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Old 08-18-2007, 12:27 PM   #1
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How long before I would expect to see some improvement on Cytomel?

How long does it take for Cytomel to start working? I'm on day two and only feel more fatigued. My t3 is below normal on my blood tests. Thanks in advance for your help!

 
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Old 08-18-2007, 10:45 PM   #2
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Re: How long before I would expect to see some improvement on Cytomel?

I can't help but ask ... Are you under a doctor's care and supervision? I can't imagine any reputable MD prescribing a dose (non dose, actually) of 7.5 mgs of Armour for as long as you took it without even trying to find out why you have trouble increasing it.
Did a doctor prescribe the Cytomel? What dose?

Last edited by midwest1; 08-18-2007 at 10:46 PM.

 
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Old 08-19-2007, 02:53 PM   #3
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Re: How long before I would expect to see some improvement on Cytomel?

Yes, I am under a doctor's supervision, a general practitioner who considers herself an "expert" in hormones based on her own hormone health issues and her own personal research.

I am VERY senstive to medications... so it's not unusual for me to have problems taking meds. I was having angina-like symptoms (which is an overdose symptom) from the Armour when I increased the dosage to over 7.5 mg/day, and since my thyroid levels (including t3) were within range at that time, my doc concluded that I must not really need the Armour. (the reasons for suspecting hypothyroidism were basal temp 97.4, consitpation, severe fatigue, low BP, low heart rate). I did try cortef in the hopes that it would address possibly adrenal fatigue, but I couldn't tolerate even the smallest dose.

I was going to discontinue the Armour since it was such a small dose, but another doc said even the small amount would probably help a little. (She apparently didn't realize that such a small dose could actually suppress thyroid function.) Since based on that experience, it was concluded that I really didn't need the Armour, and since my thyroid levels were within normal range, I really didn't focus on the thyroid issue and have been pursuing other avenues in trying to regain my health. But recently, at the urging of a friend, I went to an endocrinologist and he rechecked all my thyroid levels including t3, and that was when it became evident I was low on t3. (my docs hadn't been monitoring the t3... just tsh and possibly t4....). Regardless of whether i had thyroid issue before, now when I try to discontinue the Armour, I can't function. So now I DO have a thyroid issue. I'm pretty debilitated, so it's hard to think and figure things out when one is this tired.

The same doc who prescribed the Armour prescribed the Cytomel. I've been given 5 mcg pills starting at 2.5 mcg per day, then gradually increasing. I'm on day three of the Cytomel.

Do you know how long it would take to see improvement when slowly increasing the dose of Cytomel? I read somewhere it can take up to 3 months to 2 years to see the maximum benefit of the optimal dose of thyroid medication. But when would I first start to see real benefit when slowly increasing dosage? A few days? 6 weeks? Thanks for any help.

Last edited by sapphire5000; 08-19-2007 at 04:00 PM.

 
Old 08-19-2007, 11:19 PM   #4
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Re: How long before I would expect to see some improvement on Cytomel?

Ok...
Well, I've never taken Cytomel, so I don't know firsthand; but I have some understanding of hypersensitivity to meds.

When I started on 75 mcgs of Synthroid, my brain fog cleared within 2 weeks, and my mood and energy perked up a lot. Problem was, I was hyper on that dose within a month, and cutting the dose to 50 didn't help one iota. That is the smallest possible therapeutic dose, so I had to stop taking it. The endo deemed me "hypersensitive" to it and told me to wait until I got sicker and could tolerate it. Not an option. That's when, one month later, I saw my current doc who prescribed the lowest dose of Armour, 30 mgs. I never became hyper after that, and I now take 120 mgs.

It was rough sailing for the next 9 months, until I reached my optimum dose. I was feeling ok then, but after another 3 months, I was my old self again.

Really... everyone is different. There is absolutely no predicting what will happen with you.

 
Old 08-20-2007, 09:33 AM   #5
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Re: How long before I would expect to see some improvement on Cytomel?

Quote:
Originally Posted by midwest1 View Post
Ok...
Well, I've never taken Cytomel, so I don't know firsthand; but I have some understanding of hypersensitivity to meds.

When I started on 75 mcgs of Synthroid, my brain fog cleared within 2 weeks, and my mood and energy perked up a lot. Problem was, I was hyper on that dose within a month, and cutting the dose to 50 didn't help one iota. That is the smallest possible therapeutic dose, so I had to stop taking it. The endo deemed me "hypersensitive" to it and told me to wait until I got sicker and could tolerate it. Not an option. That's when, one month later, I saw my current doc who prescribed the lowest dose of Armour, 30 mgs. I never became hyper after that, and I now take 120 mgs.

It was rough sailing for the next 9 months, until I reached my optimum dose. I was feeling ok then, but after another 3 months, I was my old self again.

Really... everyone is different. There is absolutely no predicting what will happen with you.

Are you saying that for the first 9 months you felt worse before you felt better? Maybe I should stick it out on the Armour and see what happens???

