can you cut your synthroid pill in half?

[jjohnson5409]

my doctor put me on cytomel but did not decrease my synthroid.  he actually raised it a month ago to 75mcg.  but my FT4 was at the top of the range at 1.8.  my Ft3 was still at the lower end 286.  it was 230 when i started on the 50mcg.  So my question to you is can I cut my 75mcg synthroid in half?  or just ask my doc for the 50mcg???  he gave me 25mg of cytomel.  but I did cut it in half because I was scared to take the full dose.  any suggestions from the pros?  thanks

[goolarra]

With Cytomel, it matters a lot more than with T4 meds that your dose is not always the same.  Have you tried putting a little more time between your two doses?  Perhaps taking the second one early to mid-afternoon?  You don't want it to disturb your sleep, but sometimes you have to experiment with the timing that works best for you.

Yes, get yourself a Cadillac pill cutter, but watch that little razor blade, it's sharper than it looks (voice of experience)!

[jjohnson5409]

Yes, you are right.  I will not give up!  It took me way to much time and trouble to get here.  at least I feel alive.   I do have a pill cutter.   I am going to get a better one today though.  This cheap one is not "cutting it" lol.    I know I am not getting the same dose of cytomel every time.  they are so hard to cut!   Hopefully it is close enough.  does it matter that I get 7mcg in the morning and 3 mid morning?   hope not cause I can't cut these things in half even.  

[goolarra]

Many of them don't learn much, and many more haven't picked up a medical journal since med school.

Yes, I'd continue cutting.  It's tricky because they're so small, and once cut into four quarters, who knows what actual dose is in each?  With T4 meds, it's not such an issue since the dose builds up in your body anyway and evens out over days or a week.  But with Cytomel, you want to make sure you're not getting 25 mcg in one whack and none in the others.  Also, how much are you leaving in the pill cutter?  You do have a pill cutter, don't you?  The ones with the razor blades in them are fairly efficient.

Just my opinion, but I think 25 mcg of Cytomel is all wrong.

I'd still give it some time to see what the Cytomel ultimately does.  Yes, it works faster than T4 meds, but your body still does have to heal...make up for lost time.

[jjohnson5409]

Tell me about it!    What do these doctors learn in school?   this is CRAZY.   well in the meantime what do you think I should do?  continue on the cutting ?   I don't really feel different w/ the cytomel.   actually is sounds crazy but I feel tired.  I am always backwards!!!!  thanks for your help.  

[goolarra]

I made a couple of comments on another thread that you had posted on.

I'm sorry to say that I think your doctor doesn't know what he's doing.  Adding T4 to an FT4 that is already at the top of the range is only going to increase it even further.  This makes no sense at all.

25 mcg Cytomel is roughly equivalent to 100 mcg Synthroid.  So, your dose is now the equivalent of 125 mcg Synthroid higher than it was when you were on 50 mcg Synthroid only.  That is a HUGE increase.  It looks to me like your doctor thinks Cytomel is used in the same way and at the same dosages as Synthroid.  He's very wrong.  37.5 Synthroid and 6.25 Cytomel is about right, but aren't you taking the Cytomel twice a day for a total of 12.5?

Those little pills are very difficult to split.  It would be better if you could get a prescription for 5s and take one twice a day, but it doesn't sound like your doctor is willing.  You may need to find a new doctor.

[jjohnson5409]

I spoke to my doctor today.  He said I just need to take the 75mcg synthroid and the 25 mcg of cytomel.  in two months he will check my blood.   I don't think I will do that!  I will still cut my doses of synthroid and cytomel.  i cut the 75 in 1/2. and the cytomel, which i might say is almost impossible to cut even,  in 1/4.  so i am getting 37.5 of synthroid and 6.25 mcg of cytomel.  Does that seem about right?  with my t4 being 1.8 with the 50mcg of synthroid, i don't why he would up my synthroid And add the 25mcg's of cytomel.  but i am not a doctor so maybe I don't know what i am talking about.  What do you guys think?  

[ChitChatNine]

My pharmacist said it's ok .. actually we mixed and matched for quite some time until we perfected my dose .. but don't get too excited .. it varies up and down every 6 mos or so LOL!

C~
synthroid 75mgs at the present time

[goolarra]

There a number of things I question here:

1 - With your FT4 so high, why was Synthroid increased?

2 - Synthroid should have been reduced to compensate for the addition of Cytomel (rougly 25 mcg decrease in Synthroid for 5 mcg Cytomel added).

3 - 25 mcg Cytomel is a lot of T3, especially compared to the amount of T4 you are taking.  Ratio of T4 to T3 should be around 5:1.  Yours is 3:1...too much T3.  Just starting on T3, I'd want to err on the side of too little rather than too much.

I'd ask him for 50 mcg of Synthroid and 5 mcg of Cytomel.  If that goes well, you can play with either or both from there.

[J0415]

Synthroid adjustments are generally titrated to TSH levels. Likewise for liothyronine replacements.  If TSH is grossly out of range then T4 levels can be used to assist in titration. Serum T4 concentrations remain low in patients treated with T3, and relatively low in those treated with preparations containing both T3 and T4.  Adjustment based on free T4 only may lead to inappropriate changes in dose.