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Cytomel vs Synthroid
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Cytomel vs Synthroid

Had a TT on 7/21 and the week following the surgery I was on Cytomel (incase I needed RI).  I had no joint pain in my hips that whole week.  I started back on synthroid and am noticing it.  I was wondering if anyone else has noticed this.  

Also, for those who have tried or know of both...what is the difference?  Which do you prefer?

Lastly. could the hip joint pain be from an incorrect dosage?  I thought it was just joint pain so it suprised me when it was completely gone the week after my TT surgery.

Thanks so much for any help you can provide.  
Tags: get better, cytomel, Synthroid, Joint Pain
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17 Comments Post a Comment
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649848_tn?1357751184
Cytomel is a T3 only med; synthroid is T4 only med.  They are totally different from each other.  

When taking a T4 med, the T4 has to be converted to the usable T3, when you take a T3 med, that's what you are getting and as soon as you take the pill, it's available for use, with no conversion or anything.  

Some people do notice more aches/pains if their FT3 is not high enough.  

Do you have recent lab results, along with reference ranges, that you could post to let us see where your results fall within the range?  That would help us comment more fully on your situation.

BTW -- I take the generics of both cytomel and synthroid; and if my levels get too low, I go hypo (as I am now) and have a lot more aches/pains.
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499534_tn?1328707778
Barb- How are you doing on the generics?  My Dr is very against the generics so I take the brand names only.
However I really switched to Tirosint with the Sytomel and so far love the Tirosint.
I feel "clearer" ...lol.....I know probably sounds goofy, but i am definately feeling a difference.

Ralfina- As Barb stated....both meds are completely different hormones. You definately need to have some labs done. Please make sure you ask for Free T4, Free T3 and TSH. Dont let them try to do the Totals instead of the Free's.
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393685_tn?1325870933
These meds "should" be used to compliment each other to find complete wellness. Althrough rare... T3 Cytomel can be used only but its not thyroid protacol in the large medical practices.

T4 treatment alone is common due to its "conversion " defination but many find that they can not completely adjust to it alone to feel their best.

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649848_tn?1357751184
I'm actually doing better on the generic levo than I did on synthroid; I can't tell a difference with the generic liothyronine (Cytomel).  

I'm happy to hear that you are on the tirosint; I downloaded info on it last week and faxed to my endo, in hopes that he will let me try it when I see him on Tues.  

Because of astronomical stress I've been under most of this year, and particularly, this summer, I'm hypo again, so if my endo will give me a script for the tirosint, I'm really hoping it works.  

Laura, did you start the tirosint at the same synthroid dosage you were on? I'm excited to try it.
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Avatar_m_tn
After my TT and conclusion that no RI was needed they took me off the cytomel and put me back on Synthroid .150 mcg.  That is what I was on before the surgery.  So, they said to give it 12 weeks and then they would rerun the labs and see how my body has adjusted.  I feel very "heavy" if that is a good way to describe it.  I am kind of bummed I have to wait the 12 weeks to find out where my body has settled with the current dose and no thyroid anymore.  I'll survive and I don't want to mess with it these 12 weeks cause I do want to see right where my body truly is on this dose so we can go from there.  I don't even know what to ask them.  

So, reading the others posts...some people take both Cytomel and Synthroid in combination?  Also, what is the Tirosint?  

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393685_tn?1325870933
Tirsint is a new hypo-allergic T4 synthetic thyroid hormone medication. Its sounds promising and Laura decided to use it to see. She is very sensitive to meds. She is on Cytomel also however.

It is the most known form of taking thyroid hormone when doing a synthetc combination. Synthroid and Cytomel are commonly prescribed together and rarely is Cytomel done alone.
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649848_tn?1357751184
Tirosint is a T4 med that comes in gelcap form.  According to my research, the absorption rate is supposed to be better than with the tablets, the dosage is supposed to be more consistent (from batch to batch) and it's supposed to be more stable over time.

I see my endo tomorrow and plan to ask for it also.  

