My blood test done after lunch as requested by dr. Took my levothyroxine 30 mcg and cytomel 5 mcg at 7 am, blood test at 2:30 pm.
My triglycerides little high, slight anemic. Tsh is very low 0.12 range- 0.40-4.50. Dr suggest cutting back on cytomel to half. I plan to take cytomel 5 mcg for days only and skip 3 days a week.
Any suggestions please.
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Suzi_
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If you take T3 meds, your TSH will be suppressed - it's how it works. Do you have results for key nutrients - ferritin, folate, vit D and B12 - and for your free T4 and free T3 - they are what matter!
Do you feel well on your current dose? - it's not very much, but it's how you feel that matters. If you feel fine, I wouldn't reduce dose. Also, taking T3 less than every day isn't a great idea because of it's very short life. If your free T3 and free T4 are say less than half-way through range and you don't feel great, I would actually increase meds rather than reduce them - most of us need these to be in the top third and often the top quartile of the range.
I plan to take cytomel 5 mcg for days only and skip 3 days a week.
That wont work. T3 (Cytomel) needs to be taken every day. It has a short half life of 24 hours so you need a regularly, daily supply not take for a few days, miss a few days, or even alternate days.
Is your doctor basing the reduction on your low TSH? If so that is completely wrong. When taking T3 then TSH is going to be low, even suppressed, because that's just what T3 does. It's not possible to base doses on a pituitary hormone (which is what TSH), you need to measure the thyroid hormones (Free T4 and Free T3) and base dose on that plus your symptoms.
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
If/when also on T3, make sure to take last third or half of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test
So a test after lunch and after taking thyroid medication is useless
You also need vitamin D, folate , ferritin and B12 testec
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
It is quite possible , though not certain , that had your blood been taken at 8/9am rather than at 2.30pm, your tsh may have been within range. In some people the diurnal range is quite large, it's highest middle of night then falls through day till about 5pm ish (i've forgotten the exact times , there is a graph somewhere )
I cant see any need to reduce dose based on these tests if you feel good. If it were me i'd make sure 'you' are in charge of this decision ,not GP. Once you agree to a reduction in prescription there is no guarantee they will raise it again if you then feel less good. At least get an assurance you can go back up again if you dont like it.
Edit: and get an explanation of why / what he thinks the risks are, so you can check them out for yourself, dont take his word for it.
If you are taking T3, you must take it regularly at least once a day if not multiple time a day. You will cause your body a lot of stress and make yourself more ill if you stop it for half a week. And it will probably make no difference to your TSH (which is not a thyroid hormone and doesn't really matter).
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