1 week on compounded liothyronine t3

[flydragon]

I have just completed a week on compounded t3.  I am taking a pretty high dose of 75mcg and I feel achy and tired.  Only good thing is my hair  has stopped falling out.  I tried a low dose of cytomel about a year ago and it did not work at all.  Will this?  I desperately need to lose weight.  My weight keeps going up and I coach weight loss at Curves...very embarrassing...HELP!

[Sparkigurl07]

I also have gained weight since being on liothyronine, and I have been battling anorexia for 25 years, just digging my way out of a 3 year relapse, and this weight gain (that is truly not necessary as my weight was within goal range) is setting things off again. I'm on 20mcg in the AM, 10mcg at 2:00 & 10 mcg at 5:30pm. Cortisol levels are too low, especially in the morning. Here are my labs from feb. When I started cytomel and July when they were retested. Notice the difference, not what I was expecting.
Feb. TSH range 0.47-5.01 uIU/ml my #0.94, July my # 0.09
Feb. FT4 range 0.71-1.85 ng/dL my # 1.03, July my # 0.22
Feb. FT3 range 1.71-3.71 pg/mL my # 2.09, July my # 5.31
Feb. RT3 range 9.0 - 27.0 ng/dL my # 40.4, July my # <2.5
Cortisol results: 1745 = .074, 2200 = .082, midnight = .096, 0730 = 1.88
Range for my age (38, female) are - 31-50 years 0.094-1.515 ug/dL less than 0.181 ug/dL
I don't understand how they got so much worse over those 5 months. :( need the weight gain to stop!

[chel 81]

I was initially told when I started thyroid meds that splitting the dose would be better for me so that's what I did. I then met with a dr who suggested instead to take it all at once. For some people they require a larger single dose to flood their system and actually absorb it- I was one of those people. As soon as I started taking it in a single dose my symptoms began improving without changing the amount I was taking.

Also, not sure when you started having issues with Armour but just in case you weren't aware they reformulated it back around 2010 and many many patients started having issues with it. Some had to really increase their dosage to get the same benefits and many others like myself had to switch to another brand of NDT. I'm currently taking Erfa and prefer it to the new Armour.

The other issue you could be experiencing is like many others have said here with it being related to your adrenals. T3 is pretty powerful stuff and if you have weak adrenals and are taking such a high dose of T3 it could hurt your adrenals more and cause worsening symptoms.

[flydragon]

Thanks...that makes a lot of sense to me.  I will talk to pharmacist with my next refill.

[ahmee]

Sorry, I must have missed your reply above detailing your history as it hadn't appeared yet when I wrote my initial post. Feel free to post the actual name of the lab tests if you are not sure... for example, my FT3 is listed on my lab sheet as "Triiodothyronine, Free, Serum" which might be confusing to anyone who's looking for just "Free T3".

I don't have any experience taking a time-release T3, I just recall my doctor saying that the time release versions of T3 aren't effective enough at distributing T3 over the course of the day. However, if you are not experiencing a crash in the afternoon perhaps you are fine to take it that way. I would still think it's preferable to ask the pharmacy to split the meds into two equal doses to be taken 2x/day.

[flydragon]

thanks for your input.  See comment above on meds and my t3 is timed released.  can't split it ...it is a capsule with powder inside...compounded.  I have only been on this med for a week now.  Was hoping to see a burst of energy and at least a few pounds off by now.  I think that the results I gave for Rt3 was actually Ft3.  I'm learning to read my labs.  Used a lab for a long time that would not allow me to see my labs.  now I'm trying to figure them out.  

[Barb135]

Since your thyroid was removed, no, you wouldn't be able to make thyroid hormones; your body is completely dependent on the medication you take.  Your doctor should have known that !!

Thyroid numbers can't prove adrenal fatigue; you need adrenal tests for that. When one becomes hypo, the adrenals kick in to take up the slack for the thyroid gland.  If the hypo remains untreated for any length of time, the adrenals eventually burn out, causing adrenal fatigue.  Since you have no thyroid, you have to have an ongoing supply of thyroid hormones, but that's not going right an adrenal issue.

Free T4 is converted into, either Free T3 or Reverse T3.  Free T3 is the active hormones that your individual cells use; Reverse T3 is a mirror image of FT3; however, it's totally inactive.  RT3 is usually produced in order to prevent FT3 from becoming too high.

If you're taking the med, as ahmee suggested, then you aren't really taking 75 mcg of T3; that changes the whole picture.

47.5 mcg of T4 and 11.25 mcg of T3 is a long way from 120 mg Armour + 88 mcg synthroid..  120 mg of Armour is equal to 50 mcg T3 only or 200 mcg T4 only...  I can't help but wonder if the reason you didn't do well on that was because you were over medicated.  Some symptoms can apply to either/both over and under medicated.

