# Cytomel advice



## runlikeagirl (Apr 19, 2010)

Hi all

I'm a newbie at this but am finding this forum very helpful. About six weeks ago my doctor added 25 mcg of cytomel (I've actually been taking the generic form). I also take 125 mcg of generic synthroid and when I was prescribed the cytomel my doctor did not adjust the synthroid. Overall I feel pretty good but am starting to notice weight loss (without doing anything different) and increased heart rate not alot 41bpm to 62 bpm. When I have been working out my HR has increased significantly the past 2 weeks and am sweating much more. I also feel a little more shakey and heachachey. I take both medications at once. I don't have a blood test till August. I can go in earlier but am enjoying the weight loss which has been so hard for me even though I am very active. I am looking for some advice about dosage-don't doc.'s normally reduce T4 med's when precribing a T3?

Thanks


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## Andros (Aug 26, 2009)

runlikeagirl said:


> Hi all
> 
> I'm a newbie at this but am finding this forum very helpful. About six weeks ago my doctor added 25 mcg of cytomel (I've actually been taking the generic form). I also take 125 mcg of generic synthroid and when I was prescribed the cytomel my doctor did not adjust the synthroid. Overall I feel pretty good but am starting to notice weight loss (without doing anything different) and increased heart rate not alot 41bpm to 62 bpm. When I have been working out my HR has increased significantly the past 2 weeks and am sweating much more. I also feel a little more shakey and heachachey. I take both medications at once. I don't have a blood test till August. I can go in earlier but am enjoying the weight loss which has been so hard for me even though I am very active. I am looking for some advice about dosage-don't doc.'s normally reduce T4 med's when precribing a T3?
> 
> Thanks


That is a mighty huge dose of Cytomel; I have to say. Most patients are started on 5 mcg and they can't tolerate that too well at first and cut the pill in half to start on 2.5 mcg..

Cytomel is very powerful and I am not going to tell you what to do here but you could be in danger. It is easy to get overmedicated on this pharmaceutical and it could be life-threatening.

So..................I urge you to get in touch w/ your doctor and get labs done STAT.


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## runlikeagirl (Apr 19, 2010)

Thanks. I think that is good advise and am going to request labs done asap.


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## Lovlkn (Dec 20, 2009)

runlikeagirl,

I agree that is a huge dose on top of the 125 of generic synthroid. It really sounds like you have done well on it and if your labs come back looking good you might try splitting the dose throughout the day - every 6 hours or so.

Personally for me I notice a "boost" about 2 hours after taking my 5mcg Cytomel pill - it's so consistent I can almost set my watch with it.

Your heartrate at 41bpm sounds very low - is that normal?


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## runlikeagirl (Apr 19, 2010)

41 is low but I run and bike alot. My blood pressure was 93/56 so my doctor and I discussed adding the cytomel as my t3 was low. I can feel a difference after I take it. I actually cut my pills in half and today starting taking half until I talk to my doc. on Monday & get a blood test. I went for about a 2 hr mt. bike ride last night and my hr was really elevated. I felt dizzy afterwards and very tired. Today I was so exhausted took a 3 hr nap.

I can tell with my training I am actually slowing down, my 5k time was slower.

Thanks so much for the help.
Michelle


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## Lovlkn (Dec 20, 2009)

runlikeagirl said:


> 41 is low but I run and bike alot. My blood pressure was 93/56 so my doctor and I discussed adding the cytomel as my t3 was low. I can feel a difference after I take it. I actually cut my pills in half and today starting taking half until I talk to my doc. on Monday & get a blood test. I went for about a 2 hr mt. bike ride last night and my hr was really elevated. I felt dizzy afterwards and very tired. Today I was so exhausted took a 3 hr nap.
> 
> I can tell with my training I am actually slowing down, my 5k time was slower.
> 
> ...


You need labs insist they run a FT-4 and free T 3. These will give you the big picture of what is happening.

I am not as much an athlete as you but like I mentioned about 2 hours after taking my cytomel I feel a definite increase in what is more like tight chestness and my heart rate seems to increase as well. After that happens for about an hour all is good.

