Cytomel to Protocol

[GSKED]

Cytomel was added to protocol 4 wks ago 10 mcg daily, I also take 150mcg of levoxyl. My weight keeps going up. I was concerned when I went to the Dr. 4 wks ago I was weighing 185 now I am at 195.I am a 37 year old man and this is very heavy for me. My next visit is not until the end of the month.I will probably be around 200 by then.I am definatley going into a hypo state.Should I stop taking the Cytomel, Is a higher dosage needed for the levxyl or cytomel.need help..

[Mark Lupo, M.D.]

The addition of cytomel to levoxyl without changing the levoxyl dose should not cause weight gain unless it causes a significant increase in appetite.  In that case, it may be best to go back to straight levoxyl.  The TSH should be around 1.0 regardless of the regimen.

[tabtools]

Not qualified to address this fully -- and, anyway more information would be needed. Do so feel for you on the weight issue.

Cytomel is more potent than the T-4 meds.

Depending on how your body handles it, it can be 4 - 7 times more potent.  Thus 1 mcg of Cytomel is equivalent to about 4 mcg (or more) of Synthroid.

Thus, the addition of Cytomel to your medication has upped your dose from 150 to AT LEAST 190 mcg's. (unless you substituted it in?)

It may be reasonable to request additional testing after 4 weeks on the Cytomel to see where your levels are going. My doc tests within 4 weeks whenever I get my T-3 meds increased.

Sometimes T-3 meds can actually lower your T-4 levels, and it is the T-4 med that needs to be increased.  Dr. Kenneth Blanchard wrote about some of these issues in his book.  

[HashiMan]

Hi Maureen,
You may notice the question I posted under Fiztgerald's question, for a friend of mine. You have the thyroid website, plus have done a lot of research yourself.
Could you give your input for the man I'm seeking answers for? They are a young couple and have been distraut over his 8 past Dr.s insisting his symptoms are in his head and all of them keep prescribing antidepressants, instead of trying to get to the bottom of it.
One thing helpful to them is knowing what tests would be suggested by patients with knowlege and certainly Dr. Mark's opinion on this as well. They will be going to a specialized Dr. soon.
Thanks Maureen
(I'm also referring them to your website!)

[HashiMan]

Hey ladies, (Ancientmariner,Chocobabe & Mshypo)
I value your input and pose same request to you all, as I do to tabtools above.
Thanks so much.
(original question I added under Fitzgerald's question)

[tabtools]

Wow! I feel so complimented -- but, I am not certain that I am deserving --

As Dr. Mark would tell you, the initial tests may involve antibody tests, TSH, and the Free's.  It seems that many docs don't do all of these.  There are people who have "central" rather than primary hypothyroidism, and usually a lower T-4 is the tip-off even if the TSH is normal.

TSH is a confusing topic, because there are individual differences.

Actually, I trust the doc here to give you appropriate answers.

Anyone treated for depression should be tested for hypothyroidism, of course. If their symptoms don't resolve, they can be retested in a few months. There are also a list of other disorders that might be worthwhile checking.

The areas where I am definitely not knowledgeable (and the doc would be) are the other endocrine issues that can also contribute to mood issues. Hashiman, I think you have an area of knowledge that I don't -- my philosophy of patients coming together is that someone will have that little nugget that sheds some light -- or that, combined with someone else's nugget, will produce "a light".

[NURSELPN]

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