Slightly Increased Pulse and Noticeable Heart Beat on Cytomel 75 mcg Questions

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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.