I take slow-release T3, a specially compounded prescription med. As far as I know, the company that makes Cytomel does not make a brand-name Cytomel timed-release formula. But I could be wrong.
I had terrible difficulty tolerating regular Cytomel, even at 2.5 mcg I would get sort of a shocky reaction within 40 min. of taking it: severe fatigue, pallor, & extreme coldness. It was all I could do, to drag myself to bed. After an hour, the reaction would pass.
My reaction to Cytomel was not typical. But it does seem like there is more potential for unpleasant (some docs would say dangerous) side effects from the ultra-potent T3 hormone, than there is from T4 meds. More common reactions to cytomel include: rapid heartbeat, anxiety/agitation, insomnia, diarrhea.
With the compounded slow-release T3 I do not get the shocky reactions. I have been able to slowly increase my T3 dose (currently at 4.5 mcg/day) & am starting to see symptom reduction. My free T3 levels are still very low -- I have a ways to go -- but my TSH is becoming suppressed.
One of the things I've enjoyed most about being on slow-release T3 is that I am once again able to sweat, after years of not doing so. I hadn't associated sweating with "feeling good" in the past ... perhaps it is just that I'm able to exercise & work enough now to sweat & also to release those feel-good endorphins.
My main advice is: be sure you really need a T3 med before taking one. Make sure it's warranted on the basis of your free T3 labs. And educate yourself regarding the controversies of T3 supplementation: cardiac issues, osteoporosis, and TSH suppression. It's best to start T3 therapy with a doc who has experience with it. The majority of MDs will get jittery if TSH goes below 1.0 (even though TSH may still be in the normal range), and then pull back on the Rx.
Rstarre, if you are asking about the TR T3, it is NOT cytomel. It is neither a brand-name nor a generic drug. It is not bulk-manufactured by big pharma.
Slow-release AKA Extended-release AKA Time-release T3 is prepared one Rx at a time, to doctor's script, by a compounding pharmacy. Because it is not a typical med promoted by the pharma reps, the vast majority of docs are not even aware that it is available.
To get a script for it, you need to find a doc who will Rx it -- typically, someone who knows about it & uses it in everyday clinical practice.
I have a doc appt next week and I'm going to ask to let me try the compounded time released T3. I've been on Armour for over a year and never feel symptom free even at 3 grains. One of the worst remaining symptom is my hair continues to fall and the texture is crappy and I remember it seemed to get some better on the straight T3. A couple of years ago I got a doc to let me do the Wilsons Syndrome protocol with the slowly increased levels of time released T3 and I really think I felt better on it. Ended up quitting because he doubted my thyroid issues.
I have elevated Reverse T3 levels so I think that's why I felt better on the straight T3. The medical institute I'm using has a compounding pharmacy so the meds woudln't be a problem. I'll keep my fingers crossed that he will and that it's the right decision for me.
My Free T3 when last checked was only five points above the lowest part of the normal range. I am currently taking 25 mcg of Cytomel. I have never had the reaction you did. It sounds horrible. Nor have I had any sweating, diarrhea, anxiety etc. My TSH is suppressed also. Do you have Hashimoto's?
Yes, I am familiar with the doctors you desribe. I am seeing the fifth one for my thyroid! I am hoping the addition of the T3 will help. I had labs done yesterday. When I find out what they are, I may ask about the time-released T3.
Haven't been on the boards for a long time, but I see you're still ticking. ;-) Hope you're doing okay.
I've had the EXACT same issue with my thyroid labs. Been on Synthroid for almost a year now. It took my TSH from 5 down to 0.7, but my free T4 has stayed only a few units above "low". (~ 0.87). I just had a friend-endo at Harvard tell me he believes physicians should treat Hashimotos (that's what I also have) on their free T4 levels and symptoms. I'm still symptomatic. He believes (like most folks here) free T4 should be in the upper half. I don't know that he sees a lot of hypothyroid patients as his practice is geared more toward sexual health and dysfunction. I am on 50mcg Synthroid, and only 5mg Cytomel (in morning only). I'm going to a new endo (as I've moved recently) so again - have to go over ALL the issues. PITA!!
I'm glad if you can tolerate the regular T3 w/out side effects. I think the main benefit of the TR is for those who are ultra-sensitive, and maybe for those who are really quick metabolizers who go through a lot of peaks & valleys during the day.
I do have Hashi's -- untreated for 20 yrs. despite pleas to my docs. Can't help but wonder how much of my difficulty tolerating T3 is due to receptors that just had to wring every molecule of TH for what it was worth during those decades.
I am no expert, but it sounds like your Synthroid dose is low. Have you been on the same dose the whole time? What is your Free T3 level? Are you taking 5 mg of Cytomel or 5 mcg? Maybe you would do better with Armour Thyroid, which is T3 and T4? Many doctors panic when the TSH goes too low.
It is terrible having to see a new doctor I know, but MAYBE he/she will be better? I hope so! I am on the fifth one. I will not settle anymore. So far he seems to care, which is a plus