Cytomel side effects

[MarteeAnn]

My cytomel was recently increased to 5 mcg 1/2 tablet 3 times day and Synthroid 75 changed to unithroid 50. It has been 10 days and I am still not feeling well. I just feel unwell and feel the ups and downs of cytomel. Many changes recently due to feeling unwell . Anxiety, depression , crying spells , insomnia, fluctuating blood pressure and symptoms . Feel bad. Does anyone know how long before I should feel like this is the right or wrong medication change ?

It’s been debilitating for a year and I have not been able to function in work or daily life.

[Jazzw]

Hi MarteeAnn, welcome.

What were your thyroid blood tests results before your dosage was changed?

What dosages were you taking before the dosage changes?

Just guessing, but you aren’t on a particularly high dosage of either T3 or T4 now, so at a guess, you’re undermedicated. You may also be suffering the effects of nutritional deficits—very likely that you’re low in one of (or all of) Vit D, Vit B12, folate or iron.

[MarteeAnn in reply to Jazzw]

My last TSH 0.41, total t4 7.6, total t3 97 those results were from being on Synthroid 75 and cytomel 5mcg 1/2 tablet twice a day for 3 weeks. The change was made because I was not feeling well in that either . My b12 , iron and folate are normal .

[MarteeAnn in reply to MarteeAnn]

Vitamin d is normal also

[Batty1 in reply to MarteeAnn]

You need to add your ranges after your thyroid numbers. Do you have the lab numbers for your Vitamin D and B, if so add those as well.

How did you feel on unithroid 50?

Why did you switch to Synthyroid and Cytomel?

[MarteeAnn in reply to Batty1]

Ultra sensitive Tsh 0.4 range 0.4-4.1

Total t4 7.5 range 4.5-10.5

Tota t3 97 range 80-200

B12 712

Vitamin d 100

I don’t feel well on any of it.

I was switched because I was feeling unwell.

[Batty1 in reply to MarteeAnn]

Are you still feeling the same as before or is it different?

[MarteeAnn in reply to Batty1]

Could be the fluctuations from taking the cytomel 3 times a day. It’s definitely a weird feeling physically and mentally.

[Batty1 in reply to MarteeAnn]

Cut back on the Cytomel or split the dose if you aren’t already.

[MarteeAnn]

it’s different . I’m feeling strange off and on around the timing of taking cytomel. I can’t tell if it’s too much not enough or just needs more time. Or if I’m reacting to unithroid. But yes it’s definitely different from before .

[Poniesrfun]

Your Total T3 is only 14% of range so I imagine your Free T3 - which is the one our body actually utilizes - is even more dismal. And if the T4 is actually Total, not Free, it's only 50% of range so the Free T4 which is available to be converted to T3 is likely lower.

Bottom line - you seem to be quite under medicated. If these results were before the Unithroid was lowered, it probably shouldn't have been lowered. It appears you may not convert T4 to T3 very well and you need a lot more T3/Cytomel. When you're not getting enough T3 the peaks and valleys are exaggerated. I would try 5 mcg in the am then 2.5 around noon and again in the afternoon and see how you feel in four days. T3, if taken regularly, reaches a steady state in approximately 72 hours so four days should give you an idea if there is some improvement. You can then try adding another 2.5 mcg to your second dose - if it feels like too much then back off and wait a few more days before increasing again.

When you get to a level where you feel better, wait six weeks then test again, making sure you're following the guidelines the admins frequently post. You want your T3 to get up to or better than 50% of the range.

Patti in AZ

[MarteeAnn in reply to Poniesrfun]

Thank you . Where can I find the guidelines the admins post ?

[GlowCoach Administrator in reply to MarteeAnn]

Blood testing guidelines are as follows:

Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).

Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

[jgelliss in reply to Poniesrfun]

👏👏👏👏

[MarteeAnn]

Why are physicians not telling patients this ? Who are these guidelines from ? It makes perfect sense .

[Lalatoot in reply to MarteeAnn]

These guidelines are from patients experiences. Doctors don't generally understand or think about testing protocols.

[Poniesrfun]

here’s a link to a post with a detailed reply from Slow Dragon about testing healthunlocked.com/thyroidu...

[Nanny23]

I take 25 mcg. Cytomel and 112 synthroid T4. My cytomel had to be increased gradually but they never reduced my T4. Maybe that is why you feel unwell. Feel better. ❤️

[MarteeAnn in reply to Nanny23]

Update on my labs

12/26/23

Tsh 0.14 ( 0.4- 4.5)

Ft3 2.79 ( 2.0- 4-4)

Ft4 0.9 ( 0.8 -1.8)

Total t 4 6.3 ( 4.5-10.5)

Based on this my gyn decreased cytomel back to 5 mcg 1/2 twice a day .

thoughts ?

[MarteeAnn in reply to MarteeAnn]

Why would my tsh be so suppressed if my free levels are on the lower end ?

[MarteeAnn in reply to MarteeAnn]

I did the calculation

TSH 0.14 mIU/L (0.45 - 4.5) -7.7%

Free T4 (fT4) 0.9 pmol/L (0.8 - 1.8) 10.0%

Free T3 (fT3) 2.79 pmol/L (2.0 - 4.4) 32.9%

T4:T3 Ratio 0.323 

Thyroglobulin Antbodies (TgAb) 2 IU/mL (≤ 1)

Thyroid Peroxidase Antibodies (TPO) 19 IU/mL (≤ 34)

can someone help me make sense of it?