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Old 03-11-2011, 02:55 PM  
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Re: Figuring out t3 dose

cd---my dr. said nothing about splitting t3 dose either and also no lab instructions. So, we are in the same boat there.

I too take my t4 (synthroid) late at night or in the very early morning. Again, my dr. said nothing about this but I saw the research that showed better conversion rates when taken at night.

Could you clarify ...on the day of your labs are you taking your 8am dose of t3 as usual?

On the labs that you had after starting your t3...did you see a bump up in your free t3 level? As my free t3 is very low , nearly on the bottom of the range I am wondering what a 5mcg dose may do. Of course our results will likely vary, but just wondering what you saw on your first labs after adding in th 5mcg t3? Also did it look like your tsh went into hyper territory on that lab?
Azuree

 
Old 03-11-2011, 03:51 PM  
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Re: Figuring out t3 dose

The available information on T3 dosing - both dose size and timing is downright scary....many places list 25mcg (!!!) as the starting dose to be taken once daily.

It seems that, with treating thyroid disease, we have to do our own research and can also benefit from the experiences of others....I'm sure you've already discovered this

Dr. Ridha Arem mentions the split dosing in his book "The Thyroid Solution" and it makes sense since Cytomel has a short half-life.

Yes, on the day of my lab, I take my 8AM Cytomel dose....and then lab at 1PM.

Cytomel supposedly peaks within 2-4 hours after taking it....and I'm sure it's quite "individual-specific" as many things thyroid can be

I most definitely saw a bump in my Free T3 level - it was 3.0 (2.0-4.4) when I started 5mcg Cytomel (split into 2 doses).... and I "landed" right at my setpoint - 4.0 after 4 wks.

The labs I had done today (get results on Monday) will constitute 8 wks. on the 5mcg. Now, this past Monday, I started to have afternoon fatigue....by Wednesday, chills at night set in....yesterday, my knees started aching - these are all hypo symptoms for me.

My doctor increased my levo dose to get me started feeling back to my old self and then, after the lab results come back Monday, we'll finalize my dose moving forward.

I was supposed to have labs Tuesday but had to change my appointment to today since I had a slight fever on Monday (weird 5-hr virus - lol)....being sick can affect thyroid levels so I knew I had to reschedule my labs.

I'm sure my levels are a bit "off"....and, if I kept to my original lab schedule (every 4 wks.), I just might have been able to nip these early symptoms in the bud.

(admittedly, I took a full 5mcg Cytomel tab this afternoon to expedite my return to good health....I just might do 7.5mcg total/day until I get my lab results on Monday)

Dr. Ken Blanchard mentions this type of dosing when a patient needs a dose increase - he starts out higher for a few days - week and then brings the patient back down to the intended dose moving forward.

My doctor did that for me not too long ago but she had labs to back up the decision.

I know my body well enough to know I need a bit of a "jump start"....and the 3 days of higher dose Cytomel will not skew my labs in 4 weeks.....and, who knows, I just might need a Cytomel dose increase once we see my labs.

I need my FT4 to be 1.7 (.8-1.76) and my FT3 to be 4.0 (2- 4.4).

It is not correct to term a low/below-range/undetectable TSH as "hyper" when a person is taking thyroid hormone replacement meds.....that link I shared with you explains why.

But, as far as my TSH is concerned, you really can't use it as a reference since I have Graves' disease and my antibodies suppress my TSH. My TSH has always been below-range.....once I started Cytomel, it became undetectable - <.0006.

This is to be expected....those endo journals referenced by the other member's thread explains all this.
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Last edited by cd37; 03-11-2011 at 03:54 PM. Reason: typos

 
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Old 03-11-2011, 04:07 PM  
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Re: Figuring out t3 dose

Cd--Thanks so much that was quite informative. I agree with you on the scary high t3 doses that are discussed . My dr. was going to start me at 10mcg. --luckily I knew that would have been way too much for me as a starting dose. In fact, I am hoping that I do not need to go any higher than 5mcg.

I have also read Dr. Arem's book. I sure wish I could find a dr. as interested in thyroid issues as Dr. Arem! I also like his multi-modality approach... bringing in meditation, nutrition, exercise etc... In my personal experience all of these aspects need to be attended to.

Good luck with your labs!
Azuree

 
Old 03-11-2011, 04:17 PM  
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Re: Figuring out t3 dose

I'm glad you find my posts informative 'cuz I definitely wind up typing mini novels

I'm glad you started out slowly with Cytomel - it makes sense. I wouldn't be too concerned if you wind up needing a higher dose - I know I'm comfortable with the thought.

