T Nation

How to Convert Synthroid into CYTOMEL?

[quote]florida2001 wrote:
Im hypothyroid, last test has showed I have high RT3 so I switched from 130mcg synthroid and 1 grain armour TO 15 mcg Cytomel and 1 grain armour. I also did cortisol saliva test which shows im LOW in cortisol

cortisol morning. 2.6 ng/ml. normal range. 3.7-9.5

cortisol noon 2. ng/ml. normal range. 1.2-3.0
cortisol evening. 1.1. normal range. 0.6-1.9
cortisol night. 0.2. normal range. 0.4-1

the problem is I keep gaining weight, i have headaches, tired, feel like I have cold. What is the recomendation? How I shuld manage this. Please give me some advice. Anybody know or have an experience? Im sick of going from doctor to doctor

Additional information . All tests were done while Im on 15 mcg cytomel and 1 grain armour.
TSH 0.006 normal 0.450-4.500
free T3 3.0 normal range 2.0-4.4
free T4 0.74 normal 0.82-1.77 ng/dl - edit

After these test results, I’ve add cytomel so now im on 1 grain armour + 25mcg cytomel

Any opinion apreciated thank you
[/quote]

Honestly I don’t think 2 weeks is long enough to get blood work done after changing dosage. Give it at least 6 and then retest.

If you were gaining weight with ft4 over range, tsh .006, and ft3 high in range I don’t think your weight gain can be blamed on your thyroid. Unless your high Rt3 is really playing a big role.

I still think you might have something else going on that you should not overlook. If you don’t have palpitations I don’t think that rules out any issue with your heart. I am not saying you have an issue but if I was in your shoes I would follow it up especially if heart disease runs in the family. Have you ever had an ultrasound of your heart?

Your high bun/creatinine result could be caused by a number of things as mentioned already, buy you never replied if any of them could be a possibility.

What is your age?

Since you have been on thyroid medication for 8 years you should have a lot of previous lab reports.

Do you have any of these so we can see how you progressed to take 275mcg at 1 point and back down again?

What did your doctor say about your bun/creatinine ratio?

Ever had a hormonal panel done?

Have you ever felt good on thyroid meds since you have been on them?

I still can’t get over your 3 blood tests with TSH at .006 what are the odds.

So what do you eat typically in a day?

Your issues could also be caused by your low cortisol and keeping you hypo. I have read this can be caused by taking t4 meds for a long time and in large doses.

You could also probably up your dosage of Cytomel but might be best to wait 6 weeks check levels and adjust dosage.

look here

www.drrind.com/therapies/metabolic-symptoms-matrix

also read this and take the temperature readings as described and post your results after 5 days.

www.stopthethyroidmadness.com/adrenal-info/

Hi,
it’s been over 1 month since doc switched me from 130mcg and 1 grain armour TO 15mcg cytomel and 1 grain Armour…i added another 5mcg. The result in this month I have gained so far 8 lb. CRAZY.
To answer the questions:
Im 32 years, female
I have never done ultrasound
As for high BUN/creatinine ratio… maybe dehydration…I’m thirsty all the time, doctor didn’t say anything.
The hormonal panel was done a few months ago the result was following
vit D, 25-OH 47 reference range 30-100ng/ml
Thyroglobulin antibodies <20 refer range <20 IU/ml

Thyroid peroxidase <10 refer range <35 IU/ml
Progesterone 0.5 refer. range folicular phase <1.0, luthelal 2.6-21.5

Prolactin 7.0 refer range 3.0-30.0 ng/ml
Estradiol 148 pg/ml normal range folicular 19-144, mid cycle 64-357, luteal 56-214

HCG, total <2 referenc range <0.5mIU/ml
Testosterone, free 0.7 refer.range 0.1-6.4pg/ml
Testoster Total 24 refer range 2-45ng/dl

My TSH was always so low. 0.01, 0.004, 0.006 no matter what dosage I have been on. I have been switching medication during these years. In summary, I had always had T4 slightly over range, T3 always normal and as I said TSH very low.

