Is it normal/okay to take Cytomel then falling back asleep?

[sissaphus]

I'm new to Tirosint (previously on Levoxyl) and to Cytomel. I've been taking Tirosint and half my Cytomel dose together at 7am. I then fall back asleep until 9 am. Is this normal?

I haven't been sleeping well and wake up frequently during the night to urinate. I always drink water then too which is by the bed. Sometimes I can't fall back a sleep from anywhere from a half hour to a few hours. So I wonder if this is why I can sleep after the Cytomel?

I take my next dose of Cytomel at 11 am or 12pm. I've been mistakenly taking this dose with Copper and Vitamin D, but will start taking them four hours apart based on information I just read on another post here.

Is it normal or okay to take Cytomel and fall back asleep for two hours?

[gimel]

Synthroid probably did not work for you because your Free T3 remained too low in the range.  That could have been due to an inadequate dose, or that you were not adequately converting the T4 med to T3.  Now you are taking only a T3 med, Cytomel,which is not normally recommended unless it is to resolve an unusual problem, excess Reverse T3.  Your Reverse T3 is middle of the range, so I'm not sure why you are taking only T3 med.

At any rate your Free T3 and Free T4 are both too low in the range.  This frequently results in hypo symptoms, such as yours.  The reason your felt better last summer when your TSH was lower was probably because your Free T3 and Free T4 was higher at the time.  TSH itself causes no symptoms.  Free T3 correlates best with hypo symptoms while Free T4 and TSH do not correlate at all.  

A good thyroid doctor will treat a hypo patient 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.  

Before going further, please tell us if you have been tested for the most common cause for hypothyroidism, which is Hashimoto's Thyroiditis.  those tests for Hashi's antibodies are TPO ab and TG ab.  Also please post your Viotamin D, B12 and iron and magnesium test results, along with ranges.  

[muddblues]

hi, I've been on cytomel for several years now and I'm still exhausted.  My dose is 5 in morning and 2.5 in afternoon (around 11:30) but I recently bumped it up to 10 in am and 2.5 in afternoon but I am even more tired.  ?  Not sure what to do but levothyroxine didn't work for me- was sick all the time so I don't want to go back.  any ideas ? Recently labwork
T3 total=83
reverse T3: 21
Free T3: : 2.8
T4:: 1
TSH: 3.59 (was lower last summer when tested and I felt better then)

Note that my vitamin D and B12 were very good as I take both daily but my iron and magnesium were low.

Thanks

[Jada71]

I just recently started Cytomel 25mg, a pretty large dose in addition to Synthroid. My Endo-Specialist said she has never seen thyroid levels so low in all her 30 years of practice.

I fall asleep soon after taking it, no matter what I'm doing and feel like a zombie for the rest of the day. I found a study on Ehealth.com that supported sleepiness, especially in women who were taking Cytomel (85% of women and 15% of men who were taking it experienced sleepiness). These side effects should go away in time. I realize it's been awhile since your post and I hope your situation has been resolved. I just wanted to let you know you aren't alone!
Best Regards,
Jada

[KittyCatCove]

Hi!  I'm not diabetic; I'm not overweight, nor B12 or D deficient.  I was D deficient, which seemed wild to me because I live in Texas and do not shy away from the sun, but have been supplementing D, and it's improved dramatically.  I really was just answering Sissiphus about her sleeping after taking her meds, but I'm giving your split-it-in-half idea a try today.  I'd heard that before, but just REALLY liked the idea of not having to take something twice a day!  I know.  Lazy.  You don't need to assess me, though.  Thanks!  

I guess bump wasn't the right word.  I just meant that whereas I used to wake up unready for the day, I now wake up ready for the day.  That in and of itself is a BUMP.  The fact that I didn't have to wait several hours for alertness to sneak in on kitty cat feet.  I didn't mean to post that stupid post.  I wasn't done editing!  Darn!

Thanks for your reply.  Have a great day!

[KittyCatCove]

Hi!  Eesh.  It sounds like you're having a rough time.  

Eldepryl.  It was 13 years ago.  I don't know what my doctor's impetus was.  But, it didn't work for me!  I remember him saying not to be put off because the name sounded like it was for the elderly.  I think it WAS for the elderly.  Weird.

