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Cytomel
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Cytomel

Diagnosed with Hashimoto's a few years ago.  Am now taking 88 mcg of Synthroid.  I'm in the normal range.  Doctor just put me on Cytomel for insomnia and fatigue.  For several days I felt awesome for the first time in years but am but I am starting to feel even more awful then I first did.  Could the Cytomel dosage be too high?  Has anyone ever experienced this.  I'm almost tempted to start cutting my pills in half to try to see if a lower dose helps like it started to.
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Avatar_m_tn
Please post your thyroid test results and reference ranges as shown on the lab report.  Also, please look at this list of 26 typical hypothyroid symptoms and tell us which ones you have.

http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html
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Avatar_n_tn
I just want to know if anyone has had the same with Cytomel.  I don't have all that info available at the moment.
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499534_tn?1328707778
Hi there!  How high is your dosage of cytomel that you are taking? Are you splitting that dosage in half and taking half in morning with the other half in the afternoon?
Cytomel is very short acting and needs to be split. I split mine and take first thing in AM with my T4 med and then take the other half around 5-6 hours later. I crash and get very fatigued in the afternoons if I forget to take it.
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Avatar_n_tn
I'm taking 25 mcg of Cytomel.
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Avatar_n_tn
I'm taking 25 mcg of Cytomel.
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Avatar_m_tn
That 25 mcg of Cytomel is about the same as taking 100 mcg of Synthroid.  It is far too large of a increase.  Your doctor doing that tells me that he really doesn't know enough about diagnosing and medicating a thyroid patient.  

Without knowing anything about your lab test results, we can't be sure of what your meds should be; however, I do know for sure that you should not be increasing your meds that much all at once.  Even if 25 mcg were the best final dose, you would need to start at about 1/4 of that amount and increase only after you acclimated to the change and evaluated the effect on your symptoms.
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Avatar_m_tn
Interesting the Dr put you on Cytomel for fatigue and insomina.  Both of which are consitent with remaining Hypo.  In actuality the Dr was just increasing your Thyroid medication with the addition of Cytomel because your symptoms indicated you were still Hypo.

Gimel is 100% right.  25 mcg is a HUGE dose to just jump into.  More common starting is 5 mcg.  And as pointed out.  due to the short half life of a T3 medication which is available for use by your bodiy immediately.  It is often split and taken in two or even more doses in a day.

You mention you are "in the normal range".

My question is:  Normal range of what?  TSH, Free T4 or Free T3's???  I suspect it was only TSH which is TOTALLY insufficient to be used for tweaking out dosages.  TSH is a screening tool at best.

You really need to have your Free T4 and Free T3 tested.  That is really were the rubber meats the road.  Many people find that they have to disregard TSH and rely upon the two free tests.  They find that they need to be in the MIDDLE of the range if not slightly above for Free T4 AND (that means in addition to) their Free T3 to be in the UPPER 1/3 of the range in order to obtain symptom relief.  Simply being "somewhere" within the ranges for each is NOT sufficient.

When taking any Thyroid med and seems especially true when taking a T3 medication such as Cytomel, that TSH can be suppressed.  Meaning that TSH result goes very near zero.  Dr's will panic and take you off medications thinking that you are Hyper.  However you can remain HyPO even with a TSH near zero if the medication is suppressing TSH.  That is why it is vitally important to have the Free T4 AND Free T3's tested.

You have to be aware of HyPER symptoms so you know what to recognize if you're taking T3 medication like Cytomel.  Or any Thyroid medication for that matter.  

The fact that your Dr is medicating you on symptoms is actually a good sign since he was willing to go beyond just the "normal range" test result you were having.  I think however your Dr may have over did it with the amount of Cytomel prescribed.
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Avatar_n_tn
Yes, I am in a normal range for TSH.  That's the only thing my old doctor would check.  This one will be checking everything and he is willing to treat by my symptoms also, so I'm making some improvements.  My doctor put me on Cytomel and will be checking my other levels before I go back.  I thought that it was odd that he didn't check all my levels first and then put me on Cytomel after he knew my numbers.  I may try splitting and only taking half the dosage.  I had an appointment to go back in but his office called and he won't be there that day so I have to reschedule.  Made me mad since I can't stand waiting when I need relief from my symptoms.
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1202943_tn?1347844252
I agree that 25mcg of cytomel is a lot. Did your dr decrease your synthroid?

I added 5mcg of cytomel twice a day and decreased my synthroid from150 to 137. At first I felt better, but after a week my I felt awful & I had a constant headache. Many people are very sensitive to T3 meds especially if you've been hypo for awhile.  I had to back down to 2.5mcg twice a day for about 2 weeks and then increase slowly.    
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