Do I need to add Cytomel along with Levothyroxine after experiencing shortness of breath and fatigue when diagnosed with Hashimoto's disease?
No need to add Cytomel. Take 125 mcg Levothyroxine.
I have gone through your query.
I can understand your concern.
I have seen your attached report.
The doses of Levothyroxine has adjusted accordingly to the TSH result.
So when you are under thyroid hormone replacement therapy it is necessary to check only TSH.
I see that all your TSH results are within the normal range.
The optimal (target)levels are between 1-2 and this correspond even with the level where the majority of patients typically report feeling their best. You confirm that this is correct.
Your actual TSH level is higher than the optimal level and (which is the most important thing) you have symptoms of hypothyroidism like feeling tired, not sleeping well and constipation.
For this reason, if you were my patient I will suggest using 125 mcg levothyroxine.
I don't recommend Cytomel(liothyronine or T3) because this drug has a rapid onset of action and can produce symptoms of hyperthyroidism in synergy with the residual effect of Levothyroxine because residual effects of the other thyroid preparation (levo) may persist for the first several weeks of therapy.
To conclude: In my opinion, you should take 125 mcg Levothyroxine, you should feel better.
It is recommended to repeat the TSH test 6 weeks after you start the new doses.
Let me know the result and let me know how do you feel about the new doses.
Hope this is helpful.
Dr. Elona Xhardo
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