Are you sure your mouth sores aren't canker sores - not herpes?  Herpes rarely occurs inside the mouth, but I'm no doctor.  I, too, get huge sores in my mouth when I get dental work, (and other times,) usually at the incision site of the anesthetic.  Just that little hole is enough.  I've tried all kinds of stuff for my mouth sores.  Right now I use this stuff that is only available with a prescription or from the UK - I get it from the UK.  Oralmedic, it's called.  They say to first clean and dry your sore, and then to dab this stuff on it, which will probably burn, and how on earth can you really clean and dry a spot in your mouth, anyway?,  and by the next day it's going away and not hurting.  Only thing is, it's about $12 a pop, delivered.  I've had clusters, so that can add up and I have to keep it on hand, because it takes awhile for it to get here.  But, also, I first put Anbesol or some sort of local mouth OTC anesthetic, like Orajel, on the sore, even if that dilutes the med a little, because I've had enough pain in this life!  Before this I was using Silver Nitrate sticks that I found at Amazon.  I only sought them because I had once had my dentist treat a canker - for, like, fifty bucks - and he just dabbed it with silver nitrate.  Stings like a mother and makes the site hideous - grey-silver - but absolutely hastens healing to a remarkable extent.  I know.  Sounds gross.  The OralMedic is less hideous and stingy, all in all.

Well, sorry to be so chatty.  I'm unaccustomed to these boards.  And, I am chatty.  People feel COMPELLED to tell you what to do, and I guess I'm no different!  Sorry!  Sometimes people just want to be listened to, read, am I right?

I adore cats and have many.  When anyone in our civic club - which I'm not crazy about - asks how many, I say several.  Don't want to get too specific!  But, anyone who loves cats has a good heart and it will serve you well on your path to wellness.  Shouldn't I have my own show?  Do you have a cat now?  My cats have had their own course of ailments and being pains in my butt, bless their hearts, but they keep me happy.

Back to my thyroid-stuff, I like my doctor, and she's just my GP, because she treats me according to my symptoms, not just numbers.  She doesn't disregard my numbers, but, you know...she's been flexible.  I'm getting things done I didn't used to.  I'm glad that you are, too.  I hope that it only gets better.  You are in my thoughts.

Thanks for the kind words about my Momma.  She was a saint.  I miss her.  She had very slight thyroid problems, but you'd never know, because she wasn't one to complain and sincerely seemed content most of her life.  Wish I was more like her, complaining-wise.

Yikes, THAT was long!

Have a great day!

[sissaphus]

Yikes that was long! Sorry :)

[sissaphus]

Hi KittyCatCove,

If your off Label antidepressant was Adderall then I've taken that and fallen asleep too. I'm also diagnosed with ADHD and begrudgingly agreed to try it five days a week for a month. At the time I didn't know my Hashimoto's had made me hypo (I forgot I had Hashimoto's, but a recent medical record mailed to me showed it was diagnosed over 10 years ago and I forgot/didn't understand I had a diagnosis).

I get warm about an hour or two after Tirosint (recently reduced from 100 to 88) and Cytomel 5, and can be in a 71 degrees house without being cold. I wake up at 7, T4 and half my T3, put on socks, get a blanket and go back to sleep. By 9am, I'm warm and ready to get up and don't need socks. I don't know if that's my booste, but I think so. I have two 8 oz cups of coffee when I wake up. I can do with one, but really enjoy coffee. I get excited easily, but am not a high energy person, so maybe I don't get a booste. I use to spend a lot of the day lying in bed and that has improved a lot. I still need a lot of sleep and tend to fall asleep between 10 and 11 pm.

I was initially upset that my doctor wanted to reduce my meds because of TSH at .006, but he let me stay on my dose for over six months to see if my TSH would go up. Which I appreciate, but it didn't so he reduced my T4 from 100 to 88 last month and I'm feeling fine still. Maybe even better, but I don't know how much of that has to do with summer approaching and warmer weather?

I'm ill now and have recently had a rash on my hand that could be Derrmatitis Herpetiforms (unconfirmed). That's mostly gone away, but I now have oral herpes (inside my mouth) since going to the dentist for a temporary crown. The same thing has happened the last three times I've had dental work since becoming hypo.

But now I think less of my "illnesses" are related to my thyroid as my body has finally gotten some of the T3 it was missing. Cytomel has helped me a lot I think. As for your case, I'm glad you're taking both T4 and T3 at this point and that it's helping you too.

Also check those vitamins as Barb said. I've been low in B12, D, Iron and Copper. All of which can affect your energy levels.

I like your name too as I lurv cat's. My late cat was named Sissaphus and we called her Sissy!

Your late mother's name, Narcissa, is very beautiful.

[Barb135]

I'm not sure what caused the "switch" to go off when you suddenly felt better, after taking the synthroid for one day, because it takes synthroid 4-6 weeks to build in your system, so it wouldn't work that quickly.

No, I don't feel a "bump" when I take my T3 med in the morning.  I don't get the immediate "high" that many people indicate.  I'm only on 7.5 mcg T3 and I take 5 mcg in the morning, and the other 2.5 mcg around noon.  I still don't get a "bump" from the noon dose, either, but it does help get me past the need to nap every afternoon.

I've been on T3 medication for over 3 years.  Was on it it for several months, before my FT3 actually began rising. FT3 often lags behind FT4.

