On Synthyroid - High TSH - Low T4 - Good T3

#21
I just take the full 5mcg in the morning at the same time as my 25mcg synthyroid. I don't seem to crash mid day so it seems like I wont have to split it at this point.

Yeah i am surprised too that it had such an effect since my FreeT3 was not horrible and my RT3 was decent. looks like I need to be in the upper range of FT3. Looking forward to seeing my lab work in a months time!
Me too! Lol. I’m very curious where your numbers all are now that you’re feeling so good. Definitely keep us posted.

Can you post your thyroid labs before started T3? Are they already in this thread?
 
Thread starter #22
Me too! Lol. I’m very curious where your numbers all are now that you’re feeling so good. Definitely keep us posted.

Can you post your thyroid labs before started T3? Are they already in this thread?
will definitely update this post once i get my labs in about a month or so. Yeah they are in this thread, a few posts back. Will post it again for you.

on 25mcg synthyroid and 200mcg selenium only (Prior to T3 cytomel treatment)

Tsh 3.21 mIu/L (0.24-4)
Free T4 14.3 pmol/L (10-25)
Free T3 5.5 pmol/L (3.5-6.5)
Antibodies: negative
RT3 - 13.3 (9-24)
 
#23
will definitely update this post once i get my labs in about a month or so. Yeah they are in this thread, a few posts back. Will post it again for you.

on 25mcg synthyroid and 200mcg selenium only (Prior to T3 cytomel treatment)

Tsh 3.21 mIu/L (0.24-4)
Free T4 14.3 pmol/L (10-25)
Free T3 5.5 pmol/L (3.5-6.5)
Antibodies: negative
RT3 - 13.3 (9-24)
Awesome, thanks. Just got my labs back while on 2.5 grains of NDT only. Here’s the thread if you want to check it out.
Gman's thyroid labs

I plan on either lowering NDT dose down to 1.5 grains, or lowering down to 1.5 grains, and adding Cytomel in at a very low dose to start. Probably 5mcg at first, and increase by 5mcg every week until optimal.
 
#24
Awesome, thanks. Just got my labs back while on 2.5 grains of NDT only. Here’s the thread if you want to check it out.
Gman's thyroid labs

I plan on either lowering NDT dose down to 1.5 grains, or lowering down to 1.5 grains, and adding Cytomel in at a very low dose to start. Probably 5mcg at first, and increase by 5mcg every week until optimal.
As we have spoke previously as my Thyroid lab numbers are almost identical as yours with top 80% of FT3 range, bottom 10% of FT4 range and my RT3 being 14.9 with fluctuating TSH anywhere from 2.3 to 3.9.....

I have been on a 1/2 grain Armour in the AM for the past 2 1/2 months and have lost weight but nothing substantial in energy increase or help with mental clarity/brain fog...

I am in process of increasing to 1 grain Armour AM and 1/2 grain mid/late afternoon... Should I also add 5mcg of Cytomel to my morning Armour dose to get that RT3 down? (I have a full bottle of Cynomel the mexican equivalent of Cytomel)....
 
#25
As we have spoke previously as my Thyroid lab numbers are almost identical as yours with top 80% of FT3 range, bottom 10% of FT4 range and my RT3 being 14.9 with fluctuating TSH anywhere from 2.3 to 3.9.....

I have been on a 1/2 grain Armour in the AM for the past 2 1/2 months and have lost weight but nothing substantial in energy increase or help with mental clarity/brain fog...

