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Cytomel (Generic) and Side Effects
I was diagnosed with hypothyroidism a few years ago caused by Hashimoto's Thyroiditis. I was taking 112mcg of Synthroid for about a year, which helped with most of my symptoms, except the heart palpitations. (Yes, I am hypo and have heart palpitations - sometimes the episodes would last for up to 20 hours at a time.)
About 6 months ago, I convinced my doc to add Cytomel (25mcg) in addition to the Synthroid because I had read that Cytomel can help with palpitations when taken with Synthroid. The palpitations stopped within 2 weeks of starting the Cytomel and I was elated.
Over the past few months however I have noticed new symptoms emerging. I started feeling nauseous off and on, had very loose stools, and was bothered by frequent heartburn. All of the above symptoms have gotten really bad the past couple of weeks. And I'm beginning to wonder if it's the Cytomel(generic - Liothyronine) that I'm taking.
I do have an appointment to see my doc in 2 weeks, but I was hoping that some of you may be able to help me out with some info before I get to see my doctor. I tend to be a hypochondriac about these things now, so I have of course convinced myself that something terrible is happening within my body that is going to kill me.
By the way, I am a smoker, so that certainly doesn't help matters. Also, my mood has been all over the place lately - from feeling ok one minute to practically in tears the next.
Any help is appreciated!
About 6 months ago, I convinced my doc to add Cytomel (25mcg) in addition to the Synthroid because I had read that Cytomel can help with palpitations when taken with Synthroid. The palpitations stopped within 2 weeks of starting the Cytomel and I was elated.
Over the past few months however I have noticed new symptoms emerging. I started feeling nauseous off and on, had very loose stools, and was bothered by frequent heartburn. All of the above symptoms have gotten really bad the past couple of weeks. And I'm beginning to wonder if it's the Cytomel(generic - Liothyronine) that I'm taking.
I do have an appointment to see my doc in 2 weeks, but I was hoping that some of you may be able to help me out with some info before I get to see my doctor. I tend to be a hypochondriac about these things now, so I have of course convinced myself that something terrible is happening within my body that is going to kill me.
By the way, I am a smoker, so that certainly doesn't help matters. Also, my mood has been all over the place lately - from feeling ok one minute to practically in tears the next.
Any help is appreciated!
Thanks so much for all of the information! It's all really helpful. Do you think when I get my lab work back next week, I could post my results for you and you could tell me what you think?
COMMUNITY LEADER
As both Laura and I have said, 25 mcg cytomel is a huge dose tostart with; Laura is right - for every 5 mcg cytomel, you should decrease the synthroid by 25 mcg.
T3 doesn't help convert T4 -- T4 is converted *to* T3, mostly by the liver; so if there's a "glitch", that conversion might not happen. That's why it's so important to test for both FT3 and FT4. If the FT4 levels are high, and the FT3 levels are low, that indicates that FT4 is not being converted to FT3; that's when it's advantageous to add the T3 med, but when adding a new med, it's almost always best to start low and increase slowly. Maybe there's a dose of T3 med somewhere between 5 mcg and 25 mcg, that would be better for you.
T3 doesn't help convert T4 -- T4 is converted *to* T3, mostly by the liver; so if there's a "glitch", that conversion might not happen. That's why it's so important to test for both FT3 and FT4. If the FT4 levels are high, and the FT3 levels are low, that indicates that FT4 is not being converted to FT3; that's when it's advantageous to add the T3 med, but when adding a new med, it's almost always best to start low and increase slowly. Maybe there's a dose of T3 med somewhere between 5 mcg and 25 mcg, that would be better for you.
So, I called my doctor's office and requested new labs to test for Free T3 and Free T4. I'm going to have get my blood work done this week.
I currently just go to my PCP, as I've had no luck with endos in the state of Delaware. I've been to 2 endos in the past couple of years. Both of which would NOT even increase my Synthroid beyond 50mcg because of the palpitations.
So I went back to my PCP at the end of last year and he agreed to increase my Synthroid, stating that it made perfect sense that I could have palps and be hypo. He told me that if my thyroid isn't working right, then it makes sense that the rest of my body isn't working right either, including my heart.
When he increased my Synthroid to 112mcg I initially felt better and then the palps started again. Upon doing some research and reading about how your body needs T4 and T3 (to help convert the T4), I asked my doc to put me on Cytomel, which he did at 25mcg.
I am grateful to have a doc who will listen to me and be willing to try something different as my PCP has. However, he is just a PCP so I feel as though I am treating myself sometimes. That's why posting here has been so helpful!
I currently just go to my PCP, as I've had no luck with endos in the state of Delaware. I've been to 2 endos in the past couple of years. Both of which would NOT even increase my Synthroid beyond 50mcg because of the palpitations.
So I went back to my PCP at the end of last year and he agreed to increase my Synthroid, stating that it made perfect sense that I could have palps and be hypo. He told me that if my thyroid isn't working right, then it makes sense that the rest of my body isn't working right either, including my heart.
When he increased my Synthroid to 112mcg I initially felt better and then the palps started again. Upon doing some research and reading about how your body needs T4 and T3 (to help convert the T4), I asked my doc to put me on Cytomel, which he did at 25mcg.