The idea is not to get a "bump" when you take the medication -- it's to keep your levels steady over the course of the day, so you have neither peaks, nor valleys, just steady energy.

If you're that tired on 25 mcg cytomel, maybe you need to look at other causes of fatigue, such as low vitamin B12 or low vitamin D, diabetes, etc.

It would be  helpful if you'd please post your actual thyroid levels, so we can better assess your situation.  Be sure to include reference ranges, since those vary lab to lab and must come from your own report.  

[KittyCatCove]

I didn't quite get it right.  I went from 50 mcg. of generic synthroid daily to 25 mcg. of Cytomel daily because I'd begun being tired again.  The doctor at first had me stop the Synthroid and JUST take the 25 mcg. of Cytomel.  I took this for a week.  For several days I DID take it first thing in the morning but NEVER got the bump I wanted.  I was extremely exhausted continually.  I got so little done I couldn't believe it.  I stayed in bed a lot.  I then asked my doctor if I could add back half of the Synthroid, and she said: Sure.  And I did.  And the next day, a switch went off.  I was SO much better.  I got SO much done and have ever since.  I often respond differently to things than others.  I was prescribed something for depression years ago, that in hindsight I'm sure had to do with my underactive thyroid, and not the usual Zoloft and stuff you're seeing on TV all the time, something off-label - and was ASSURED it would be stimulating - that everyone who took it found it almost speedy - I slept all day every day for a week on that stuff.  I stopped taking it and didn't try anything else.  I got over that spell, but, that's another story.  Do you feel a bump when you take Cytomel first thing in the morning?  Or do you stay tired for awhile?  Another thing, I don't wake up EXHAUSTED now.  Before      

[Barb135]

Cytomel is T3 med, which is pretty fast acting and doesn't stay in your system for very long... most of us on T3 med find it advantageous to take 1/2 in the morning with T4 med, then the other 1/2 about mid day.

Unlike T4 meds, such as synthroid, cytomel and generic T3 meds do not have to be taken on an empty stomach; they can be taken with or without food.......

If you split your cytomel dose, you might be able to skip the afternoon tiredness.  Recommended not to take cytomel/T3 med after around 3:00 pm, as it may interfere with sleep......

[KittyCatCove]

I know that it's a while since you posted this, but I only just saw it.  Your nickname reminds me of my late Mother, Narcissa who was called Sissy.  I like that.  I started taking Cytomel with Synthroid about a week ago.  I'd been taking 50 mcg. of Synthroid.  Now I take 25 Synthroid and 25 Cytomel and I take them BOTH at about 4 in the morning and go RIGHT back to sleep.  That way when I wake up around 8 I can take whatever vitamins or what have you I want and eat, too.  I have been getting sleepy around noon, but a cup or two of a caffeinated beverage keeps me going until night, or I go ahead and take a brief nap.  Also, I haven't been getting quite enough sleep because I'm busy, and that might well be why I'm sleepy.  I don't sleep very long during the day anymore and I wake up ready to go again.  I don't know if this is RIGHT, but I absolutely feel better than I used to, and that's what matters to me.  I hope that you're doing better now, too.  It's been several months.

[Brucergoldberg]

ouch...   im not switching again for a long time.  im sticking to this naturethroid stuff, if it doesnt work im going to have my thryoid removed and start over.   no more switching for me.  im on a straight path :)

[sissaphus]

Thanks for your reply flyingfool. I think you're right about sleep. I'm tired and sleep terribly. Problem now is that doctor thinks I'm over medicated TSH 0.06, but FT3 below 66% and FT4 just a hair below 50%. I posted my labs and mess I'm in a few days ago, but didn't express in the title enough of what was going on. I just started to feel about 10% better too :(

I'm collecting articles from medical journals that supports my case and I will also look for some about sleep. He mentioned a sleep study during my last appointment to rule out sleep apnea. I have about a dozen hypo thyroid symptoms and he's telling me I've gone to the other side! Very frustrating and sad!

[flyingfool]

I don't know about Cytomel's (T3) effects on sleep patterns.

But I can say that my wife a few months back clearly went hypo again. And she was unable to sleep well.  She can and always could fall asleep before her body heat could even warm the pillow.  But then she reported sleeping like crud.

In fact we have I think determined HER first signs and symptoms of going hypo.  For her about the first sign is her menstral cycle starts to get off track. Both in terms of timing as well as how it will start light for a day or so and then almost go away only to come back again.  The next sign is her fatigue and then even though fatigued and tired she is not able to sleep soundly or good through the night.  One would think that if you are so tired you should sleep like a rock.  Well that apparently ain't so when Hypo. At least not for my wife.

Once her meds were increased she is now back to sleeping more soundly.

