Cytomel generic

[phirestar]

After 18 days I stopped taking 5mcg of Liothyronine bc

I was having all kinds of side effects (hyper like) of taking to much and it was all day/evening long. I was also taking 150mcg compounded levo and this wasn’t reduced. Doc rx’d Liothyronine bc tt3 was one point under range (but would be in range for 2 other major USA labs). I didn’t have symptoms of hypo (in fact I’ve been asymptomatic for over 5 years). My tsh (labs5/6) went from 20 to .323 (under range) my ft4 increased 67% (in range high end), my rt3 was 18, the highest it’s ever been, and my ft3 stayed the same at 3.1 (2.3-4.2) My tgab went from 301 to 2085. Doc wanted me to split into 2 x/day = 2.5 per dose. Since I experienced these side effects all the time and was taking it around 10 am, I haven’t been able to find any info that splitting the dose would help bc everything seems to indicate the peak/trough scenario. I hadn’t taken it for over 24 hours when the labs were run. I’ve not had the t3 for 4 days and I’m back to feeling great. If a dose is split in half for 2.5 mcg, it’s still the same total dose for the day so I don’t understand how that could improve side effects if they are all day/evening long. Any thoughts? I’m 70 and in the USA. Thx

[greygoose]

I was also taking 150mcg compounded levo and this wasn’t reduced.

Whether or not levo is reduced depends on your FT4 result before starting T3. It isn't compulsory to always reduce it.

Doc rx’d Liothyronine bc tt3 was one point under range

TT3 is the wrong test. It doesn't give you any useful information. It's the FT3 he should have tested. That can be normal even if the TT3 is low.

(but would be in range for 2 other major USA labs)

That is of no interest whatsoever. You can only use the range that came with your results to interpret your results. Ranges are fixed according to local population and calibration of the machine used for the analysis.

My tsh (labs5/6) went from 20 to .323 (under range)

Were these labs before you started T3, or after? If after, then one would expect the TSH to drop - doesn't matter if it's under-range when taking T3.

my ft4 increased 67% (in range high end)

67% through range isn't that high. It would be much better if you gave us the actual numbers - results and ranges - rather than an interpretation of the results.

my rt3 was 18, the highest it’s ever been

Totally irrelevant. The rT3 test doesn't give you any information you can't get elsewhere. It will tell you if the rT3 is high, but not why. And, there are many, many reasons for high rT3. Only one of them is anything to do with thyroid. And, at 67% through the range, your FT4 is not high enough to cause high rT3 - if it is high, that is, but you don't give us a range.

my ft3 stayed the same at 3.1 (2.3-4.2)

Well, below mid-range, so too low. But, if these labs were done after being on T3 for only 18 days, it was too soon. The level could have gone higher if you'd waited the full six weeks, as recommended.

hadn’t taken it for over 24 hours when the labs were run.

Well, then obviously the FT3 was going to be low. The gap should only be 8 to 12 hours. So, all in all, these labs are pretty worthless.

My tgab went from 301 to 2085.

At that level, pretty certain you have Hashi's. But the fact that the antibodies have risen is of no significance. Antibodies fluctuate all the time. It doesn't mean anything.

Doc wanted me to split into 2 x/day = 2.5 per dose.

A bit pointless splitting a dose of only 5 mcg. It wouldn't have any effect on anything. 2.5 mcg is much too small a dose to have any impact. But, I don't know if it would have changed the side-effects - which were probably due to the fillers, anyway, not the actual hormone. Splitting doses can be easier on some bodies, because it's less of a shock to the system to take several small doses, rather than one large dose, which might be too much for some individuals. But, unlikely to make much difference with 5 mcg.

You say it was generic T3? I didn't know such a thing existed. What, exactly do you mean by 'generic'? Maybe try taking a different brand? Or, maybe you just didn't need it at all. But, impossible to say without seeing the correct labs, done in the correct way, before you added T3.

[phirestar in reply to greygoose]

Thanks for the reply. In USA, cytomel /Pfizer is considered brand and there are several generic manufacturers of Liothyronine- mine is made by greenstone,LLC.

What I was experiencing was shaking/tremors(had difficulty writing), muscle pain soreness in my legs, hips, thighs, felt my heart on occasion, hungrier than usual, anxiety (I think bc I’ve not had this ‘feeling’ before), some eye issues, headaches off/on (different times during the day), all day/evening long. All this stopped after stopping the t3med. This is a new pcp under a new Medicare plan. As a follow up lab, he only ordered a tsh test. My prior doc, different plan, I think was much better as she she kept my labs in range but also took into account my asymptomatic status. I (for whatever reason) can have some pretty wonky thyroid labs and feel fine which has befuddled my prior docs. I have an episode of tsh going from 59 to to 3.23 on the same dose of levo over a period of a year (a high stress year). It went from 59-17.6-31-3.23. My frees stayed in range but w high tsh went down to below mid range and lower tsh went to over mid range. My frees have never gone below range.

I didn’t experience the peak/trough like feelings that most seem to do on a t3 med based on what I’ve read.

