# advises on starting on T3 / Cytomel and what to expect



## Alya (Sep 24, 2014)

Hello, if i'm to start on T3 / Cytomel / Liothyronine Sodium what should i expect? i know i should start on a low dose but anything else you can share with me would be great

i had a thyroidectomy 2 years ago, and i'm on levothyroxine, i'm fine mostly, but i have gained weight despite having a healthy lifestyle, i'm convinced it have something to do with t4 conversion to t3

These are my last lap results:

*TSH*: 1.35

Unit: ulU/ml
Range 0.25 - 5.0

*Free T3*: 2.54
Unit: pg/ml 
Range: 1.71 - 3.71

*Free T4*: 21.27
Unit: Pmol/I
Range: 12 - 22

Thank you


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## Lovlkn (Dec 20, 2009)

> *Free T4*: 21.27
> 
> Unit: Pmol/I
> Range: 12 - 22


You would need to reduce your levothyroxine dose as adding T3 hormone will also increase FT-4 levels. You might also consider getting RT-3 testing done as your FT-4 is so high in range.

Add Cytomel slow - like 1/2 a pill every 6 hours if on a 5mcg dose. If you have any side effects such as anxiety , rapid heart, back down to 1/4 a pill 2x a day until the symptoms subside. If you only take 5mcg daily, I would suggest splitting as it does have a 6 hour 1/2 life and 1 pill in my opinion needs to be spread out during the day.

I take my Cytomel away from my T4 hormone and also with some food mid day as I tent to "feel" my second dose.

Most avoid taking Cytomel past 3pm as it seems to affect sleep habits.


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## Alya (Sep 24, 2014)

thank you so much for this, i'm just wondering does taking t3 long term is advisable? i mean should i take a break every 6 months or so? i'm trying to figure why endocrinologists dislike it that much


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## Lovlkn (Dec 20, 2009)

Why would you want to take a break from your medication.

I wake several times during the night so I got in the habit of taking my Levothyroxine at 2 am. then I wake around 5:30 and take my Cytomel.

I do this because I take calcium supplements 3x a day and need to avoid my thyroid hormones as best as I can. Since I take my Cytomel 3x a day I figure at least the first dose is 4 hours away from calcium or food.

You can start by adding 1/2 a T3 hormone pill when you take your levothyroxine. I don't do it that way but most people do. Avoid food for at least 1 hour and be sure to take your pills with a full 8 oz of water.

Your second T3 hormone dose will naturally fall around lunch so it's harder to avoid the food.


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## Alya (Sep 24, 2014)

> Why would you want to take a break from your medication.


i talked to an acquaintance of the family, he's an endocrinologist consultant "old school though, he's retired, some of his information needs to be updated" and he said that he doesn't recommend using cytomel for 2 reasons, my lab results are great and there is no need to change anything, and t3 wont effect the weigh gain issue + even if i start using cytomel, how long will i keep this? 
i told him "forever? same as i would use the t4" to which he replies "it could cause osteoporosis if t3 levels were high for a long period of time"

i did a quick research and the fear seems to be there, but i mostly found results saying there is no relation between the two and using t3 for long periods and not being hyber of time won't cause osteoporosis
i don't know, maybe i'm being selective here

Also, should i fear hair loss when i start taking T3?


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## Lovlkn (Dec 20, 2009)

> he said that he doesn't recommend using cytomel for 2 reasons, my lab results are great and there is no need to change anything, and t3 wont effect the weigh gain issue + even if i start using cytomel, how long will i keep this?


I've been on Cytomel for 9 years. I have never ever heard someone suggest stopping for a period of time.

Your labs are not optimal - your FT-4 is top range. I for one feel horrible with top range FT-4. You will feel better and lose weight if your FT-4 is closer to the 1/2-3/4 of range and your FT-3 is also in the 1/2 - 3/4 of range. Your TSH will likely suppress if optimally dosed.

Why was your thyroid removed?


