So I'm taking cytomel (t3)
My tsh and t4 are suppressed (0-0.20) range like they suppose to be when you take t3. BUT my T3 is on 2.3 from a range of (2.0-4.4 pg/mL)
Before I had TSH. 5, very high..and reverse t3..high too.
Should I up it to 75mcg? I just don't want to go hyper and start losing muscle mass.
Hiya
What dose are you on now and how long have you been on the T3 (assuming you switched over recently)? Also how long before was your last dose of T3 before the blood test?
I've been taking 50mcg for the 2 months. And based on what I read ..im not suppose to take it before a blood test. So I just took my night dosage of 25mcg but didn't take the morning dosage of 25mcg.
Yes that's fine as long as the test was early in the morning. You don't want to leave it more than 12 hours or the results would be somewhat skewed. I am on T3 only and my levels drop quite fast if miss a dose.
It might take a little longer for your body to adjust - sometimes, my dose changes take three months to take full effect and your result would be a little lower than your usual daily level.
T3 is much more potent than T4 and 60mcg is considered maximum dose for T3 so you're already nearing that level and certainly wouldn't want to increase by another 25. You shouldn't increase T3 more than 10mcg at a time with retests after 6-8 weeks, maybe a little longer 
How are you feeling?
I'm feeling good. Maybe I should retest it. Mmm
If you're feeling good, I would leave it another month and see how you feel then
If you are feeling good you should not increase your dose. If you take L-T3 twice daily I would have the blood taken five or six hours after your dose. Leaving longer will give a result a little lower than it really is. Always try to stay on the lowest effective dose.
Yes, I actually do agree with you jimh to be honest as my levels fall too quickly and wouldn't leave it 12 hours and normally leave 5-6 hours to get a better representation of myself as normal but I have an endo who doesn't mind a suppressed tsh. These docs are rare so will generally advise 12 hours as is usual on here for the majority who have issues with their silly docs lol
Yes there may be one or two people who require more but this is not common and 50-60 is usual for people without thyroid function and no other issues such as absorption, other deficiencies or hormone resistance. I have no thyroid function and I'm on 30mcg T3 and 25mcg T4 full dose as just recently swapped from 40mcg T3 to get a little T4 back in as have none.
Obviously some people have different requirements which is why I said considered maximum dose but I can only advise based on the norm and then advise further is they are still showing problems with this?
It would be more dangerous to advise people based on your situation which is not usual
Do you have any studies to back up the assertion that 50-60mcg of T3 is the norm?
Not to hand but it's written on the label and on the british formulary as maximum dose for adults - maybe lower depending on weight?
I think Paul Robinson in one of his books states that an average dose is about 50mcg of T3. He gets his information from members of his facebook group "Recovering with T3".
Thanks
The recommended dose of liothyronine is 40 - 60 mcg daily, although I would suggest 40 - 50 mcg as I think 60 mcg is a little too much for most people.
However, many people require more than 60 mcg, I did. This strongly suggests they have some form of resistance to thyroid hormone since they need much more than a full replacement dose. In this case you have to take extra care as you can't be sure all tissues are equally resistant. So one has to distinguish between a maximum for normal replacement and the need for higher doses in a subset of patients.
The 40 - 60 mcg figure comes from the manufacturers of liothyronine. This makes sense as this would equate to 120 - 180 mcg levothyroxine.
Liothyronine is very well absorbed so it is quite unlikely anyone has poor absorption. A blood test taken in a reasonable time after ingestion (five or six hours) will confirm absorption.
Yes, you are right, it is actually normally better absorbed as I could absorb this when I couldn't absorb anything else to be fair but having absorption issues could mean you have deficiencies for things you need to use it effectively I suppose and I also had to decrease my dose from 60-40 when I resolved my absorption issues and was proven under later trials so it can be a problem
T3 has a half life of about 8 hours. If you did not take any T3 during the 12 hours before your blood test then your reading of 2.3 is a MINIMUM. If you take your meds then have another blood test within an hour you will get a MAXIMUM. I believe the drop off from Max to Min is exponential, you could draw such a line to accommodate those two points. That should give you a general idea of your level at different times of the day. You could also do a third test in the middle of your dosing period and see if it falls on that line. I'm afraid T3 is a very volatile quantity and hard to say what it "should" be, it depends upon other factors, e.g. When did you take your meds, did you use up a lot of it exercising or working very hard. I alarmed my doc once by taking my NDT (has T3 in it) before my blood test. My T3 reading was over maximum and he told me to reduce my dose! I had to explain that I had stupidly taken my meds that morning by mistake.
But the bottom line is, how do you feel? If you feel fine, stick with that dose.
Well now I'm really confused.. even more than before.
So I took the t3 at 5am like I normally do instead of skipping it like the last test. This were the results. Not sure how TSH is that high, it hasn't been that high since last year when I had it 5.8 before I started t3 and it dropped and got suppressed.
TSH
5.440 HIGH (last month test was 0.013 which is normal when taking Cytomel but now is 5.4)
Reference Range: 0.450-4.500 uIU/mL
T4,Free(Direct)
0.29 LOW (last month was 0.12)
Reference Range: 0.82-1.77 ng/dL
Triiodothyronine,Free,Serum
2.8 NORMAL (last month was 2.3)
Reference Range: 2.0-4.4 pg/mL
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