Re: Slightly Increased Pulse and Noticeable Heart Beat on Cytomel 75 mcg Questio

May 16, 2010

A low ferritin (below 70-90) is a very common cause of not tolerating T3. If it

were me I'd try decreasing the T3 very slightly to see if the side effects

improved; if yes, ferritin needs to be raised before increasing T3 again.

Lots of folks just can't tolerate the T3 they need until they raise their

ferritin, as T3 requires a good ferritin level in order to be utilized properly.

>

> Please help me with these questions based on the background info below:

>

> 1. Should I ask the doctor about decreasing the dose of Cytomel? Or

> at least until I get my ferritin up?

>

> 2. Would I be better on a higher dose of desiccated thyroid than

> what I was on before he switched me to synthetic (150 mg Erfa Thyrod)

> instead of being on synthetic T4 and synthetic T3?

>

> 3. What about a higher dose of desiccated thyroid than I was on

> – say 3 grains or 180 mg. with the addition of a little bit if

> Cytomel, but not as high a dose of Cytomel as he has me on now (75 mcg)?

>

> 4. What about T3 only?

>

> Background:

>

> A week ago, my doctor switched me from Erfa Thyroid 150 mg. (2 ½

> grains) to 75 mcg Synthroid (T4) and 75 mcg Cytomel (T3) (Take 25 mcg of

> Cytomel 3 times a day) because the muscle/tendon pain in my ankles, the

> tops of my feet, knees, wrists, hands and elbows was getting worse; and

> my brain fog and fatigue were getting worse.

>

> Recent labs (04/20/2010) while on 150 mg Erfa Thyroid:

>

> Free T3: 3.5 (2.3 – 4.2) PG/ML

>

> Free T4: 0.74 (0.89 – 1.76) NG/DL

>

> TSH: 0.015 (0.35 – 5.50) uIU/mL

>

> Reverse T3: 19 (11 – 32) ng/dL

>

> Ratio FT3/RT3 = 350/19 = 18.42

>

> (I know this needs to be at least 20.)

>

> Ferritin: 25 (10 – 291) ng/mL

>

> (I know this needs to get much higher.

>

> Started taking four 27mg Blue Bonnet iron bisglycinate capsules

> each day. About 3 weeks ago.)

>

> Cortisol saliva lab results from about one and a half years ago:

>

> 8:00 am 5.5 (7.0 – 10.0) ng/ml

>

> 12:00 noon 2.5 (3.0 – 6.0) ng/ml

>

> 4:00 pm 2.8 (2.0 – 4.0) ng/ml

>

> 11:00 pm 1.5 (< 1.5) ng/ml

>

> Doctor also has me on:

>

> · Cortef (HC) 15 mg. per day (7.5 in morning, 5.0 at noon,

> 2.5 about 4 pm)

>

> · DHEA 10 mg.

>

> · Estrogen 0.025 mg patch (bioidentical)

>

> · Progesterone, bioidentical – 100 mg at night

>

> Since starting the synthetic 75 mcg T3 and 75 mcg T4, about 2 hours

> after I take my Cytomel (divided into 25 mcg 3 times a day) I have

> noticed that my pulse is anywhere from 80 – 100 and I

> " notice " my heart beating a little more forcefully. I am aware

> of it, whereas normally I don't notice my heart beating. My normal

> pulse is about 70 – 72.

>

> Nick, if you see this message, you wrote earlier that I might do better

> on simply a higher dose of desiccated thyroid period once I get my

> ferritin level up to where it should be.

>

> Or maybe that with a little bit of Cytomel added?

>

> Val, if you see this message, you suggested T3 only.

>

> So, I'm a little confused. And, I'm a little concerned about the

> pulse and heartbeat thing. Is that anything to worry about?

>

> Many thanks for your time. Am extremely grateful to all of you.

>

> Read the STTM book through from cover to cover again this weekend to try

> to absorb everything.

>

May 16, 2010

Thank you Margery. I don't understand why my doc put me on 75 mcg of Cytomel

when he knew my T3 was so low. Will try decreasing and see if feel better. I

would also rather stay on natural with a slight addition of T3 until my ferritin

comes up. Then if I am still making too much RT3, go to T3 only.

> >

> > Please help me with these questions based on the background info below:

> >

> > 1. Should I ask the doctor about decreasing the dose of Cytomel? Or

> > at least until I get my ferritin up?

