Dosing with cytomel only: After years of trials... - Thyroid UK

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Dosing with cytomel only

bhm90503 profile image
27 Replies

After years of trials with levo and ndt for hypothyrodism, I switched to cytomel (lio) only. Current dosage is 62.5 mcg, and I am now controlling my BP with 1/2 my former BP meds (Indapamide 2.5 and Telmisartan 80). All drugs are taken at 6AM. The hope is that patience and titration of the lio will allow elimination of the BP meds. I feel fine over a wide range of lio; the control of BP appears to be a much more demanding marker. Finally note that issues of T4->T3 conversion go away with the levels of T3 fixed.

Questions:

1) I have not read the book by Paul Robinson but his claim to have prospered on 62 mcg lio alone for 15 years seems to give assurance that any other hormones issued by a normal thyroid are not essential. The fact that I seem to be homing in to the same dose seems amazing. Any comments?

2) levo became available 1927 and lio 1957. Is there any medical reason why the simplicity of lio should not have taken over from levo?

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bhm90503
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27 Replies
JudithW profile image
JudithW

Hi BHM, once I started Liothyronine my breathing, which had almost overnight become terrible it had been investigated, both Heart and Lungs and nothing was found wrong) rapidly improved. I had been started on Thyroxine which had made my condition worse

My Blood pressure went from borderline requiring medication to being back to the normal range, and in fact sometimes low 87/59 being the lowest.

I was able to lose over 7 stone in weight (7x14 lbs)

My eyebrows outer third grew back

My hairline which had receded a bit is re-growing really dark like I used to be.

My temperature which was regularly recording 35.4oc is back up into 36+ but still a bit low.

Plus a good few other things one gets with underactive thyroid.

Dr in UK in the main do not acknowledge Cellular Hypothyroidism, so all test I had performed were private, as was the Dr who prescribed Liothyronine.

24 hour Urine showed a T3 of 292 ref range 800-2500, I had high cortisol, which is probably what was causing the body to convert Thyroxine to reverseT3 which was high in another of the tests I had performed, with the ratio rT3/T3 being wrong.

Certainly if you are taking Liothyronine you would not need any other thyroid medication asT3 is the really active portion of they thyroid hormones. I did read Pauls book, and joined his group on facebook. Some people will say you should have a small amount of Thyroxine, I am fine without. I take 75-100mcg a day in 4 divided doses. I cannot comment on your similar dose to Paul perhaps you have similar body size and shape?

Now my cortisol is down (cortisol produced by stress, and stress is accumulative, in the 2 years before I started symptoms I completed my degree as well as working fulltime, I moved from Devon to Yorkshire, bought a house and started a new job,) I would like to get off Liothyronine but finding a consultant endo to help is impossible.

Your second point about Levo and Lio... some would say cost, however Liothyronine has been extortionately priced in UK £800+ for 100 tablets. In european mainland £21-25 for 100 tablets. The company has now been fined a huge amount. gov.uk/government/news/cma-... it will take some years for Drs to accept this, and a few years to research the use. They reckon it does not really help. My theory is that they have not used a high enough dose.

bhm90503 profile image
bhm90503 in reply to JudithW

Thanks for your reply. I just bought 1000 50 mcg lios for $250 from India. I took a month before showing up at KFK NY. I think the delay was caused by the requisition of planes for the Afghan flights. Forgetting costs dosing with lio is far superior to levo because so many problems (conversion, autoimmune flaring, etc) are avoided; tsh is blocked so that your thyoid is blocked. Why shouldn't a removed thyroid be treated the same way? Why is levo ever recommended? I tried divided doses with no benefit. The biological half life is said to be 2.5 days, so testing for plasma T3 seems of little value. refs:

thyroidpatients.ca/2020/02/...

thyroidpatients.ca/2021/05/...

shaws profile image
shawsAdministrator in reply to bhm90503

Just a reminder that 25mcg of liothyronine is the equivalent of 100 mcg of levothyoxine.. Increase gradually according to your symptoms.

I wish you well.

bhm90503 profile image
bhm90503 in reply to shaws

You probably know that weight lifters take 75-100 mcg lio to reduce skin fat for ~3 months before a competition. They can take the full dose at once but are advised to taper off to withdraw. However if taking levo, that will produce a big increase in BP. In my case (75 levo) I had to slowly increase lio over several weeks to let the levo die out.I would welcome any references documenting any adverse effects of taking lio only over years of use. I as yet have found no reason not to prefer lio over levo for any situation where T3 is low. In my case getting my iron levels up was almost impossible so I resorted to lio in the hope the improved iron absorption would provide the needed increase in ferritin. It worked! But so what - conversion is irrelevant(mostly?) if I just keep providing lio. I occasionally add thyroid glandular to see if the less well known components of a healthy thyroid make any difference. Two references:

thyroidpatients.ca/2020/02/...

thyroidpatients.ca/2021/05/...

