Because my free T3 is on the low end (2.5), (I am on .75 mcg of Synthroid: TSH is 2.29 and have Hashimotos (69 is blood test reading - I am gluten free) and all my vitamin levels are in order, I thought of asking my dr to give me something to raise my T3. Has anyone taken Cytomel or Liothyronine and are there side effects? How long does one know if it is working? My dr feels with my history of insomnia and anxiety that I am not a candidate for a T3 medication. She said that both the T3 and a higher dose of Synthroid could make my symptoms of insomnia and anxiety worse. However I have read that the following symptoms can be attributed to a low Free T3 level and I have all of them! : anxiety, excessive fear, mood swings, rage, irritability. She mentioned upping my Synthroid in lieu of medication to raise T3. I have also read that starting Cytomel can cause hair loss which I already have. Any feedback would be greatly appreciated. I am in the US so I believe thyroid issues are treated a bit differently than in the US.
Medications for increasing Free T3 and side eff... - Thyroid UK
Medications for increasing Free T3 and side effects?
Cytomel or Liothyronine are not medication to raise T3, they are T3, just as Synthroid is T4. So, if your doctor doesn't want to prescribe T3, she's not going to give you Cytomel.
Anxiety and insomnia can be symptoms of hypothyroidism - i.e. low T3 - in which case, adding Cytomel to your Synthroid could improve those problems, rather than making them worse. On the other hand, raising your Synthroid by too much could make your conversion worse.
But, before anyone can advise further, it would be necessary to actually see your results. Can you post them, with the ranges? 
Greygoose, whomever you are...you are AWESOME. Here are my ranges:
Total TSH - 2.29 (range .40 - 4.50)
Free T4 - 1.3 (range .8 - 1.8)
Free T3 - 2.5 (range 2.3 - 4.2)
Total T3 - 102 (range 76 - 181)
I was recently upped to .75 mcg Synthroid for .50 mcg because total TSH went from 1.48 to 3.46. After Synthroid increase, my total TSH is 2.29. After joining this amazing group, I saw that my lab request from Endo Dr didn't even ask for Free T3 so I circled it on lab request to get that.
ALSO, my voice has become hoarse...had it all checked out with ENT. Mucous secretion might not be right... Feel it is because Thyroid is out of whack....also have severe severe insomnia and depression which no psych meds or herbs or Benzos or Sleeping PIlls have helped. Shout out a big THANK YOU to everyone on this group.
Well, 75 mcg is not a high dose of Synthroid, and your FT4 is only mid-range, so room for an increase in that.
And, your FT3 (no point testing TT3, doesn't give any useful info) is very low. But, your TSH is still too high - should be down to 1 or under - and you can't really tell about your conversion until it gets down to 1. So, I think it might be best to increase your Synthroid by perhaps 25 mcg, and see what happens. If it's too much, you can always reduce it again.
A hoarse voice is a hypo symptom. And, if your insomnia and depression are caused by low T3, the only thing that will help will be to increase your T3 - after all, no-one ever suffered from Benzo deficiency, so not surprising that doesn't help.
As I said above, my endo dr : "On the other hand, raising your Synthroid by too much could make your conversion worse" from T4 (which is good) to T3 (which is too low) ..is this true?
My Free T4 is good so wouldn't adding more Synthroid not bode well? Shouldn't I just increase the T3? Wouldn't that help to lower total TSH? I have a fast heart beat and can get low blood pressure at night, as well (coldish hands/feet).
I also read from another dr: "It is important to realize that if a patient has thyroid antibodies, all bets are off. All thyroid blood tests from that point on are thrown off, including the Free T3. In that case, one definitely has to go by symptoms to decide the correct level of thyroid medication."
From your advise it sounds like the best route would be to raise T3 because of insomnia and hoarse voice. I have NO IDEA if depression and insomnia are some of the symptoms of my low TSH. Thanks so much!!!!
On the other hand, raising your Synthroid by too much could make your conversion worse
Yes, that's true, but the most important words are 'too much'. I'm not suggesting you raise it 'too much'. I wouldn't call your FT4 'good', it is only mid-range, most hypos need it higher than that, so there's plenty of room for an increase.
And, whilst it might be preferable to just take Cytomel for all sorts of reasons, the problem is getting it prescribed. And a lot of doctors do not want to prescribe it because they don't understand it. Not to put too fine a point on it, they are scared witless of T3. So, it's worth trying to raise the FT4 slightly first, to see if that does the trick.
It is important to realize that if a patient has thyroid antibodies, all bets are off. All thyroid blood tests from that point on are thrown off, including the Free T3.
Not quite sure what he means by 'off', but they can jump around a little. Do you know how Hashi's works? Even so, they have a purpose to serve because often one cannot distinguish between hypo and hyper symptoms, and blood tests give an indication which way you're going. Symptoms are important, but I wouldn't just dismiss blood tests like that.
