Blood Tests - Help Needed - Thanks

[dadavid]

Hi,
Took 125mcg synthroid for 1YR with mixed results so added cytomel.

endo reduced synthroid to 75mcg added 10mcg cytomel
after 6 weeks blood:
THYROID STIMULATING HORMONE (TSH)
0.35 - 5
2.29 mIU/L
NORMAL
FREE T4
12 - 22
12 pmol/L

FREE T3
3.4 - 5.9
3.7 pmol/L

Well was feeling cold so endo added 10mcg of cytomel.
So on 75mcg synthroid and 20mcg cytomel
afetr 6 weeks lab:
THYROID STIMULATING HORMONE (TSH)
0.35 - 5
0.32 mIU/L
LOW
FREE T4
12 - 22
12 pmol/L
NORMAL
FREE T3
3.4 - 5.9
5.1 pmol/L

I have muscle pain now burning sensation and cramps in legs and hands.

Is it the FT4?
What now?
Reduce cytomel? increase synthroid?

Don't know what do do.
Will be happy for some help. Going to endo on Thursday.

 

[sweetpeat]

My guess is that your t4 levels are too low. When mine were bottom of the range like yours, I had a lot of pain especially in my feet. It was so bad it kept me from attending my son's college graduation in another state because I didn't feel well enough to travel. Since raising my levels, I have not had pain like that again.

Finding a good thyroid dose is a lot of trial and error. Your doc seems willing to work with you though. It's too bad he didn't let you try the 10mcg cytomel while taking 125 mcg synthroid. Going from 125 to 75 is a pretty big drop.

 

[dadavid]

Thanks for your response.
I reckon I'll try 100/10 t4/t3

 

[aguilaroja]

Hi,
Took 125mcg synthroid for 1YR with mixed results so added cytomel.
...endo reduced synthroid to 75mcg added 10mcg cytomel...
Well was feeling cold so endo added 10mcg of cytomel.
So on 75mcg synthroid and 20mcg cytomel
...I have muscle pain now burning sensation and cramps in legs and hands....

First, if not already doing so, please give thought to dividing up the amount of T3(Cytomel) throughout the day. Taking a large amount, say, 20 mcg or more at one time may not be especially helpful.

Second, when there is muscle cramping, mineral metabolism is often an issue. Dr. Peat has noted that good thyroid function is needed to retain salts, including sodium and magnesium. Similarly, some with low thyroid function find relief, even unintentionally, by boosting sodium and food sources of magnesium.

Third, thyroid blood tests are rarely sufficient for optimizing thyroid therapy. Tracking of symptoms and signs (including resting pulse and temperature) always helps. Many forum threads discuss this. Few endocrinologists or physicians do this well.

Thyroid: Therapies, Confusion, and Fraud
“Since T3 has a short half life, it should be taken frequently. If the liver isn't producing a noticeable amount of T3, it is usually helpful to take a few micorgrams per hour. Since it restores respiration and metabolic efficiency very quickly, it isn't usually necessary to take it every hour or two, but until normal temperature and pulse have been achieved and stabilized, sometimes it's necessary to take it four or more times during the day. T4 acts by being changed to T3, so it tends to accumulate in the body, and on a given dose, usually reaches a steady concentration after about two weeks.

"An effective way to use supplements is to take a combination T4-T3 dose, e.g., 40 mcg of T4 and 10 mcg of T3 once a day, and to use a few mcg of T3 at other times in the day. Keeping a 14-day chart of pulse rate and temperature allows you to see whether the dose is producing the desired response. If the figures aren't increasing at all after a few days, the dose can be increased, until a gradual daily increment can be seen, moving toward the goal at the rate of about 1/14 per day.”

Salt, energy, metabolic rate, and longevity
“A slight decrease in temperature can promote inflammation (Matsui, et al., 2006). The thermogenic substances--dietary protein, sodium, sucrose, thyroid and progesterone--are antiinflammatory for many reasons, but very likely the increased temperature itself is important.”

 

[dadavid]

Thanks for your reply.
On 125mcg synthroid my pulse was ~60 and temp summer time :36.5 at waking winter time: at waking 36.3.
I added cytomel because of leg muscle weakness , pressure in chest during workout,shortness of breath and general lack of energy.
It took me a year because this things are gradual and grow on you until you one day realize it wasn't like that just short time ago...

Anyways on 75/20 pulse is 80 and waking temp in winter is 36.6. 1-2 hours after breakfast it's 36.9 - not bad. Energy good. Makes you happy this cytomel.

I do divide 2x10. But the burn and muscle cramps and headaches are bad. Today i took 5mcg only in the morning and burn / pain / almost gone. No headache either. This is not anecdotal , i was on 75/10 for 6 weeks.
I reckon it's some king of adrenal response to 10 mcg or the liver does something funky with the the t3. I cannot handle more than 5mcg in one take.
Thanks again

 

[Dotdash]

Thanks for your reply.
On 125mcg synthroid my pulse was ~60 and temp summer time :36.5 at waking winter time: at waking 36.3.
I added cytomel because of leg muscle weakness , pressure in chest during workout,shortness of breath and general lack of energy.
It took me a year because this things are gradual and grow on you until you one day realize it wasn't like that just short time ago...

Anyways on 75/20 pulse is 80 and waking temp in winter is 36.6. 1-2 hours after breakfast it's 36.9 - not bad. Energy good. Makes you happy this cytomel.

I do divide 2x10. But the burn and muscle cramps and headaches are bad. Today i took 5mcg only in the morning and burn / pain / almost gone. No headache either. This is not anecdotal , i was on 75/10 for 6 weeks.
I reckon it's some king of adrenal response to 10 mcg or the liver does something funky with the the t3. I cannot handle more than 5mcg in one take.
Thanks again

The comments about magnesium are important ones. In an email correspondence with Dr Peat he said the following: "Thyroid lets cells use magnesium normally, but when there's not enough in the diet, some places like the bones, liver, kidneys, and brain seem to have priority, reducing the amount that's available in the blood for muscles." "With increased thyroid your cells will bind more magnesium, and a supplement of magnesium carbonate is the quickest way to get it. The water from boiling leafy greens is a safe source of magnesium."

You increased the active from of thyroid via more T3 and decreased the inactive form T4. Increased magnesium would be worth trying for the muscle cramps you are experiencing.

 

[dadavid]

Thanks.
I have strange reaction to magnesium , bicarbonate especially.
My main symptom of thyroid problems was and is muscle pain/burning.
So when I found out that my thyroid doesn't work (took forever...) and taking T4 pains have been reduced.
Every time I tried to supplement magnesium I would get the pain back after 2-3 days and it will linger after I have stopped for a while.
The strangest of all it is that those are the exact same symptoms as taking T3 or NDT which was the worst. I remember reading in one of Ray's articles that Mag and T3 are interchangeable.
Well I have started magnesium again, the legs hurt anyway on T3 right now. Noticed that pain reduced when taking 1/2 tsp of salt with the Mag.