Cytomel and muscles constricting?

[DVS1956]

I am wondering if any one else gets shoulder blade and neck muscles constricting (drawn up so tight and can't get them to relax) while taking Cytomel as well, not being able to sleep good, shortness of breathe too? I had to cut my pill in half to take only half of a 5 mcg. pill. My doc wanted me to take 2 x 5 mcg - I can't or at least I need to titrate very SLOWLY?

[DVS1956]

That article is good for the Armour, but have you not heard about the shortage of natural desicated T meds....not available...so that won't help either of us at this point to try it.

My doc said she wanted me to go on it, and I was to afraid to. Also, I forgot to mention to her about the waiting list for pharmacies to get it...and now I have read its not available and people are having to go onto Synthetic meds.....what a jolt for them.

How can we not have blood work done and know how much T4 and T3 med to take? We may get to much or not enough? Just like that girl in his office. Tweaking Cytomel is a scary thing to me.....since I had to stop and restart at a low dose without having muscle spasms so bad and moodiness! Today I  had to take my second half pill earlier...since my symptoms started up again. So I have no idea how to work with Cytomel....scary to me!

I swear this is such a roller coaster ride and I am getting so tired of it all! Can't stay on an even keel. One doc told me if it continued like this, he was going to take my thyroid out for a solution to the Hashimoto's....that about scared the **** out of me too! They say to keep it as long as you can..just like your female organs. I just wonder if  one was to remove the T gland, would it be easier and less of a roller coaster ride with Hyper/Hypo symptoms?

Thanks, didn't mean to go on and on!

[punkin284]

Read this article about how blood work is of no use for someone with Hashimoto's I too have been diagnosed with Hashimoto's and just recently read this article and thought it would be helpful and made alot of since
http://thyroid.about.com/gi/dynamic/offsite.htm?zi=1/XJ&sdn=thyroid&cdn=health&tm=30&gps=167_604_1003_585&f=22&su=p284.9.336.ip_p726.5.336.ip_&tt=2&bt=1&bts=0&zu=http%3A//www.thyroid-info.com/articles/woliner.htm
Good luck with everything I too and trying to get mine worked out. As far as the muscle problems mine has occured during hyper and hypo and I use heart palpitations to know when I am hyper but I have that with both also.

[DVS1956]

First off, I want to apologize for the length of this post. Please understand, I have to try and be as complete as possible so maybe someone can help me understand some of the things that are continuing and not getting better.

I was finally diagnosed in 1-2004 with Hashimoto's and Hypothyroid. Never felt myself since I was 10 years old - always had episodes of depression and breathing (cleansing breath, not shortness of breath). I always new I was different than other kids/adults, but could never get a doctor to answer why I would have these major episodes. Take a anti-depressant and be on your merry way. Infuriates me! Took the anti-D meds and they would work and then wouldn't work. I think I had a T problem, during my entire life, but since I wasn't out of the RANGE no one would listen and, of course, if I knew back then what I know now about the T problem, I could have had a better life. "Should have, could have, but didn't...doesn't help the past and I am okay with that!

So this is what has been happening since I started HRT back in May of this year!

I started HRT after battling over 4 years with major hot flashes, sleeplessness, depression etc. I thought it would help, and it has at least where the hot flashes are concerned (no more since starting HRT). Sleep got better after about a month, but is not as good as it was after first starting HRT.

Now, I'm in another T mess because of the HRT.

I know before starting HRT, my T med (Levothroid) was either to much (75 mcg) which would plument my TSH under 1.0 and I was having severe Hyper/hypo symptoms, or not enough (50 mcg) and when my TSH would go above 2.0 I would have Hyper/hypo symptoms. (Have have always had hypo and hyper symptoms, so I never know if I am actually getting to much or to little, but when I get them, I know it needs to be adjusted, so I can feel somewhat more normal . So I had my doctor place me on (125 mcg split to make 62.5 mcg, since Levothroid doesn't come in that amount. Continued on 62.5 since last Septemember '08. I continue(d) to complain of depression and exhaustion, so she put me on Cytolophram 20 mg. I went off after starting the HRT, since it stopped working again (yes, I titrated down to stop, so I wouldn't have a major crash and burn episode.)

This is a what has been happening lately.