Cytomel made such a big difference in how I feel and that's why I took a full 5mcg tab this afternoon - absolutely no hyper symptoms afterwards and my afternoon fatigue didn't happen - yay!

I agree with you about Dr. Arem.

And, when you mentioned exercise, it reminded me of my current situation. I think my new level of exercise is what caused me to need a dose increase.

You see, earlier this month, I increased the amount of time I workout from 35-45 min/day to 50-60 min/day....and I increased the amount of weight I lift during my weight-training exercises.

Well, muscles use more energy than fat....and muscles require more thyroid hormones than fat.

We can't win for losing sometimes

Thanks for your good wishes about my labs - I'm really curious about them 'cuz, now that I'm taking both T4 and T3, it should be interesting to see which level moved...or if both moved.

Best of luck to you moving forward with Cytomel!
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Last edited by cd37; 03-11-2011 at 04:19 PM. Reason: typos

 
Old 03-19-2011, 09:22 AM  
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Re: Figuring out t3 dose

Help!

I have half my T gland and have gone .75 two years ago to .88 now. When they changed me to .88 I felt great and that lasted about 9 months. Now my TSH is up again, it is constantly going up and down.

So they kept me at .88 and added .5 mcg of cytomel once a day for 3 days and then twice a day if I don't feel better.

I cannot really tell. It has been 4 days and for some reason I feel the early morning dose is making me sleep longer!
I take .5 at 4 in the afternoon and take .5 and .88 syn at 3-4 am when I get up to go to bathroom. I know that my stomach and gut are empty at that time and I can safely drink coffee at 6:30.

My question is, what will the cytomel do for me? I need more energy, less pain in my joints, less brain fog, etc. When I got on .75 the difference was amazing. Then when I got on .88 again I felt like myself. But that didn't last but 9 months and now here we go again.

I was told to take the cytomel away from vitamins and food same for synthroid.
A little advice??? How to know if it is working?
Today I noticed my appetite is off and I seem more alert and wide awake. Making better decisions. This is the 4th day on cytomel.

 
Old 03-19-2011, 11:38 AM  
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Re: Figuring out t3 dose

Hi Golfhat--I certainly am not an expert on this...just trying to find my way through adding in 5mcg of cytomel as well. While you put .5mcg of cytomel...do you mean 5mcg?

My regimen is to take the synthroid at night . And, then do the 5mcg in a split dose ...2.5 when I get up and then 2.5 in the early afternoon like 1:00. The second dose is definitely not on an empty stomach but it is ok for me.

Cytomel is known to have a quick onset and a stimulating effect...so I wouldn't want to take it in the middle of the night. Nor would I want to take the cytomel in the late afternoon.

Also I would perhaps give a dose change more than a few days to see how it works for me. I think it takes the body sometime to readjust to a new dose

While you may get adequate response here tacked onto this thread...if you find that you do not get much response, you may want to start a new thread where I think more people would see your question. Also it may help if you show your lab results and lab ranges prior to starting the cytomel. Good luck!
Azuree

Last edited by azuree; 03-19-2011 at 11:42 AM.

 
Old 03-20-2011, 06:53 PM  
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Re: Figuring out t3 dose

Yes, i got an answer from someone on a thread that I started. It was very helpful.

I talked to the pharmacist today who is on the same doses I am on.
She said she usually takes just one 5mcg (not .5 mcg like I typed) in the morning with her synthroid and may take another one in the afternoon if needed. But she is so stabilized on cytomel that she can tell when she needs an extra boost.

Yesterday I felt like I had the flu by the time I went to bed.
Those are hypo symptoms for me. But today, I feel better!

By the 4th day my appetite was back to normal. I have been having such hunger pangs the last couple of months. I guess my TSH was going up slowly. WTH? I wish it would settle down.

Today is the 7th day on cytomel. I feel very irritable for about 2 hrs after I take it. Why is that?

I didn't realize the effect builds up the way synthroid does.
I am doing ok on the 5 mcg a day so far.

Last edited by golfhat; 03-20-2011 at 06:54 PM.

 
Old 03-21-2011, 01:37 AM  
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Re: Figuring out t3 dose

Quote:
Originally Posted by golfhat View Post
I feel very irritable for about 2 hrs after I take it. Why is that?
Maybe you absorb the med very quickly and that does it? Have you tried splitting the dose?

Last edited by FinnMaid; 03-21-2011 at 05:00 AM.

 
Old 03-22-2011, 12:40 PM  
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Re: Figuring out t3 dose

Hi asides
Would not decrease my t4 meds finnmade is rit they do different things t4 and t3

I am on 30mcg of t3 and 162 of t4- I am also increasing my t3 as I am pregnant so please don't worry

Rachel

 
 

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