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## Alya (Sep 24, 2014)

> *Free T3*: 2.54
> Unit: pg/ml
> Range: 1.71 - 3.71
> 
> ...


by (1/2-3/4 of range) you mean:
get the ft3 to 2.7 - 3.2 
and the ft4 to 17 -19 
correct?

as for why i removed them, in 2008 removed to left side for "weird looking nodule" it was part solid part Fluid - filled, they removed the Fluid and analyzed the solid and said it was benign, less than 2 months later it was filled again, i did another ultrasound and both doctors said it looked weird, better removed it and analyze it all, it was benign

in 2014 i had 2 cold solid nodules, did an autopsy, it was benign too but doctor said better to remove the remaining thyroid for there was a high probability for it to turn cancerous, and so i did

this year my doctor had my doing a Thyroglobulin test + Thyroglobulin ab(tgab) test just to make sure, and results were good


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## Lovlkn (Dec 20, 2009)

> by (1/2-3/4 of range) you mean:
> 
> get the ft3 to 2.7 - 3.2
> and the ft4 to 17 -19
> correct?


Yes.


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## Alya (Sep 24, 2014)

Hi there, i did the rT3 test and just got the results

*Reverse T3 {Q}*: 32
Unit: ng/dl
Reference Range: 8.0 - 25.0

i do get there's too much rT3. but just how much is this? from your own experiences?

for now i'm focusing on improving the FT4 to FT3 conversion naturally by raising my Iron level "it was 9.5 one month ago" and also raising the Zinc, B6 and Selenium, hopefully this will work, if not, i will start on the t3 bills, very low dosage "2.5"

but should i also lower my t4 intake for now?

i'm really thankful for your help, i wouldn't have done the rT3 test which proved there is indeed a problem if not for the advice, it just disappointing that non of the 4 endocrinologist consultants i went to suggested that, but then again of course they wouldn't, they don't consider there to be a problem to begin with 
*sigh* sorry for venting and thanks again


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## jenny v (May 6, 2012)

Ugh, that's a terrible reverse T3 result, unfortunately. You want it much lower in the range, closer to 10-12. It shows that the T3 is being built up in your system, instead of being used by your cells. I don't think the natural route is going to make much difference with an rT3 that high, I would start on the T3 meds myself.


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## ssMarilyn (Nov 15, 2013)

I took the lowest dosage they had, 5mg I believe.. and cut it in half and it still made me feel like I was on speed. I took it maybe two times and that was it. I switched to Armour, which made a huge difference, but now I'm suffering from SAD, which I never had an issue with on Synthroid.


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## Alya (Sep 24, 2014)

Thank you both for the insights, i'm stilling hoping for more inputs if i may xD


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## ssMarilyn (Nov 15, 2013)

*After we got my Armour adjusted to the correct dosage for me, SAD went away and I feel GREAT!*


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## Lovlkn (Dec 20, 2009)

ssMarilyn said:


> *After we got my Armour adjusted to the correct dosage for me, SAD went away and I feel GREAT!*


I'm curious to see your lab's. Do you have any with ranges you could share? Is vitamin D a test they run regularly as well?


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## Sabrina (Aug 30, 2016)

Wondering if you started the T3 and how you are feeling? I'm about to start it as well.


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## Alya (Sep 24, 2014)

Sabrina said:


> Wondering if you started the T3 and how you are feeling? I'm about to start it as well.


hi, no not yet  i can't actually find it where i am "saudi arabia" and don't have a prescription so i can't order it online, i will look into Bahrain pharmacies, its an hour ride from where i live, i really hope i can find it,

but you may want to try this



> for now i'm focusing on improving the FT4 to FT3 conversion naturally by raising my Iron level "it was 9.5 one month ago" and also raising the Zinc, B6 and Selenium, hopefully this will work, if not, i will start on the t3 bills, very low dosage "2.5"


there were one improvement, i lost 3 kilos in a 1-2 weeks from starting -didn't change anything but taking iron bills + Brazil nuts for the Selenium and sunflower & pumpkin seeds for the zinc & b6- but that's it, i lost these 3 kilos and not more, been like this for months now, guess its better than gaining, did a ft3 test and it's was actually lower than before xD so yeah, may work better for you though

anyway my iron level still low (11) i will wait few months more for the iron to raise to 14, if until then and if still no raise in the ft3 levels, than i really need to find me cytomel and start on it

so i advise you to make sure your iron levels aren't low and affecting your conversion from t4 to t3

good luck


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