Insomnia and cytomel

I have a slightly underperforming thyroid and was put on synthroid which made me nauseous, even when the dosage was lowered. So I have now been put on 25mcg of cytomel and am having real trouble falling asleep. My doctor told me to half the dosage but I still cannot sleep and am now taking sleeping pills as well. I usually take the cytomel in the morning and I read somewhere that it can help to take it at night, which doesn't make sense to me. Also don't synthroid and cytomel have different hormones? I also find I am feeling much more irritable which I suppose could be the sleep problem but I'm wondering if it is the medication. Any suggestions from anyone would help as I don't want to have to depend on sleeping pills.

[Smilerdeb]

Cytomel is a T3 medication and Levo is a T4 medication.

Be careful you dont get hyper symptoms on T3 med alone.
I would be going back to your Docotr and asking for Synthroid which is not a generic form of T4 which is what he/she had you on before.
Cytomel can be taken with a T4 med but a lower dose of T3.

[cheadlebeagle]

Unfortunately the synthroid made me feel nauseous even on the smallest dose. Is there another brand in Canada other than synthroid I could try? I'm going to stop the cytomel for a few days and see how I feel and go back to the doctor.

[goolarra]

I don't know about Canada, but there's generic levothyroxine and Levoxyl here, just to name a couple.  Some people seem to have negative reactions to some of the fillers in the drugs, so changing brands can be helpful.

Smilerdeb is correct - Cytomel is T3 only;  Synthroid, Levoxyl and generic levothyroxine are T4 only.

The problem with taking T3 only is that it is very fast-acting and doesn't stay in your system for very long.  If you're just going to take T3, you would have to spread it out over multiple doses throughout the day or you're going to have peaks and valleys.  The other alternative is to have it compounded into a time-release form.

It's doubtful, because of how short a time it stays in your system, that T3 taken in the morning is the DIRECT cause of your sleeplessness.  And you're right, the irritability could be from not sleeping.  If you're fatigued and you're sleeping well, that's a sign of being hypo.  BUT, if your fatigued and not sleeping, then maybe you have very good reason to be tired, and perhaps it's not thyroid-related.

Also, T3 is considerably more potent than T4.  Depending on who you read or talk to, T3 is three to eight times more powerful than T4.  If you're only "slightly hypo", 25 mcg of T3 seems like a lot (disclaimer:  I'm not a doctor!).  When my PCP wanted to try a small amount of T3 with me, she consulted her computer, which told her to put me on 25 mcg, along with the 25 mcg of T4 I was already taking.  I protested loudly.  Not only is that a lot of T3, but usually the ratio of T4:T3 is 4-5:1 as a starting dose.  So, somone on 25 mcg of T4 might try adding 5mcg of T3 to see what happens.

Hope this is helpful.  Good luck.

[Barb135]

I'm on 50 mcg levothyroxine and 10 mcg cytomel daily.  I take the levothyroxine and 5 mcg cytomel first thing in the morning which is 3:30 am for me; then I take the other 5 mcg cytomel at 9:30 am.  I have more energy than I've had in years and I'm even beginning to sleep almost the entire night.  I do start getting pretty tired around 3:00-3:30 pm, but that's ok because I'm home from work by then and I go to bed very early (7:30 pm) so I need to "wind down" anyway.  

I think you need to talk to your doctor and see about an adjustment to your med.  Maybe the insomnia isn't thyroid related; however the I agree that the irritability is probably related to the insomnia.  

[cheadlebeagle]

Thanks for all your advice. I didn't take cytomel yesterday so I'll see how it goes for a couple of days and go see my doctor.

[cheadlebeagle]

I have stopped taking the cytomel about 5 days ago and overall I feel much better and more like my old self. The sleeping is still a bit of a struggle but I feel it isn't quite as bad as it was so I'm hoping to wean off the sleeping pills. I see my doctor next week. Neither synthroid nor cytomel seem to agree with me so I'm not sure what he will suggest next. But I fell much better not taking either.