# Put on cytomel only??



## lizziesue (May 29, 2012)

Hi all, I have been treated for hypothyroidism for about 2 years now, and I am still struggling to get back to feeling somewhat normal. I started on 50 mcg of levothryroxine (synthroid I guess is the name brand) and my TSH went down for about a year. Then, all of the sudden my TSH went back up, so my dr. upped to me 75 mcg of levothyroxine. When I had my blood tested to see whether the new dose was helping, the dr's office called to say that my T3 was low and the dr. wanted me to come in and talk about changing up my meds.

Then, I got pregnant and the dr. office told me that my obgyn would take over management of my thyroid issues while pregnant. The obgyn sent me for blood tests, but I didn't realize until I got the results that they didn't even test my T3. Anyway, I sadly miscarried toward the end of my 1st trimester and after several weeks went back to my regular doctor because he wouldn't give me any more refills until we retested and saw the whole picture.

So, my last blood test showed a TSH of 0.6 (range .4-4.0) and a T3 of 70 (range 80-200 if I remember correctly). He didn't tell me my T4 # but said it was in range. The dr. told me he wanted me on a medicine with T3 and that he thought many of my symptoms would be improved if we could get my T3 up. I was happy to comply as I have had symptoms the whole 2 years even when my TSH was in the normal range.

Anyway, when I picked up my prescription, it was for 25 mcg of liothyronine (cytomel) and no levothyroxine at all. It seems everything I read talks about adding T3 meds on top of the T4, not replacing it altogether. Anyone else only on cytomel and no synthroid??


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## Andros (Aug 26, 2009)

lizziesue said:


> Hi all, I have been treated for hypothyroidism for about 2 years now, and I am still struggling to get back to feeling somewhat normal. I started on 50 mcg of levothryroxine (synthroid I guess is the name brand) and my TSH went down for about a year. Then, all of the sudden my TSH went back up, so my dr. upped to me 75 mcg of levothyroxine. When I had my blood tested to see whether the new dose was helping, the dr's office called to say that my T3 was low and the dr. wanted me to come in and talk about changing up my meds.
> 
> Then, I got pregnant and the dr. office told me that my obgyn would take over management of my thyroid issues while pregnant. The obgyn sent me for blood tests, but I didn't realize until I got the results that they didn't even test my T3. Anyway, I sadly miscarried toward the end of my 1st trimester and after several weeks went back to my regular doctor because he wouldn't give me any more refills until we retested and saw the whole picture.
> 
> ...


Hoh, boy!!










Firstly, I am so so sorry for your loss.

Now.................THAT is a very very high starting dose of Cytomel. Most of us cannot tolerate 5 mcg. and have to split the pill in half for a few weeks and slowly work our way up by small increments.

Apparently, your doctor thinks that you are converting your T3 to rT3 and one way to set that straight (or so I hear and read) is to Rx Cytomel only. I advise you to query this doctor and here is info on rT3 (reverse.)

rT3
http://thyroid-rt3.com/whatis.htm

And I am not out to doctor bash BUT..............your doc should be running the TSH, FREE T3 and FREE T4 all at one time and not basing Rx on the TOTALS (T3 and T4.)

Here is info on that.

http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm

have you had any antibodies' tests or an ultra-sound of the thyroid?


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## lizziesue (May 29, 2012)

Thanks for the links, Andros! The rT3 link especially was very helpful. It helped me to know that T3 only treatments do exist as I hadn't found any mention of that anywhere else.

Now, I LOVE my doctor for a variety of reasons, but perhaps the biggest one is that after years of complaining of the same kinds of symptoms to other doctors, the minute he heard my complaints he tested me for several things, including thyroid problems. He does test me for several things each time, but I honestly don't know as much as I should about the different numbers (Free T3, T4, etc.) so I am not including all the results he shared with me, just the ones that I wrote down because I thought they were the most significant. I think I will ask the dr. office to send me the full lab report so I can do a little research and educate myself better on exactly what is going on with me.

I think he tested my antibodies back when my TSH started going back up. He also sent me for an ultrasound because I had been having some tightness in my throat around my thyroid area. They didn't see anything out of the ordinary on the ultrasound, and so he sent me to an ENT to deal with the throat pain (turned out to be silent acid reflux that was damaging my vocal chords).