 
Old 08-20-2007, 06:04 PM   #6
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Re: How long before I would expect to see some improvement on Cytomel?

I have been hypothyroid for nearly 5 years due to thyroid surgery. I have gone the straight Synthroid route, the Armour route, and the Synthroid/Cytomel combination. Like you, I seem to be very sensitive to thyroid meds., and T3 medication in particular. I was not successful with Armour when I took it quite some time ago and became quite ill. My doctor thought it was because of the ratio of T4 to T3 was out of balance for my particular body. (too much T3 in proportion to the T4)

So far the synthroid/cytomel combination has been the best for me. My labs also show my FT3 level to be just below the bottom of the range. I'm at 2.3 on a range of 2.4-4.2. I started cytomel last November at 5 mcg. in combination with 100 mcg. Synthroid. I did not feel well with the addition of T3 at the time, but stuck it out for several months until I got "used" to it. I had some awful insomnia prior to starting the T3 and right away when I took even the 5 mcg of cytomel, I started sleeping very peacefully and naturally through the night. That was the only benefit for me at first, so maybe you could say it did make me a little fatigued. I slowly titrated up from the 5 mcg. to 7.5 and then up to 10 mcg along with my regular 100 of synthroid. Each time I bumped up in just the smallest dose increase I did not feel great (not awful, but not "right" either) for a good few weeks. But when my body got used to the increase, I must say I did feel better overall than before I had the increase in dosage.

Unfortunately, my labs still are very low, and do not reflect any improvement. I saw my endo last week and my labs were at .16 (.4-4.7 range) for TSH, .81 (0.7-1.8) for FT4, and still at 2.3 (2.4-4.2) for FT3. Eventhough I don't really feel bad, I do think I could feel better. I still have some soft tissue aches and pains, especially in my shoulders. I really can't say I have been fatigued, I have enough energy to get through the day pretty well, but not much to spare for extra activities. My doctor wanted to increase my meds by just a small amount to see if it will help me. I also requested to try Armour again for the T3 dose since it is so much less costly for me than cytomel. He therefore put me on 1 1/2 grain of Armour, or 57 mcg of T4 and 13.5 of T3, giving me a slight increase in T3; but also told me to take 50 mcg of synthroid, which puts me very close to the same ratio I was at with the synthroid/cytomel combo. yet just a small boost in both T4 and T3. The jury is still out on this new dosage and meds combination as to how I feel... Again I do not feel "bad", but I can sure tell I have had a meds change. I do labs again in about 6 weeks.

Anyway, I hope my experiences with thyroid meds can help you in your search for just the right combination to stabalize you. Midwest is so right when she says we are all individual in our thryoid needs, and each of us will react to medication differently. Unfortunately the only way to know is through trial and error for each of us. I am glad though that I stuck it out to get used to some T3 even though for me it was difficult and took a long time. I DO think it has helped me, eventhough my labs do not reflect it yet.

Good luck to you in your quest to feel better. Hope to see you around the board with great news about your health!

 
Old 08-20-2007, 07:48 PM   #7
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Re: How long before I would expect to see some improvement on Cytomel?

Quote:
Originally Posted by sapphire5000 View Post
Are you saying that for the first 9 months you felt worse before you felt better? Maybe I should stick it out on the Armour and see what happens???
I think I'm safe in saying that nearly everyone experiences new symptoms and exacerbation of existing ones during the time they titrate up to their optimal dose. When I was in that process, I would get a dose increase, feel the same for 2 weeks, feel good for one week, and slide backward until the next labwork at 8 weeks. This went on for a full nine months, until I found that 120 mgs was the right dose. Then it took another 3 months for all the symptoms that were caused by my thyroid to be resolved completely.

It's also reasonable to expect that you'll have to put up with a certain amount of feeling bad before you feel good. Thyroid hormone isn't an instant fix like aspirin fixes a headache. I've said for years that hypoT requires a patient patient.

Whenever a certain brand/type of thyroid med doesn't get the job done, it's time to try something else. Only you can decide when that time is, so only you can decide whether to stick it out on Cytomel or to go back to Armour, or to try a T4-only med like Synthroid.

I'll be pulling for you to get it all figured out!

 
Old 08-21-2007, 09:34 AM   #8
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Re: How long before I would expect to see some improvement on Cytomel?

Thanks Midwest and Red Maple for your kind and wonderfully generous and helpful responses.

Yesterday, I took my temperature and I had a slight fever... 99 degrees, which is unusual for me since I am usually subnormal, and rarely get fevers... I think it may have been a reaction from the Cytomel... I called and the pharmacist said it could have possibly been a "febrile reaction," which is not a true allergic reaction, but some people do get fevers as a reaction to some meds ..... anyway, guess I'll just have to continue to play around with various meds and doses... thanks again!

Last edited by sapphire5000; 08-21-2007 at 09:59 AM.

 
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