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Occasional T3 use?
I recently consulted the partner of the Endo I normally see, because I continue to feel wretched on even a small dose of T3
I had an immediate rapport with this woman and could tell she really wanted listen and was more concerned about how I was feeling than anything else.
Her proposal is that I remain off T3 for the time being, increase my Levo from 100mcg to 125mcg, go back in a month for a review. Then we will look at possibly increasing my Levo to 150mcg (I used to take 175mcg in the good old days where everything was fine from one year to the next) and/or increase my bio HRT (I'm on a really small dose). Certainly when I first started my HRT, all the thyroid problems righted themselves (albeit temporarily). Anyway, she wants to make changes one at a time.
She also said - and here's my question - if the above doesn't work, then adding back a small dose of T3 a couple of times a week might be an option. I've done a quick search but haven't found anyone using it this way.
Does anyone have any feedback about this approach?
I had an immediate rapport with this woman and could tell she really wanted listen and was more concerned about how I was feeling than anything else.
Her proposal is that I remain off T3 for the time being, increase my Levo from 100mcg to 125mcg, go back in a month for a review. Then we will look at possibly increasing my Levo to 150mcg (I used to take 175mcg in the good old days where everything was fine from one year to the next) and/or increase my bio HRT (I'm on a really small dose). Certainly when I first started my HRT, all the thyroid problems righted themselves (albeit temporarily). Anyway, she wants to make changes one at a time.
She also said - and here's my question - if the above doesn't work, then adding back a small dose of T3 a couple of times a week might be an option. I've done a quick search but haven't found anyone using it this way.
Does anyone have any feedback about this approach?
Best Answer
COMMUNITY LEADER
I really do think you were started on too high a dosage of T3 med and for some reason your body is just not tolerating it, at this point. Have you thought of trying a dessicated medication that's a T3/T4 combo? Some people who haven't done well on synthetics, do great on those. I'd suggest that you insist on starting at a very low dosage, testing at 5-6 week intervals and increasing meds VERY slowly.
Well, I called for an appointment and the original Endo was on holiday til the end of January, so she didn't get a choice ;-) Serendipitous....I have a much better rapport with the new woman
COMMUNITY LEADER
Yes, I do recall, now, that you were seeing that partner. Does that work okay with the original doctor? The medical practice I was with really frowned on patients switching over to a partner.
Good luck.........
Good luck.........
FWIW I'm now seeing the partner of the woman who started me on 20mcg of T3.....hindsight and all that!
COMMUNITY LEADER
Since you are only taking 5 mcg cytomel, once/day is fine, if that works for you. I'm on 5 mcg, also and I only take it once/day, a couple hours after I take my Tirosint. As I said before, I don't get the rush most people get from T3 med, so it takes longer to work for me, which makes it last later into the day.
Why not post your new labs when you get the results, so we can see where you're at. Sounds like you might need an increase in med(s).
Valdab - I agree with your doctor making gradual changes - too bad she didn't do that with the cytomel. Really, I don't think you'd be having all this trouble if you hadn't started such a high dose of T3 med.
Why not post your new labs when you get the results, so we can see where you're at. Sounds like you might need an increase in med(s).
Valdab - I agree with your doctor making gradual changes - too bad she didn't do that with the cytomel. Really, I don't think you'd be having all this trouble if you hadn't started such a high dose of T3 med.
We need to see your labs.
While not impossible. It seems most people when a Dr finally adds in a T3 med it is usually after a fairly moderate to high dose of T4 meds.
You taking only 50 mcg a day is barely more than a starter dose of T4. So to add in the T3 med @ 20 mcg seems like a high starter dose of T3. At least to me. Maybe it makes sense. But is hard to tell without labs.
Some people can tolerate starting out at 20 mcg of T3. But I would say they are the exception not the rule. Many times people starting a T3 med will start out with 5 mcg and maybe even splitting that to half in the morning and half in the afternoon. So a 1 time shot of 20 in the afternoon would be common for people to feel a little weird.
While not impossible. It seems most people when a Dr finally adds in a T3 med it is usually after a fairly moderate to high dose of T4 meds.
You taking only 50 mcg a day is barely more than a starter dose of T4. So to add in the T3 med @ 20 mcg seems like a high starter dose of T3. At least to me. Maybe it makes sense. But is hard to tell without labs.
Some people can tolerate starting out at 20 mcg of T3. But I would say they are the exception not the rule. Many times people starting a T3 med will start out with 5 mcg and maybe even splitting that to half in the morning and half in the afternoon. So a 1 time shot of 20 in the afternoon would be common for people to feel a little weird.
Thanks Barb135; I did mention desiccated to my Endo but she said she wanted to first increase my Levo, then tweak my HRT and then take things from there. She wants to introduce very gradual changes.
Certainly starting on 20mcg of T3 seems to have done me no favours at all. I wonder if I'd be having these problems if I'd started much more slowly.
camarcocarol - sorry to hear you're struggling; I hope your energy increases and depression lifts. This is becoming the most frustrating condition I've ever encountered - I've been really depressed to and it makes tackling the thing so much harder. Most frustrating is having to wait such a long time to see the results of changes in the T4 meds.
Last night had a major panic/tachycardia attack - only lasted about 5 minutes, but it was terrifying. Symptoms seem to come and go for no obvious reason.
Thanks to everyone for taking the time to share their wisdom
Certainly starting on 20mcg of T3 seems to have done me no favours at all. I wonder if I'd be having these problems if I'd started much more slowly.
camarcocarol - sorry to hear you're struggling; I hope your energy increases and depression lifts. This is becoming the most frustrating condition I've ever encountered - I've been really depressed to and it makes tackling the thing so much harder. Most frustrating is having to wait such a long time to see the results of changes in the T4 meds.