I agree that right now, it appears that you're due for an increase in your med.

[ahmee]

I take Naturethroid, which is desiccated thyroid in the ratio of 38mcg T4 & 9mcg T3 per 60mg (1 grain). I just used those ratios as an approximation of what you are on, which is probably equivalent to 1 1/4 grains. If your symptoms have not resolved on that dose, it could be because you need more medicine still. It's great that your hair loss has stopped-- mine did too, around that dose-- but it took twice that dose for me to feel at my best. Everyone is different, but it's possible that you are due for some sort of increase. However, we would like to see the ranges for the labs you posted above so we can interpret them correctly, and I'm curious if you were tested for Free T3 as well, because I don't see it listed above.

Were you on a T-4 only med such as synthroid before trying the compounded med, and if so, what was the dose?

Additionally, are you splitting up your 75mcg dose to take twice a day? This is very important to do for any med containing T3.

[flydragon]

yes...how did you figure those ratios out and what does that mean exactly?

[flydragon]

I also want to add that in the middle of all of this, I had a back injury which has really messed up my exercise program.  Doctor said that as far as my adrenals were concerned, that may have been a blessing.  She said I was over exercising.  I'm afraid to put anything in my mouth...lol...just looking at food makes me gain weight. Though I will say that I have not gained a pound all week which has been the length of time I have been on the new med.  Sorry about the length of all this.  You seem very knowledgeable.  Are you a professional?

[ahmee]

I'm assuming if the med is compounded, there is a T4 plus a T3 component. 75mcg of T3 alone is a lot. Likely it's compounded similar to any desiccated, which would make her dose approx. 47.5 mcg T4 and 11.25mcg T3.

[flydragon]

You are probably right on your clarifications.  I have trouble understanding the difference between the two.  As far as meds, here's my history.  I am currently 55 years old.  My thyroid was removed when I was 36 due to thyroid cancer.  I was on synthroid briefly, but did not respond well to it.  I was then on armour for years with no issues up until a year ago when I had pelvic floor surgery.  After that my numbers went haywire.  Saliva tests revealed that I was not making any cortisol at all.  Doctor bad me break my dosage of armour into 3xday (total dosage was 180mcg, so 60 3xday.  Symptoms got worse so she took me off armour completely and put me on 5mcg of cytomel.  After 6 weeks of that and me dragging myself out of bed everyday, bloodtests revealed that I was not making any thyroid hormone of any kind at all.  Dosage was changed to armour 60 mcg 2xday and 88mcg of synthroid in the morning.  Felt great on that for about a month or so.  Then weight gain started again (all in the middle).  Went back to the doctor crying.  I was eating good, walking 4 miles a day 3-4xweek and doing curves circuit 3xweek and a zumba class once a week, plus my husband and I clean 2 houses every Saturday morning during the summer.  New blood tests were the ones I posted yesterday.  Her thoughts were that the numbers proved adrenal fatigue...now making too much cortisol and that the straight t3 time released would pump up metabolism and correct the adrenal issues.  Found info on the sttm.com website backing that theory up and had a long talk with the compounding pharmacist who agreed with her.  This doctor has a highly respected reputation in my area.  I am also on bioidenticals as well.

[Barb135]

Your doctor is testing RT3, but not FT3, when she has you on a mega dose  of T3 med?  Wow, I'd run from her.  

A simple result for RT3 is not what counts; it's the ratio of FT3:RT3.  The RT3 result you posted above looks more like an FT3 result.

Probably, you aren't converting enough FT4 to FT3, because your level is so low, there's nothing to convert... What's the reference range for the FT4 and also the RT3?  Ranges vary lab to lab and have to come from your own report.

Adrenal issues should be addressed before thyroid. Your symptoms are definitely those of hypothyroidism.

Are you also taking a T4 med?  If so, which one, at what dose?

[flydragon]

iOkay...my free t4 is 0.87, within normal range.  My TSH is .021, below normal range.  My reverse t3 is 2.3 which is the low end of normal.  Doctor says I am not converting enough t4 to t3 which is causing weight gain.  She says this will work.  Other symptoms were dry brittle hair, swelling in extremities,  bloating after exercise and severe adrenal fatigue.  cortisol was working overtime.  Remember this is time releases.  Pharmacist says this is the magic compound for my issues.

[Sarah1945]

Hi,

I totally agree with Barb.  That's an extremely high dose of T3.  Keep in mind that T3 is four times as potent as T4.  Do post your lab results with the ranges.

Sarah

[Barb135]

I'm somewhat confused, as to what you're trying to accomplish.  Are you taking the compounded T3, only to lose weight?  It's very rare for a doctor to prescribe T3 only for a thyroid condition, particularly that high a dose.

If you have current thyroid blood tests, please post the results here, so we can see what your levels are.  Be sure to include reference ranges, as those vary lab to lab and have to come from your own report.