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Synthroid & cytomel - does the combo help hypo?
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Synthroid & cytomel - does the combo help hypo?

I have hashi/hypo. My last TSH test was 1, but I still have lots of hypo symptoms!!! I'm wondering if taking a combo of Synthroid and Cytomel might work better. Is anyone taking both drugs for hypo/hashi? Do you feel better? Also, why/how did your MD decide to supplement the cytomel?
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Avatar_f_tn
Science has done trials with thyroid patients and say no.  No benefits to patients and symptoms.

When people say it does, it usually a placebo effect - on the brain, i.e. fooling the brain into thinking that its working.

None of the thyroid medications or drugs are a 100 percent cure-all for symptoms.

T3 is no "magic" pill that will necessarily make us feel better. It might and it also might not. I have read on other forums of persons having to go off T3 after a period of time because it was creating heart issues. Plus they ended up with the same symptom as the reason for going on T-3.

We  have T3 in our body so the natural breakdown of T4 into T3   occur all the time because the cells use T3 not T4. But the natural breakdown occurs as we need it not when its pop  into the mouth.   T3 it is harder to manage finding that right dose, and it also is much more dangerous to overdo it. T3 is the most potent form of thyroid hormone. It is the form which enters directly into cell metabolism.
Taking T3 in pill form is like swallowing uppers because there's a  immediate rush, and then a quick let down-turn  and it can have serious, adverse health consequences. I heard it called cocane of thyroid drugs. that will bring out the wolves. T3 levels can lead to unpleasant symptoms such as rapid heart beat, insomnia and anxiety. Too high T-3 has a risk for dangerous cardiac arrhythmias and heart attacks and also can harm the heart and the bones.

quote - The Journal of Clinical Endocrinology & Metabolism
Combined Thyroxine/Liothyronine Treatment, T-4 and T-3, Does Not Improve Well-Being, Quality of Life, or Cognitive Function Compared to Thyroxine Alone - jcem.endojournals - unquote

quote - In conclusion, with regard to the outcomes measured in this study, we did not find evidence to support the hypothesis that substitution of L-T3 for a portion of daily L-T4 produces better outcomes in a primary (mostly autoimmune) hypothyroid population than treatment with the original amount of L-T4 alone; and therefore, we cannot recommend this treatment for the average patient. Additionally, this conclusion is consistent with the majority of evidence in the literature. This study adds to the knowledge base by extending outcomes to fatigue - pubmedcentral - unquote

quote - Several 2005 studies suggested that although some patients may prefer combination therapy, T3 and T4 together do not work better than T4 alone.   It does not appear that combination products offer any advantage for normalizing TSH levels. Dr Koop - unquote

quote - "Today, many patients with complaints of chronic malaise or fatigue approach their physician seeking T3 therapy, but the fact is that none of the handful of well-designed randomized controlled trials done since then has been able to confirm the initial report of superior outcomes ... There is reason for concern that supraphysiologic doses of T3 in this setting could interfere with protein and fat metabolism and interact synergistically with catecholamines to increase myocardial oxygen demand, with resultant increased arrhythmia, MI, heart failure, and death" Clinical Psychiatry News, 2/05 - unquote
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Avatar_n_tn
Thank you for that information!! I'd also read about the T3 induced cardiac symptoms elsewhere. I'm beginning to think completely feeling well is just a past memory.....
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Avatar_f_tn
You are going to eventually feel well again.  Maybe not 100 percent, but nor does the average population.

Be positive - most of this stuff is in the brain.  So laugh, be happy, be positive. Self hypnosis, meditation, yoga, etc. can help. You are the strong one, not your illness nor symptoms, so don't let them win over you and your health.  Things could be worse.  When you feel down go visit a hospital; Veterans, Children's, etc. I visited these and more, so learned at a very young age, to be every thankful for my health no matter road blocks I face.

You are going to be ok - just give it time, as much time as it/you/health needs.
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Avatar_f_tn
Just fyi - any gym rat can tell you body builders love t3 - speeds the metabolism - increases heart rate etc , burns calories etc but very dangerous - bodybuilders try to obtain cytomel legally or otherwise - since they like other dangerous hormones it isn't surprising - Im not a fan of cytomel - exercise can rev up sluggish metabolism and yes yoga does work for thyroid - see Dr. Andrew Weil's take on what yoga does for thyroid -
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Avatar_n_tn
Thanks for your words of encouragement. I actually am (or was) a happy person and don't have much stress in my life right now except for "chronic" thyroid symptoms which seem to persist even w/ tsh 1.  I know these symptoms are NOT in my BRAIN, especially since many of them occur at night when I'm ASLEEP in bed!!!! They're all due to hashi/hypo, NOT unhappiness, insanity, an unhealthy lifestyle, bad attitude, other med (which I don't take), another medical condition, etc. -- I hope you're right when you say, I'll eventually feel well again because I really don't know what else do to!!!!!!!  And, yes, I have told myself that I could have a MUCH worse disease. Even so, I'd like to feel well again and if it exists find the "right" treatment to relieve my pesistant symptoms. My Endo Md is VERY little help and extremely vague. thanks for your post!
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Avatar_f_tn
I knew you would take my post wrong. I am not saying you are mental.  it is a true fact that the brain not only control the mind, but our body as well, all body functions, even while we sleep. your attitude doesn't seem 100 percent, which is reasonable for your thoughts on thyroid and symptoms. I am just saying we do what we can do to feel our best, whatever it takes for the mind, body and soul.

