How slow and how long?

[experimental1]

My back story, which some of you might recall; In 1994 prescribed Cytomel by my then psychiatrist, as I had depression, was cold, constipated, weight gain and erectile dysfunction. With the first 25 mcg tablet, my body came back to life. I was on it for 11 or 12 years, then, it seemed to stop working. The endo I was then going to wouldn't go beyond 75 mcg and it was generic, too. So, for 17 years, I've been wandering in search of answers. I've tried NDT but I feel more depressed on it. When I go back to T3(self purchased) I become hyper(at least that's how I feel) on a low dose, between 5 to 10 mcg. Sleep has been rubbish for 17 years (treatment resistant bipolar illness). I keep going over why Cytomel resolved my health issues, gave my life back, then quit on me. It's beyond frustrating. I'm going to be 72 in May. I'm exhausted from the struggle. I'm on weekly B12 injections, testosterone replacement, my iron panel and ferittin are well within range. Haven't done a 4 specimen salivary cortisol. Broda Barnes just prescribed NDT and slowly titrated. Dr. Lowe would slowly titrate T3 or NDT. So, the question for those T3, especially higher doses; what was your starting dose and how long until you achieved full(or close to full) symptom resolution? Thank you.

[Lalatoot]

Dr. Ken Blanchard claims in his book The Functional Approach to Hypothyroidism that folks on high doses of T3 only will become unwell after a long period on T3 only as their body will be totally depleted of T4 at a metabolic level. Now we know that on this site there are members who are well on long-term, high doses of T3 so his statement cannot be true for everyone. However, it may be true for some - and maybe you are on of them.

It may be that you need T4 and T3 as individual doses rather than contained in NDT. With T4/T3 combo you can alter the doses to suit you as an individual. Adding T4 to T3 might also overcome the hyper sensations you spoke of. Sometimes a low dose of T3 added to T4 is all you need.

On T3 alone doses seem to range from 25mcg to 65mcg per day either as one dose or split doses.

Starting T3 is usually at 5mcg for the first week then 5mcg added every fortnight until you reach a total dose of one tablet. Stop and hold for 6 weeks - do bloods - then increase 5mcg every fortnight until you reach 2 tablets or sooner if you think a lower dose will do.

Please understand that this is my opinion and that I am not medically qualified.

[experimental1 in reply to Lalatoot]

Dr. Blanchard and Dr. Lowe had an ongoing debate over his microdose approach versus Dr. Lowe's T3 only, dosed until symptom resolution. I've read both their protocols. I was like Dr. Lowe when I took my first dose of Cytomel; the lights came back on in my world. He stayed on his final dose of 150 mcg, daily, until his death. He needed that high dose to overcome thyroid resistance from a malfunctioning pituitary/hypothalamus. That seems to be me.

My urologist concluded I have secondary hypogonadism, which is from a malfunctioning pituitary/hypothalamus and that would fit into secondary hypothyroidism, with which he agrees. And with bipolar, there are continual genetic mutations occurring. I'm a walking disaster but the emotional pain from never ending depression is leading me to desperation. I'm caring for my wife who has early stage dementia and I need to be healthy and functional.

I don't know if I can'force' my body to utilize T3 , as it once did, but my excellent response to it leads me to conclude, maybe erroneously, that I need to push through the resistance of my malfunctioning neuroendocrine system if I'm going to not only survive, but thrive.

[Hidden]

Sorry if you have mentioned this elsewhere, but do you have hypothyroidism? I know that in the past doctors prescribed T3 for depression, but it seems that is no longer the case since it shuts down the body`s own hormone production.

[experimental1 in reply to Hidden]

I have to disagree with you. There are psychiatrists who are still successfully using thyroid medication for patients with depression, since that depression is likely a reflection of malfunction of the pituitary/hypothalamus, not primary hypothyroidism. And on a pragmatic level, as William James said, "If it works, it's true."

[Hidden in reply to experimental1]

Well, in that case, they would still be T3 deficient. I was talking about prescribing T3 as an anti-depressant to euthyroid patients which would result in suppression of their own thyroid function, which is why I think that treatment method is no longer recommended.

[experimental1 in reply to Hidden]

I understand. There are people, though, who don't respond to antidepressants or develop side effects. IMO, a doctor might prescribe thyroid medication as a 'last resort', even if the patient has what appears to be normal thyroid function. Labs are not the end all, be all.

[SlowDragon Administrator]

When were vitamin D, folate levels last tested

What are your most recent thyroid results

[marigold22]

I suggest you get blood test done for vitamin B12, ferritin, folate & vitamin D. In my own case, I always thought my longterm depression was linked to my hypo. Recently I've discovered I've got a mutated MTHFR gene, which caused the mental health struggle, and is now recognised as being fairly common. By taking METHYLATED (sorry to "shout") multi B vitamins, I have got rid of the horrendous depression I suffered. The mutated MTHFR gene causes the body to be unable to convert folic acid (which is the synthetic form) into folate; and unmethylated vitamin B12 into the methylated form.

healthline.com/nutrition/fo...

healthline.com/nutrition/me...

[humanbean in reply to marigold22]

That's a really good point.

I've read that B12 injections usually used in the US provide B12 in the form of cyanocobalamin.

Methylcobalamin would be much better for a lot of people on this forum with hypothyroidism.

[experimental1 in reply to marigold22]

I've tried methylcobalamin and I seemed to feel, subjectively, worse. As I'm sensitive to fillers and binders, I need to find a 'clean' brand or a liquid form. A lot of the sublinguals use xylitol which is derived from birch trees and gives me a definite allergic reaction.