> >

> > 2. Would I be better on a higher dose of desiccated thyroid than

> > what I was on before he switched me to synthetic (150 mg Erfa Thyrod)

> > instead of being on synthetic T4 and synthetic T3?

> >

> > 3. What about a higher dose of desiccated thyroid than I was on

> > – say 3 grains or 180 mg. with the addition of a little bit if

> > Cytomel, but not as high a dose of Cytomel as he has me on now (75 mcg)?

> >

> > 4. What about T3 only?

> >

> > Background:

> >

> > A week ago, my doctor switched me from Erfa Thyroid 150 mg. (2 ½

> > grains) to 75 mcg Synthroid (T4) and 75 mcg Cytomel (T3) (Take 25 mcg of

> > Cytomel 3 times a day) because the muscle/tendon pain in my ankles, the

> > tops of my feet, knees, wrists, hands and elbows was getting worse; and

> > my brain fog and fatigue were getting worse.

> >

> > Recent labs (04/20/2010) while on 150 mg Erfa Thyroid:

> >

> > Free T3: 3.5 (2.3 – 4.2) PG/ML

> >

> > Free T4: 0.74 (0.89 – 1.76) NG/DL

> >

> > TSH: 0.015 (0.35 – 5.50) uIU/mL

> >

> > Reverse T3: 19 (11 – 32) ng/dL

> >

> > Ratio FT3/RT3 = 350/19 = 18.42

> >

> > (I know this needs to be at least 20.)

> >

> > Ferritin: 25 (10 – 291) ng/mL

> >

> > (I know this needs to get much higher.

> >

> > Started taking four 27mg Blue Bonnet iron bisglycinate capsules

> > each day. About 3 weeks ago.)

> >

> > Cortisol saliva lab results from about one and a half years ago:

> >

> > 8:00 am 5.5 (7.0 – 10.0) ng/ml

> >

> > 12:00 noon 2.5 (3.0 – 6.0) ng/ml

> >

> > 4:00 pm 2.8 (2.0 – 4.0) ng/ml

> >

> > 11:00 pm 1.5 (< 1.5) ng/ml

> >

> > Doctor also has me on:

> >

> > · Cortef (HC) 15 mg. per day (7.5 in morning, 5.0 at noon,

> > 2.5 about 4 pm)

> >

> > · DHEA 10 mg.

> >

> > · Estrogen 0.025 mg patch (bioidentical)

> >

> > · Progesterone, bioidentical – 100 mg at night

> >

> > Since starting the synthetic 75 mcg T3 and 75 mcg T4, about 2 hours

> > after I take my Cytomel (divided into 25 mcg 3 times a day) I have

> > noticed that my pulse is anywhere from 80 – 100 and I

> > " notice " my heart beating a little more forcefully. I am aware

> > of it, whereas normally I don't notice my heart beating. My normal

> > pulse is about 70 – 72.

> >

> > Nick, if you see this message, you wrote earlier that I might do better

> > on simply a higher dose of desiccated thyroid period once I get my

> > ferritin level up to where it should be.

> >

> > Or maybe that with a little bit of Cytomel added?

> >

> > Val, if you see this message, you suggested T3 only.

> >

> > So, I'm a little confused. And, I'm a little concerned about the

> > pulse and heartbeat thing. Is that anything to worry about?

> >

> > Many thanks for your time. Am extremely grateful to all of you.

> >

> > Read the STTM book through from cover to cover again this weekend to try

> > to absorb everything.

> >

>

May 16, 2010

That sounds like a good plan. If your RT3 is caused solely by low ferritin,

that may be all you need to do.

You are right, you will need to watch the RT3, though, if it has another

cause(s), you'll still be making too much, and you may need to take the T3-only

route.

I may have sent you the ferritin-raising suggestions already, but just in case

not: for raising ferritin, many here have had good results with bluebonnet

iron, 150-200 mg/day. Here's a link:

http://www.iherb.com/Bluebonnet-Nutrition-Chelated-Iron-90-Vcaps/11571?at=0

Iron can sometimes cause digestive side effects, starting on a low dose and

tapering up may minimize these.

> > >

> > > Please help me with these questions based on the background info below:

> > >

> > > 1. Should I ask the doctor about decreasing the dose of Cytomel? Or

> > > at least until I get my ferritin up?