unblocktheplane profile image
unblocktheplane in reply to bhm90503

Don't think you need the glandulars, BHM. Read Paul Robinson's books for how this works.

shaws profile image
shawsAdministrator in reply to bhm90503

I didn't know about weightlifters also taking levothyroixine. It's something that wouldn't enter my head to take any medications to try to achieve an aim of winning. Would that not be a type of 'cheating'?

unblocktheplane profile image
unblocktheplane in reply to shaws

Shaws, responce to T3 is so individual, I don't think one can state an unequivocal equivalance between T3 & T4. I maintained wellness on T4 150 ug. Were I to expolate my current 62.5 ug T3 dose, that would be 250 ug.

shaws profile image
shawsAdministrator in reply to unblocktheplane

I cannot take levothyroxine at all. It made me far more unwell and also severe palpitations that the cardiologist was considering putting an implant in my heart 'to see what was going on;.

That coincided with me being prescribed T3 to T4 and palpitations resolved and I did not need an implant. I then went onto T3 only and my health recovered.

100mcg of levo - it is stated is the equivalent of around 25mcg. lio.

Sama999 profile image
Sama999 in reply to shaws

Yes indeed, I doubled it after 2 weeks and got palpitations.

unblocktheplane profile image
unblocktheplane in reply to bhm90503

Hi BHM, I maintain a patient advocacy list of Liothyronine sources. Be happy to share it with you. Will you please let me know your source in India so I may add it? (You can message me, if admins will not permit that here.) I myself had no luck ordering T3 from India. Part of the problem is it's impossible to pay due to Indian currency restrictions. So...how did you pay?

bhm90503 profile image
bhm90503 in reply to unblocktheplane

Just go to indiamart.com and you will be connected to any company that wants to sell your requirements. I had trouble with the payment until I connected to a supplier with whatsapp , he supplies me with an email address, and I send money from my bank account via the application called WISE that is setup beforehand on my cell. The transfer is almost instantaneous and the exchange fee very small.

unblocktheplane profile image
unblocktheplane in reply to bhm90503

Hi BHM, Indiamart listed dozens of companies when searching liothyronine. Not one of them panned out for me. Please drop me a PM here with specific details which may be valuable to others. TIA!

Jodysmit91 profile image
Jodysmit91 in reply to bhm90503

Hey there! May I ask where in India/from which webshop you bought the Lio?

Thanks in advance

unblocktheplane profile image
unblocktheplane in reply to JudithW

Hi Judith, it's interesting you mention HIGH cortisol when the opposite is true for everyone I ever heard of. How was this assessed? Four point saliva cortisol? I'd be interested to see those results at your most symptomatic. Good health to you!

JudithW profile image
JudithW in reply to unblocktheplane

Hi unblock,I did have a 4 point salivary test, expecting as you rightly comment to find the result to be low. My readings were .

Result Ref range

Sample 1 post awakening 30.21 7.45-32.56 mmols

Sample 2 + 4-5 hours 17.49 2.76-11.31

Sample 3 +4-5 hours 6.36 1.38- 7.45

Sample 4 (prior to sleep ) 6.16 0.83 - 3.86

After research I started taking Phosphatidyl Serine 100mg which is supposed to reduce Cortisol.

Next thought what dose do I need? I used Medical Dowsing to find out, how much I need. I just used my body, ( connected to Kinesiology and muscle testing )as the dowsing tool no rods or pendulum. The closest I can find for evidence for you is

suemckenney.wordpress.com/2...

There is this video on facebook a bit windy but explains what I have said. facebook.com/watch/?v=20266...

I did have a more precise web page at one point, but needless to say cannot find it. Similar to using a rod or a pendulum you establish what is a yes, and the body which is upright with easy knees will sway back or forward. after that it is yes /no questions, answers. ie Holding the article in your right hand, 'Do I need this for my health and well being' if yes, 'One a day' continue increasing the amount until you get a no.

Okay yes be sensible if you have got up to 10 a day maybe regroup and start with a lower dose, and retest after a couple of days. As Doctors would have absolutely no idea about this natural medication no need to bother them. They would base an answer on the safe dose as suggested on the pack.

1st page of report
unblocktheplane profile image
unblocktheplane in reply to JudithW

Wow, Judith! You've done some amazing work.

I will check out the links. All of the adaptogens also mitigate cortisol; you may find one which works for you.

Zinc is what's used clinically--say, in trauma or surgery--to reduce cortisol. Easy to try!

Following the RT3-Adrenals group, you may find that Dr. Rind's Daily Average Temperatures over five days provide a helpful analysis: rt3-adrenals.org/temperatur....

This page is useful for me: rt3-adrenals.org/does_it_af....

If you find that webpage, please point me to it.

unblocktheplane profile image
unblocktheplane

I have been on T3 only for 30 months or so (72-year old male, 170 lbs). I, too, find myself at a total daily dose of 62.5 ug. I’m not sure this is any sort of magic number!