Anyway, I feel like he has tried to be very thorough, and he is certainly the first doctor to actually take my symptoms seriously. That being said, I thought this dosing was very strange based on the little research I have done about T3 treatments. In fact, my first instinct was that there had been a problem in the transmission of my prescription to the pharmacy and my levothyroxine prescription had been lost.

Anyway, it looks like I need to call the doctor and ask about getting a copy of my labs and at least splitting my dose, if not starting slower and ramping up to 25 mcg.


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## teri2280 (Feb 7, 2012)

I didn't exactly have your same situation, I was on Cytomel only for 2 weeks in prep for RAI, but I LOVED it. I was on 50 mcg total (25 ea. 2x a day, after discontinuing 175 mcg of levothyroxine, so while your dosage may seem high to others, it seems about right to me, considering your levo dosage was about half what my levo dosage was), and I kid you not, I could have taken on ANYTHING. It seriously was one of those things where it took me feeling better to realize I'd felt bad. All this time, even before TT, I've had "normal" labs, and when I was talking to my endo's secy. about feeling so much better on Cytomel, she "supposedly" asked him about it (something I'm not entirely sure of, but that's another story lol), and I was told it was all in my head. I'll admit, while I didn't totally buy that, I was somewhat open to the possibility, at least until I felt the crash. (Cyto doesn't stay in your system as long as Levo, from what I've seen and been told, so it was pretty much an immediate thing.) I suppose, it still could have been "in my head", as I was only on the Levo for 4 weeks before the switch to Cyto, so I'll have to see what happens when I go back on my Levo, but my doc is one of those endo's who is always-right-doesn't-like-when-you-do-your-own-research, so I'm going to have to give it some time before I run my theory by him. (I think I need some frees run. They've never been run, and I think my body is having trouble converting, and to tell the doc this 2 weeks after RAI/going back on Levo will just be stupid on my end. LOL.) At least I have a goal- to feel as good as I did while I was on the Cytomel. Whether that will have to include Cyto or not, I have no clue at this point, but we'll see what happens about 6-8 weeks back on the Levo.


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## Andros (Aug 26, 2009)

lizziesue said:


> Thanks for the links, Andros! The rT3 link especially was very helpful. It helped me to know that T3 only treatments do exist as I hadn't found any mention of that anywhere else.
> 
> Now, I LOVE my doctor for a variety of reasons, but perhaps the biggest one is that after years of complaining of the same kinds of symptoms to other doctors, the minute he heard my complaints he tested me for several things, including thyroid problems. He does test me for several things each time, but I honestly don't know as much as I should about the different numbers (Free T3, T4, etc.) so I am not including all the results he shared with me, just the ones that I wrote down because I thought they were the most significant. I think I will ask the dr. office to send me the full lab report so I can do a little research and educate myself better on exactly what is going on with me.
> 
> ...


This paints a whole new picture; indeed......................I believe you do have a very good doctor! And we are all glad for it!

Keep us informed on your progress if you will? And know that we are here for you.

And, I would like to know what your doc says about cutting the 25 mcg. Cytomel dose to start. You very well may end up on 25 mcg. though on the long haul. I am stable on Armour 3 grains which is a total of 27 mcg. of T3. However, I started at the bottom. LOL!

You are welcome and............................


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## lizziesue (May 29, 2012)

Glad to hear that someone has loved being on cytomel! I have a friend who said it was like a light when on in her when she started on it (though hers was added to synthroid, so I don't know if that makes any difference). I have felt pretty crazy on it the last few days - dizzy, confused, headaches, and so tired that walking around seems overwhelming. I always seem to feel more hypo symptoms the first week I have my dose changed, though. Not sure why that happens, but this is the 3rd time I've noticed it.

Anyway, put in a call to the dr. yesterday, and the nurse called back and said the dr. definitely wants me only on the cytomel for now but that if it is bothering me I should feel free to split the dose. For those who split their dose, do you try to take it on an empty stomach or do you take it with food or other medicines? I am on a kind of crazy medicine schedule right that is already pretty spread out throughout the day (thyroid meds first thing at 6:00am, heartburn meds before breakfast at 7:30, allergy meds and several vitamins at lunch, and iron supplements just before dinner). Not sure when to fit in the second dose! I was thinking maybe an hour or so before lunch or sometime between lunch and dinner. Starting to feel 90 years old pulling out my little daily medicine pill box so many times a day!


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