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Cytomel questions
Hello all! I had a TT 4 yrs ago. It's been a struggle, not once have I felt my hypo symptons disappear. My doctor will only test TSH, as well my endo agrees with this. My tsh as been gradually going up, I just had it tested its 8 now. Three months ago, I believe it was at 6. I know not a reliable blood test but it's all I've got right now. Anyway, my dr called yesterday and told me once again she was increasing my synthroid it's at.150 to .200. I told her I didn't want it increased I already feel bad enough on that high dose. I asked if we could try another approach since increasing my dose has not worked in the past. She's said she is not familiar with armour and told me to stop taking synthroid and perscribed me Cytomel only. I haven't picked up the RX yet but I believe Cytomel only comes in two doses, so she has put me on the highest one. I have ordered a book on how to change from t4 to t3 only treatment. I haven't received it yet. Does anyone have an opinion in this type if treatment I'm a little concerned but willing to give it a try.
Thanks for reading!!
Thanks for reading!!
Just want to point out to you that the half life of T4 meds like Synthroid is about one week. The half life of T3 med is less than a day. So, since you have had a TT and you have stopped your T4 med, and plan to go ahead with the T3 only, please be aware that you cannot get by on T3 only. A minimal amount of T4 is necessary. As a result of your Synthroid dose, you will have a residual amount of T4 that will diminish to essentially zero over the next 6 weeks.
As you are increasing your T3 med, don't be deluded that the effect is going to continue long term. When your T4 level hits rock bottom, you will understand why several of us recommended just reducing your T4 and adding in enough T3 to relieve hypo symptoms. The peak effect from T3 is about 3 hours or so and then it starts diminishing until the next dose. Without any T4 it will be like a mini roller coaster for you. In addition T4 has other benefits as well.
Even though the T4 med alone was not doing it for you, it was likely that your body was not adequately converting the T4 to T3, and the resultant low Free T3 was inadequate. There are many members who have gone through that and been successful by just adding in a source of T3 to our meds. Going to T3 only is almost a last resort for a Reverse T3 dominance problem, which you cannot know you have at this point.
As you are increasing your T3 med, don't be deluded that the effect is going to continue long term. When your T4 level hits rock bottom, you will understand why several of us recommended just reducing your T4 and adding in enough T3 to relieve hypo symptoms. The peak effect from T3 is about 3 hours or so and then it starts diminishing until the next dose. Without any T4 it will be like a mini roller coaster for you. In addition T4 has other benefits as well.
Even though the T4 med alone was not doing it for you, it was likely that your body was not adequately converting the T4 to T3, and the resultant low Free T3 was inadequate. There are many members who have gone through that and been successful by just adding in a source of T3 to our meds. Going to T3 only is almost a last resort for a Reverse T3 dominance problem, which you cannot know you have at this point.
Thank you for the info, I did order that book from amazon, read it in two days. I have started with t3 slowly just taking one tab divided 3x aday I've divided a small amount of my pills in 1/4's. I have no hyper feelings as of yet. (Half in the Early morning and 1/4 at lunch and then another 1/4 at dinner time. I have read stop the thyroid madness as well. I guess no matter what you read there seems to be controversy either way. How is your wife feeling? Is she on t3 only as well. I of course do not have bloodwork to prove I am high rt3, but all my symptoms suggest that. I stay on this t3 and see how I feel, since I was getting more ill every day on synthroid.
Why assume that this member has a Reverse T3 dominance problem when there was no testing whatsoever to confirm that? Without any tests for Free T3, or Free T4 or Reverse T3, I see no probability that the doctor was addressing a high RT3 problem. Experience has shown high Reverse T3 to be the exception, not the rule. No way would I recommend that mango should change her meds and take T3 only, before getting Free T3 and Free T4 tests done. We can always say that she should also get a Reverse T3 test done just to be sure, but realizing that she is in Canada, it will be difficult enough to even get Free T3 and Free T4 tests as the first step. Even mentioning Reverse T3 would probable blow her doctor's mind. LOL
Usually taking T3 only is suggested when a patient has high reverse T3 levels, which my wife has. A website which has suggestions for taking T3 only can be found at www.*************************/dosing-with-t3-only/
If for some reason the link is not readable search these words: "stop the thyroid madness dosing with T3 only" and you should find the information.
A 25 mcg tablet can be used but you want to start out slow. One suggestion is taking 1/4 tablet in the morning and then another 1/4 tablet at noon for 5 days then adding a third dose of 1/4 tablet. Some say to dose 4 or 5 times a day every 3 or 4 hours and others say three times a day is sufficient with another dose at bedtime as long as it doesn't interfere with your sleep.
It is usually suggested to take T3 only on a temporary basis to correct high rT3 (reverse T3) levels for 8 to 12 weeks at which time you could switch to natural desiccated thyroid or a combination of synthetic T4 and T3.
