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DixieBelle 12-28-2013 05:47 PM

Newbie question
Hi everyone! Newbie here. 38 yr old female just diagnosed with Hash in September (thyroid anti - 763). Diagnosed with hypo at 20.

Will post my story when I get back from movies but did habe this question while I habe a minute - should RT3 be included in every blood work? I'm suppose to get mine done again next week and when I just saw my order she doesn't habe that one marked. She has anti-thyroglobulin AB, CDC differential, Complete metabolic profile, ferritin, Free T3, Free T4, TSH, Thyroid perox AB, vit d 25 hydroxy, and hypothyroidism. What else should be tested?? I ordered a cortisol test online (saliva)myself and it should be here next week. My dr is Lena Edwards here in Lexington KY. I have be seeing her for about 6 months. She is first dr to even mention T3 or hash to me so I'm hoping she is what I need. I will write (bc I have a minute) that since seeing her she put me on Tirosent 200mcg with 5mg cytomel (has been compounded since September). During first visit to her I was put on Tirosent 200mcg with one cytomel 5mg and another 5mg in afternoon. I lost 24 lbs during the two months on this during summer. She took cytomel down to 5 and cmpded it in September bc I complained of sweating issues. I would sweat so bad it. Was affecting my job. Problem is that since then I have gained the 20 back and am now just getting back some energy. Anyone want to take a stab at that?? Could that extra bit of cytomel really habe made that much difference in those first two months?? And could the cmpding be making the tirosent/cytomel combo less effective?? I have a big cruise coming up in June and I would like to get off at least 30lbs by then. I was weight training and eating low carb for those two months in summer when I lost the weight, but that was bc it seemed to be working and I felt motivated. Once things changed in September I got discouraged and stopped. Thanks for reading and any help you all could offer would be great!!! I believe many of you missed your calling and should be in medical field. Maybe they could come up with thyroid advocates at dr offices to help physicians out!!! I'm convinced so many are clueless.

ravenrose 12-28-2013 09:18 PM

oh yes. Liothyronine/Cytomel is very powerful. I feel like I am balanced poorly on the edge of it too. either I am gaining weight or I have symptoms of too much.

Leo41 12-29-2013 03:41 AM

Yes, I have Hashi's and take Cytomel and agree with Ravenrose (based on my experience) that even 5 mcg of Cytomel can make a vast difference. I currently take 25 mcg, but my endo began with 5 mcg and increased it by 5 mcg each time my T3 tanked (people with Hashi's often experience conversion problems according to my endo, and I'm one of them).

However, you also mention that you were eating low carb and strength training when you lost that weight and then became discouraged and 'stopped.' That could account for the gain, apart from any issue with Cytomel.

Since you're getting labs, your T3 level will determine whether or not you need additional Cytomel. My own experience is that in addition to weight gain, when my T3 is too low, I have overwhelming fatigue as well.

Keep in mind that it's more difficult to lose weight when you're hypothyroid. Twice I asked for a T3 test because I seemed to be gaining inexplicably, and both times my T3 was fine. I just needed to eat a lot less than I wanted to:-)

DixieBelle 12-29-2013 03:42 PM

Thanks for responding. When I went back to dr in September and she rx'd the tirosent and cytomel she halfed both. So for then till week of thanksgiving I was getting only half of what I had gotten the first two months when I was doing so well (tirosent 100mcg and 5 of cytomel). I didn't realize till right before I went back for November appt what had happened (that she halfed more than my cytomel). I was crying all the time and very reclusive. Now she has me on proper tirosent amt but I'm still skeptical about just the 5 of cytomel. I am slowly getting back to old exercise routine, but energy level is still not what I had in summer so it is hard.

What about RT3? Should that always be a part of lab work. She doesn't have it listed for this round. And when I went to look at labs she hasn't done T3, T4, TSH since I started going to her in June. She did the TPO AB for my September visit but nothing else specific for thyroid since June and September. So this new blood work I do this week will be first thyroid stuff done in six months. That is too much time between, isn't it??

Leo41 12-30-2013 05:34 AM

I don't think that 6 mod is too long for testing. It takes a while for your blood levels to reflect the specific dosage. I'm tested every 4 months, but I suspect that many doctors have to consider what insurance will allow in terms of testing.

I know some people who only get annual thyroid checks. In any case, your labs will show whether your T3 is low and you need more Cytomel.

I don't know about RT3. It's very popular on internet boards, but my endo (excellent doctor) doesn't test it, nor does my PCP.

DixieBelle 12-30-2013 03:15 PM

Thanks for responding. I'm just so frustrated and sick n tired of being sick n tired. Get my labs one next Monday and see dr next Thursday. Just anxious to see where I am bc it can't be good. I've been depressed and bloated since cmpding and decrease of cytomel. I do know that I went to my ob/gyn end of October and they did include TSH in their blood work.
THS: 2.70 Range: 0.34-5.60

This says a lot ( explaining my blah feeling) even though it isn't FT3, FT4.

Leo41 12-31-2013 04:59 AM

If you're medicated, your TSH should be around 1.0 (or lower). In addition to that, I've found that when I'm under medicated, I bloat and retain water (and my cardiologist told me it's due to low thyroid).

When my T3 tanked, my TSH was 2.6, and I was so fatigued that I could barely get out of bed.

A good thyroid doctor will consider BOTH lab numbers and symptoms, so be prepared to list ALL your symptoms when you meet with your doctor. My endo once raised my Cytomel entirely because of my symptoms when the labs seemed fine--and it was the right move. Another 5 mcg, and I felt fine.

DixieBelle 12-31-2013 11:06 AM

Thanks so much for the comment. I pray I feel better when she adjusts the meds. I know she knows what she is doing ( she helped the first visit, but decreased the cytomel hen I complained of being so hot). I just wanna get this fixed bc I know this can be regulated. :up:Thanks again and Happy New Year to all!! :jumpjoy:

Leo41 12-31-2013 12:00 PM


Keep in mind that doctors are very cautious when it comes to Cytomel because that T3 is extremely powerful, and too much can quickly cause cardiac disturbances. Many doctors don't treat with T3 at all, and I've often wondered whether it's because they know how powerful it is and how some people will 'self treat' and cause themselves problems. The usual reason for not giving T3 is that they learned in medical school that the body converts T4 to T3, so only T4 is necessary. However, it's been established that many people with Hashi's experience conversion problems--as I did 5 years after my initial diagnosis. Without Cytomel, I'd be unable to function, and I'm grateful that I, like you, have a good doctor who prescribes appropriately.

The power of T3 may be why your doctor lowered your dose when you mentioned feeling hot. And it's possible that it wasn't the Cytomel at all.

Whenever my endo raises my dose, he cautions me to watch for heart palpitations or 'jittery' feelings. I know the feeling because when I first was diagnosed, the 50 mcg of Synthroid was too much for my body to handle initially, and those were exactly the symptoms I experienced. My endo had to start me on only 25 mcg and then gradually raise the dosage.

I've never had any problems with Cytomel, even though I've gone from 5 mcg to 25 mcg (in 5 mcg increments), mainly because every increase has been essential.

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