How do you know your symptoms are thyroid, especially with a TSH 1.  Thyroid symptoms are so non-specific.  In other words, a lot of other health conditions have the same symptoms as thyroid, it is very difficult to distinguish where the symptoms are coming from or which health conditions are the cause.  If your TSH level was above 10, then it would suggest thyroid symptoms. with level in labs normal range, symptoms are most likely non-thyroid and from some other health issue. i think i gave you enough links to confirm.

sorry if I offended you, but facts are facts.
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Avatar_f_tn
The Shoulder Stand yoga position (at least once daily for 20 minutes) is believed to improve the thyroid

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Avatar_n_tn
None of the numerous specialist who has run countless, extensive labs, MRIs, scans, and a variety of other medical exams and tests can ever find else wrong, not even neurologist. All have sent me back to the endocrinologist and/or told me that the symptom(s) I was sent to specialist for was mostly likely due to hashi/hypo. Until a MD or test indicates otherwise, that is the ONLY diagnosis! Are you a physcian?
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Avatar_f_tn
no i am not a doctor nor am i a bcb.

my tsh was at 29 and you complain of 1.

seems to me your test already suggest otherwise.

but no skin off my nose.

whats in the mind is what matters.
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251991_tn?1239299630
It is in our throat not brain,lol. I heard someone else state that they told there doc that and I thought yes they are right. Graveslady has alot of good info and just trys to help but we are all still up in the air about T3. Do a poll like I did on Neuropathie and see what kind of results you get then print that out to show the doctor.
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251991_tn?1239299630
Well I guess this is a poll, see how bad I am LOL:) I use to be smart and a good speller to and my kids are smarter than me now and they are 11-12.
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251991_tn?1239299630
Dang there I go again! They are almost 10-11, SEE WHAT I MEAN! My hubbys Bday cake I done the same thing i wrote happy 34th and he is 35 my kids were like MOM! grrrr Brain Fog.
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Avatar_n_tn
You got me laughing!! I can completely relate to the mind fog and scrambled numbers, spelling, etc. I'm sure your husband was happy to turn "34" again! I hope you're recovering from your surgery and doing ok!!
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Avatar_n_tn
I'm also a newbie - just diagnosed a month ago and I think all the conflicting and various sources of information out there is overwhelming. I'm already gone up a dosage on Synthroid and i have to say the first few weeks I took even the low dose I felt great. But from what I've read extensively on the internet, having good labs or within the 'normal' range isn't the only way to know that you are feeling well. I was in the good range for years but I knew something was wrong, my body was telling me that it wasn't getting older or not eating or exercising because I was doing all of those things. I love to work out (okay I like to, love is too strong a word!) but because I was so exhausted all the time from hypo, I thought it was just laziness. I think its good to get lots of different opinions but I think you have to trust your own instincts and what your body is telling you as well. I'm sticking with Synthroid for the minute and see how I go for another few weeks before I swap out therapies again!
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Avatar_m_tn
My tsh was 99.99 I no how she feels even when blood tests say things should be back to normal I dont feel that way and from all the books I have read have stressed that symtoms (symptoms) should be treated rather than taking to much notice of the blood test results!!!!
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Avatar_f_tn
I agree with your post.  I have had hypo for about 12 years now.  I'm 53 now and have the Hashimoto's.  I had the biopsy last Feb.  I have nodules.  My endo told me my thyroid will eventually stop working.  Great right?  I think I'm losing hope of ever feeling well.  I don't sleep well.  I wake with my heart racing and weird feelings in my head.  My doctor put me on cytomel  5 mcg.  once a day.  I don't think it's making a difference.  I've recently started having chest pain.  I exercise daily and can't seem to lose any weight.  I've gone to a vegetarian diet and eating healthy foods.  I feel your pain.  
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649848_tn?1357751184
This is a very old thread and Newbee2000 has not been active on the forum for some years now, so I'm sure you won't get a response.

With Hashimoto's, the antibodies attack the thyroid, until there is no longer healthy tissue to produce hormones - your endo is right, on that.  Many of us with Hashimoto's, have nodules; they are, typically, nothing to worry about.

I had all of your symptoms, when I was still very hypo.  What are your actual lab results, with reference ranges?  Just because they may be in the normal range, doesn't mean they are normal for you.

Are you also on a T4 med, with the cytomel?  If so, which one, what dosage and how long have you been on it?  

You might want to start your own thread, so your situation gets the attention it deserves, rather than attaching to one as old as this.  You can do that by clicking on the orange "Post a Question" button at the top of this page, type your comments, then click the green "Post a Comment".
You can also access the the home page, which can be reached via the following link:
http://www.medhelp.org/forums/Thyroid-Disorders/show/73

Be sure to post current labs and include reference ranges, since those vary lab to lab and have to be posted with results.
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