Addition of Cytomel

[jarock]

Follow up to previous post . TT several years ago with brand Synthroid 125 mcg only as medication.

Added generic cytomel 5 mg daily in March and switched to generic Synthroid 125 mcg at the same time. Generic cytomel 5mg plus generic synthroid 125 mcg daily )

Labs in March before Cytomel was added

FREE T3 = 2.4 Range 2.3 -4.2

FREE T4 =1.2 Range 0.8 -1.8

TSH 0.13 Range 0.40 -4.50

Labs a few days ago approximately 8 weeks after Cytomel was added

FTEE T3 = 2.9 Range 2.3 -4.2

FREE T4 '= 1.4 Range 0.8 -1.8

TSH = 0.01 Range 0.4 -4.50

Any thoughts on these results please ? Do I need to decrease the Synthroid ?

Thanks

[Hidden]

After a TT, particularly if you also had RAI, it is unlikely you will ever get well on any dose of synthetic T4 with/without the synthetic T3.

Many have tried T4 for years, including me, and most, including me, have given up and now take NDT in order to get our lives back.

If you want to stick with the T4, I reckon you need more T3 and probably less T4, but that's just my suggestion.

[jarock in reply to Hidden]

Thanks for your input. RAI was not a part of my treatment I had TT due to noncancerous nodules. I would love to try NDT but I have tried several Docs who are against giving me NDT. I had to fight for the T3. I will try your suggestion while I keep looking for NDT.

[SlowDragon Administrator]

How do you feel on this dose?

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you did your tests?

When did you last test vitamin levels ?

What vitamin supplements do you currently take

Perhaps you need to try adding a second 5mcg dose of T3 and retest in 6-8 weeks

[jarock in reply to SlowDragon]

Honestly I feel much better with the added T3 than with the Synthroid alone. I still have difficulty losing weight despite watching my diet and going to the Gym 4 days /week

I had stopped both medications about 24 hrs before testing . Vitamin levels done in March were fine excepting slightly elevated B12. I will increase the T3 as you suggested. Another member suggested lowering the Synthroid with an increase in the T3 .

In my quest for wellness I am interested in NDT because it seems to work for a lot of people, but I have a difficult time getting a prescription. I think I will go back to the brand Synthroid during my next refill even though I will have to self pay. I have read so many negative stories about the generic versions. Thanks for your continued suggestions.

[SlowDragon Administrator in reply to jarock]

Next test make sure to only leave 8-12 hours between last dose of T3 and blood test

NDT doesn't suit everyone

[jarock in reply to SlowDragon]

Thank you. I will be sure to keep that in mind during my next testing.

[shaws Administrator]

The recommendation when on a T4/T3 combination is a 3:1 or 4:1 basis. Your T3 dose is too low, I think. Besides, seeing that the blood tests were introduced along with levothyroxine alone, it is our symptoms that have a priority. That's how we used to be treated, i.e. given NDT and small increases every few weeks until symptoms were relieved and we felt well again.

[jarock in reply to shaws]

Thank You. I was told that high doses of T3 will cause heart problems If I decrease the T4 to 100 and up the T3 to 25 (100/25 ) . Would that 25 mg be considered too high ? My Doc will not endorse this because he was even too scared to give me 5 mg , so I will make these changes on my own .

My next intention is to try NDT but I may have to source that on my own too. Thanks for your continued suggestions.

[vocalEK in reply to jarock]

To my knowledge, you can't get any lower dose of Cytomel than 5 mcg. And I think whoever told you that high doses of T3 cause heart problems might be confused. Having high levels of Free T3 in your blood could be hazardous, but you would know that was happening because you'd have a racing pulse and/or palpitations. To get rid of hypo symptoms, you probably will need a high enough dose of Cytomel to get your blood level of Free T3 up into the top quartile of the range. That would equate to an FT3 of 3.725. You are currently only 32% through the range.

FT3 = 2.9 Range 2.3 -4.2

[jarock in reply to vocalEK]

Thank you so much. I intend to try 4 : 1 T4/T3 ratio--100 mcg T3 and 25 mg T4. Starting out 100mcg T4 / increasing T3 by 5 mg weekly until max 25 mg. Then retest after 6 weeks . 5 mg daily is max amount that my Doc will prescribe so I am not even sure where to source the extra T3 .

[shaws Administrator in reply to jarock]

The ratio should be T4/T3, so your T3 would be too high (100mcg) and T4 too low:

I only take 25mcg T3 daily at present and have been on this dose for quite a few months now..

