mixing different t3 meds

[Viv123]

I was taking cytomel for 6 years. Tsh went successfully down, but I never could reach normal ft3 because of my poor adrenals. Now when my thyroid worsened, tsh went from 0 to 4,5, anti TPO increased and anti TG appeared though never had them before, ft4 at lowest and ft3 aroung middleof the range.

I am well supported by HC now and can start slowly increasing my t3, im on 30 mcg per day now. Which is considered very low. My GP would not agree to up my dosage. So I’m wondering how to switch to Tyromel carefully.

im taking now 7,5 mcg cytomel 4 times a day, one of which is before bed.

I can do only small increases by 1,25 of cytomel at a time due to still sensitive adrenals. so I can’t add 6,25 Tiromel at once…

My goal is to raise to 60-70 mcg per day.

If I start tiromel, dividing 25 mcg by 4 will give me 6,25. My question is - Can I temporarily combine it with cytomel?

It would be something like: 1. Changing my morning dosage to 6,25 Tiromel + 1,25 cytomel

2. Replacing all the dosage similar over time

3. When all doses are equal adding to each 1,25 Cytomel continuing raising

4. When I reach 6,25 cytomel I replace it again by Tiromel and so on

have someone had experience combining different brands this way?

[helvella]

You might care to read my blog entry about this. Although the title refers to levothyroxine, the issues also apply to liothyronine.

helvella - Mixing Levothyroxine Formulations

A discussion about mixing (and switching) formulations of levothyroxine.

helvella.blogspot.com/p/hel...

[Brightness14]

I am wondering exactly the same thing. I am prescribed 25mcg Cynomel each month 30 in total. I require more as I have no thyroid. I am going to just take the Tiromel which I have 200 of.

[Viv123 in reply to Brightness14]

do you take it only once a day or more?

[Brightness14]

I am still learning. I was taking thyroid s for over seven years. After covid the batch I was on left me falling over with a very low FT3.2.76. Therefore, I had to try something different. I am doing a six week test of 100 levo taken 9pm. The first week on the T3 I took extra 34, a day. the second week 31.5 a day third week 25 a day and forth week before my blood test 18.75 a day. The result was 20.3 FT4 and 4.64 FT3 the FT3 is too low for me I need 6 plus.

These were all split into four or five lots a real pain.

I started again with the idea of six weeks but keeping the T3 to around 25 to raise my FT3. I am only on week 3 so I will have to wait. The Levo doesn't work for 4-6 weeks I don't know if I convert or not. I have only been on NDT.

I will run out too at this level and will have to go onto the tiromel then. I don't think that I will mix the two. I have no gut problem but I can't take the Levo and T3 together. I have taken 12.5 at 6.20am this morning and another 9.33 at 9.20am. I find that it runs out quickly in the morning.

What about you are you going to mix them. Do you take Levo?

[Brightness14]

If you can understand my answer you go to the top of the class, it's complicated.

[Brightness14]

You could do with an answer from someone like yourself in the same situation. I have no thyroid so it's not the same.

I did work out that I got around 56 T3 a day from the thyroid s over the years.

[Viv123 in reply to Brightness14]

My problem is weak adrenals and liver/gut abnormalities on top of autoimmune thyroiditis. Also more than 6 years on thyroid hormones. My ft4 was a bit high in range in the beginning but Ft3 wasn’t even nearly near the top of the range, and antibodies of course.

Levo worked only first 3 months for me and then it stopped converting and I tested high Rt3. Have you tested your Rt3, I assume it’s the best way to understand whether you are converting. Or are you planning it along this 6 week trial?