There is also a book available at Amazon which deals with taking T3 only and it is extremely thorough written by a patient who after many years found that T3 only was the only thing that worked for his particular case. The book is called: "Recovering with T3: My Journey from Hypothyroidism to Good Health Using the T3 Thyroid Hormone".
If for some reason the link is not readable search these words: "stop the thyroid madness dosing with T3 only" and you should find the information.
A 25 mcg tablet can be used but you want to start out slow. One suggestion is taking 1/4 tablet in the morning and then another 1/4 tablet at noon for 5 days then adding a third dose of 1/4 tablet. Some say to dose 4 or 5 times a day every 3 or 4 hours and others say three times a day is sufficient with another dose at bedtime as long as it doesn't interfere with your sleep.
It is usually suggested to take T3 only on a temporary basis to correct high rT3 (reverse T3) levels for 8 to 12 weeks at which time you could switch to natural desiccated thyroid or a combination of synthetic T4 and T3.
There is also a book available at Amazon which deals with taking T3 only and it is extremely thorough written by a patient who after many years found that T3 only was the only thing that worked for his particular case. The book is called: "Recovering with T3: My Journey from Hypothyroidism to Good Health Using the T3 Thyroid Hormone".
Ok, well after a long day of working and worrying, I have picked up my RX, I spoke to the pharmacist there but after I stated all of my concerns she looked on line and said I should be fine. She said it's not a common treatment she sees but if I feel strange to call the dr immediately. So I did take 1 Cytomel just to see how I would feel. I haven't taken my synthroid for 3 days because I was feeling so ill. It's been a few hours and I feel ok, not really sure what to expect. I've been reading a book tonight, recovering with t3, interesting read. I will start with the .137 synthroid and 1/4 Cytomel tomorrow. And pay close attention to how I feel. Here in ontario, there is a shortage of doctors and it seems nearly impossible to get a new one, I feel like I'm in the twilight zone sometimes, it's strange not to be able to find a new dr. I'm hoping to find some help through the naturalpath dr I've been seeing, it's hard though, I do not have any benefits (insurance) and have to Pay for those appt 's as well as my Rx's, I had no idea Cytomel was so expensive!! Thank you all for your advice, I will be very careful with my meds and see how it goes. I am very aware that my dr is text book, 'thyroid is simple to treat' attitude. But I do believe she has realized now that t4 only is not working for me and although I do not at this receive proper blood work, I feel like I may be getting somewhere (very slowly) with her. The fact that she even gave me t3 when she has said all along she would never and has never prescribed, it's odd that she would just put me fully on Cytomel without proper bloodwork first. I think she thinks I'm crazy? Or making up my symptoms, but really I have way better things to do, and I told her that on our last conversation. I'm really hoping I will eventually be able to find a new dr. My naturalpath can order bloodwork for me, she will do so my next appt. ugh, I'm ranting, I will stop now, thanks to all of you! And happy thanksgiving!!!!
COMMUNITY LEADER
37.5 mcg cytomel is too much to start with. Most of us start with about 5 mcg and work up as needed. Additionally, most of us find that splitting our T3 med into multiple doses each day works better than taking the whole dose at once. T3 is fast acting and out of your system in a few hours, so if you take it all at once, you get an initial "jolt", then before the day is over you run out and risk crashing.
You might be okay with the 137 mcg and 1/4 of 25 mcg cytomel, but of course, we always have to discourage self-medication. How many of the 137 mcg pills do you have? If you're going to quarter the cytomel tabs, you would only be taking 6.25 mcg/day, which is about right to start and wouldn't need to be split into more than one dose.
What's the reason you haven't been able to get a new doctor? Is it because of your NHS?
You might be okay with the 137 mcg and 1/4 of 25 mcg cytomel, but of course, we always have to discourage self-medication. How many of the 137 mcg pills do you have? If you're going to quarter the cytomel tabs, you would only be taking 6.25 mcg/day, which is about right to start and wouldn't need to be split into more than one dose.
What's the reason you haven't been able to get a new doctor? Is it because of your NHS?
Just a thought for you. I spend a lot of time trying to help members find a good thyroid doctor, per the definition I gave you previously. One of the most successful ways I have found is to call a compounding pharmacy and ask if they will help me find a good thyroid doctor by giving me names of doctors that regularly prescribe T3 type meds like Armour thyroid or Cytomel. That usually turns up 2 or 3 names. Then I call those doctor's offices and mention that before making an appointment for treatment of hypothyroidism, I'd like to ask someone a question. Then I ask if the doctor is willing to treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, rather than treatment based on TSH. If the answer is no, then I keep on looking.