Labs done at the doc's office on 4/30/09 (Levothroid 62.5 mcg taken every day at 3:00 AM):

Test                        Result     Units          Range
TSH                         3.38       uIU/mL        0.400-4.000 (symptoms before starting HRT)
FT3                          3.150    pg/mL         1.810-5.110 (need to be in upper quadrant)
FT4                          1.610     ng/dL          0.890-1.760

DHEA-S                  97.600    mIU/ml         0.000-20000.000
Estradiol                <20.000    pg/mL          0.000-20000.000
Progesterone             .0239    pg/mL          0.000-20000.000
SHBG                     23.000     nmol/L (H)  18.000-114.000
Total Testosterone      4.980    ng/mL       (nothing on the report for range)
Vit b12                       516      pg/mL          211-911
Vitamin D, 25 Hydroxy               22.6      ng/mL          19.1-57.6 (low end)

She put me on these meds:

Vivelle-Dot Dis 0.05 mg 2x's weekly
Prometrium - 100 mg 2 x's day (morning 9 AM and bedtime 9 PM)
Cytomel - 5 mcg 1 x daily (7 AM take every day)
Compounded Testosterone Cream 1/2 gram daily (morning)
DHEA - 5 mcg daily (10ish)(was to do 10 mcg, but didn't)
Vit D3 - 5,000 IU daily (after lunch)

I also started Omega 3 (EPA/HPA 1500 mg total daily (since I can't take statins for my cholesterol).

Labs done at Lab Corp on 7/29/09 - (Levothroid 62.5 mcg @ 3:00 AM daily):

Test                        Result    Units          Range (different on some)
TSH (went up)           5.53       uIU/mL        0.450-4.500
FT3  (went down)       2.5        pg/mL          2.3-4.2
FT4  (went down)       1.11      ng/dL           0.61-1.76

These all went up:

Estradiol                  48          pg/mL          0 - 31
                                                               Post Menopausal (untreated)
                                                    
Progesterone            17.9      pg/mL          0.0 - 0.7 (Postmenapausal)
Total Testosterone      34        ng/dL           14-76
Free Testosterone      0.2       pg/mL           0.0-2.2
Vitamin D, 25 Hydroxy               41.1     ng/mL          32-100.0 (came up)

Went to doc appt. Monday, August 17th and I told her that I was not good, can't get cleansing deep breath, anxious, moody, depressed, extremely exhausted, muscle spasm in my right shoulder blade and neck muscles. She said she couldn't believe how much my T labs changed, so she upped my T meds.

Vivelle-Dot Dis 0.0375 mg 2x's weekly (Lowered it since I had a little bloody discharge during 7/09)
Cytomel - 5 mcg 2 x daily (7 AM take every day) (increased it)
Levothroid - 75 mcg. daily (3 am daily) (increased it)

My shoulder and neck muscles were really bad and I had to take Advil (4 or 5 at a time at least 2 -3 x's daily). In addition, I have been absolutely exhausted for months and of course, its gotten worse since my Appt. on 6/22/09 (follow up). She wanted to change my Levothroid at that time, but I didn't want to tweak it without knowing what my range was after starting HRT on May 15th (Though I should have let her and I may not have gotten so bad). So she said we would wait for my labs to be one on 7/29/09 and go from there. So here I am...a mess.

Should I take a dose of my Cytomel 2.5 mcg at 3 am with my Levothroid?

I felt better mood wise after about the 2 wk of HRT, but my depression was still there, but I continue to manage. My exhaustion is getting better each day unless I get an episode of not being able to get that cleansing breath and the shoulder starts tightening up. Take the second half of the Cytomel around 2 pm and within a half hour to 45 mins I am feeling better.

I have read that T3 will help depression when added to one's T4 med and I feel a little better, but not a lot. So hopefully it will start working soon.

I get new labs done at the end of this month at Lab Corp, since their labs show slightly different ranges than the doc's office. I also understand it takes up to 8-10 weeks before T meds to adjust properly in the body, but she wants me to have the labs done in 5 wks? Should I stretch it out to at least 8 weeks and then go in? I have yet to make my appt for my follow up lab work so I could stretch it out longer.

Any one have any suggestions as to why my TSH went so wacky and when Cytomel was added it didn't help. I know the new increase of Levothroid will eventually start helping my TSH to get better.

I am very sensitive to meds so I have had to stop taking it the way I was told. I did as instructed from June until last Friday (8-28) I started Sunday 8/30 only taking a half pill (2.5 mcg.) of Cytomel (5 mcg.) at 7 am and then around 2 pm (since the symptoms start coming on - anxious, can't get the cleansing deep breath, shoulder blade starts getting tight and my neck gets exhausted from holding my head up, as well as be very crabby.

Just so you know I always take T med on an empty stomach and no meds together at the same time.  Stay away from Calcium and iron at least 4 hours before or after.

Sorry for the length of this post, but I wanted to be complete!

[TamraW]

Also, it might be your D levels. Make sure you're getting 1,000, I-U D3 daily.

Vitamin levels tend to run low in hypos.

:) Tamra

[LazyMoose]

Could the tightness your feeling  just be a temporary hyper feeling from the powerful acting Cytomel?. Some people need to add it in baby steps. It gave me a killer headache for weeks and I felt nervous and hyper at first.

You dont mention how long you have been on it(?).

Usually T3 in any form helps muscles.