I'm also on cytomel but mine is a pretty low dose; only 5 mcg/day, but if I take more, I have heart palps, rapid heart rate, etc.

We are all so different that it's not unusual for us to react differently to a given med.  I am sort of surprised that your doctor put you on such a high dose of synthroid right off the bat, then isn't testing for 12 weeks.  It's usually best to start out at a much lower dose and work up slowly; usually retesting every 5-6 weeks, since that's about how long it takes to get the full effect of a dosage change.  Admittedly, it takes longer to get to the "feel good" level, but often we get there more safely.  

Are you tolerating the dosage well?  I think that much all at once would have sent me over the edge.  
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Avatar_m_tn
I was on Synthroid .150 mcg for like 6 months prior to finding out all this nodule, cancer, surgery etc.  I think that is why he put me on that dose, he said he was gonna keep me where I was, give my body 12 weeks to adjust and then run the labs and see where my body will fall without the thyroid helping the meds.  Is that not the norm?  I have never questioned these things, but now my curiousity is perked because of not having that hip pain for the whole week after surgery and I went off the cytomel and back to synthroid and BOOM it was back,

Note:  I only took the cytomel for one week post op and I did that in case the pathology showed cancer that needed the RI.  Mine was very small and they all said the TT was the treatment and no RI was needed, so that week after he put me back on the current dose of synthroid I was on.  I am anxious for October to see where it's all at now.  

That tirosint sounds very promising.  I wonder if it's hard to get insurance to cover it unless medically necessesary.  

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Avatar_f_tn
When I take Synthroid I had horrible joint aches but as soon as I switched back to dessciated which contains T3 & T4 the aches go away.  I also have it to a lesser degree when I am not taking enough dessicated.  It is a balancing act for me. The reformulated armour works better than reformulated Nature Throid and ERFA works better than both of those.  I've switched to ERFA now and loving it.
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649848_tn?1357751184
Now I understand better why you were put on that high a dosage; however, I guess I still think it's to high to start with, even if you had been on it before.  I was at 150 at one time, too, but if my doctor were to jump me back to that all at once, I don't think I'd tolerate it too well.  

A lot of us taking a T3 med, whether dessicated or cytomel have less pain/aches than when just on the T4 med.  

I saw my endo this morning and got a script for the tirosint.  I'm going to take it to the pharmacy after work which is just a few minutes from now.  I will let you know about the insurance.  There is no generic for it, so if the doctor prescribes it, I don't see how they can not allow it, but stranger things have happened.  Will let you know.
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649848_tn?1357751184
I took the script for the Tirosint to my pharmacy after work; they didn't have it in stock, but will get it in tomorrow and I can pick it up after work and begin taking it on Thurs.

I had them check the cost; it will be $27 and change for a 90 day supply.  That's equivalent to what the synthroid was when I was on it.  My generic levo is $2.58 for 90 days.  

I do have insurance and apparently, there was no issue with it.
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Avatar_m_tn
Wow, that was totally foreign to me.  LOL  What is "dessicated"  "ERFA" and "Armour".  Are they all prescriptions you would get instead of synthroid.  

After reading these I am thinking I need something with T3 and T4 or a combo and that might help the joint pain.

Thanks so much to everyone, you all have been such a big help!
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Avatar_m_tn
I am anxious to see how you do on the tirosint.  If it is just a T4 like Synthroid is then I am thinking that might not help my joint pain.

I am not sure about the .150 mcg, I am guessing since I needed that much before the thyroid was removed they figured I'd still need at least that high of a dose???  I have been taking synthroid for 10 years now.  I was on .137 mcg for years and then this past year leading up to the TT my blood work changed drastically.  I am assuming it was the Hashimoto's, Severely enlarged gland and the 3.8 cm nodule on my isthmus.  So, I am really anxious for October to see where I am at and try something to help with the joint pain.  

Also, 12 weeks is the recomended time frame for the thyroid meds to fully take effect correct?  

