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Terrible side effects on dosage changes
I have recently added cytomel .25 in to my Tirosint. My ft definitely had room. I lowered my tirosint from 137 to 125 mcgs with the addition. I could not tolerate the added cytomel. Had every hyper symptom and lost 12 pounds in two weeks. I stopped cytomel, and after 3 days I have tried to resume the 137 MCG of tirosint. I have been on this increased dose for 8 days. I am experiencing exhaustion, muscle aches, racing heart and anxiety with major crying spells. Should I just try to ride this out? I was no where near hyper in labs on this dose before. Is this just my body adjusting?
Absorption problems can also be related to low stomach acid that can occur with hypothyroidism.
It was done in er. I don't not have lab values, but Dr said are you anemic? I told her I was never checked since last pregnancy, but was very anemic at that time. She then said, yes you need to start iron. Thought maybe my nexium interferes with iron absorbtion. Will ask endo tomorrow.
Yes, had labs done yesterday and low iron. Starting iron twice a day with glass of oj. Dr said taking with the oj is just as effective as IV.
Hello Barb. I was advised by Dr to skip two days of Tirosint and resumed at lowered dose of 125mcg, down from the 137. I felt so much better by the end of the first day. My mind was clear, anxiety/panic stopped. Bp and hr lowered to normal. I resumed the 125 MCG and in an hour I felt a weird head rush, dizzy, chest tightness and of course the anxious feeling and unable to think clearly. My labs were done, and tsh is below 2 with t4 above midrange. The t3 was about mid as well. I just don't understand why a month ago my labs were hypo on the bigger dose, but now feeling hyper off even the lowered dose. Seeing endo tomorrow, but any thoughts??
COMMUNITY LEADER
Neither of your labs indicate hyper... you're going by TSH levels.
When adjusting T4 meds, it takes 4-6 weeks for a dosage change to take full effect, so you're not feeling effects immediately. If you are, most likely it's a reaction to fillers/binders or dyes in the med, which is quite rare.
Guppy - that doesn't apply to you, because your doctor nearly halved your dosage, when it was too low already, so you could very easily be feeling hypo effects.
When adjusting T4 meds, it takes 4-6 weeks for a dosage change to take full effect, so you're not feeling effects immediately. If you are, most likely it's a reaction to fillers/binders or dyes in the med, which is quite rare.
Guppy - that doesn't apply to you, because your doctor nearly halved your dosage, when it was too low already, so you could very easily be feeling hypo effects.
Wow, that is a big drop. Sounds like you need somewhere in the middle, unless it just takes a while for our bodies to readjust. I was feeling pretty calm, but as of a couple hours ago, a little jittery and foggy thinking. Ugh...Idk anymore!! Just want to get to right level. Here's hoping we both find thatsweet spot soon!! II'm beginning to think I havepost ttraumatic stress disorder from dealing with all this!!!
seasidesaweed; I dropped from 88 mcg levothyroxine down to 50 mcg last Tuesday.
Just 2 days later I started to get really tired. And now my under eye bags are back, I'm swollen in the whole face, also in my ankles this time. I have a subtle headache, my head feels "mushy".
I also have muscle ache and my sit bones hurts weirdly enough.
I wasn't hyper either, my thyroxine levels weren't on the high side. But my tsh was 0,10.
I was wondering too if this is an adjustment and it might get better.I did have a pretty large drop. I'm gonna call my endo tomorrow and ask if I can get back up, at least to 75 mcg.
Just 2 days later I started to get really tired. And now my under eye bags are back, I'm swollen in the whole face, also in my ankles this time. I have a subtle headache, my head feels "mushy".
I also have muscle ache and my sit bones hurts weirdly enough.
I wasn't hyper either, my thyroxine levels weren't on the high side. But my tsh was 0,10.
I was wondering too if this is an adjustment and it might get better.I did have a pretty large drop. I'm gonna call my endo tomorrow and ask if I can get back up, at least to 75 mcg.
Hello Barb, after a miserable week my endo felt I was a little hyper on the 137 MCG tirosint. He has lowered me to 125 after skipping a day. The insomnia and anxiety immediately stopped. I do however feel extremely tired and heaviness in legs. Although I will take this over the hyper feeling any day. Do you think it is just a adjustment period?
I'm having terrible hypo symptoms and PMS along with it. I can barely think straight and am so irritable.
Yes, my friend's endo has Hashis, and tried cytomel. She said she couldn't even drive home. I think it is just too potent for me. I am hoping to get back to 137 MCG smoothly and look for more natural ways to convert better.....less stress over thyroid would be a great start!!!
Hi,
There is a subset of individuals who have a particular sensitivity to thyroid medication. For example, Synthroid is a drug that has a narrow therapeutic index meaning that there is a fine line between an effective dose and a toxic one. As for Cytomel, I took 2.5 mcg (along with Synthroid) and also had a hyper reaction so stopped taking it. My physician told me that she has seen this response from other patients.
