I started cynomel 8 days ago. 6.25mcg twice a day. I was on Levothyroxine 125mcg but reduced this to 100mcg prior to introducing cynomel. The last three days I have been incredibly tired I could sleep all day and all night. I’m sleeping really well at night. My day is starting ok, but by 11am I’m done, I need to rest. My skin is very dry again and today I’ve woken up moved and seemed to have sprained my Achilles’ tendon.
I know the advice is not to increase too quickly but today I decided to try 12.5mcg twice and it’s made no difference. Should I stick with this for a bit longer.
On a positive note my heart rate has come down and I feel better from that point of view.
I’m feeling a bit fed up of being ill for so long now.
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I know the advice is not to increase too quickly but today I decided to try 12.5mcg twice and it’s made no difference. Should I stick with this for a bit longer.
You reduced Levo by 25mcg and by taking 12.5mcg T3 twice a day you are taking the equivalent of between 75mcg and 100mcg Levo. YOu have gone from zero T3 to 25mcg T3 in 8 days.
Members who have been impatient in the past and increased too quickly against the suggestion of other members have ended up regretting it.
If I were you I'd take the advice to increase slowly. It takes time, you can't rush these things.
Starting dose is 6.25mcg T3 to replace 25mcg Levo, then to add another 6.25mcg T3 after 2 weeks, if necessary another 6.25mcg T3 2 weeks later then another 6.25mcg (total 25mcg after a total of 8 weeks), then stick with that for 6 weeks then retest.
Would you need to do the same process if you are switching from NDT to synthetic T3? As I'm already getting some T3, Can I just start at the equivalent of what I was on NDT?
If you were currently on NDT then you'd swap to the equivalent T4 and T3 that your NDT dose gives you. But you're not, you've only been taking Levo so you can't use your past NDT dose as you would have been having some T3 already in that. As you've been taking only Levo you body is currently not used to the T3 so you need to build it up slowly, as you would have built the dose up slowly when originally starting NDT.
Thank you seasidesusie. I've actually been on NDT for the past 3/4 months. Not doing much difference appart from the mood being a bit better, probably due to the vit suplt. I've ordered cynomel online which is much cheaper and will see how it goes.
When I first started on T3 I would have overwhelming desire to sleep after each dose
Suggest you cut the (12.5mcg) 1/2 tablet into two 1/4 tablets (6.25mcg) and split dose between waking and mid afternoon
After a few weeks increase by 1/4 tablet.....either 3 doses of (6.25mcg ) 1/4 tablet at 8 hour intervals or 2 doses per day - 1/2 tablet waking and 1/4 tablet pm
Add last 1/4 tablet after a further few weeks
Hold at this dose and retest thyroid levels 6-8 weeks later
Thanks I’m reassured by your comment that you had an overwhelming desire to sleep after each dose. I think I thought it was making me need more because I was getting what I thought were hypothyroid symptoms increasing again.
I’ll drop down to two quarter tablets twice a day and see what happens. Thank you
My FT4 at the last test in October was 21.5 Pmol/l (12-22) FT3 was 5pmol/l (3.1-6.8)
I wasn’t well and my heart rate was very high resting was over 100. It is better on a slightly lower dose. I suspect it’s going to take some adjustments to find my optimal doses of T3. & T4.
Hipolion, when a person is on a substantial dose of T4 already, when adding in T3 the usual thing to do is to reduce by an equivalent amount of T4 at the same time. This keeps the overall dose roughly stable.
To add in T3 without reducing T4 is a dose increase. It's fine to do that if you need the increase. But often when people add T3 they just want to juggle the form of thyoid hormone they're taking and don't actually want to increase.
I’ve reduced the cynomel as advised and I can confirm I feel less tired today. I’ll admit to being surprised at the effects of increasing too quickly I think I thought I might have loads of energy. It’s the long road for me now.
You've added a daily dose of 12.5mcg of T3, and reduced by 25mcg of T4. This is a bit of a dose increase. T3 is about 3-5x as potent as T4. In my own dosing I always assume 4x for simplicity, so if you add in 10mcg of T3, the equivalent decrease of T4 would be 40mcg.
As I mentioned to another poster below, it's fine to take this increase if you feel you need the increase, but it's very unlikely you are now undermedicated.
I find that almost any symptom can happen when having a dose increase. This is doubly so when adding in T3, as many people find that a bit of a rough ride. It's great to feel tired and sleep more because it probably means your body is able to heal in ways it couldn't before you added T3. I tend to say to people that when adjusting thyroid hormone be as kind and gentle to yourself as you would if you had the flu, and don't be surprised by any symptoms you get until at least 5 weeks or so have passed. Changing dose is putting a big strain on your body, so just give it time to settle.
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