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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Adding Cytomel
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.
Adding Cytomel
by Levojunki, Dec 07, 2006 12:00AM
I'm getting ready to add Cytomel to my Synthroid treatment.
I have been on Levo- then synthroid for 6 months now. I have had a modest (15-20% improvement) but not enough to get work. I am looking at adding Cytomel T3, but my current doctor is uncomfortable with that, so I will have to pony up for a specialist, as I have no insurance. Is there any way to covince my current doctor (free clinic) to presrcibe BOTH t-3 and T4? He has no problem doing JUST T3 Cytomel, but he does not want to do both, but I cant afford a specialist. What are my options?
Thanks
I have been on Levo- then synthroid for 6 months now. I have had a modest (15-20% improvement) but not enough to get work. I am looking at adding Cytomel T3, but my current doctor is uncomfortable with that, so I will have to pony up for a specialist, as I have no insurance. Is there any way to covince my current doctor (free clinic) to presrcibe BOTH t-3 and T4? He has no problem doing JUST T3 Cytomel, but he does not want to do both, but I cant afford a specialist. What are my options?
Thanks
Doctor's Answer
by Mark Lupo, M.D., Dec 10, 2006 12:00AM
, Dec 10, 2006 12:00AM
Your doc must be comfortable with the treatment - that is in your best interest as well as his.
T3 alone is typically not suggested.
T3 is about 4x as potent as T4 (ie 100mcg T4 is about 25mcg cytomel).
One common protocol is to use 5mcg in am an again at 2-3pm of cytomel. The T4 dose is then decreased by about 40mcg to accomodate the cytomel (provided the TSH is at target on the current T4 dose).
I have seen cytomel prescribed at T4 doses by docs who don't realize it is 4x as potent -- make sure this mistake is avoided.
T3 alone is typically not suggested.
T3 is about 4x as potent as T4 (ie 100mcg T4 is about 25mcg cytomel).
One common protocol is to use 5mcg in am an again at 2-3pm of cytomel. The T4 dose is then decreased by about 40mcg to accomodate the cytomel (provided the TSH is at target on the current T4 dose).
I have seen cytomel prescribed at T4 doses by docs who don't realize it is 4x as potent -- make sure this mistake is avoided.
Ask for Armour Thyroid - it has both T3 and T4 in it. It is MUCH cheaper than Synthroid+Cytomel. I pay about $16 for a 90 day supply at my pharmacy. You regular doctor shouldn't have any problem prescribing it instead of the Synthroid. It also works really well (at least it has for me).