Yikes! I feel nervous now! Cytomel strength is 25mcg. Instructions are to take 1.5 pills aday. I have tried 6 times to no avail to get a new dr. It's really tight here in London ontario. I am picking up my script after work today, maybe the pharmacist will have some suggestions?? I went to a compounding pharmacy here and the pharm there wasn't very helpful. I'm going to a naturalpath as well she is trying to get me a referral to a new endo, with no luck ATM. Maybe in the mean time since I'm feeling so down, I will quarter my t3 and use up my .137 t4 script that I have from awhile back. And keep digging to find some new help. We so have walkin clinics here but I don't know how helpful they could be. Thanks for replying I will keep you all posted.
Here is my suggestion. Find a compounding pharmacy in your city. Go there and ask the druggist for a list of doctors names who prescribe ERFA Thyriod (which is the Canadian version of Armour). Ask the druggist which doc that they would go to ( i.e. which one do they think is best).
I would not go on T3 only...
I would not go on T3 only...
Yikes. Though some people do have luck doing just a T3 med, it has to be very carefully monitored and often started low, slow, and steady. Even if you add in a little T3 while staying on a T4 med, you still need to start slow. Do you have any way of getting new doctors? You need to be checked for more things than just TSH.
COMMUNITY LEADER
Your doctor obviously is not knowledgeable about how to tread a thyroid patient. You should find another asap.
Your body needs both T4 and T3. Stopping the T4 med and going only to cytomel is very dangerous, especially, if she put you on a high dose of cytomel. Cytomel comes in 5 mcg, 25 mcg and 50 mcg pills. We need to know what dosage she prescribed.
While it's very common to add cytomel (or generic T3) to a dose of T4 med, it's almost unheard of to put a patient on "only" T3 med. It's also bordering on malpractice to prescribe a T3 med, without testing Free T3 and Free T4 levels.
I'm sorry, but this scares me to death. Giving you a high dose of cytomel with no T4 med is a recipe for disaster. Unlike T4 meds, T3 is fast acting and a dose that's too high can send you hyper in a very short time.
You should call your endo immediately and talk to him/her about this. If s/he agrees, then find different doctors. You also need to insist on getting the Free T3 and Free T4 tests done. Trying to treat by TSH alone is like shooting at a moving target. Both of your doctors are doing you a huge disservice.
Common protocol when one is on a T4 only med and symptoms are not relieved is to add a small amount of cytomel (T3 med), typically, starting with 5 mcg. Protocol also calls for decreasing T4 med by 25 mcg for each 5 mcg of T3 added. T3 meds should always be started at the lowest possible dosage and worked up very slowly, as needed to alleviate symptoms.
Please talk to another doctor before switching, completely, to a T3 only med.
Your body needs both T4 and T3. Stopping the T4 med and going only to cytomel is very dangerous, especially, if she put you on a high dose of cytomel. Cytomel comes in 5 mcg, 25 mcg and 50 mcg pills. We need to know what dosage she prescribed.
While it's very common to add cytomel (or generic T3) to a dose of T4 med, it's almost unheard of to put a patient on "only" T3 med. It's also bordering on malpractice to prescribe a T3 med, without testing Free T3 and Free T4 levels.
I'm sorry, but this scares me to death. Giving you a high dose of cytomel with no T4 med is a recipe for disaster. Unlike T4 meds, T3 is fast acting and a dose that's too high can send you hyper in a very short time.
You should call your endo immediately and talk to him/her about this. If s/he agrees, then find different doctors. You also need to insist on getting the Free T3 and Free T4 tests done. Trying to treat by TSH alone is like shooting at a moving target. Both of your doctors are doing you a huge disservice.
Common protocol when one is on a T4 only med and symptoms are not relieved is to add a small amount of cytomel (T3 med), typically, starting with 5 mcg. Protocol also calls for decreasing T4 med by 25 mcg for each 5 mcg of T3 added. T3 meds should always be started at the lowest possible dosage and worked up very slowly, as needed to alleviate symptoms.
Please talk to another doctor before switching, completely, to a T3 only med.
OMG, your doctor has no clue about proper testing and treatment. TSH is totally unreliable as a diagnostic by which to medicate a hypothyroid patient. Since you are still feeling bad while taking 150 mcg of T4 likely means that you are not adequately converting the t4 to T3, resulting in Free T3 level that is too low. Since Free T3 correlates best with hypo symptoms, that would account for you still having hypo symptoms. Next, Cytomel is something like 4 to 5 times as powerful as T4 meds, so switching you to T3 only is totally wrong.
In summary, you need to run, not walk, away from that doctor and find a good thyroid doctor. By that I mean one that will treat clinically, by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results, and especially not TSH.
Under the National Health Service, what options do you have available for finding another doctor?
In summary, you need to run, not walk, away from that doctor and find a good thyroid doctor. By that I mean one that will treat clinically, by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results, and especially not TSH.
Under the National Health Service, what options do you have available for finding another doctor?
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