Thyroid UK
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New dilemma new results

Hello everyone. I called endo Monday morning because i was getting afternoon crashed once my cytomel wears off. I asked for a second dose of T3 and she sent me for labs tuesday. Total 3, free T4 and TSH.... no free T3. They called yesterday. They want me to stop T3 all together. I came right out and said no. I felt horrible before the T3 and i had to beg for it to start. So of course they called back and asked me to come in next week to "talk" Because i wasn't available until then. She said i am hyper...... I have zero hyper symptoms. No insomnia, palpitations, diarrhea and definitely no weight loss which is the main one for me when i am hyper. She said my TSH is .35 (which little does she know the new ranges at some labs are 0.3-3.0.) I also asked what my other test results were since i am not symptomatic and they said TOTal 3 normal and free T4 normal. They would not give my numbers. So i am going to see what my copy says when it decides to come. I refuse to stop my T3 and i cannot reduce because i only take 5 mcg. What do you think? I am actually thinking of asking of trying Nature throid by RLS labs. 1 grain dose has 38 mcg T4 and 9 T3 which is 65 mcg dose. I thin that would be my dose? I am currently on 5mcg cytomel and alternating 50/75 synthroid brand. Greyggose and clutter or anyone please help.

9 Replies


How can you possibly be hyper (or more accurately over medicated) when TSH, FT4 and TT3 are within range?

I grain NDT has 38mcg T4 and 9mcg T3 which is equivalent to 65mcg T4. You will need more than 1 grain. You are currently taking the equivalent of 77.5mcg T4.


so you are with me on the fact that i believe i am in range at .35 right? I do not have the patience or time to be looking for yet another dr!!


You are in range. But even if you weren't, a low TSH when your T3 and T4 results are in range means nothing at all.

They've been taught badly about what low TSH means, unfortunately. It's only significant if accompanied by high FT3 and FT4 levels. It's like they don't even understand how TSH works. But I've tried that argument with endos before and they look at me as if I've grown two heads...

1 like

I have the same issue. I feel like i know more than them! Now my dilemma, do i stay on what i am on or try the Nature throid?


If you want to try the option of a T3 increase while keeping T4 about the same, then

25 mcg Synthroid + 1 grain NDT = 63 mcg T4 + 9 mcg T3


I take 50/75 alternating doses of T4 and 5 mcg daily of cytomel so that is 60 of synthroid and about 15 of T3 i was told Clutter and smallbluething. She said i was not getting anymore meds because i am hyper. I don't get it! i was ok to her at .99 and now hyper? I do not have any symptoms at all. Like i said just that late day crash when T3 wears off.


Alternating 50 and 75 mcg gives you an average of 62.5 mcg. I don't think trying to compare doses of T4 to combination doses is much point, as different people have a need for no added T3; a small amount; an NDT proportion; more than the NDT proportion; or T3 only. Nevertheless, a cautious approach is preferred.

My GP thought it was OK to leave me with a treated TSH under 5.0, when I'd first gone in with symptoms with it at 3.8. I stated that it was acknowledged that a TSH under 1.0 should be aimed for, and this was reluctantly agreed to. Suggesting increases alternating 25 mcg per day, like your current dose, may have helped, as it allowed me to say I could back down if I had problems.

TSH under 1.0 by itself didn't help me, so I've resorted to self-treating, which is cheaper and quicker and most probably better (in the UK) than waiting for a referral. I already have a consultant for another condition, and progress is painfully slow -- a managed and observed death spiral?!

In my case, other drugs can cause constipation, chills, facial flushing and weak arms and I have sleep apnoea which caused great fatigue before treatment, so knowing what's a true hypo or over-treatment symptom can be a problem.

It seems that your option may have to be self-treatment, which can be scary, but needn't be so if you need the additional T3 and proceed with caution. I revert to Levothyroxine before NHS tests, which gives me an unpleasant reminder of treatment without additional T3.


Yes as i mentioned i had to beg the endo i see now for the addition of T3 to try. She only gave me 5mcg. I did horrible without it. I cannot take Levo because i got headaches and nausea so they put me on brand name only synthroid, no generic. I was told 50/75 alternating is 60 mcg then plus the 5cmg of cytomel. I think the closest dose of nature throid is 65. 38 and 9 mcg. So i do not know how that will work out. I wish she would just leave me as i am but she does not listen to anything i say. I know one thing for sure, I refuse to let her take my T3 away again. I need that to function properly.


You could be ultra-cautious and start with half a grain of NDT and increase from there. You may need up to 1-and-2/3 grains if you're the type who finds they need their original T4 dose plus T3 in NDT proportions; or you may need to add Synthroid if the T3 content of NDT is too much for you.


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