Last night had a major panic/tachycardia attack - only lasted about 5 minutes, but it was terrifying. Symptoms seem to come and go for no obvious reason.
Thanks to everyone for taking the time to share their wisdom
I only take my cytomel once a day...my dr has never told me to take it twice a day,im on a very low amount..5mcg..started a new generic version today and very scared about i,im on 50 mcg of synthyroid and my hormone pills,plus femring.had new lab done on the 12th waiting for the results. Im not having much energy and feeling depresed again.
If you're getting wired from 1/3 of a 5 mcg pill, I have to wonder if T3 is the proper medication for you
I think you might be right. My next step was to give up caffeine I only drink three cups of tea a day and I'm very reluctant to stop (take my wine, take my chocolate, take my bread, but please don't take my tea LOL).
Oddly enough when I first went on T3 (I was started at 20mcg daily) it took almost a month before I started to feel wired. Now I can't seem to take even 2.5mcg. I have read of people sticking with it and adapting to its effects, so maybe I should hang in there.
Does anybody know of any viable alternatives? I first consulted my Endo because T4 alone wasn't really working for me, so I suspect I will need to find something. Unless she's right and the HRT increase will help.
I think you might be right. My next step was to give up caffeine I only drink three cups of tea a day and I'm very reluctant to stop (take my wine, take my chocolate, take my bread, but please don't take my tea LOL).
Oddly enough when I first went on T3 (I was started at 20mcg daily) it took almost a month before I started to feel wired. Now I can't seem to take even 2.5mcg. I have read of people sticking with it and adapting to its effects, so maybe I should hang in there.
Does anybody know of any viable alternatives? I first consulted my Endo because T4 alone wasn't really working for me, so I suspect I will need to find something. Unless she's right and the HRT increase will help.
COMMUNITY LEADER
From http://www.drugs.com/pro/cytomel.html
"Since liothyronine sodium (T3) is not firmly bound to serum protein, it is readily available to body tissues. The onset of activity of liothyronine sodium is rapid, occurring within a few hours. Maximum pharmacologic response occurs within 2 or 3 days, providing early clinical response. The biological half-life is about 2-1/2 days."
I don't get the immediate rush that a lot of people seem to get from T3 med and when I first started taking it, it took about 4 weeks for my FT3 levels to start rising; so while it's fast acting, there still could be some residual, but I'd still think you'd need to take it more than twice a week. I would think, no less than every other day, but that would depend on the dose. If you're getting wired from 1/3 of a 5 mcg pill, I have to wonder if T3 is the proper medication for you.
"Since liothyronine sodium (T3) is not firmly bound to serum protein, it is readily available to body tissues. The onset of activity of liothyronine sodium is rapid, occurring within a few hours. Maximum pharmacologic response occurs within 2 or 3 days, providing early clinical response. The biological half-life is about 2-1/2 days."
I don't get the immediate rush that a lot of people seem to get from T3 med and when I first started taking it, it took about 4 weeks for my FT3 levels to start rising; so while it's fast acting, there still could be some residual, but I'd still think you'd need to take it more than twice a week. I would think, no less than every other day, but that would depend on the dose. If you're getting wired from 1/3 of a 5 mcg pill, I have to wonder if T3 is the proper medication for you.
well I did question her quite closely about T3 as I wanted to try to establish why I felt so wired about 8 hours after taking it. She confirmed that it is very fast acting but says some of it stays in the body longer. She then touched on the interaction of the thyroid hormones and the HRT I am taking, but it was very brief. I will question her more fully next time I see her.
Interestingly enough, I have been having progressively worsening air-hunger since giving up the T3 (understandable I guess). It got quite bad today, so I took about 1/3 of a 5mcg T3 tablet. Felt 'wired' again for a couple of hours; that has now abated but the air-hunger has gone too. It will be interesting to see how long this lasts.
Interestingly enough, I have been having progressively worsening air-hunger since giving up the T3 (understandable I guess). It got quite bad today, so I took about 1/3 of a 5mcg T3 tablet. Felt 'wired' again for a couple of hours; that has now abated but the air-hunger has gone too. It will be interesting to see how long this lasts.
Just reading one of your other posts...I forgot you were in the U.K. Since T3 meds are not widely used (understatement) in the U.K., I have to wonder how many doctors have any experience whatsoever prescribing them.
Your doctor's suggestion of a small dose of T3 a couple of times a week makes me think that she believes it acts a lot more like T4 than it does.
Ask lots of questions.
Your doctor's suggestion of a small dose of T3 a couple of times a week makes me think that she believes it acts a lot more like T4 than it does.
Ask lots of questions.
It's definitely a bit of an unconventional approach...as in "I never heard of it before", with the usual disclaimers on that stement (I'm not a doctor, just a lowly patient).
T3 is very fast-acting. In order to avoid peaks and valleys in FT3 levels, you have to take it more than once a day. So, I can't quite see the logic of taking it a couple of times a week. It might make you feel better for a few hours, but it's not going to help the rest of the week.
I'd ask more questions, and I'd love to hear her response...
T3 is very fast-acting. In order to avoid peaks and valleys in FT3 levels, you have to take it more than once a day. So, I can't quite see the logic of taking it a couple of times a week. It might make you feel better for a few hours, but it's not going to help the rest of the week.
I'd ask more questions, and I'd love to hear her response...
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