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I have been prescribed 25 mcg cytomel to be taken 1 on empty stomach!! I've been very sick for 6 yrs unable to work live or hardly function. I asked my dr for thyroid meds and finally she calls this in because my tpo antibodies were 3x normal. I was diagnosed with hashi in 2010... I tried ndt a couple times over the years but failed. I'm starting out with only about 1 mcg 2 x a day because my body had slowed so far down I knew it would land me in a hospital taking it as she prescribed. Today was day 3 and felt fatigued and in bed must of day.. I'm thinking the stress hormones ( adrenaline). are starting to lower . I'm thinking I will increase tomorrow slightly . I've been doing 2 doses but have read how many follow dr Lowe and do 1.. I follow dr Ray peats work. He suggests using t3 by using some closely matching our own physiology (4) mcg an hour is around what I body makes. Well I know we are all different and I'm very sensitive to any uppers! But I don't want to be feeling worse if possible... I ordered naturethroid and am considering adding it. Not sure when I should try that? So advice please as to using this t3 .. I eat very pro metabolism diet no gluten no pufa low muscle meat.. So I'm eating dairy, gelatin , fruit , some meat , eggs ... I have felt better on this diet and not bedridden after 2 years!! Thank you!

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  • Quiltgirl,

    Welcome to our forum and sorry to hear you are not feeling well.

    Cytomel will only replace the missing thyroid hormone and will not directly address the auto immune condition. I understand your reticence in possibly taking too much, too quickly, but 2 mcg T3 isn't enough. A usual starting dose would be 5 or 6.5mcg, adding a further dose after a week, if no adverse effects were felt.

    NDT is not always sympathetic to the possible iron//nutrients deficiencies caused by years of low thyroid hormone, and some find it difficult to introduce when so unwell.. You will need to have thyroid hormone levels tested to be able to medicate the correct amount of any replacement .

    Because the immune system is in a heightened state, many experience an over reaction to gluten ( and dairy). A gluten free diet and optimal nutrients will help the bodies immune responses to dampen, and slow the progression. Supplementing selenium has not only been shown to reduce TPOAb but encourages the T4-T3 conversion of thyroid hormones.

    To gain a good understanding of thyroid autoimmunity, a good read is "The Root Cause" Isabella Wentz..

    Ask your GP to test thyroid hormones (including T3) and Vit B12, folate, ferritin, Vit D and post any results complete with ranges (numbers in brackets) for members to comment.

    Members whose GP's are uncooperative re testing T3 levels use private labs - link below.


    Thyroid//gluten connection






    Private labs testing

  • Ty .. Yes I do labs just didn't post . I did the aip for 15 months then slowly reintroduced foods. I have no reaction to dairy or eggs. While abstaining all those months their were no difference in my symptoms. That was a long 15 months! I maintain strict diet of real food and no gluten . I have been using low dose naltrexone for 3 years it completely wiped out my antithyroidglobulin antibodies it took about 7 months. This last blood lab dr only ran tpo which in past was never elevated, this time it was 3 x normal. So she gave me cytomel? Not sure why no ndt or combo. Anyway I did order some ndt just not sure if I should use it or wait.

  • Quiltgirl,

    I agree that T3 is a strange choice to initially start replacement on but if you post all labs complete with ranges, members will comment.

    Optimal thyroid hormone often helps to reduce thyroid antibodies as everything just works so much better.

    If your nutrients//iron are all optimal, have you looked into sex hormones ? ? ...

  • You did not say anything about testing. Did your doc actually test your FT3 and conclude that it is low? And are you already on T4?

    As for dosing: when I was on T3-only, I used five 12.5mcg doses across the course of a day. I did not try the John Lowe "hail mary" approach of taking all T3 once daily. Since you are sensitive, I would start with one 6.25mcg dose (1/4 tab) per day and increase by 6.25mcg every couple days. If you start feeling hyper, the T3 has a short half-life so dropping it will get you out of hyper quickly. But if you are not on T4, one 25mcg tab of T3 daily isn't going to meet your thyroid need. While I was on T3-only, I found I needed about 0.82mcg/kg body weight to be euthyroid. Of course, some (e.g. John Lowe) will need more.

  • Ty eddie83 . Wow honestly I think that that much for me will spark adrenalin . Would you suggest that 1/4 start dose be spread through day? I've been doing 2 doses a day so far but I can see I will need more or as my dosage increases perhaps it will be better. Last nite i woke after only half hour with pounding heart I did salted oj with a bite of cheese paper bag breathing and I fell asleep ... honestly I thought the t3 is fully peaking around 4 hrs so then it starts to wear off? But it stays in body for couple days?

    Ferritin- 26 (15-150)

    TSH 1.670 (0.450-4.500

    Ft4 1.09 (0.82-1.77)

    Ft3 2.7 (2.0-4.4)

    Vit D 40.6 (30.0-100.0)

    Rt3 15.7 (9.2-24.1)

    TPO 107 (0-34)

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