You say you have been on it for a few months - have you noticed any anxiety type issues with taking it? That seems to be the first thing I notice when my FT-3 is higher than it should be.


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## runlikeagirl (Apr 19, 2010)

I notice being shakey and jittery right away when I started taking it. After about 6 weeks I ntoiced my mind racing, difficulty sleeping, fatigue and increase over the last 3 weeks when I run or bike in my hr. I feel better now that I cut my med's in half. But will request blood work you recommended when I call the doc. on Monday.

Thanks so much!


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## Lovlkn (Dec 20, 2009)

runlikeagirl said:


> I notice being shakey and jittery right away when I started taking it. After about 6 weeks I ntoiced my mind racing, difficulty sleeping, fatigue and increase over the last 3 weeks when I run or bike in my hr. I feel better now that I cut my med's in half. But will request blood work you recommended when I call the doc. on Monday.
> 
> Thanks so much!


Hi runlikeagirl,

Well... welcome to the "Cytomel zone" my friend refers to it as TNC - Cytomel is very powerful and many people can "feel it" just like you and I do. I had to give up 2.5mcg with just over mid range FT-3 due to it making me a bit "on edge" and kind of back to a hyper feeling at times.

From what I recall reading in your experiences it has been quite awhile since you have had labs. When you get some lab's done please let us know where you are along with ranges. You should at minimum request the Free T-4 and the Free T-3 (Triiodothyronine )

lovlkn


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## peaches (Sep 29, 2009)

How close together does everyone take their cytomel dosages? I had been taking mine at 5:15am and 3pm but just recently started taking my second dose at 1:30pm. What is the minimum amount of time that they can be taken apart? I am on 2 5mcg doses of cytomel daily. I was not sleeping well taking it at 3pm.


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## Lovlkn (Dec 20, 2009)

peaches said:


> How close together does everyone take their cytomel dosages? I had been taking mine at 5:15am and 3pm but just recently started taking my second dose at 1:30pm. What is the minimum amount of time that they can be taken apart? I am on 2 5mcg doses of cytomel daily. I was not sleeping well taking it at 3pm.


http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=2844
Per the Cytomel drug insert:
"Dosage and Administration

The dosage of thyroid hormones is determined by the indication and must in every case be individualized according to patient response and laboratory findings.

Cytomel (liothyronine sodium) Tablets are intended for oral administration; once-a-day dosage is recommended. Although liothyronine sodium has a rapid cutoff, its metabolic effects persist for a few days following discontinuance."

- I simply do not see how that is possible to take it once daily.

I have been taking 2 1/2, 5mcg pills daily and just cut out the 1/2 due to what I believe are hyper symptoms. About 2 hours after taking it I can definitely "feel it". The package insert said Cytomel is completely absorbed into your system in 4 hours.

I take my Cytomel upon waking and approx 6 hours later. When I was taking the other 1/2 pill I tried taking it at my second dose and got extremely hyped up so I began taking it about 3-4 hours later.

I read or heard from someone a long time ago that it should be dosed every 6 hours but I do not have a source and no doctor ever told me that. It seems to work for me - dosing every 6 hours.


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## Andros (Aug 26, 2009)

peaches said:


> How close together does everyone take their cytomel dosages? I had been taking mine at 5:15am and 3pm but just recently started taking my second dose at 1:30pm. What is the minimum amount of time that they can be taken apart? I am on 2 5mcg doses of cytomel daily. I was not sleeping well taking it at 3pm.


When I had to take Cytomel due to Armour shortage, I took the full dose every morning @ 5:20 AM. If you take your med in a timely fashion, it will build up and you will be steady on.

The biological half-life is about 2 1/2 days depending on your level of actual physical activity.


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## runlikeagirl (Apr 19, 2010)

I went to the doctor today and had a TSH, free T4 & free T3 test. At first they were not sure about doing a blood test as I cut my dose in half since Sat. and had only been taking 12.5 vs 25 mcg. I could not imagine conituing to take the 25 mcg-I thought I might have a heart attack. I will let you know when I get the lab results.


