To Cytomel, or not to Cytomel....

[fitfreak]

So I was on .025mcg of Cyotmel and .75mg Synthroid. I was feeling crappy again and went to a doctor that said I had to get off the cytomel, I had gone the other direction and was now HYPER thyroid. As I looked up the symptoms, I can say I have NEVER had a symptom of hyperthyroid. So I had more blood tests, my TSH was still low so he reduced my synthroid down to .5mg. My T4 was normal. I am gaining weight, dry skin, etc. So I went back and got my Free T3, Free T4 and TSH tested. TSH is normal, T4 is normal, T3 is low. Now, they want me to up my synthroid to .88mg and my cytomel to 1/2 a .025mcg tablet every second day. My head is kind of spinning. I am thinking that I will keep my synthroid at .75mg, back on cytomel 1/2 tab every 2nd day. Please help, what does everyone think?

[stella5349]

its another combo T3/T4 combo thyroid med only made from porcine (natural) thyroid.

Taking Cytomel wouldn't work every-other day. Its short lived by 4 to 6 hrs. Your only defeating the purpose of using it if you do that.

[fitfreak]

Hi there,

I am relatively new to all of this but what is ERFA desiccated thyroid? I am almost frightened to ask! Haha! I think that I am not going to take the cytomel every second day as that doesn't seem to be helpful. .5mcg synthroid and cytomel every day seems like a better option. Thank you!

[stella5349]

Oh forgot...

Taking T3 medication as I read you right above - every OTHER day - is certainly not going to resolve anything. In fact it will probably be bad.

If anything - I would take .50mcg T4 meds and keep the Cytomel going every day.

[stella5349]

I don't always say this but seriously basing your labs and location of being in Canada ... oh..... I hate to throw another wrench here on you too... but

it may be wise (again based off labs) to consider going to ERFA desiccated thyroid. It think the ratios of desiccated would be beneficial for you if you go to ERFA Canadian thyroid.

[dancingG]

I might be interested to get on ERFA (I am in Quebec, Canada) but the real problem is finding a doctor who will prescribe it... Do you have names or suggestions? Thank you

[Barb135]

I don't know that we have the names of any doctors that prescribe ERFA in Canada, but you can check with your pharmacy... Pharmacists that work in stores that sell the product will know of doctors in the area that prescribe it and most are willing to provide that information to their customers.

[fitfreak]

Thank you so much for the help! When I get home I will look at my Cytomel bottle. Now that you mention it, it might be 25 mcg. That's what happens when I try to go from memory, haha. That does make sense.  Thank you for finally giving a definitive answer! I didn't think I was hyper, as I read the symptoms and it just didn't fit! I will up my synthroid, and split my cytomel into two doses. That makes way more sense to me than anything else I have heard!  Thank you!

Fitfreak

[Barb135]

Yes, it makes sense, once you add the reference ranges.  You are hypo.  Your latest FT4 was barely in range - 15.49 (range 12.00-22.00) and your FT3 is totally below range 0 9 (range 1.3-3.1).   They are dosing you based on your TSH, which is going to keep  you sick.

It doesn't work for everyone, but rule of thumb is that FT4 should be about mid point in its range; FT3 should be upper third of its range.  

Your latest FT4 is barely in range, and your FT3 is actually below range.  I'm not even looking at your TSH because cytomel tends to suppress TSH and your FT's are both either barely above bottom range or below.  My TSH stays at less than 0.01; my former doctor panicked and began lowering my thyroid med and made me even sicker yet.. I think that's what they've done to you.  

I am confused though; do you really mean cytomel at 0.025 mcg or do you mean 0.025 mg, which would be 25 mcg?  Take a look at your med bottle and see what it says.  For instance, I'm on 88 mcg levo (generic synthroid) and 5 mcg liiothyronine (generic cytomel).  

I would agree that you might be good to up your synthroid to 88 mcg; I'd also think that your cytomel could be at 25 mcg/day, split into 2 doses; one (12.5 mcg) in the morning, the other (12.5 mcg) around noon or in the early to mid afternoon (depending on what time you get up/go to bed). You could actually even split it into 4 doses, spread evenly throughout the day, if you wanted to.  By splitting the T3 med into more doses, you will keep your levels more steady throughout the day, but you want to make sure you take it early enough that it doesn't interfere with your sleep.  

Hope I haven't totally confused you........

[fitfreak]

Hi there,

My results may be a little confusing as the first tests were done in Nevada, the most recent in Canada. On March 11 I had blood work done in Nevada with no T3 done. I didn't know at the time to request it. My TSH was so low it was immeasurable, my T4 was 1.40 with a range of .82-1.77. On April 28 I had blood work done in Las Vegas and my TSH was .020 with a reference range of .450-4.5. My Ft4 1.38 with a range of .82-1.77. I had my blood work done last week in Canada, and the results were TSH .32 with a range of .27-4.20 mIU/L. Free T4 15.49 with a range of 12.00-22.00 pmol/L, and my Free T3 was .9L with a range of 1.3-3.1 pmol/L. I hope that makes more sense to you, than to me! Haha! I also really hope you can help!

Thanks!

[Barb135]

What are the actual results of your TSH, Free T4 and Free T3?  Just saying they are normal, isn't enough for us to comment on, because even though they may be in the "normal" range for the lab report, they might not be "normal" for you.  Please post the results, along with the reference ranges, since these are lab specific.  The reference ranges should be right next to the result, often in parenthesis.  

Cytomel is a fast acting med and doesn't stay in your system for more than a few hours, so I can't see where taking it only every other day is going to do much, except have you "flying" one day and dead tired, the next.  It's also best to divide the dose into more than one/day in order to keep your levels more steady.

And don't worry about the TSH being low; cytomel often suppresses TSH and is not a worry as long as your FT's are where you need them to be. My TSH stays below 0.01 all the time and I know there are others who have similar results.  

At any rate, please post your actual results, along with the reference ranges, so we can comment further.