> > >

> > > 2. Would I be better on a higher dose of desiccated thyroid than

> > > what I was on before he switched me to synthetic (150 mg Erfa Thyrod)

> > > instead of being on synthetic T4 and synthetic T3?

> > >

> > > 3. What about a higher dose of desiccated thyroid than I was on

> > > – say 3 grains or 180 mg. with the addition of a little bit if

> > > Cytomel, but not as high a dose of Cytomel as he has me on now (75 mcg)?

> > >

> > > 4. What about T3 only?

> > >

> > > Background:

> > >

> > > A week ago, my doctor switched me from Erfa Thyroid 150 mg. (2 ½

> > > grains) to 75 mcg Synthroid (T4) and 75 mcg Cytomel (T3) (Take 25 mcg of

> > > Cytomel 3 times a day) because the muscle/tendon pain in my ankles, the

> > > tops of my feet, knees, wrists, hands and elbows was getting worse; and

> > > my brain fog and fatigue were getting worse.

> > >

> > > Recent labs (04/20/2010) while on 150 mg Erfa Thyroid:

> > >

> > > Free T3: 3.5 (2.3 – 4.2) PG/ML

> > >

> > > Free T4: 0.74 (0.89 – 1.76) NG/DL

> > >

> > > TSH: 0.015 (0.35 – 5.50) uIU/mL

> > >

> > > Reverse T3: 19 (11 – 32) ng/dL

> > >

> > > Ratio FT3/RT3 = 350/19 = 18.42

> > >

> > > (I know this needs to be at least 20.)

> > >

> > > Ferritin: 25 (10 – 291) ng/mL

> > >

> > > (I know this needs to get much higher.

> > >

> > > Started taking four 27mg Blue Bonnet iron bisglycinate capsules

> > > each day. About 3 weeks ago.)

> > >

> > > Cortisol saliva lab results from about one and a half years ago:

> > >

> > > 8:00 am 5.5 (7.0 – 10.0) ng/ml

> > >

> > > 12:00 noon 2.5 (3.0 – 6.0) ng/ml

> > >

> > > 4:00 pm 2.8 (2.0 – 4.0) ng/ml

> > >

> > > 11:00 pm 1.5 (< 1.5) ng/ml

> > >

> > > Doctor also has me on:

> > >

> > > · Cortef (HC) 15 mg. per day (7.5 in morning, 5.0 at noon,

> > > 2.5 about 4 pm)

> > >

> > > · DHEA 10 mg.

> > >

> > > · Estrogen 0.025 mg patch (bioidentical)

> > >

> > > · Progesterone, bioidentical – 100 mg at night

> > >

> > > Since starting the synthetic 75 mcg T3 and 75 mcg T4, about 2 hours

> > > after I take my Cytomel (divided into 25 mcg 3 times a day) I have

> > > noticed that my pulse is anywhere from 80 – 100 and I

> > > " notice " my heart beating a little more forcefully. I am aware

> > > of it, whereas normally I don't notice my heart beating. My normal

> > > pulse is about 70 – 72.

> > >

> > > Nick, if you see this message, you wrote earlier that I might do better

> > > on simply a higher dose of desiccated thyroid period once I get my

> > > ferritin level up to where it should be.

> > >

> > > Or maybe that with a little bit of Cytomel added?

> > >

> > > Val, if you see this message, you suggested T3 only.

> > >

> > > So, I'm a little confused. And, I'm a little concerned about the

> > > pulse and heartbeat thing. Is that anything to worry about?

> > >

> > > Many thanks for your time. Am extremely grateful to all of you.

> > >

> > > Read the STTM book through from cover to cover again this weekend to try

> > > to absorb everything.

> > >

> >

>

May 17, 2010

Margery, thanks more. Will give it a try. I am taking the Blue Bonnet iron

bisglycinate b/c others wrote that it did not upset stomach. Have been noticing

some stomach issues though. Only 27 mg, so am taking 4 a day. Will check out the

ones for which you sent the link though. Am trying to grasp all of this, but so

complex, even after reading the book completely. All of it interplays so

dynamically - the cortisol, the ferritin, the T3. I am having trouble even

walking b/c my feet hurt so badly and diffcult even picking up a glass of water

b/c my hands hurt. Had this pain for about 5 years, and when my doc first put me

on Armour, it all went away after about a month. It was wonderful. But only

lasted about 9 months, then downhill. That's why I am wondering if it was low

ferritin all along, or that and low cortisol (my cortisol was low on testing) or

also in combo with the first two or alone. Others have mentioned that the dose

of Cortef th doc has me on is too low (15 mg.) - can cause more harm than good -

that I should be on at least 20 mg.