I am in process of increasing to 1 grain Armour AM and 1/2 grain mid/late afternoon... Should I also add 5mcg of Cytomel to my morning Armour dose to get that RT3 down? (I have a full bottle of Cynomel the mexican equivalent of Cytomel)....
Ya I honestly would. I would start tracking your morning temps though. Stay at 1.5 grains for your NDT. Don’t go any higher with that. Now add in 5mcg of T3. And increase by 5mcg every 7 days, until your morning temps get close to 98.6, and or your symptoms are resolved. If none of your symptoms improve, I would stop once you get to 20mcg of T3, and get labs done. Usually everyone needs to add in some straight T3 to get their thyroid optimal. It’s pretty much impossible to do so by taking synthetic T4 only, and it’s pretty rare to do so on NDT only. Straight T3 is almost always part of the picture to get your thyroid completely optimal. So I would definitely start throwing some in. 5mcg is a great starting dose. That’s what I’m using atm, and I even split the tab and take 2.5mcg twice per day. You might even want to lower NDT down to 1 grain. Then when you get labs done, if your free T4 isn a little too low, you can just raise NDT slightly. Always better to start low with timings and titrate up. On 2.5 grains of NDT, my free T3 was 7.3, and RT3 22. So right now I’m on T3 only to let RT3 get back down. But will add back in 1 grain of NDT in a couple weeks.
 
Last edited:
#26
Ya I honestly would. I would start tracking your morning temps though. Stay at 1.5 grains for your NDT. Don’t go any higher with that. Now add in 5mcg of T3. And increase by 5mcg every 7 days, until your morning temps get close to 98.6, and or your symptoms are resolved. If none of your symptoms improve, I would stop once you get to 20mcg of T3, and get labs done. Usually everyone needs to add in some straight T3 to get their thyroid optimal. It’s pretty much impossible to do so by taking synthetic T4 only, and it’s pretty rare to do so on NDT only. Straight T3 is almost always part of the picture to get your thyroid completely optimal. So I would definitely start throwing some in. 5mcg is a great starting dose. That’s what I’m using atm, and I even split the tab and take 2.5mcg twice per day. You might even want to lower NDT down to 1 grain. Then when you get labs done, if your free T4 isn a little too low, you can just raise NDT slightly. Always better to start low with timings and titrate up. On 2.5 grains of NDT, my free T3 was 7.3, and RT3 22. So right now I’m on T3 only to let RT3 get back down. But will add back in 1 grain of NDT in a couple weeks.
So when/if I move up with T3 do I increase the morning dose from 5mcg to 10mcg or do I add another 5mcg in mid-day or 3 or 4 times a day?
 
#27
So when/if I move up with T3 do I increase the morning dose from 5mcg to 10mcg or do I add another 5mcg in mid-day or 3 or 4 times a day?
Add it mid day. So with 10mcg/ day, I would take 5 in the am, and 5 around noon. If you were taking 15mcg/ day, I would take 5 when you wake up, 5 around 11am, and 5 around 2pm. I would always space them out as much as you can, and just take the last dose no later than around 3pm. Although, some people report taking T3 before bed, and it improving sleep quality. So it probably doesn’t really matter what time you take your last dose. And just for connivence sake, I would probably only spit my doses up 3 times per day. Anymore than that and it gets pretty annoying. Even 3 times per day will probably be annoying.
 
Thread starter #28
OP here. about 3 weeks out on 5mcg cytomel. Feels like it is losing its punch and benefits. wondering if perhaps because the decrease in tsh would reduce my natural production? may try to go to 10mcg after looking at my labs at the end of the month. will this be a never ending cycle of increasing dosage?
 
#29
OP here. about 3 weeks out on 5mcg cytomel. Feels like it is losing its punch and benefits. wondering if perhaps because the decrease in tsh would reduce my natural production? may try to go to 10mcg after looking at my labs at the end of the month. will this be a never ending cycle of increasing dosage?
I'm currently taking 12.5 mcg of cytomel and 90 mg of armour. I have used up to 25 mcg cytomel in the morning and 12.5, 12 hours later.
 
#31
OP here. about 3 weeks out on 5mcg cytomel. Feels like it is losing its punch and benefits. wondering if perhaps because the decrease in tsh would reduce my natural production? may try to go to 10mcg after looking at my labs at the end of the month. will this be a never ending cycle of increasing dosage?
No it definitely won’t be a never ending cycle. Especially if you’re getting labs done. Eventually your T3 will go too high. Everyone on STTM FB group recommends starting at 5-10mcg, and increasing 5mcg every week until optimal. They say that you can regress if you stay on a sub-optimal dose for too long. That’s probably what’s going on with you.
 
