Low dose T3 (Cytomel) for fatigue

[Ardoc2]

I'm posting this for reference and information only but would welcome any insights/comments you all may have.

In June of 2018 I had blood work done after visiting my TRT doctor regarding fatigue and trouble sleeping. My sex hormones turned out to still be in the same good range that I had been stable at for quite some time, but as usual we also tested my Thyroid hormones.
These were my results;

JUNE 11, 2018
TSH 1.5 mIU/L RANGE: 0.32 - 4.00
FT3 2.9 pmol/L RANGE: 3.1 - 6.2 LOW
FT4 15 pmol/L RANGE: 9 - 19
rT3 29 ng/dl RANGE: 8 - 25 HIGH

OCTOBER 3, 2018
TSH 1.21 mIU/L RANGE: 0.32 - 4.00
FT3 3.6 pmol/L RANGE: 3.1 - 6.2
FT4 10 pmol/L RANGE: 9 - 19
rT3 17 ng/dl RANGE: 8 - 25

DECEMBER 21, 2018
TSH 1.05 mIU/L RANGE: 0.32 - 4.00
FT3 3.1 pmol/l RANGE: 2.6 - 5.8 (THIS RANGE WAS CHANGED FROM 3.1 - 6.2 on NOVEMBER 4, 2018?)
FT4 13 pmol/l RANGE: 9 - 19
rT3 18 ng/dl RANGE: 8 - 25

After the June 2018 visit my Dr. started me on 5mcg of Cytomel per day taken in the morning bumping to 10 mcg after one week. I have been on that dose ever since and it has reduced my fatigue and improved my sleep. According to the results above it seems to have corrected (helped to correct?) my high rT3 while leaving my TSH and other values within normal range.
The FT3 value shown in December still indicates its on the low side but this was 24+ hours after taking my last Cytomel dose. Based on what I have read (Single Dose T3 Administration: Kinetics and Effects on Biochemical and Physiologic Parameters) after a single dose of Cytomel, serum concentrations will fall almost to baseline levels after 24 hrs. Meaning this is the lowest level that I should measure over any 24 hour period?

I always hear about how virtually any amount of exogenous hormones will completely suppress the endogenous production which does not seem to be the case here? My TSH has fallen but is still well within normal range.

Should I test my FT3 a few hours after taking my Cytomel dose just to determine peak value on this protocol?

I have also since read about someone on a bodybuilding forum who takes 12.5 mcg ongoing daily with moderate recomp benefits. I have also experienced a subtle, but noticeable improvement in that regard.

As thoughts on thyroid hormones and their role in TRT seems to be evolving, I thought some may want to read my experience with low dose cytomel.

Any thoughts or comments are welcome.

 

[Systemlord]

It seems like your doctor isn't optimizing you, fT3 is midrange, fT3 higher than mid range could be dramatic in a good way and is optimal. Suppressing TSH lower is of no consequence.

Optimal VS Normal Thyroid Levels for all Lab Tests & Ages

 

[Vince]

There's two points of view on that subject. I do labs before I take my thyroid meds, then other doctors tell you take your meds and then do Labs. I have a thread on it, I'll see if I can find it.

 

[Vince Carter]

RT3 can be treated like you did here with T3 application, seems to be working and you're pleased with the results. The interesting part is why the pooling to start with which is a difficult question where the easier approach is to apply a little T3 and see if it resolves.

 

[Vince]

Take your thyroid meds before of after your Labs?

 

[Ardoc2]

Systemlord I understand your point and don't disagree in principle. The fact that I am feeling good without crushing my TSH has me reluctant, although not completely against, trying a larger dose. Lowering my TSH is only a concern to me because it SEEMS I am currently supplementing my endogenous T3 rather than replacing it (as would be the case with a larger dose). I would really need to know where my FT3 falls at other times during that 24 hour period to have a better idea. So I might just test 4 hours after the dose to see.

Vince thank you in advance. Would like to see that thread if you can find it.

 

[Ardoc2]

VC my "belief" is that my rT3 was high due to intermittent fasting/ketogenic dieting. This is supported by several things I've read.
I'm also curious if Low dose Cytomel may be a good strategy for dealing with the plateau one can experience when doing a lot of dieting? It may help to offset some of the slow down in metabolism? Just thinking out loud.