I had to go t3 only and it helped, my ft4 got surpressed, rt3 issues stopped and it was fine. But adrenals were not supported for too long and that was why I couldn’t raise my t3 properly, now I’m finally on HC and raising doses goes easier. My schedule now looks like this

t3 - 30 mg total

Hc - 30 mg (6ml 0,5% cream) total

@7:15 7,5 t3 + 10 mg HC (2 ml)

@11:15 7,5 t3 + 10 mg HC (2 ml)

@15.15 7,5 t3 + 5 mg HC (1,5ml)

@21.30 7,5 t3 + 2,5 HC (0,5ml)

This are rt3 adrenal recommendations for my schedule. Have you ever tried talk to them too? They helped me a lot. The best for me now is to spread t3 into equal doses 4 times a day. As we also need t3 at night I found it very beneficial. My goal is now to raise t3 to 60-70 mcg, controlling the tests of course. I’m super hypo on 30 mcg t3.

[Brightness14]

Thank you for sharing your regime with me. It's hard for you with all your problems but it seems to be working for you now. T3 of 30 is only a small amount you will get better on more.

Some people on the site take their T3 all at once first thing and it seems to work.

I have just translated the Tiromel ingredients from the Turkish to English. Do your have your Tiromel?It's probably a good idea to keep on with the four doses if it suits you.

This morning I took a 12.5 half of T3 and I felt slightly better. The second dose is around 10,20 but is seemed to run out at only 9.33 T3 before lunch. Tomorrow I will increase it to 12.5 x twice in the morning. i.e. 25 am. Perhaps 6.25 at 2ish I will see and the other 6.25 at around 4pm.

I am waiting to see if the Levo converts also, it's only been 15 days so far.

It's a guessing game, although it shouldn't be. Do you take adrenal cortex for them.

I am Hypo too lets hope that we can get to the bottom of it and become well again.

[Viv123 in reply to Brightness14]

I’m basically currently disabled. Some times I find some pieces of a puzzle and get better but than crash again. I think it’s because I’m under medicated for thyroid for too long.

I was on similar schedule like you about half a year ago, but without Levo.. I think you run out too fast on your second dose because you don’t have enough at night. Then first dosage your absorb it so hungrily that then it’s not evenly distributed.

My honest advice to you would be to try taking last dosage before bed. And spread dosages about 4 hours apart.

You haven’t answered what you know about rt3 adrenal org and what you think of their approach if you’re acquainted with them. let me know also your plans to measure rt3.

I tried adrenal cortex for too long but it just made things worse for me. I had to be on hydrocortisone (HC) from the start. Now that schedule above includes my HC intake.

[Brightness14]

I don't know very much about the thyroid at all. I had mine removed back in 2015. I never had any problems before that it was working perfectly. I was on 100 levo for 5 months and started to feel ill. I joined this site and ordered thyroid s which I had been using since then. After Covid the Thyroid s changed and never suited me. I have been ill now for nearly 18 months with no idea of how to survive.

I am now 77 years old so it's not so important. I cannot take Levo and T3 together it makes me feel sick. I take Levo at 9pm so cannot alter the T3 timing.

Thanks for the information, anyway. As soon as my levels reach a good level I will go back to the NDT Thyroid s.

[Viv123 in reply to Brightness14]

Im sorry to hear about your experience. And 77 is indeed very advanced age to begin with treatment of thyroid. I think it’s very brave you started t3, and your dosage is not even that small. But I highly would recommend you to even the dosages of t3 and space them by 4 hours. Also please test you rt3 and ft3 on the same day. And as for ft4 pay attention so it wouldn’t go higher than the middle of the range.

If you need any help to register on the rt3 adrenal forum let me know, I could send you their link and explain how to register there, it’s free. They can be very helpful with minimum risks and you won’t feel alone in this struggle. They saw lots of patients with removed thyroid.

[Brightness14]

Thank you for the information. As I live in France there is no private testing so having to visit a GP which I loath may be a problem. The health care system is great here but no perfect.

I usually only test for these when visiting the UK.

[Brightness14]

Thank you for the information. As I live in France there is no private testing so having to visit a GP which I loath may be a problem. The health care system is great here but no perfect.

I usually only test for these when visiting the UK.