The following is a link which may be helpful. It is by one of TUKs advisers - now deceased). Read Safely getting well on thyroid hormones:-

naturalthyroidsolutions.com...

[jarock in reply to shaws]

That was written in error (100 mcg T3 and 25 mcg T4.) I meant 100mcg T4 and 25 mcg T 3. 4:1 ratio . Thank you. I will take a look at the site

[shaws Administrator in reply to jarock]

When on levothyroxine when I was first diagnosed, (I was very unwell anyway due to being undiagnosed and TSH 100) levo didn't do anything for me but we struggle on as it is all new to us.

I was forever in and out of the cardio dept due to severe palps, espcially during the night. I had the usual tests and Cardiologist was puzzled and was considering putting something in my heart to 'figure out' what was going on. Shortly after the appointment T3 was added to T4 - palps stopped and I never saw the cardilogist again. I eventually went onto T3 alone.

[jarock in reply to shaws]

Thank you. My Doc does not want to prescribe more than 5mg T3 daily . I am struggling with finding ways to source T3. on my own.

[shaws Administrator in reply to jarock]

Put up a fresh post asking for private message to be sent to you of where to source T3.

Your post will then be closed but you will receive private messages from members who source it elsewhere.

You will see an red alert appear on the top line.

[jarock in reply to shaws]

I will do that . Thank You.

[shaws Administrator]

I assume that a T4/T3 ratio is 100mcg T4 and 1/4 tablet of T3 as one 25mcg tablet of T3 is approx equal "in its effect" to 100mcg of levo then a 4:1 ratio would be 100 mcg of T4 and 1/4 tablet of T3. If I'm wrong someone will correct this statement. Read safely getting well on thyroid hormones:-

naturalthyroidsolutions.com...

[jarock in reply to shaws]

Are you saying that 4:1 T4/T3 Ratio would be 100 mcg levo and I/4 of a 25 mg tab T3 (approx. 6 mg T3.).?

On YOU TUBE there is a video with a doctor who recommends about 80 : 20 ratio for Synthroid to Cytomel . As an example he suggested. 100 mcg Synthroid to approx 20 mcg Cytomel. which is not exactly 80:20 ratio but it is close enough .

[shaws Administrator in reply to jarock]

I quoted what other researchers have found.

25mcg of T3 is equal, in its effect on the body, to approx 100mcg of levo. Therefore12.5mcg T3= 50mcg T4 and 1/4 T3 = 25mcg T4. Of course there may well be variations as most of us don't have identical experiences with thyroid hormones.

[jarock in reply to shaws]

Thank You

[shaws Administrator in reply to jarock]

I should also state that I'm not medically qualified and also knew nothing about hypothyroidism - neither did any of the doctors/specialists I saw before I diagnosed myself when TSH was100. No doctor or specialist or A&E knew any clinical symptoms which they did before the introduction of blood tests which means many remain undiagnosed.

[jarock in reply to shaws]

I agree. I have decided to lower my Levo to 100 mcg with 1/2 of 25 mcg T3....So 100 mcg levo with 12.5 T3. I will adjust accordingly.

[shaws Administrator in reply to jarock]

I hope you find a benefit and I also am aware that it can be difficult to get the exact dose you require to make you feel well.

[Freddyy]

Why do you want to mess up your own T3 production ?

You can simply replicate the physiological T3 production with cytomel... In other words take only 10% T3 of your T4 dose

If you are on 100 T4 take 10 T3, that’s enough

[jarock in reply to Freddyy]

Due to my Total thyroidectomy it seem as if over the years I have developed poor T4 to T3 conversion , because I have borderline low FT3 on several labs. I have tried a low dose of cytomel but my FT3 remains low. Thanks for your response.

[pennyannie]

Hello Jarock

Just to add my " tuppence worth " and sorry I missed your post when recent, some 2 months ago.

A fully functioning working thyroid would be supporting you on a daily basis with approximately 100 T4 and 10 T3 daily.

I am with Graves post thyroid ablation with RAI and am now on Natural Desiccated Thyroid.

I did source and trial myself T3 and NDT, as I found no help or support within the NHS.

Both thyroid hormone replacements worked, but have settled on NDT since it's seems currently to be easier to source and somewhat less " turbo charge " as was my experience when I trialled a T3 and T4 combo.

[jarock in reply to pennyannie]

I had TT years ago and used T4 only until about 5 months ago I added T3 . I will check my FT3 level again within a week . I think I will source and try the NDT if the T3/T4 combo is ineffective. Could you please PM me the source of your NDT. Thank you.