Thyroid med

[pctva]

Hi Doctor Lupo
My fitness instructor became hypo 9 yrs ago after RAI due to GD. She is on 75mcg Synthroid & 25mcg Cytomel daily. She told me she was 20 lbs over weights due to being hypo and was only be able to loose few lbs even with teaching many aerobic classes and eating healthy until she heard of Cytomel. She started taking 25mcg of Cytomel 4 yrs ago and noticed the fat melted quickly. She is now at her ideal weight and very fit.
She said Cytomel is 100% T3 active thyroid hormone and absorbed quickly into the intestine which helps the fat to melt away quicker… and (low T3 does not show up on blood test b/c it occurs inside our cells not outside in the blood stream. If the cell has a decreased ability to convert T4 into T3, cellular metabolism could be too low (low T3) despite the standard blood thyroid hormone tests being normal. Is there a reason doctors don’t prescribe Cytomel much to hypo patient? Would you prescribe Cytomel to your patients who want to try Cytomel to loose the extra fat and help speed up their metabolism? Even with normal blood tests? What the dose of Cytomel to start with? She told me even some body builders take Cytomel short term to help them loose the “fat” quickly when they are in training. What do you think? Thanks so much.

[hypogirl80]

Do you know if your fitness instructor reduced the regular T4 meds when she added the 25 mcg of Cytomel ?  If she did, what kind of thyroid med she took before?  and how much ?
Thanks/

[Mark Lupo, M.D.]

25mcg of cytomel is an excessive dose, likely causing hyperthyroidism and subsequent weight loss. THis is not a typical story and the T3 shows up on blood tests so it is measurable.  Cell levels of thyroid hormones do not show up on blood tests and this is an area of research.  Several studies have looked at T3 dosing and have not found that appropriate cytomel dosing in combo with levothyroxine offers any benefit.  That being said, I have a rare handful of patients who have truly done better with 5mcg of cytomel 2x/day in addition to their T4 -- but this seems to be the exception, not the rule.