I eat in AM 2 egg whites, 1 whole wheat bread with low fat cream cheese, 1/2 low fat yoghurt, coffee
snack 1 apple and 2-3 oz chicken, sometimes few baby carrots
lunch salad- lettuce, beets, 1 spoon coleslaw, FF dressing, chicken 3 oz
snack few nuts, veggies
dinner - salad, sprinkle parmasan, FF dressing and chicken grilled or some fish or crab cake
if im hungry later i get 1/2 low fat yoghurt

so flustruating… im tired of doctors they don’t know how to solve this, they are just guessing… don’t know what else to try.

You may have a pituatary problem with constant TSH that low no matter what.

However, I see two things. Your adrenals are low in the morning-they should be high. So you start the day with low adrenal function.

Your FT3 should be really high to get benefit.

I recommend you google these sites for more help:

stopthethyroidmadness

Recovering with T3

These two sites will have all the information you need to get you on the right track.

[quote]florida2001 wrote:
Hi,
it’s been over 1 month since doc switched me from 130mcg and 1 grain armour TO 15mcg cytomel and 1 grain Armour…i added another 5mcg. The result in this month I have gained so far 8 lb. CRAZY.
To answer the questions:
Im 32 years, female
I have never done ultrasound
As for high BUN/creatinine ratio… maybe dehydration…I’m thirsty all the time, doctor didn’t say anything.
The hormonal panel was done a few months ago the result was following
vit D, 25-OH 47 reference range 30-100ng/ml
Thyroglobulin antibodies <20 refer range <20 IU/ml

Thyroid peroxidase <10 refer range <35 IU/ml
Progesterone 0.5 refer. range folicular phase <1.0, luthelal 2.6-21.5

Prolactin 7.0 refer range 3.0-30.0 ng/ml
Estradiol 148 pg/ml normal range folicular 19-144, mid cycle 64-357, luteal 56-214

HCG, total <2 referenc range <0.5mIU/ml
Testosterone, free 0.7 refer.range 0.1-6.4pg/ml
Testoster Total 24 refer range 2-45ng/dl

My TSH was always so low. 0.01, 0.004, 0.006 no matter what dosage I have been on. I have been switching medication during these years. In summary, I had always had T4 slightly over range, T3 always normal and as I said TSH very low.

I eat in AM 2 egg whites, 1 whole wheat bread with low fat cream cheese, 1/2 low fat yoghurt, coffee
snack 1 apple and 2-3 oz chicken, sometimes few baby carrots
lunch salad- lettuce, beets, 1 spoon coleslaw, FF dressing, chicken 3 oz
snack few nuts, veggies
dinner - salad, sprinkle parmasan, FF dressing and chicken grilled or some fish or crab cake
if im hungry later i get 1/2 low fat yoghurt

so flustruating… im tired of doctors they don’t know how to solve this, they are just guessing… don’t know what else to try.
[/quote]

So how many calories all up in those meals?

Have you ever tried eating a less than that and did you lose weight? I don’t know how many calories you are eating from what you wrote. For arguments sake, say you ate half of what you normally eat would you lose weight or not?

Your Vitamin D could be higher maybe think about supplementing that to raise the levels a little higher I guess aim for 70-80’s.

So even before you started thyroid meds your TSH was very low, above range FT4 and normal FT3? Do you have the exact numbers you can post up?

Did you read the links I posted? Do any of the adrenal symptoms stick out?

Your HCG came back at <2 with reference range <0.05 ??? No chance of being pregnant?

Hi,

I eat aprox 1000 - 1200 cal
5’6" 32 years Female, cardio 4-5 days, weights 3x/week

I was able to lose some weight when I was on Phentermine and had been eating like bird. ( maybe 700 cal). That’s crazy.
I don’t have exact number with me now.
Im not pregnant

Tomorow im going to get another blood test for AM cortisol, blood sugar, insulin, so I will post the results as soon as I get them.

I would look at factors which could be affecting thryroid response at the tissue and cellular receptors. Low gluthione, low ferritin, low cortisol levels, progesterone /e2 imbalances.

Increase t3 can depelete progesterone which can cause imbalance with estrogen. I see it all the time since I have been helping with hormone issues for over 6 years …

Still need more information to look for potential underlying pathology …

Hi, thank you for reply. What estrogen imbalance do you mean? does it means that T3 lower progesterone and so that estrogen too?

here i have additional test . tell me what do you think? could be possible that i have some sort of infection. my ALT and Bun ratio is high? why?