I’ve been fine on the compounded levo (horrible reactions to mylan levo and synthroid). I wondered why he wanted to add Liothyronine bc I didn’t feel bad and I thought the reason of adding a t3 med for low tt3 was unusual based on what I’ve read. I’m also 70. I’m not sure I need a t3 med. My ft3 at 5/6 was 3.1 (2.3-4.2) and the range for the other lab is (2.0-4.4). My ft4 at 5/6 was .84 (.76-1.8) and on this lab 1.41 (.82-1.77).

I don’t normally pay much attention to antibody numbers but I was surprised at the tgab number bc they’ve been going down for some time. After starting the t3, I was having some discomfort on the right side of my neck and I think swollen lymph nodes. When I stopped the med, this also stopped.

I did these labs bc what I’ve read said that t3 meds were fast acting , the half life being 2-3 days given someone’s metabolism. As there was no adjustment in t4, I thought 18 days was sufficient for a lab and I was feeling so bad that I thought a lab might be helpful. Neither doc who is involved w this has mentioned that labs were to soon. The only things they’ve said is I seem to be sensitive to t3 meds and wanted confirmation of not having had t3 in the last 24 hours. I don’t discount the fact that excipients might be involved bc that was my issue on levo - I just got sick for a year (all firsts at 65/66) and I responded to the levo. On tirosint, after 1.5 months this all stopped and haven’t resurfaced for the last 4 years. I was sicker and on more antibiotics than the previous 30 years of my life. I used to say that my immune system had gone to war!

From January to May, I’ve been dealing w 4 uti’s that weren’t initially treated bc I didn’t have the ‘normal’ symptoms. However, my cultures indicated E. coli and many other abnormalities. My uric acid was 6.1 (2.6-6.0) and he rx’d a black box drug for gout (no symptoms) but he backed off this when he apparently spoke to the rhuemy I’m supposed to see bc she thought it’s probably due to the uti’s. My esr was also high. I’ve found some research articles that suggest a thyroid/kidney connection in a uti.

My levo knowledge is much better than my Liothyronine knowledge and there doesn’t seem to be much on google doc for Liothyronine. There is no other option under my formulary and I’m already paying oop for 3 meds. I have a lab order for tsh,ft3/4 under this plan. I’m planning to do it the end of the week.

[greygoose in reply to phirestar]

Well, it does sound as if it was the fillers in the tablets causing you to react badly.

I didn’t experience the peak/trough like feelings that most seem to do on a t3 med based on what I’ve read.

I've never experienced those, either.

I thought the reason of adding a t3 med for low tt3 was unusual based on what I’ve read.

Well, I don't know what you've read, but TT3 readings have little to do with anything. The reason for adding T3 is poor conversion. But, there's no way I can tell you how well you convert - as I said above - without seeing the correct labs on T4 only.

I’m also 70. I’m not sure I need a t3 med.

It has nothing to do with your age! A poor converter is a poor converter whatever their age. And, T3 is the active thyroid hormone needed by every single cell in your body. You cannot live without it. So, if you cannot raise your FT3 to a healthy level on T4 only, then you need to take T3 - no matter how old you are.

My ft3 at 5/6 was 3.1 (2.3-4.2) and the range for the other lab is (2.0-4.4). My ft4 at 5/6 was .84 (.76-1.8) and on this lab 1.41 (.82-1.77).

As I explained above, it doesn't matter what the ranges are in other labs, you have to use the ranges given with your results.

I don’t normally pay much attention to antibody numbers but I was surprised at the tgab number bc they’ve been going down for some time.

Totally irrelevant. Antibodies fluctuate all the time, but when they're that high, it means you have Hashi's. Do you know what Hashi's is?

I did these labs bc what I’ve read said that t3 meds were fast acting , the half life being 2-3 days given someone’s metabolism.

Sorry, but that's wrong. The half-life is about 23 hours, in the blood. That means that if you take 10 mcg T3 at 8 am one day, at 8 am the following day there will be 5 mcg left. Minus what gets into the cells. The T3 that gets into the cells stays there for about three days.

BUT none of that has anything to do with how fast-acting it is. By fast-acting one means it gets into the blood faster than T4, and as it doesn't have to be converted, it has an effect more rapidly. But, it still needs time to build up in the blood and the cells. So, it's best to wait six weeks or so before testing.

Neither doc who is involved w this has mentioned that labs were to soon.

Doubtful they would even know. They rarely know much about the subtilties of testing for thyroid hormone.

wanted confirmation of not having had t3 in the last 24 hours.

24 hours is too long, as I said above. Given that the half-life of T3 in the blood is 23 hours, there won't be much left after 24 hours, so you won't know what your normal circulating level is. Which is what you need to know. As I said, doctors don't know much about testing.

I used to say that my immune system had gone to war!

Well, it sort of has, because you have Hashi's, and your immune system is attacking your thyroid.

I have a lab order for tsh,ft3/4 under this plan. I’m planning to do it the end of the week.

OK, but don't leave 24 hours between your last dose of T3 and the blood draw, or you will have a false low results.

24 hour for levo

8 to 12 hours for T3

if you want accurate results.

But, if you don't like taking T3, there's no law says you have to.

[phirestar in reply to greygoose]

Thanks - been helpful. I feel much better not taking it.

[greygoose in reply to phirestar]

You're welcome. But, if it should come to pass that you really do need T3, make sure you get a different brand.