Thyroid UK
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Advice on Cynomel dosage for newbie

Hi,

I posted a few months ago with my results and have worked really hard on supplementing my iron,folate,B12 levels etc and am eating very cleanly plus gluten free and have really noticed a big difference in my energy levels and overall sense of wellbeing (even after sadly losing my job a couple of weeks ago).

After going back to my docs (who was hopeless again) I'm giving up with them.I'm totally ok with taking charge of my own health now and realise that i can do this and get better without the "help" of the NHS.

SO after a lot of research (and a recent holiday to Mexico) I now have a supply of Grossman Cynomel 25mcg.

I've split them into 4 doses of 6.25mcg (as read on here as an ideal starting dose) and i've taken my first quarter at 7am this morning and am due another at 11am,then 3pm.I will gauge how i get on with this for now and see if i need to add a final dose later c8pm .

My issue is fitting in food and supplements! Do i have to wait 1 hr before food,2 hrs after? Am struggling to fit the eating bit in as that only gives me a one hour window.Also would love advice on when to take my supplements as i usually take 2 Solgar Easy Iron capsules,washed down with a Higher Nature vit C "drink" and i also apply a slow release iron and b12 patch to my skin which slowly releases over 8 hrs (these have been amazing as i don't feel sick). This morning i've read that there should be a 4 hr window between T3 and supplements-arghhhhh.My head is spinning with the schedule.How do any of you juggle this? I also take a magnesium supplement at night and a probiotic too.

Thanks in advance!

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So you're planning to start on 25 mcg a day? I really don't think you read that advice on here. Hormones should always be started low, and increased slowly. It's usually advised to start on a quarter pill a day - 6.25 - and increase by a quarter every two weeks until you reach 25 mcg. If you're not used to taking T3, starting on 25 mcg is going to be too much for you, I'm sure.

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Thank you greygoose.I was planning on taking 6.25 at 7am/11am/3pm (think this came from recoveringwitht3.co.uk) but if advice on here is to start slower i'd rather do that and get it right!

I've just taken a second dose at 11am so i'm up to 13mcg :-(

Would it be ok to just take one dose daily at 7am then and wait and see how i fare on that for a couple of weeks and based upon my symptoms then add a second dose of 6.25 at 11am?

Thank you so much.It's bad enough trying to get it right but with a fuzzy head i'm struggling sometimes x

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How much levothyroxine were you taking before you switch? There's absolutely no need to split doses. When you are on the optimum dose you feel good. 25mcg T3 is equal to approx 100mcg of levothyroxine.

Before you begin you should take your pulse/temp several times a day so you have a starting point and when you begin do the same until you get to a dose which you feel well. Sometimes we feel very hot - temp may be the same and also the same with the pulse. If either go too fast, drop to previous dose and stay on that dose.

The problem with splitting doses is that our stomach has to be empty as food interferes with the uptake. Also it is a life-time of taking thyroid hormones replacements so you want to make it as easy as possible.

Read the following January 30, 2002

web.archive.org/web/2010103...

The action of T3 is to saturate the receptor cells, then that one dose lasts between one to three days.

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Thanks Shaws-i've never taken any thyroid medication before (as the docs have refused to listen to me for two years).

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Dr Lowe was an expert on T3 as he himself took it (150mcg in the middle of the night) . I take T3 only in one dose when I get up and have done so for the past three or four years (time passes too quickly for me :) and am pleased that it has worked for me.

You should start on 1/2 tablet once daily = 50mcg of levothyroxine and increase by 1/4 abut every 2 weeks, taking note of your pulse/temp several times a day and before you begin and afterwards. Sometimes we feel too hot but temp might be the same - sometimes we get palpitations. If either happen we should reduce back to previous dose.

web.archive.org/web/2010103...

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Thank you shaws! I've read a bit of Dr Lowe and he just makes total sense.

Because i've not taken any thyroid medicine before i'm going to do this slowly and will measure my temp/pulse too (have the spreadsheet in place already!).

Am going to take this one day at a time (literally too)at 6.25mcg and up every two weeks til i feel optimal and hopefully it will work for me (and if not i'll go back to the drawing board again-not giving up now...have accepted my ill health for too long now and i want my old life back)! Can't wait to see now...

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Dr Lowe only used T3 for his thyroid hormone resistant patients, The others were prescribed NDT. This is a chapter from his book:-

web.archive.org/web/2010112...

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The more i read (and know from family members still suffering on levo) i think this is the right road for me too.Time will tell! Thanks so much for our support

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I don't think 'recovering with T3' is talking about people that have never been on any thyroid hormone before. I thought it was for people who aren't recovering with T4 only. I think you're playing with fire, at the moment. No, I really cannot advise you to take another 6.25 today. You've already had too much for someone that has never been on any thyroid hormone replacement before.

I don't know what the people on STTM forum were talking about. Maybe you didn't explain your situation clearly. But, on the other hand, I think one often gets bad advise, on there!