Sarah
There is a subset of individuals who have a particular sensitivity to thyroid medication. For example, Synthroid is a drug that has a narrow therapeutic index meaning that there is a fine line between an effective dose and a toxic one. As for Cytomel, I took 2.5 mcg (along with Synthroid) and also had a hyper reaction so stopped taking it. My physician told me that she has seen this response from other patients.
Sarah
COMMUNITY LEADER
Your symptoms were those of being hypo, and your thyroid labs confirmed it.
IMO, you need to cut back more on the Tirosint then add tiny doses of T3.
IMO, you need to cut back more on the Tirosint then add tiny doses of T3.
Sorry, also wanted to add symptoms prior to cytomel...swelling, tired, unable to lose weight and anxiety. The endo also could not believe I had such a reaction. I was at the same dose (levo) for years before all this, just want to get back there!!
Thank you, I will ask for blood test for ferritin next month. I also thought of adrenals but several tests showed no problems.
I think I may just be too sensitive to meds...ugh!! I took a quarter of klonopin and was "hungover" for two days..lol. I'm wondering since that ft4 just came up to that range after 5 weeks on 137mcg if the ft3 would eventually ease up? I always converted fine the first 14 years of this disease. I slipped hyper after losing 20 lbs two years ago, and a doctor really messed everything up. I am going to try to ride out these symptoms until my appt in two weeks. I think I just need to settle in...miserable though.
My endo was increasing my tirosint by adding one or two of the next dose up a week. So example I would take 75 MCG 5 days a week and 88 MCG 2 days a week. If we move any faster I would get adregenic responses. Tried beta blockers but bp always falls too low and chest tightness.
My endo was increasing my tirosint by adding one or two of the next dose up a week. So example I would take 75 MCG 5 days a week and 88 MCG 2 days a week. If we move any faster I would get adregenic responses. Tried beta blockers but bp always falls too low and chest tightness.
COMMUNITY LEADER
Whew-- I was afraid your doctor needed to have his license taken away if s/he was starting you out at 25 mcg cytomel... lol
Your FT3 is definitely too low and your FT4 is slightly above our recommended mid range at 60%. Your FT3 was only 25% of its range and the recommendation is upper half to upper third of its range. It certainly looks like you aren't converting adequately.
Since it was only 2.5 mcg cytomel you started, not 25 mcg, IMO, you should have dropped your Tirosint down to 112 mcg, since your FT4 was higher than it needed to be, to start with.
It's important to note that symptoms often get worse or new ones appear when changing medications or dosages. It's also important to note that some symptoms can apply to either hyper or hypo - for instance, I had the exhaustion, muscle aches, racing heart and anxiety when I was very hypo. With your FT3 as low as it is, I believe you're hypo, now, as well, since FT3 correlates best with symptoms. Losing 12 pounds in 2 weeks would be considered hyper, in most cases; however, if it were me, I'd consider it normal, since I've had trouble losing weight ever since my thyroid whacked, since I never had a weight issue in pre-hypo days.
I know the cytomel pills are tiny, but have you tried quartering them? It's not easy, but I've done it. You could try taking 1/4 of a pill in the morning and 1/4 of a pill around noon. Most of us on a T3 med find that we have to split the total dose into more than one. For instance, I'm on a total of 10 mcg/day and I take 5 mcg in the morning, with my T4 med and 5 mcg at lunch time.
T3 is a fast acting med, so it gets into your system quickly, peaks within a few hours and then is gone. By taking it in 2 doses, we keep the level stable throughout the day, rather than getting it all in one big slug in the morning, then having nothing the rest of the day.
If you find that you can't quarter the pills, sometimes, we just have to ride it for a while until our bodies get used to having the right hormones. When we're hypo, our adrenals kick in and try to take up the slack, then when we start providing adequate thyroid hormones again, the whole body has to re-balance. It takes a lot of time and patience, as well as ingenuity to figure out how to get the dosages we need.
I'm curious to know how you have been increasing Tirosint by 3-7 mcg at a time?
Your FT3 is definitely too low and your FT4 is slightly above our recommended mid range at 60%. Your FT3 was only 25% of its range and the recommendation is upper half to upper third of its range. It certainly looks like you aren't converting adequately.
Since it was only 2.5 mcg cytomel you started, not 25 mcg, IMO, you should have dropped your Tirosint down to 112 mcg, since your FT4 was higher than it needed to be, to start with.
It's important to note that symptoms often get worse or new ones appear when changing medications or dosages. It's also important to note that some symptoms can apply to either hyper or hypo - for instance, I had the exhaustion, muscle aches, racing heart and anxiety when I was very hypo. With your FT3 as low as it is, I believe you're hypo, now, as well, since FT3 correlates best with symptoms. Losing 12 pounds in 2 weeks would be considered hyper, in most cases; however, if it were me, I'd consider it normal, since I've had trouble losing weight ever since my thyroid whacked, since I never had a weight issue in pre-hypo days.
