Just started Cytomel

[momofJSG]

Hi, Hashimoto's for 18 years. Fluctuating TSH and on different Levothyroxine doses (never based on FT3 or FT4). Last labs:
FT4-0.97
FT3-2.2
Taking .112mcg Levothyroxine. Just started Cytomel 5mcg (split in 2 doses am and pm) because I was having intense brain fog, fatigue, lethargy and weight gain.  I'm having palpitations, insomnia, headaches and feel pretty anxious while taking Cytomel. The great thing is that brain fog is gone and I have more energy. Let me know what you think. My doctor is very willing to listen make wise changes. Oh, and I'm pretty physically active, 45 and eat mindfully.

[gimel]

I just sent you a PM with info.  To access, just click on your name and then from your personal page, click on messages.

[momofJSG]

Thank you gimel. I'm on it! Do you know any excellent Endo MD's in Twin Cities?

[gimel]

I agree that you need to raise your Free T3 level.  I mentioned a couple of possibilities for your reaction to the T3 med.  One was to make sure to give it time for your body to acclimate.  The other was to test and make sure your ferritin level was adequate.

I also think you need to raise your Free T4 level to the middle of the range, at least.  A good thyroid doctor will treat a hypo patient clinically, by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.  You can get some good insight from this link written by a good thyroid doctor.

http://www.hormonerestoration.com/Thyroid.html

In addition to getting your Free T4 and Free T3 to optimal levels, you need to supplement with D3 to get your Vitamin D up to 55-60.  Also supplement with B12 to reach the very upper part of its range.  You also need to test for ferritin and if necessary supplement with a good iron supplement to raise your ferritin up to 60-70

[momofJSG]

Oh, and I felt like Super-Woman for 2 days after I started Cytomel. I had to drop dose down because of insomnia, palpitations, anxiety. If I know I'll get past these side-effects I will keep taking the Cytomel. Do people commonly have these types of side effects at first? Do they usually subside?

[momofJSG]

Oh, and I felt like Super-Woman for 2 days after I started Cytomel. I had to drop dose down because of insomnia, palpitations, anxiety. If I know I'll get past these side-effects I will keep taking the Cytomel. Do people commonly have these types of side effects at first? Do they usually subside?

[momofJSG]

Gimel,
Thank you so much for your response. I'm open to trying whatever might work to feel better.


Ferritin was not tested.
Vitamin D 41
B12 468
Magnesium 1.9
Folate 13
Hemoglobin 12.0
Hematocrit 35.7

I was feeling so low-energy, and a bit hopeless, that I went to a DO to see if there was an alternative approach I could pursue. That was not helpful really-it was expensive too. After that visit I went back to my FP who understood my desperate feelings and decided to try Cytomel. I asked him to decrease my Levoxyl dose because it seemed to make sense to me. I think that was based on what I've read about Cytomel. So, now I'm on .100mg of Thyroxine and the Cytomel.

I'm really motivated to feel better! Thanks for your insight.

[gimel]

Obviously with those symptoms and those lab results being so low in their ranges, you need to increase your thyroid meds.  I would say that you also need some additional T4, along with the T3.  

I can think of two possibilities for what you encountered.  One is that you just need to give it some time to get used to the T3 med, since you have been hypothyroid for so long.  Sometimes it takes  a while for the body to heal and to acclimate to med changes.  The other possibility that comes to mind is that sometimes hypo patients with low levels of ferritin have reactions to increasing T3 in their meds.  


Hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  If tested for those, please post results.