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JLeslie's avatar

Hypothyroidism sufferers and doctors: what is your opinion about adding Cytomel (T3) to your medication routine?

Asked by JLeslie (47745 points ) June 19th, 2012

For this discussion I am not very interested in Armour Thyroid, which I know some people have had great success taking.

I am considering requesting from my doctor the addition of Cytomel, because my thyroid is difficult to regulate and maybe at least my T3 will stay more stable. I have been told by women that it greatly improved their symptoms.

I have never heard anything negative about taking T3, but there must be some negatives, so I would really like the hear those things too. I also wonder if once you start taking it can you never go back to just taking Synthroid? Does your body lose the ability to convert to T3?

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14 Answers

bookish1's avatar

Wow, I have never heard of Cytomel… I’ve been on synthroid/levothyroxine for most of my life, though, so following this question with interest.

keobooks's avatar

Why aren’t you interested in Armour? It’s another T3 regulator. If you have trouble with your T3 levels, a T3 regulator, Armour or Cytomel is just fine. Synthroid only regulates T4. You probably couldn’t go back to just synthroid because it wasn’t doing enough in the first place if they are talking about adding a T3 regulator. It’s not an either/or thing. You’ve likely had a T3 imbalance for as long as you had the T4 imbalance, but because doctors don’t usually check for it unless they have suspicions, it went unnoticed until the doctor realized synthroid wasn’t cutting it for you.

JLeslie's avatar

@keobooks My doctor isn’t suggesting it, I might. My T3 does regulate when my TSH is in normal range, but I am difficult to regulate. Right now I have moved back into normal ranges, and my T3 is the very low side of normal, for the next 1–2 months my TSH will stay in good ranges and my T3 will come up to a better number, as it usually does, and then my TSH will move out or close to out of normal within the next few months and I start all over again. So, I was wondering if I take T3 I might at least control that number better. My T3 is pretty much always in the normal range but moves within the extremes of it, where my TSH can dive fast or shoot up very very fast. In fact, I wonder if the addition of the T3 will help me be more stable in general.

I didn’t want to talk about Armour for this discussion; I have looked into it. I said that because I figured a bunch of people would tell me how Armour has T3 also and how they used to take years ago and loved it, etc etc. I already know those stories, but for now I wanted this conversation to stick to cytomel. Not that I am annoyed you brought up Armour, but that is why I specificially mentioned not getting off track with a discussion about Armour.

JLeslie's avatar

@keobooks I don’t think Synthroid regulates T4, I think it is T4? And, then the body converts what it needs to T3. Kind of like how Vitamin D2 converts to D3.

keobooks's avatar

The days of doctors only suggesting T3 or T4 are almost over. In the near future, most patients will likely be offered a combination of the two. Measuring TSH only has turned out not to be effective in diagnosing or treating hypothyroidism. My TSH levels are totally normal as are my T4 levels. I was undiagnosed for almost a decade even though I had all the classic symptoms.

For a lot more people than they originally thought, Synthroid alone does NOT work well enough to take it alone. The conversion isn’t exact enough to regulate well. For people with very classic Hashimoto’s, this mostly works – well enough they may not need T3. But more people than doctors imagined would do better on a combo.

I don’t think that I know enough about how the thyroid works to talk about how the medication would affect you in the long run. I just know that I had to go to several doctors before I found one that said she always did a combo (except in cases like mine – I have an atypical thyroid condition and only need T3.) And she said that in the next few decades, most doctors were likely to do the same.

JLeslie's avatar

@keobooks I can pretty much rely on just my TSH actually, but I do check my T3 and T4 free every 4 to 5 months. I check my TSH every 2–3 months. The reason I say I can rely on my TSH is because that seems to be very reliable in being outside of noemal levels when I feel symptomatic and the the other numbers kind of line up with my TSH, when one is low the other high etc. It saves me money not to check all three every time, and I can pretty much guess accurately where the other numbers will be according to my TSH at this point. It’s basically the same as I can guess what my cholesterol will be based on how I am eating.

augustlan's avatar

I think it’s worth a try, if you can convince your doctor to give it to you. What’s the worst that could happen?