Glucose. 79. normal range 65-99
A1C. 5.4. normal range 4.8-5.6
insulin. 5.6. normal range. 2.6- 24.9
Cortisol AM. 22.5. normal range. 6.2- 19.4
Bun/creatinine ratio. 30. normal range 8 - 20
ALT. 60. normal. 0-40
AsT. 34. normal. 0-40
BUn. 18. normal. 6-20
creatinine serum. 0.61. normal range. 0.57-1.0
bilirubin total. 0.4. normal range. 0.0 - 1.2
phosphorus serum. 3.6. normal. 2.5- 4.5
sodium. 138. normal range. 134-144
potassium. 4.0. normal range. 3.5 - 5.2
A/G ratio. 2.1. normal. 1.1- 2.5

[quote]florida2001 wrote:

Hi, thank you for reply. What estrogen imbalance do you mean? does it means that T3 lower progesterone and so that estrogen too?

here i have additional test . tell me what do you think? could be possible that i have some sort of infection. my ALT and Bun ratio is high? why?

Glucose. 79. normal range 65-99
A1C. 5.4. normal range 4.8-5.6
insulin. 5.6. normal range. 2.6- 24.9
Cortisol AM. 22.5. normal range. 6.2- 19.4
Bun/creatinine ratio. 30. normal range 8 - 20
ALT. 60. normal. 0-40
AsT. 34. normal. 0-40
BUn. 18. normal. 6-20
creatinine serum. 0.61. normal range. 0.57-1.0
bilirubin total. 0.4. normal range. 0.0 - 1.2
phosphorus serum. 3.6. normal. 2.5- 4.5
sodium. 138. normal range. 134-144
potassium. 4.0. normal range. 3.5 - 5.2
A/G ratio. 2.1. normal. 1.1- 2.5

[/quote]

can you give me an input on the last test? still trying to figure out what’s happening? Should be glucose lower compare A1c or is it in good spot.
thank you :slight_smile:

This last test you had done bun/creatine ratio high again. Did you fast by not eating any protein for 24hrs prior to blood draw?

I read when this test is done no protein intake within 24hrs is needed.

Or were you dehydrated again?

You know what, since you have had this ratio elevated twice in a row I would ask to have a 24hr urine analysis done.

This will paint a much better picture of your kidney function and will most likely show if you have a problem with your kidneys.

Also get the heart ultrasound done, considering heart disease runs in your family history this should be a no brainer. Add to the fact you are complaining of water retention this should be a priority.

thank you iroczinoz
Im going to go to check Heart. in a few weeks. I have fasted before test. What about glucose and insulin shouldn’t be glucose lil lower?

I just found my 2 HR oral glucose test that has been done 5 months ago

Glucose fasting 87 mg/dl norma 65-99
after 75 g glucose drink
glucose 1/2 hr 151 mg/dl norma 65-199
glucose 1 hr 159 norma 65-199
glucose 1,5 hr 93 mg/dl norma 65- 199
glucose 2 hr 81 norma 65-199

Still looking at only small bits of the equation. Need to look deeper at cell what factors could be affecting thyroid at the cellular level. I have already mentioned a few of them. Progesterone tanks and P/E2 ratio can increase. I have seen t3 also induce alterations with major issues with monthly cycles.

thanks,
than is there something I can do? Should I do another blood test? If yes what kind in order to find out what is affecting thyroid. What do you recomended?

These test were done about 1month and half. I have done these in 18 days of my cycle.

Progesterone 0.5 refer. range folicular phase <1.0, luthelal 2.6-21.5

Prolactin 7.0 refer range 3.0-30.0 ng/ml
Estradiol 148 pg/ml normal range folicular 19-144, mid cycle 64-357, luteal 56-214
HCG, total <2 referenc range <0.5mIU/ml
Testosterone, free 0.7 refer.range 0.1-6.4pg/ml
Testoster Total 24 refer range 2-45ng/dl

Hi, im still strugel with a hormones issue .i have done another Oral glucose tolerance test. The doctor used g;lucose meter and the result came out

1.Fasting 92
2. after 75 g glucose drink 30 min. 206
3. 60 min. 159
4. 90 min. 219
5. 120 min. 153
6. 150 min. 137

He put me on Metformin 500mg daily to regulate glucose. What do you think? How these test look like to you
My weight has been going up despite diet and exercise.