I know the cytomel pills are tiny, but have you tried quartering them? It's not easy, but I've done it. You could try taking 1/4 of a pill in the morning and 1/4 of a pill around noon. Most of us on a T3 med find that we have to split the total dose into more than one. For instance, I'm on a total of 10 mcg/day and I take 5 mcg in the morning, with my T4 med and 5 mcg at lunch time.
T3 is a fast acting med, so it gets into your system quickly, peaks within a few hours and then is gone. By taking it in 2 doses, we keep the level stable throughout the day, rather than getting it all in one big slug in the morning, then having nothing the rest of the day.
If you find that you can't quarter the pills, sometimes, we just have to ride it for a while until our bodies get used to having the right hormones. When we're hypo, our adrenals kick in and try to take up the slack, then when we start providing adequate thyroid hormones again, the whole body has to re-balance. It takes a lot of time and patience, as well as ingenuity to figure out how to get the dosages we need.
I'm curious to know how you have been increasing Tirosint by 3-7 mcg at a time?
I would not expect that amount of T3 to cause the reactions you had. Which made me wonder if you have been tested for ferritin. Following is a quote on this subject, which prompted my question.
"Excessively low ferritin as well as low iron can resulting in hyper symptoms when raising desiccated thyroid (armour). Severely low ferritin or iron can be improved quickly with iron injections or IV iron infusion - a few weeks as compared to a few months from iron supplementation."
What, if any, symptoms were you having before adding the Cytomel?
"Excessively low ferritin as well as low iron can resulting in hyper symptoms when raising desiccated thyroid (armour). Severely low ferritin or iron can be improved quickly with iron injections or IV iron infusion - a few weeks as compared to a few months from iron supplementation."
What, if any, symptoms were you having before adding the Cytomel?
So sorry, meant 2.5!! Half a 5 MCG cytomel.
My labs prior were
Tsh 3.53 (.5-5.0)
Ft 1.4 (.8-1.8)
Ft 2.5 (2.0-4)
It was still too much cytomel for me. I have been raising tirosint by 3-7 mcgs every 4 weeks for past 18 months. My original tsh was 30. I am just so desperate to feel better. Thanks for your input
My labs prior were
Tsh 3.53 (.5-5.0)
Ft 1.4 (.8-1.8)
Ft 2.5 (2.0-4)
It was still too much cytomel for me. I have been raising tirosint by 3-7 mcgs every 4 weeks for past 18 months. My original tsh was 30. I am just so desperate to feel better. Thanks for your input
COMMUNITY LEADER
Were you taking all 25 mcg of cytomel at one time? If so, I can see why you had hyper symptoms... Wow!!
First off, 25 mcg of cytomel is WAY to much to start off with and T3 is almost always best split into more than one dosage/day.
One should always start off with very low doses of T3 and work up slowly to whatever dose you need. A typical starting dose of T3 is 5 mcg, split into 2 doses/day. If this is tolerated well, an additional 5 mcg can be added after 2-3 weeks, with testing done after 6 weeks to see what effect the addition has had on your FT levels.
It's also customary to decrease T4 med by 20-25 mcg for every 5 mcg of T3 added; you only decreased by 12 mcg for 25 mcg of T3. It should be noted that most of us don't have to drop a full 20-25 mcg for every 5 mcg T3, but we do need to drop more than 12 mcg for every 25 mcg of T3.
What are your actual thyroid hormone levels now? Please post the most current results, with reference ranges, which vary lab to lab and have to come from your own lab report.
You may have to drop back to the 125 mcg with no cytomel for a while and let your body adjust, then gradually add small doses.
First off, 25 mcg of cytomel is WAY to much to start off with and T3 is almost always best split into more than one dosage/day.
One should always start off with very low doses of T3 and work up slowly to whatever dose you need. A typical starting dose of T3 is 5 mcg, split into 2 doses/day. If this is tolerated well, an additional 5 mcg can be added after 2-3 weeks, with testing done after 6 weeks to see what effect the addition has had on your FT levels.
It's also customary to decrease T4 med by 20-25 mcg for every 5 mcg of T3 added; you only decreased by 12 mcg for 25 mcg of T3. It should be noted that most of us don't have to drop a full 20-25 mcg for every 5 mcg T3, but we do need to drop more than 12 mcg for every 25 mcg of T3.
What are your actual thyroid hormone levels now? Please post the most current results, with reference ranges, which vary lab to lab and have to come from your own lab report.
You may have to drop back to the 125 mcg with no cytomel for a while and let your body adjust, then gradually add small doses.
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