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## Andros (Aug 26, 2009)

runlikeagirl said:


> I went to the doctor today and had a TSH, free T4 & free T3 test. At first they were not sure about doing a blood test as I cut my dose in half since Sat. and had only been taking 12.5 vs 25 mcg. I could not imagine conituing to take the 25 mcg-I thought I might have a heart attack. I will let you know when I get the lab results.


Oh,Lord. If you felt the need to do that, all the more reason to do the tests. My gosh, where does the actual patient fit in here?
We will all be anxious to see the results and ranges. Let us know and thank God you cut your dose in 1/2.


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## runlikeagirl (Apr 19, 2010)

I got my labs back today and sorry but I forgot to get the normal lab ranges.

TSH .01
free T4 Normal
free T3 477-which the nurse said was high. I have an appointment scheduled next Wed.

I started to take the Cytomel because my T3 was low or on the low end of normal and I was feeling so tired.

Any advise on what to ask the doc. I honestly don't know why she prescribed such a high dose of Cytomel should I ask to go down to 5mcg?

Thanks
Michelle


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## Lovlkn (Dec 20, 2009)

runlikeagirl said:


> I got my labs back today and sorry but I forgot to get the normal lab ranges.
> 
> TSH .01
> free T4 Normal
> ...


HI Michelle,

First thing you need to do is get copies of your lab work and post actual numbers with ranges. I never take their word when they say normal.

Your high FT-3 is what I think we were all expecting. What did the nurse say about taking your medications? You can probably split your pills one more time (1/4) and take that until you see the doctor to help bring your levels down. Lucky for you T-3 is a short acting hormone so you should start to feel better soon.

Personally I think your doc should have started you on the 5mcg dosage and then run labs and increased if necessary.


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## runlikeagirl (Apr 19, 2010)

Thank you. I will get the actual levels and normal ranges when I go to the doc. next week. I think that I will cut my pills in half and when I meet with my doc ask to be put on the 5 mcg.


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## Andros (Aug 26, 2009)

runlikeagirl said:


> I got my labs back today and sorry but I forgot to get the normal lab ranges.
> 
> TSH .01
> free T4 Normal
> ...


I agree with Lovlkn totally. I feel your doctor did wrong to Rx such a high dose of Cytomel. You are lucky you did not end up in the ER. And I am truly terribly sorry this happened to you.


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## runlikeagirl (Apr 19, 2010)

Hi all:

I saw my doc. this week. Below are the lab results from the June 22nd blood work with the normal ranges.

TSH .01 (.4-4.5)
T4 1.4 (.8-1.8)
T3 477 (230-420)

My doc. admitted that she should have reduced my synthroid and apologized. Don't think she is used to prescribing this or working with endo clients. Hopefully she has learned for future use. I'd go to an endo but the ones around here won't prescribe cytomel. We discussed changing my med's and after asking me what I wanted she put me on 5 mcg of cytomel and for now the synthroid is the same. I have a blood test in 6 weeks and am feeling much better on the 5mcg. I did a 10 k run yesterday to raise money for women in the congo and it felt so good to be out there again with my heart functioning like it should.

I want to thank all of you for your really good advice. I can't imagine continuing to take the 25 mcg of cytomel until I could see my doc.

Thanks to all
Michelle


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## HeidiBR (Apr 4, 2010)

runlikeagirl said:


> Hi all:
> My doc. admitted that she should have reduced my synthroid and apologized. to all


Do you mean CYTOMEL instead of Synthroid? If your T3 is that high, wouldn't she reduce your Cytomel instead?


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## runlikeagirl (Apr 19, 2010)

Yes she reduced my cytomel from 25 mcg to 5 mcg.


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## Andros (Aug 26, 2009)

runlikeagirl said:


> Hi all:
> 
> I saw my doc. this week. Below are the lab results from the June 22nd blood work with the normal ranges.
> 
> ...


Michelle; that should be perfect for now. Good deal. Also good on the 6 week lab. Since you run, you may go up a bit on the Cytomel over time as per your labs with doctor's approval but that would only be if you run consistantly. Like every day.


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