I have NO IDEA if depression and insomnia are some of the symptoms of my low TSH
Your TSH isn't low, it's too high. But, either way, the TSH itself does not cause symptoms. It is T3 that causes symptoms when it's too high or too low.
Also read the following regarding too much T3: "hot flashes, weight gain, sweating, heat intolerance, heart palpitations with irregular heart beat, painful aching in the calves, an increase in bowel activity, irritability, anxiety, menstrual problems, hair loss, depression, exercise intolerance and chest pain." I guess I will ask for T3 but very low doses...Not looking forward to "watching" my symptoms...it's exhausting!
Also, though I have insomnia...am always hyper...never feel fatigued...don't know what it feels like to be "sleepy" anymore..also have ADHD. My cortisol levels aren't too bad; had Micronutrients, etc. tested with functional dr...who also tried me on Progesterone which did not help with sleep and effected vision which I can't have since I have glaucoma.
ADHD can be another symptom of hypo.
Do you have the results for your micronutrient tests?
Yes...but it's quite extensive, everything looked good..raising my D intake a bit, but iodine, selenium, calcium all good.
Well, that probably depends on your definition of 'good'. You thought your FT4 was 'good', but it isn't.
Just being 'in-range' isn't automatically 'good'. Most nutrients should be at least over mid-range. But, some need to be higher than others.
Did you have your magnesium tested? If so, it was a waste of time. The magnesium in the blood is irrelevant and will always be in-range, but that doesn't mean you're not deficient. Most people are, because soils are depleted, but you're at further risk from being hypo. So, if I were you, I would just take some magnesium and see if it helps.
Thanks. I take 400 mg divided of Optimag Neuro magnesium glycinate from Functional dr. Have taken magnesium for years. I am supplementing my B vitamins since I agree with you regarding ranges of nutrients. Appreciate all your valuable feedback.
Hi, I've just clicked through from the other thread because we were highjacking it a bit. In replying to this message from you:
>Thank you. I don't see how you think my Free T4
>is not in range. It is 1.3 (range .8-1.8) while my
>Free T3 is clearly low. I keep reading that the
>Free T3 level is as important, if not more so,
>than total TSH. Would taking a bit of T3 also
>lower my TSH? Wouldn't just taking more T4
>(Synthroid), just raise my TSH without fixing my
>Free T3 levels?
With thyroid hormones it's not just about being inside the range, its about where you are in the range. For freeT4 you are exactly halfway through the range, most people will feel well with it right at the top of the range or even slightly over. Most people with a result in the middle will still be quite sick. Both your freeT4 and freeT3 are quite low, so I'd expect you to still feel ill and have symptoms with these results.
You're right, freeT3 level is very important, and probably the most important of the three numbers in a thyroid panel, because it most closely reflects symptoms and how ill we are.
The primary way we get T3 in the body is by converting T4 into T3. T4 is a storage form of hormone, like tins in the cupboard to eat later, while T3 is the active form, like a hot meal we have to eat right now.
The way things should theoretically work is that the more T4 you take as a tablet, the more T3 your body will make, so this will make you feel better, and will also raise your freeT3.
When people are poor converters, they will struggle to convert the T4 they take as tablets into enough T3 for their body to use. The only way to find out if someone is a poor converter, is to raise their dose till they have a good high level of freeT4, and then check to see if they are converting it into freeT3. If someone doesn't have a good freeT4, we can't really tell how well they are converting. This is because you can't make T3 out of nothing, there needs to be plenty of T4 available.
So yes, taking T3 would raise the T3 in your body and make your freeT3 look better (this will also reduce your TSH) but taking more T4 should also do the same thing, because your body will hopefully take that T4 and convert it into T3.
Whereas in your current situation, taking a dose that is too low for you, leaves you having symptoms and feeling ill.
As I said before, if T3 is easily available often people will like to have a little in addition to T4. But until you try your optimal dose of T4, you won't know whether that would also make you feel better. Its often the simplest thing to do, just to optimally dose on T4, see how you feel, and at that point you can try other things if you don't feel well.
>I am scared about trying Cytomel because of >fast heart rate. Should I try upping 100 mcg of >Synthroid/Levo from 75 mcg FIRST, to lower my >TSH from 2.29 (my Free T4 is 1.3) rather than >adding T3 to raise my Free T3 from 2.5 to a >better level? I heard that the Free T3 level can >be more important than total TSH, especially >with Hashimotos...sorry for all these posts...I am >going bonkers trying to figure this out.
My personal approach is to want to go through things systematically one at a time, so my advice would be to raise your Synthroid (T4) until the freeT4 is at the top of the range and see how you feel there. You can always swap in some T3 later. Unfortunately this is always a slow process, so we need loads of patience!
The best way to raise the T4 is in 25mcg increments. Stay on that dose for 6 weeks, then get a new blood tests and adjust again if needed. You may need to adjust a few times to get to where you need. Once your freeT4 is at the top, if you're lucky you'll feel loads better and your freeT3 will be nice and high, too.
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