Graves and T3

[Maryloo03]

 Hello , I am really struggling with feeling cold . 3 weeks ago my Dr. added 5 mcg cytomel to my  175 synthroid . Still feeling cold, but have more energy .He may not knows how to dose the Cytomel /Synthroid . 

TSH

 3.82 pmol/L

T4 Free 23 pmol/L

T3 Free

 3.2 pmol/L

 

[shaws]

What a miserable 5mcg of T3 - equal to around 15mcg of levo. This is a link and go to page 80 and on the left-hand side you will see the latest combined recommendation.

Give GP the whole article highlighting the appropriate part:

tpauk.com/images/docs/reduc...

Usually in the UK, if they add T3 they reduce levo by 50mcg an add 20mcg of T3. 

Your TSH is too high should be 1 or lower, or suppressed for some of us. Your T3 looks on the low side and there's no ranges. We need ranges as labs differ throughout the UK, just to make things a bit more difficult.

[Maryloo03 in reply to shaws]

TSH      

3.82            0.30 - 5.50 mU/L 

T4 Free

    H 23      11 - 22     pmol/L 

T3 Free

  L 3.2         4.0 - 7.8    pmol/L

Thanks Shaw . I am in Canada .

[Clutter in reply to Maryloo03]

Maryloo03,

You are undermedicated to have TSH 3.8 and FT3 below range.  Your FT4 is over range but isn't converting well to T3.  I think your endo needs to increase T3 dose in 10mcg increments until FT3 is 6-7.8.

__________________________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[Maryloo03 in reply to Clutter]

TSH  

0.39  0.30 - 5.50 mU/L

 

T4 Free

 H 25     11 - 22 pmol/L

 

T3 Free

 4.8 4.0 - 7.8  pmol/L

May I have you opinion on these results ?

[Clutter in reply to Maryloo03]

Maryloo03,

Low TSH, high FT4 and low FT3 indicates you aren't converting T4 to T3 very well and would probably do better with more T3 added to a slightly reduced dose of Levothyroxine to raise FT3.

I think this set of results is better than the first set you posted but not optimal. 

____________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.