JLeslie's avatar

@augustlan I’m going to discuss it with her today. The worst that can happen is I hate it, but hopefully stopping would rememedy feeling badly on the drug, that is why I ask if it permanently changes our ability to naturally create T3. Sometimes taking a hormone inhibits the bosy’s ability to produce the hormone on its own supposedly. I think Testosterone works that way for men, but maybe the doctor who told me that is wrong, because women obviously use The Pill and then stop and revert back to normal, I don’t know why Testosterone is differenct than the girl hormones. Or, if the drug has some long term side effect not realized.

I am not a pill taker, so I am always relucatant to add a medication of any sort. I believe every medication has a side effect. You have probably seen in my answer even about vitamin and minerals I tell people to get a blood test to see if they are deificient or not. I don’t take things unless I pretty much know I have to. I am not saying everyone should be like that, it is just how I am, it partly has to do with being risk aversive, partly the belief that one bad thing can change our lives forever, and partly not being a good pill swallower.

bookish1's avatar

@JLeslie: I do know that if you have testicles, taking T will make them shrink. A side effect I don’t face luckily :-p I don’t know about the estrogen side of things, however.

And I think it is very good that you are risk averse about medications. Everything does have a side effect, and often new drugs are marketed heavily before all of the side effects have been fully understood.

JLeslie's avatar

The doctor did not like the idea of adding the cytomel. She didn’t really explain why, except that she doesn’t feel I need it. She prefer to really focus on some sort of system that I will be more stable. Like taking one dose for 4 weeks and then change it to another dose for a couple weeks. It’s almost impossible I think for me to get a reliable pattern. The best is to just get tested every 2–3 months. I might ask another endocrinologist at some point for a secnd opinion.

JLeslie's avatar

Update: I had another appointment with my doctor, and she still was not fond of the Cytomel idea. I brought it up again to try to get a little more informationas to why. Anyway, the conversation quickly turned to me asking about Armour again. I just have this idea in my head that if I get some T3 directly I will do better. She at first felt like I was doing well on Synthroid (I actually take the generic) but then she asked me if I want to try the Armour, or if I am asking her opinion only. I said I didn’t know, it was not that I was insisting, more like trying to figure out if I should try it. After going back and forth a little, she just said, “you know what, let’s just do it, we can always switch back.”

I have been taking the Armour for just over two weeks, and I do think it is better. I don’t think I will really know for sure for another 3 months, once I have been on it a while. I might just be having a few good weeks right now aside from the medication change. I had a blood test at the two week point and my T3 is much much higher, while my TSH is around the same. My hair is filling in and my skin is more supple, and my stamina seems to have increased (although I also have been very good about taking my iron, which might also affect my stamina, and I have been megadosing my vitamin D). I have gone through having good weeks or months on the unithroid, but eventually it gets all screwed up because I was so hard to stabilize.

I am going to check my blood every 2–4 weeks untill I feel confident the dose is ok. I don’t want to wait 8 weeks and be so overmedicated that it takes weeks to come back down.

SpatzieLover's avatar

I’ve been on Armour for about 3 or 4 mos now @JLeslie. I must say that I’m glad my doc suggested it. His opinion was that we’d try this for about 6mos, see where it takes me, then delve into T3 if it seems necessary. I’ve definitely gained energy over the last month…Whoo-hoo!

JLeslie's avatar

@SpatzieLover Thanks for commenting. I’ll be interested to know how things progress for you. The Armour has T3, that is what makes it different than Synthoid. I read soe information that said that some people their T3 gets too high, and they take a combination of Synthroid and Armour.

JLeslie's avatar

Update: I switched to Armour about 6 months ago. I am overall very happy I made the switch. The first few weeks were amazing, but it did not stay at that amazing level, but still better than before. During the time of the initial weeks and feeling great my T4free level was high nornal and my T3 was also. Weeks later the T4 level dropped to low normal. I think the higher T level was good, I think that is what helped me feel so great the first couple weeks when I switched drugs, because I had a lot of T4 still in my systen from the previous drug, since T4 has a very long half life.

I have tried to add a small amount of T4 while taking the armour, but it didn’t work out so far, I didn’t have the dose right. I am not sure if I am going to continue to try to tweak the dose by adding T4 to the armour dose, or just take the Armour and settle so to speak.

Oh, and when I had suggested maybe adding the T4 with my doctor, the first thing she said was, “maybe we should put you back on the T4 and add Cytomel.” Can you believe it?!

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