If you are going to carry on with the T3 only - although I wouldn't advise it without knowing very much about how you react - I think you should just one dose of 6.25 mcg for the next two weeks, and see how your body reacts. Otherwise, you are rather asking for trouble.

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i got in a real mess trying to schedule everything, so now i take my whole dose when i wake often 3-4am go back to sleep and then do my supplements with breakfast 7-8am if i need additional t3 if busy day i juggle a window. I have been t3 only for just over a year, i think starting out its best to split doses but its not easy, i set reg alarms on my phone xx

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I'm wondering why you're starting on T3 only?

Your other post a month ago showed results of

Thyroid Stimulating Hormone : 5.07 (0.27-4.20)

Free Thyroxine : 11.88 (12.00-22.00)

Total Thyroxine T4 : 80.7 (59.00-154.00)

Free T3 : 4.33 (3.10-6.80)

With folate deficiency, barely in range B12, and iron results which humanbean advised were screaming out for iron. She suggested you post on the PA forum for advice, which you haven't done, and that your nutrient levels needed addressing before your thyroid.

No thyroid hormone is going to work unless your nutrients are in a better position, preferably optimal which is

Vit D - 100-150

B12 - top of range

Folate - at least half way through range

Ferritin - half way through range

Plus, because of your poor iron status you need to know if you have iron deficiency anaemia.

As far as thyroid meds are concerned, your best bet, if you can't get diagnosed by your GP, is Levo to start with (or possibly NDT). You have little total T4, under range FT4, which is not surprising with your high TSH and your body is doing it's very best to push out at least some of the active hormone (T3) as you can see in your FT3 but that will eventually fall as well.

You don't know if you need T3 because you don't know if you can convert T4 to T3. Conversion needs optimal nutrient levels, but you also need some T4 to see if you can convert it.

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Thanks SeasideSusie.I've been addressing all my nutrients religiously now for a couple of months and whilst i'd originally thought of the ndt route i'd posted on STTM page first (way before discovering this site) and was literally "told off" for even considering adding any more T4 and advised to look at T3 only-which i'd never heard of up til then!).I'm even more confused now as thought i was doing the right thing.

I planned on another full thyroid panel test in September and another medichecks well woman to check my nutrients after the three months but sadly i now can't afford it (til i get another job) .So i'm having to use my symptoms as my guide for now.After paying a lot for blood tests,adrenal tests and nutrient tests to get this far i'm now having to prioritise the kids and the bills.

I do feel i'm going on the right direction though and am hopeful i'll feel even better over time...and as a single mum i need to get back to working asap

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"was literally "told off" for even considering adding any more T4"

I can't see anywhere in either of your two threads where you say you are taking T4. Are you actually taking any Levo?

Do you really need the Medichecks well woman test? Is the Thyroid Check Ultravit not enough, that tests thyroid plus Vit D, B12, folate and ferritin for £99, sometimes on offer at £79. If you need iron status it's £39

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I've never taken any thyroid meds before and it was on a different site i was told to not consider adding T4 as a medication as my body was struggling to convert the T4 it was already making.

So i paid for the nutrient blood test to check my iron,d,B12 etc levels before supplementing (and i've felt a lot better as a result-and have more energy again.)I'm prob now have 4/10 in energy levels after being a 1/10 and can't wait to get this higher with either t3 or NDT.

Hopefully i'll see an improvement taking the T3 slowly :-)

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There's no way you can know if you convert T4 to T3 well enough when you're not producing much T4 of your own anyway. You know that from your results. Your body is doing it's utmost to provide you with some T3 at the moment, which every cell in your body needs, from the piddling amount of T4 available.

Levo works well for probably 80% of people who use it but you won't find them posting on here because they're well. So levo is the best place to start.

For those who don't do well on Levo, the easiest next step is to add some T3 as you get the flexibility of being able to fine tune the dose of each to suit the individual.

NDT has a fixed amount of T4 and T3 which suits some people but not all.

It may be that you are one of those people who do best on T3 only, but you should try Levo first as you could do very well on Levo only, or a levo/T3 combo if you find you don't convert well enough.

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Thanks SeasideSusie,

I've got several close family members on levo who have only proceeded to feel worse not better (but they are still blindly trusting their doctors advice) so i'm ultimately wary of levo.

I will investigate ndt though if my blood tests (which i can hopefully get again in the next few months) show no improvement.Thanks again for all your advice :-)

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Please take notice of what SeasideSuziesays... She really does know what she's talking about. A lot of us here complain about Levothyroxine because we took it for years without any marked improvement before being prescribed T3... Very few people (in fact, I suspect, nobody) started on T3 without having tried T4 beforehand.

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HI,

Regarding Vitamins I read years ago the best time to take them is one hour after your main meal, it worked for me. Minerals you should take on an empty stomach, so I take Minerals in the morning and Vitamins after tea. Don't go for high dosage supplements, they do harm in the long run (Unless for some reason a doctor advises otherwise for some reason) You can buy Vitamins and Minerals separately from Health stores or like me Amazon.

Hope that helps :-)

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