#32
How you feeling Vince, and how long have you been on this protocol?
I feel fine on my current protocol of 90 mg of armour and 12.5 mcg of cytomel. When I up my dose of cytomel, my LDL cholesterol really drops. That's the main reason I like good free T3 levels. I'm having thyroid Labs on June 4th and my consultation on June 18th.
 
Thread starter #33
I'm currently taking 12.5 mcg of cytomel and 90 mg of armour. I have used up to 25 mcg cytomel in the morning and 12.5, 12 hours later.
How is your FreeT3 on that dose? mine was above mid range prior to cytomel. I am aiming for the top 1/3rd of the range.
 
Thread starter #34
No it definitely won’t be a never ending cycle. Especially if you’re getting labs done. Eventually your T3 will go too high. Everyone on STTM FB group recommends starting at 5-10mcg, and increasing 5mcg every week until optimal. They say that you can regress if you stay on a sub-optimal dose for too long. That’s probably what’s going on with you.
how are they increasing it every week? they are getting labwork, seeing the doctor all in that time? I think i actually feel worse than before cytomel right now, where two weeks ago I felt amazing. Perhaps my natural production shut down is that the reason they say you can regress, natural is shutdown and the administered dose is not sufficient?
 
#36
how are they increasing it every week? they are getting labwork, seeing the doctor all in that time? I think i actually feel worse than before cytomel right now, where two weeks ago I felt amazing. Perhaps my natural production shut down is that the reason they say you can regress, natural is shutdown and the administered dose is not sufficient?
I would assume it would start shutting down your natural production, but I could be wrong. On 2.5 grains of NDT only, my TSH went from 0.73, to 0.01 (0.4-4.5). Basically completely suppressed, and I assume all the T4 and T3 in my system was purely from the NDT. So ya maybe the low dose can suppress your thyroid levels, and the exogenous T3 is just not enough to keep things optimal on its own right now for you.

The way they do it, is they increase T3 by 5mcg every week, until their morning temps are close to 98.6, or their symptoms resolve before then. They obv get labs when they can, and adjust things based off the labs as well. But in between labs, it’s mostly checking morning temps, and assessing their symptoms.

Have you been checking your temp? On nothing, mine was around 96.2, which is horrible. Right now on 10mcg of T3 only, my morning temp was around 97.1, as of this morning. So obviously not optimal, but going in the right direction. I have 3 more days on 10mcg, and then will be adding in 5mcg, and taking 5mcg 3x/ day for a week.
 
#37
I feel fine on my current protocol of 90 mg of armour and 12.5 mcg of cytomel. When I up my dose of cytomel, my LDL cholesterol really drops. That's the main reason I like good free T3 levels. I'm having thyroid Labs on June 4th and my consultation on June 18th.
Awesome to hear Vince. And yes, optimizing thyroid levels is an extremely efficient method of optimizing cholesterol levels. Definitely needs to be more talked about.

If you don’t mind me asking, does your insurance cover Cytomel? Mine would not cover the name brand. Even with a GoodRX coupon it was around $350 to fill my prescription. The prescription was for 180 5mcg tabs.
 
#38
Awesome to hear Vince. And yes, optimizing thyroid levels is an extremely efficient method of optimizing cholesterol levels. Definitely needs to be more talked about.

If you don’t mind me asking, does your insurance cover Cytomel? Mine would not cover the name brand. Even with a GoodRX coupon it was around $350 to fill my prescription. The prescription was for 180 5mcg tabs.
My insurance covers the cost, I believe it's a very inexpensive drug. They also sell a generic brand on reliable RX, which actually does work excellent.
 
#39
My insurance covers the cost, I believe it's a very inexpensive drug. They also sell a generic brand on reliable RX, which actually does work excellent.
My insurance denied it, but I’m going to call them Monday and see if there’s any chance that they would cover it. I wish it was inexpensive. Without the GoodRx coupon it was $700. The pharmacy actually called me to see if I even wanted it filled since it was so expensive.
 

fifty

Well-Known Member
#40
I know you like name brand but I would go generic given the huge cost difference. Generic isn’t perfect but idk if real cytomel is worth the huge price diff in this case.
 
Top