Thanks again for you help.  
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Avatar_f_tn
It is like a foreign language.
dessicated = dried pig thyroid that contains T4, T3, T2, & T1 (been around for over 100 years and is considered old fashioned by newer docs.
ERFA = dessicated version sold in Canada
Armour = dessicated version sold in the US.  Worked wondered for many years for many poeple but was reformulated last year and does work as well now.
Nature-Throid = dessicated version also sold in the US.  Many people switched to it when Armour was reformulated.  It was reformulated this year and same problems developed

Usually 2-3 months for labs is normal for T4 medicine.  It takes a while to build up in the blood.  If it is a T4/T3 medicine often you don't have to wait as long as the T3 is fast acting.  I think the half life for T3 is 4-5 hours.  For T4 it is 7 days I think. I can tell a difference immediately on the dessicated medicines.

Good article = http://thyroid.about.com/b/2009/01/27/the-desiccated-thyroid-controversy-why-endocrinologists-dont-like-armour-thyroid.htm.
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649848_tn?1357751184
I agree with everything Emmy said about the dessicated med.  For most of those, it seems that ERFA is doing the best.  

T4 med, does take a while to build up, but it's figured that you will get the full effect in 5-6 weeks; then you should retest to see where your levels are.  Until your levels are stable, I would not recommend that you go more than 5-6 weeks between blood tests.   I was dx'd in 2008; however, it's just this year that I've been allowed to go longer than 6 weeks between labs.  I'm only now starting on 12 week labs.

It's true that T3 gets into your system faster and is gone within a few hours; however, even at that, I was on cytomel for a couple of months before my FT3 levels actually came up, in spite of the fact that I could tell a difference in the way I felt.

The idea with the Tirosint is that it's a gelcap and the absorption rate is supposed to be a lot higher than tablets.  Assuming (not always good, but bear with me) that you get better absorption, and your conversion is adequate, it could very well help your joint pain (if it increases your FT3 levels).

The problem could come in if you don't convert the T4 to T3 adequately; then you would need a T3 med, either in the form of cytomel (synthetic T3, that I take) or a dessicated that has both T4 and T3.  I think they are equally good.  One thing I like about the synthetics is that I can control the amount of each hormone better.  I can take xx amount of T4 and xx amount of T3 and if levels of one or the other go too high/low, I can adjust them individually; whereas with the dessicated, you "take what you get".

I seriously considered going to dessicated until the reformulations; I decided that I was better off with the synthetics, but those on dessicated do very well also, and knowing how different we all are, I would never discount either form of med.

I did pick up my Tirosint today and will begin it tomorrow.  I'm really anxious to see how it's going to do..............  BTW - I've been on 88 mcg levo + 5 mcg generic cytomel (I don't seem to convert well) for the past 8-10 months...........  As of tomorrow, I will be on 100 mcg Tirosint + 5 mcg generic cytomel/day...........  
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Avatar_m_tn
Do you need your thyroid gland to convert the T4 into T3?  Do you still have your thyroid gland?  I am gonna ask about the tirosint and the desiccated and see what my endo says at my next appt.  I hope she'll be open to trying something new for me or a combo because this joint pain hurts pretty bad.  :(  
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Avatar_m_tn
Thanks so much for the info.  I read that article too.  It's so disheartening to know Dr.'s can be such douche bags.  That is fine if they have a preference but when it's not working for someone, then come on...do what you can and try other ways to help them.  

I am just nervous after losing my gland and then the joint pain coming back that things won't get evened out for me and I'll be stuck like this.  Not to mention I feel like I am for real ready for bed at like 4:00 pm and was not that bad before.  I know I could still be feeling the effects and body adjusting to the thyroidectomy.  I am just about one month post op.  

I am gonna talk to my Dr. about these things.  I also changed my appt to another Dr. in the office I go to because I have lately been seeing a Doctor's Assistant or something, just below a Dr. and I heard great things about another Dr. in there so I want to speak to a real Dr., no offense to the other one or whatever she is.

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