So now at least we can look for these signs if they start to show up between blood labs being drawn.

I just thought I'd add this to the sleep quality discussion as it relates to Thyroid and what experience I've seen.

Bottom line is that being hypo no matter how tired you feel may result in not sleeping soundly. So it may not be a reaction to a medicine, it can actually be a sign of being UNDER medicated not over medicated.

[sissaphus]

I don't feel hijacked, but sometimes people just read the original question and then reply and in that case they wouldn't see yours (or others) and you'd get more traffic on a new one.

Getting your labs will help you figure out where you're at level wise.

Do you think your sensitive to any fillers in naturethroid? I switched from Levoxyl to Tirosint because of the fillers.  I use to have itchy shin and even got cellulitis on my shins in April, but I was both undermedicated (I believe) and alternating Levoxyl with a dose with a dose other than 50mcg (the one with less fillers). Haven't had itchy shins since not taking the dose with fillers and not since switching to Tirosint. Although I'm now also taking Cytomel and that has fillers.

What do you know, last night I had a horrible sleep, drenching night sweats, but felt cold inside my body and woke up feeling like I was drunk! I also been stressed and have a cold or something since Saturday so maybe that's why.

[Brucergoldberg]

PPS  - i was coming on here to post about this and then i saw this thread, the reason i added to it.

[Brucergoldberg]

wow.  i just saw it was an old post that got kicked up.  love the small tizzle.. Its the most exciting thing that ive seen on here in a long time LOL

ok back to business!   I dont want to hijack this thread and may need to start a new one if you need me to.  I realize i am very hypo still.  I think i may of actually of entered a new galaxy at this point.  I went to my doctor today to get my blood tested as its been 33 days since i started naturethroid (yipee 33 days!)  I am only taking 1/4 grain + 1/16 grain (roughly 19.5 mcg of t4 etc)  but im working my way up.  I am very sensitve to the meds, my ears ring real bad when i take it, and i get very nauseas.

She tested my free t3, t4, tsh and wanted to do a RT3 on me which just impressed the hell out of me.

But I told her one of my main issues is that when i take the meds it makes me very very tired, so i wake up mid sleep (4 or 5 am, i go to bed at midnight and sleep til 9 typically) and it near kills me.  She doesnt have a solution for this, but it is very difficult.  But i must keep pushing forward.  

[sissaphus]

Maybe you're experiencing what LazyMoose suggested about a calming effect? I have woken up on occasion feeling like I've had too much wine without having been drinking, but it's rare and I haven't been able to make any correlation with medicine, food etc.

Well, I hope you get some quality sleep after you take your thyroid med.

[sissaphus]

This post was from mid October, but somehow got kicked up again today with a comment that doesn't seem relevant. Maybe posted in error even?

I thought insomnia would increase when hyper? Great to know that it's increased when hypo since I believe I'm still a bit hypo. I fall asleep instantly, but wake up lots in the middle of the night, but usually fall right back asleep.

Recently I've been taking Tirosint at 7am and Cytomel at 8 am and not going back to sleep after they Cytomel.

You might be on to something about Cytomel calming my bodies need for more thyroid. It's entirely possible. I also feel my body warm up an hour or two after I take it. The same thing use to happen with T4 meds when I was very, very hypo and first treated.

I think eating earlier (before 7pm or at least not after 9pm) has helped a lot getting better sleep and waking up earlier.

[Brucergoldberg]

By the way,  if you feel the same way i do, its not just a slight drowsiness that comes on after taking the meds, its almost like a drunken drowsiness, like you drank too much wine and trying to sleep it off or something.

[Brucergoldberg]

LOVE IT!! You go girls!

I have a similiar issue, maybe its sort of what you are going through.  I take my thryoid (naturethroid) at 4am.  I cannot sleep sound throughout the night.  However at 4 am when i typically wake up to pee, i take my hormone and it hits me like a ton of bricks.  I go back to sleep for the next 5 hours like a zombie.  It actually scary.  I cant imagine taking the hormone and functioning if I were to take it at 9 am.  This has been my biggest challenge.

[sissaphus]

I'm not confused about what I'm feeling. I'm confused about my hypothyroid and since my doctor is not at my beckon call. I come here and seek the help of those who have been/are going through issues with their thyroid.

I'm sorry you've been second guessing yourself you said because of your boyfriend. That must be difficult for you to go through.

I've resolved this issue. In part because of Barb135's help and suggestions. That's why I'm here to learn and get suggestions. I know I can discuss issues with my doctor - thanks for that suggestion.

[Barb135]

Why would say *I* sound confused about what I'm feeling?  I was merely answering the questions of the original poster.  

You are totally wrong about my situation, and I have no idea what you are talking about or why you would come at me like that, because *I* am not the one with the sleep issues, at this point.