Brief Answer:
Thyroid

Detailed Answer:
Sorry to note your symptoms.

1 When a person takes cytomel it is often seen that the T4 levels are on the lower side. This is because cytomel is T3

2 Cytomel is generally not recommended by thyroid experts as it is deemed unsafe

3 Thyroid hormone preparations containing T3 alone or in combination with T4 include the following : T3 alone (eg, Cytomel), T4-T3 combination preparations (eg, Thyrolar), and desiccated thyroid (a mixture of T3 and T4 made from porcine thyroid glands, eg, Armour Thyroid).

For most patients with hypothyroidism, thyroid specialists (ie endocrinologists) do not suggest treatment with T3 containing preparations. Patients treated with currently available T3-containing preparations have wide fluctuations in blood T3 levels throughout the day due to its rapid absorption from the gut and its relatively short stay in the circulation.

In addition, blood T4 levels remain low in patients treated with T3, and relatively low in those treated with preparations containing both T3 and T4; while serum TSH in steady state conditions will reflect the adequacy of therapy, measurement of serum T4 may be confusing and lead to inappropriate changes in dose. This is what is exactly being seen on your laboratory report

There are few legitimate uses of cytomel nowadays. One example is this : Temporary treatment with T3 is appropriate in patients with thyroid cancer who are to undergo radioiodine imaging and possible treatment. To shorten the period of hypothyroidism, the patient's T4 therapy is discontinued and T3 is substituted for three to four weeks until the T4 is cleared

4 You will be best served by seeing an endocrinologist in person who will have the opportunity to examine you, and manage the complexities of hypothyroidism

When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
Anti Thyroid Peroxidase (TPO) antibodies
Anti Thyroglobulin antibodies
25 hydroxy Vitamin D

None of these tests require any fasting and can be done at any time of the day

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Brief Answer:
Follow up

Detailed Answer:
Sorry to inform you that this forum is not meant for prescribing medications.

Phone and Web consulting are not an option either.

You clearly need prompt help especially with your imminent travels.

I sincerely hope you get to see an Endocrinologist immediately.

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