You did not mention how you divide your doses. T3 has a six-hour half-life; it’s not a daily dose like T4 or NDT.

Mine are precisely six hours apart. 25 ug CT3M* @ 0300; 12.5 ug @ 0900 / 1500 / 2100. * Some people don’t need to boost cortisol but, for many Hashimoto’s sufferers, it’s a key piece to the puzzle.

It’s also hard to determine the right dose at the right time through a process of trial-and-error and saliva cortisol test results. Not to mention, setting an alarm for 3am every night is a royal pain.

The reason Liothyronine has not taken the suffering world by storm is frequent dosing. Such frequent dosing means low patient compliance. Compounding pharmacies may tell you they can make sustained-release T3 but none of those helped reduce my dose frequency.

My doc was in the last year T3 was taught in med school. Today, it’s all T4. One would think there are such a huge number of hypothyroid patients, it would be in the interests of a big pharma corpo to develop a time-release formula & patent it. No so far.

To allay your fears, on T3-only, TSH is minimal & FT4 is in the lowest percentile. Don’t let any doc tell you you’re unwell with these results.

PLEASE, read all three of Paul Robinson’s books. As you adjust to T3-only, it’s crucially important to record your temps & BPs both before & two hours after every T3 dose so you can assess your body’s needs.

BP. You may also find that 100 mg CoEnzyme Q10 morning & night and Tart Cherry Extract capsules are helpful. >120/80 on a regular basis is healthy.

You’ll get far more info from these books. As I scrolled down, I see you're already connected with Thyroid Patients Canada, avaluable resource esp if you’re interested in the science. (Don’t need to be Canadian!)

If you are not dividing your doses, it’s true some rare birds can take T3 in a single dose. But it’s very, very unusual. If that’s you, consider yourself lucky. And luck to have a coöperative doc!

Good health to you!

bhm90503 profile image
bhm90503 in reply to unblocktheplane

Do not confuse plasma half life with biological half life (~2 1/2 days) which accounts for the delay in transfers into the cell where the action occurs. I tried averaging the lio doses around the clock and it made no difference for me. And I have no cooperative doc. The FDA guidelines in the US say only levo is needed for hypothyroidism and open up docs to litigation, and boy are they nervous! Except for rare drugs that I do not take, lio is remarkably free of cross reactions. And it almost completely absorbed in 3-4 hours food or no. I take all meds at 6am. What convenience compared to levo!

Cheers

unblocktheplane profile image
unblocktheplane in reply to bhm90503

Very cool the one dose method works for you! Are you familar with the late Dr. Lowe's megadosing? Seemssome people need it.

JAmanda profile image
JAmanda in reply to unblocktheplane

So you’re fine with minimal t4 but how high is your T3? I’m scared to go over the range but my temp is still not up to 36.5 (it’s about 36.1 up from 34.1).

bhm90503 profile image
bhm90503 in reply to JAmanda

Forget about measuring T3 - ramp up T3 until you become jittery. Then back off until you achieve peace. I think that there is entirely to much fear mongering about overdosing.

JAmanda profile image
JAmanda in reply to bhm90503

I’m loving this thread - it’s like I’ve finally found the truth! I’m ok right now but when and if I get some more T3 delivered I might increase what I’m taking.

unblocktheplane profile image
unblocktheplane in reply to JAmanda

I feel best, Amanda, when my temps at 37° or above. Glad you get by on two doses. Take temps before you dose & two hours after so you see how T3 is working in you. I'll Chat you my email so I can send you my T3 suppliers list.

JAmanda profile image
JAmanda in reply to unblocktheplane

Thanks. Interesting.

JAmanda profile image
JAmanda

Thanks for the really interesting thread! I too wasn’t well till I took a decent amount of T3. I take it in two doses and seem ok. I wonder what everyone’s T3 levels are. Mine is at top of range - do any of you go over?

And no I didn’t exactly know that bodybuilders took so much! Thx.

bhm90503 profile image
bhm90503 in reply to JAmanda

I no longer concern myself with measuring T3 when dosing with lio. Go with how your symptoms respond. I pushed lio up to 75 mcg at which point I became jittery and nervous; then backed off until that stopped. Several references have remarked that the most common error in treating hypothyroidism is under medication. My original goal was to eliminate my BP pills based on the likelihood that my long standing hypertension (~45 yrs) is secondary to hypothyroidism, so my criterion for dosing lio is sharpened by BP. I am now controlled on 1/2 my former BP meds and am patiently hoping to >- 0 BP meds. Cheers.

Phoenix415 profile image
Phoenix415

This is helpful as I am messing up my 4x a day dosage and not feeling an ounce better so losing motivation. I figured out that the extreme fatigue and lack of motivation was ADHD though I do have subclinical hypo. I was diagnosed with ADHD many years ago but felt if I properly treated my thyroid it would get at the "root" of the condition. It has been a rough 15 years.

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