Can Cytomel cause Hashimoto's to become more aggressive?

[UmmYeahOk]

I started taking the generic version of Cytomel last Tuesday morning, splitting it into 2.5 mcgs, and taking it once in the morning 9-10ish and once in the afternoon 3ish. I started to have more energy with the very first dose, and Tues-Thurs I found myself doing all sorts of housework that I usually put off until harassed. With each passing day my brain fog got better, though was still there. However, today, Friday, the fourth day on it, I feel exactly the same as I was without it. What happened?

When I was given the prescription, my PCP told me to just take the whole 5mcg in the morning with my synthroid. Should I be doing that?

[ahmee]

Just don't take your morning dose of cytomel on the day of the appointment until after the blood draw. This will keep the FT3 levels from artificially inflating. FT4 levels reflected in that test will be accurate whether or not you take your cytomel before the test because they reflect mostly the T4 you took several weeks ago. The biggest issue seems to be that your doctor might look at your TSH, which will undoubtedly be in the basement as often happens when one is taking T3, and freak out. I would just make it clear to them the symptoms you are still having, and that you do not feel you are adequately treated yet.

[UmmYeahOk]

So, I don't really have a conversion issue. At least not one that I know of. I was hoping that my PCP would increase my synthroid dose, but since he didn't want to, I leaped at the opportunity of cytomel when he offered it. Since I have that April appointment, should I stop taking my cytomel at a certain time so my levels adjust, and if so, when? I want to go in with accurate synthroid levels, and am worried the extra T3 might complicate a possible dosage increase. If it supposedly doesn't stay in your system long, could I stop the day before? Or just not take it the day of?

Since I don't really feel it either way, at least in my mind, should I go back to just taking the 5mcg?

[Barb135]

T3 doesn't always build in your system quickly, and not everyone even feels like they're taking it.  I was on 5 mcg for quite some time before my levels started coming up and even then, I didn't feel like it made a difference, so I didn't take it for a few days.... Wow - I knew then, that it really was working.  I was on 5 mcg for about 3 yrs and I finally increased on my own to 7.5.  When I told my endo that I had increased and was feeling better, he went ahead and increased my dosage.  Just last year, I finally increased on my own to 10 mcg and again, when I told my endo that I was feeling better, he went ahead and wrote the script for 5 mcg taken twice /day.  

My point is that we don't all react the same way or in the same time frames.  I don't get that "high" that some people get right after taking T3 med, either, but I sure crash if I don't take it.

[ahmee]

If you can't find an endo who will listen and run the right tests, you might want to look at local primary care doctors, nurse practitioners, and naturopathic doctors instead. Sadly many endos rely on outdated tests and an extreme adherance to numbers rather than considering patient symptoms and input.

[ahmee]

It sounds to me like you could use an increase. When I was raising with T3 I knew after a week or week and a half whether or not I needed to raise based o symptom relief. If you raise slower you get that sort of "whiplash" effect as your body adjusts to the intake of new meds. T3 is very fast acting, building in the blood within a few days. I take the equivalent of 22.5mcg of T3 and 90mcg T4 in the form of desiccated, so some of us just do better with more T3. I would not recommend stopping the cytomel cold turkey until you talk to your doctor. It sounds like you need a doctor who is not just looking at TSH, though. When properly treated you may find your TSH approaches 0, as does mine and many others on this board.

[UmmYeahOk]

So it's been over two weeks since I started taking the whole 5mcg pill, and I feel no such "high." I don't experience an afternoon "crash" either since I feel exactly the same in the mornings as I do in the afternoon. It's almost as if I haven't been taking cytomel at all. On February 3rd, my results were: Free T4 1.20 0.82-1.77 40%
Free T3 2.8 2.0-4.4 33%
My TSH was also 2.76 (0.45-4.50) even though on 1/20 it was 0.45 (0.30-5.10).

The only reason I had blood redrawn 2 weeks from each other is because I have yet to find an endo who will test FT4 and FT3. My PCP did it only because I asked the nurse to run it. I was grateful for the cytomel prescription, but the doctor wouldn't increase my synthroid. Because of the low FT4/FT3 numbers, I did a no-no and increased my own meds from 88mcg to 100mcg almost 3 weeks ago. Still feel my same old crappy self, though I understand that it takes 4-6 weeks for t4 meds to take full effect. I just think its odd that I am still taking the 5mcg of cytomel and feel absolutely nothing. In fact, last Tuesday (3/4) I did another no-no and took 2 5mcg, so 10mcg of cytomel in the morning all at once. Have been doing this for 3 days now and still feel nothing. No change. No afternoon crash, as I feel the same before as I did after.

I have an appt with endo #3. Hopefully, this one will test and treat me properly, but I think it's odd how I don't feel any different with or without cytomel. I'm picking up my second refill today, but am wondering if I should just quit or not. Will I be even worse off now without it? My appointment is on the 14th of April, which is 8 weeks after I started taking 100mcg. So far Ive only felt better, briefly 2 weeks after the 25mcg starter dose of synthroid and the first 3 days of cytomel. I just don't understand why I can so quickly adjust to being good, and then just as quickly feel nothing.

I feel like I'm "chasing the dragon" as no matter how much I take, I will never reach that feeling I once had. I don't plan on increasing anything else, until I finally have another blood test in April. Much easier to get a prescription for 100 or 112, than trying to cut up old meds and hope you have enough. It was just that I've been stuck on 88 for the past 3 visits, since my TSH is so low when they test it, and that's all they look at. Oh, and of course, since my meds have not changed during those times, my husband thinks I'm "stable" and can't excuse my behavior, even though I have always told him that its not an "excuse," but an "explanation."

[Barb135]

It typically doesn't work that fast, but some people get lucky.  It's not unusual for symptoms to get better, then worsen or for new ones to appear when changing doses and/or medications.  

Taking the whole 5 mcg at once, could give you a "high" for a few hours, then a crash later in the day... T3 meds are fast acting and they only stay in your system for a hours.  By splitting the pills, and taking them at different times, you're keeping the T3 more steady in your system.

My endo first prescribed my T3 to be taken all at once, but when I told him that it works better to split the dose, he now writes the script that way.

[UmmYeahOk]

Is it possible that my body just adjusted to the 2.5mcg dose, and in reality I just need more T3? Seems odd that Id get 3 good days out of it, and I'm going on 2 days of being "blah" again despite taking it. I think tomorrow morning I will just try the whole 5mcg and see what that does.