Thanks again.

> > > >

> > > > Please help me with these questions based on the background info below:

> > > >

> > > > 1. Should I ask the doctor about decreasing the dose of Cytomel? Or

> > > > at least until I get my ferritin up?

> > > >

> > > > 2. Would I be better on a higher dose of desiccated thyroid than

> > > > what I was on before he switched me to synthetic (150 mg Erfa Thyrod)

> > > > instead of being on synthetic T4 and synthetic T3?

> > > >

> > > > 3. What about a higher dose of desiccated thyroid than I was on

> > > > – say 3 grains or 180 mg. with the addition of a little bit if

> > > > Cytomel, but not as high a dose of Cytomel as he has me on now (75 mcg)?

> > > >

> > > > 4. What about T3 only?

> > > >

> > > > Background:

> > > >

> > > > A week ago, my doctor switched me from Erfa Thyroid 150 mg. (2 ½

> > > > grains) to 75 mcg Synthroid (T4) and 75 mcg Cytomel (T3) (Take 25 mcg of

> > > > Cytomel 3 times a day) because the muscle/tendon pain in my ankles, the

> > > > tops of my feet, knees, wrists, hands and elbows was getting worse; and

> > > > my brain fog and fatigue were getting worse.

> > > >

> > > > Recent labs (04/20/2010) while on 150 mg Erfa Thyroid:

> > > >

> > > > Free T3: 3.5 (2.3 – 4.2) PG/ML

> > > >

> > > > Free T4: 0.74 (0.89 – 1.76) NG/DL

> > > >

> > > > TSH: 0.015 (0.35 – 5.50) uIU/mL

> > > >

> > > > Reverse T3: 19 (11 – 32) ng/dL

> > > >

> > > > Ratio FT3/RT3 = 350/19 = 18.42

> > > >

> > > > (I know this needs to be at least 20.)

> > > >

> > > > Ferritin: 25 (10 – 291) ng/mL

> > > >

> > > > (I know this needs to get much higher.

> > > >

> > > > Started taking four 27mg Blue Bonnet iron bisglycinate capsules

> > > > each day. About 3 weeks ago.)

> > > >

> > > > Cortisol saliva lab results from about one and a half years ago:

> > > >

> > > > 8:00 am 5.5 (7.0 – 10.0) ng/ml

> > > >

> > > > 12:00 noon 2.5 (3.0 – 6.0) ng/ml

> > > >

> > > > 4:00 pm 2.8 (2.0 – 4.0) ng/ml

> > > >

> > > > 11:00 pm 1.5 (< 1.5) ng/ml

> > > >

> > > > Doctor also has me on:

> > > >

> > > > · Cortef (HC) 15 mg. per day (7.5 in morning, 5.0 at noon,

> > > > 2.5 about 4 pm)

> > > >

> > > > · DHEA 10 mg.

> > > >

> > > > · Estrogen 0.025 mg patch (bioidentical)

> > > >

> > > > · Progesterone, bioidentical – 100 mg at night

> > > >

> > > > Since starting the synthetic 75 mcg T3 and 75 mcg T4, about 2 hours

> > > > after I take my Cytomel (divided into 25 mcg 3 times a day) I have

> > > > noticed that my pulse is anywhere from 80 – 100 and I

> > > > " notice " my heart beating a little more forcefully. I am aware

> > > > of it, whereas normally I don't notice my heart beating. My normal

> > > > pulse is about 70 – 72.

> > > >

> > > > Nick, if you see this message, you wrote earlier that I might do better

> > > > on simply a higher dose of desiccated thyroid period once I get my

> > > > ferritin level up to where it should be.

> > > >

> > > > Or maybe that with a little bit of Cytomel added?

> > > >

> > > > Val, if you see this message, you suggested T3 only.

> > > >

> > > > So, I'm a little confused. And, I'm a little concerned about the

> > > > pulse and heartbeat thing. Is that anything to worry about?

> > > >

> > > > Many thanks for your time. Am extremely grateful to all of you.

> > > >

> > > > Read the STTM book through from cover to cover again this weekend to try

> > > > to absorb everything.

> > > >

> > >

> >

>

May 17, 2010