I just read your tread.

FIRST THING FIRTS.

GET OFF THE ARMOUR, It contain T4 which will Make more Reverse T3.

Secondly.

Go On CYTOMEL T3 alone with a dosage of 25mcg MINIMUN per day, Splitt in 2 dose during the day.

Go up to 100MCG per day over a period of 3 months.

See how you feel after this.

T4 medication is junk.

You need T3 ONLY.

If you have any question pst me.

Hi Florida,

I appreciated your posting so much detail into your thyroid issues. I also appreciated all the comments by others. Amazing great information.

I just had a total thyrodectomy 2 months ago and have been fighting with doctors to get what I feel is best for me. I am sitting pretty much where you were a year ago and was wondering if you ever got this worked out. It seemed they were recommending you stopping or lowering your T4 and increasing T3 or changing from Armor to straight t3 to see if you could get your reverse t3 down.

I was feeling great the first 3 days in hosp after thyrodectomy and on cytomel 25mg only. Had bad reaction (hypertyroid) on 125mg levothyroxin generic so he switchted to 100mcg Synthroid. After 2 weeks still felt tired, and brain fog so bad I couldn’t function at work. Another dr added Armor 60mg and reduced Synthroid to 88mcg and I started feeling GREAT!!!

However, I stopped using estrogen a week ago and have been in pms hell and ended up in hospital after feeling like I was loosing my mind! They thought I had stroke I was so irritable! Thats been ruled out and I started my estrogen and I am feeling fine again. However now the dr wants to stop my armour and not increase my synthroid! wtf? Mind you he refuses to test my estrogen he is just bent on getting me off armour.
88mcg synthroid 60mg armour thyroid 2 weeks
tsh 0.03 (.34-5.0)
t4free 1.49 (.5-1.5)
t3 118 (not free) (87-119)
dr refuses to do reverse t3

If Im feeling GREAT, however I am still don’t have the brain clarity I had on cytomel only, and my blood test numbers are all normal exept tsh. am I being unreasonable in requesting a reverse t3 and assuming my t4 is higher because my reverse t3 is likely very high and that it is to much t4 not t3 that if not corrected could cause more problem than it fixes. Am I right is thinking that if I stop the t3 and go t4 only that its only going to make matters worse?

The hospital refused to give me my armor yesterday and today so I have missed 4 doses now. I was fine but now I am hot flashing, acid reflux, my head it itching so bad I want to rip my hair out, I can’t taste salt, and my sence of smell is gone, all the things that disappeared the 3rd day I was on Armour!

My cat scan is normal, everything else they have tested for is normal. They still haven’t tested estrogen and since I started using it again the day I got here I have stopped pmsing and acting like I am bipolar!

Note: For those of you reading this and having difficulty taking t3… Progesterone inhances the assimilation of t3. In my case I had to lower my progesterone in order to tolerate the t3. I was getting the results I wanted from t3 but having hyperthyroid symptoms until I lowered the progesterone. Since then I have been taking it and getting no hyperthyroid symptoms, have great comprehension and no brain fog.

53 year old female
160lb
currently a computer engineer
gluten free diet 100% compliant
bhrt estrogen/Progesterone/Testosterone

There is an issue where some cannot convert T4–>T3 and T4 monotherapy can be a disaster for those and there are varying degrees of course. If the thyroid gland is gone, T4–>T3 cannot happen there. Some T4–>T3 OK in peripheral tissues OK, others not.

Check your body temperature. If at or below 97.3 when you wake and/or cannot get to 98.6 during the day, you have functional hypothyroidism. Increase dose of thyroid meds until temperatures normalize. Waking up at 97.7 would be good.

Iodine still has a role in the body.

Have you checked DHEA-S levels?

Acid reflux: Often is from a hiatal hernia.

You can test rT3 on your own: http://www.lef.org/Vitamins-Supplements/ItemLC070104/Reverse-T3-Blood-Test.html?olditem=LC002212