I am grateful to have a doc who will listen to me and be willing to try something different as my PCP has. However, he is just a PCP so I feel as though I am treating myself sometimes. That's why posting here has been so helpful!
First....25 mcg of Cytomel to start is huge! And, when you start cytomel your suppose to cut your T4 med back by 20 mcg I believe.
Second...you cannot treat with a T3 med without testing your Free T4 and Free T3...that is how you dosage and treat. T3 will supress the TSH and you cannot go by this whatsoever when on both meds. You should be having a Free T4 and Free T3 done with your TSH EVERY time. Cytomel and generic comes in 5mcg dosages for easier dosaging. T3 med will only stay in your system approx 6 hrs or so, so it is very important to split your dosage twice per day.
I don't understand why your Dr would automatically start you on 25mcg and didn't even test your frees...quite crazy. That is a good way to go very hyper. For every 5 mcg of T3 medicine, it equals 25 mcg of T4 med. So you have now increased 125 mcg, if you converted that to T4 medicine...that is a huge jump.
I get palps as well when I go hypo....and they disappear when I am properly medicated with enough. :)
Second...you cannot treat with a T3 med without testing your Free T4 and Free T3...that is how you dosage and treat. T3 will supress the TSH and you cannot go by this whatsoever when on both meds. You should be having a Free T4 and Free T3 done with your TSH EVERY time. Cytomel and generic comes in 5mcg dosages for easier dosaging. T3 med will only stay in your system approx 6 hrs or so, so it is very important to split your dosage twice per day.
I don't understand why your Dr would automatically start you on 25mcg and didn't even test your frees...quite crazy. That is a good way to go very hyper. For every 5 mcg of T3 medicine, it equals 25 mcg of T4 med. So you have now increased 125 mcg, if you converted that to T4 medicine...that is a huge jump.
I get palps as well when I go hypo....and they disappear when I am properly medicated with enough. :)
COMMUNITY LEADER
My first impulse is to say "yes", cut back on the cytomel, but if you do that, you won't know what your levels actually are at this time. Would it be possible to call your doctor and get the blood draw now, then cut back?
Otherwise, you could just split the 25 mcg pill in 1/2 and see how that works, but you won't know your levels because by the time you see your doctor in 2 weeks, they will have changed.
You should always make sure you get a copy of the lab report for your records. I write on the lab report, the dosage of med(s) I was on at the time and what, if any symptoms I was having. That way, when I hit a level at which I feel good, I have a "target" to aim for
Otherwise, you could just split the 25 mcg pill in 1/2 and see how that works, but you won't know your levels because by the time you see your doctor in 2 weeks, they will have changed.
You should always make sure you get a copy of the lab report for your records. I write on the lab report, the dosage of med(s) I was on at the time and what, if any symptoms I was having. That way, when I hit a level at which I feel good, I have a "target" to aim for
The last time I had my blood work done was about 4 months ago. My TSH was at 1.55 after being on the 112mcg of Synthroid for about a year and the 25mcg of Cytomel for about 4 weeks. I don't know my T4 and T3 numbers. The reference ranges that my lab uses for TSH are 0.4 - 4.0 I have my next appointment with my doc in 2 weeks, so I won't have any new labs until then.
I do in fact take the 25mcg of Cytomel all at once. With the way I'm feeling, should I try cutting the Cytomel back over the next couple of weeks until I see my doc? I feel awful!!!
I do in fact take the 25mcg of Cytomel all at once. With the way I'm feeling, should I try cutting the Cytomel back over the next couple of weeks until I see my doc? I feel awful!!!
COMMUNITY LEADER
Hmmm - that's a new one on me - T3 med usually causes palps, not gets rid of them!! What are your latest thyroid hormone test results. Cytomel (generic Liothyronine) should not cause those symptoms, unless your dose it too high.
I'm on generic Liothyronine also - much smaller dose - and have no problems with it at all.
Do you split your T3 dose throughout the day, or take the whole thing all at once? 25 mcg is a pretty high dose and most people find that splitting it between 2 or even 3 doses works better than one large dose. T3 med is pretty fast working and doesn't stay with you very long, so it could be that when you take the 25 mcg (if you take it all at once), you are getting a "spike", which sends you a bit hyper. I wonder if you would get the desired result, without the undesirable symptoms if you cut back to 10-15 mcg.
Please post your most recent labs and the reference ranges, since these vary from lab to lab. That will help member to comment more fully on your particular situation.
I'm on generic Liothyronine also - much smaller dose - and have no problems with it at all.
Do you split your T3 dose throughout the day, or take the whole thing all at once? 25 mcg is a pretty high dose and most people find that splitting it between 2 or even 3 doses works better than one large dose. T3 med is pretty fast working and doesn't stay with you very long, so it could be that when you take the 25 mcg (if you take it all at once), you are getting a "spike", which sends you a bit hyper. I wonder if you would get the desired result, without the undesirable symptoms if you cut back to 10-15 mcg.
Please post your most recent labs and the reference ranges, since these vary from lab to lab. That will help member to comment more fully on your particular situation.
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