Cytomel Hyper Symptoms

[Andyb1205]

Hi. I see this Endo in a few days.

Meanwhile, since adding 5mcg Cytomel around ten days ago to 112mcg Synthroid (previously was self dosing on 125mcg), I’ve noticed that for the past few days I’ve been sweating a lot and feeling jittery. Feels like I’m over medicated.

Right now I take the Cytomel in the morning with the Synthroid, will it simply take time for my body to adjust or should I split the dose? I assume splitting it 12 hours apart would work?

Assuming the Endo will be cooperative, unsure if I should stick to the Synthroid and titrate that dose, or continue with combination therapy. Perhaps Cytomel was added prematurely.

Also, how do I get accurate test results on combination therapy considering the half life of T3?

Thanks!

[shaws Administrator]

T3 enters the T3 receptor cells and is absorbed quite quickly I believe.

I have read on the forum that if you're on T3 you should allow 12 hours gap between dose and test. I myself (T3 only) leave 24 hours and have had no problems with test results. Always the earliest possible test.

I would do what is easier for you when you get your test. Also the tests were introduced along with levothyroxine alone, therefore with combinations it should be all upon how the patient 'feels' on doses.

[Judithdalston]

you have already been on 125 mcg Cytomel, but reduced it presumably because you felt overmedicated before? Adding T3 to T4 is a case of experimenting and being patient- its short life means you can just miss a whole or part dose, or split it into two doses thru out the day, or at night, to see what works for you. Taking T4 alone is far far easier, from personal experience, than using T3 too- did you not get the T4 dose up to top of FT4 range to see if your FT3 would rise adequately without adding the T3? I leave between 8-12 hours between last T3 dose and blood draw, then if necessary take your dose straight after.

[Andyb1205 in reply to Judithdalston]

Sorry I just edited my post to indicate that I was previously on 125mcg, and then decreased to 112mcg and for the first time began Cytomel.

My family doctor refused to increase from the 112mcg Synthroid. Long story short I was trying to find a doctor to give me 125mcg (I was already self dosing), and strangely enough I found one who was more comfortable giving me Cytomel than just increase the Synthroid.

I’ve been feeling hyper symptoms these past few days and am unsure if it’s because the 125mcg Synthroid is still leaving my system or my body is very sensitive to the 5mcg Cytomel.

[Judithdalston in reply to Andyb1205]

Ok , I'll repeat to make sure I'm understanding correctly...you have self medicated T4 upto 125 mcg, but your doctor wouldn't prescribe this dose, but you found a doctor who would up your 'meds' by reducing T4 slightly to 112 mcg T4 , and adding 5 mcg T3. Did you have any full thyroid blood tests when on T4 either 125 or earlier 112 mcg- they would give you the best idea of how you were converting T4 to T3, and whether you were under or overmedicated before you started on T3. Once you start adding T3 blood tests become somewhat meaningless, except for FT3, FT4 starts decreasing and TSH goes down dramatically...so you largely have to go on how you feel after 6 weeks on a set up dose. For me adding T3 to T4 has been very difficult...infact adding 25 mcg T3 to 75 mcg of T4 has actually reduced my FT3. In the 3 weeks I started taking and slowly upping my T3 I had palpitations, raised Bp, pulse...but not an increase in basal temperature...it should settle down, if it worries you skip a dose, or try it at bedtime, or split doses say twice over 24 hours. Is the doctor intending to increase the T3 dose, or tweak the T4 if necessary? Have you made sure your VitD, B12, folate and ferritin are optimal as you are still largely relying on T4 conversion to produce active T3 for good thyroid health. Lastly do you know if you are Hashimoto's as well as having hypothyroidism- worth getting two autoimmune antibodies tested to see?