Yes, I have an appointment on Tuesday with my endo and I had labwork done on Thursday.  On Tuesday morning I will tell my endo that I went to another doctor and he doubled both my meds.  I think he will have a temper tantrum.  Thanks, goolarra, again.  I am going to cut back the Cytomel to 5 mcg for today and tomorrow and we'll see.

[goolarra]

T4 meds (Synthroid) take 4-6 weeks to reach their full potential in your bloodstream.  During that time, FT4 levels continue to build after an increase.  T3 meds, on the other hand are very fast-acting and reach peaks very soon after taking.  

So, as the time from your increase lengthens, your FT4 is rising.  At some point in time, you might reach a level that tips the balance toward hyper.  The good thing about T3 meds is that you can cut back on them and feel a much more immediate change than when you cut back on T4 meds.  Also, sometimes increasing too fast can give us hyper symptoms even when we're not...our bodies just have to have time to adapt.  

I think you are doing what you should.  Cut back on the Cytomel for the weekend until you can speak with your doctor.  If your chest discomfort goes away, you'll pretty much have your answer.  If I remember correctly, you have labs and/or an endo appointment scheduled soon???  You should be able to have labs in a week or two which will reflect most of the change from your increase of T4.