Hypothyroid? Will You Benefit From T3 (Cytomel)?
Over 20 years ago endocrinologists had experience with hormone compound pills containing both T4 and T3. Those physicians who had the opportunity to use these compounds know that patients frequently seem to do better with them than with the more traditional T4 (Synthroid, L-thyroxine, Levoxyl etc.). For various reasons most companies stopped producing combination thyroid hormone pills two decades ago.
Why does combination therapy with T4 and T3 appear to provide more benefits than either hormone alone? The reason was clarified in an article published in The New England Journal of Medicine summarized in this news report;
NEW YORK, Feb 10 (Reuters Health) — Patients with hypothyroidism show greater improvements in mood and brain function if they receive treatment with two types of thyroid hormones instead of one, according to a report in the February 11th issue of The New England Journal of Medicine.
Hypothyroidism, where the gland has ceased to function or has been removed, is usually treated with daily doses of thyroxine hormone. But the researchers found that substituting another thyroid hormone, triiodothyronine, for some of the thyroxine dose led to improvements in mood and in neuropsychological functioning.
“There are two thyroid hormones, thyroxine and triiodothyronine,” Dr. Robertas Bunevicius, of Kaunas Medical University in Lithuania, and colleagues explain in their paper.
“Not all tissues that need thyroid hormone are equally able to convert thyroxine to triiodothyronine, the active form of the hormone,” the researchers write. “Nevertheless, most patients with hypothyroidism (reduced thyroid function) are treated only with thyroxine.”
To determine whether patients would benefit from receiving triiodothyronine as well, Bunevicius’ team studied 31 women and 2 men who lacked a functioning thyroid and were dependent on thyroxine.
The research team divided the study into two 5-week sessions. During one session, each patient took his or her usual dose of thyroxine. During the other session, the researchers replaced 50 micrograms (mcg) of the thyroxine dose with 12.5 mcg of triiodothyronine.
On 6 of 17 measures of mood and cognition — a catchall term that refers to language, learning and memory — the patients scored better after receiving thyroxine plus triiodothyronine than after receiving thyroxine monotherapy.
No score was better after monotherapy than after combination treatment, the study group determined. The authors also detected biochemical evidence that “thyroid hormone action was greater after treatment with thyroxine plus triiodothyronine.” But in an editorial, Dr. Anthony D. Toft, of the Royal Infirmary, Edinburgh, Scotland, recommends that physicians should not use thyroxine and triiodothyronine in combination until the study findings are confirmed by additional research.
Toft notes that “most, if not all, of the currently available combined preparations of thyroid hormones contain an excess of triiodothyronine as compared with thyroxine.” Besides, he argues, the majority of patients taking thyroxine “have no complaints about their medication.”
SOURCE: The New England Journal of Medicine 1999;340:424-429, 469-470.
I have used Cytomel (T3) in treating hypothyroidism for over 18 years and I am still surprised and gratified at just how well it works. For those complaining of persistent fatigue, muscle pain, constipation, or weight gain, despite blood tests showing normal levels of thyroid hormone, combining T3 with T4 therapy appears to boost the thyroid hormone action. Combining the two hormones can actually avoid the sometimes frankly negative aspects of simply increasing the level of T4. If you or someone you know has similar problems with thyroid hormone replacement I suggest consulting with an expert health care professional such as an endocrinologist about adding T3 supplementation.
Please, where can I find you for a consultation? I am in the New York area and would love to finally see a good doctor….
Of course, what a great site and informative posts, I will add backlink – bookmark this site? Regards, Reader.
Thank you Seshaya. We take pride in providing quality thyroid and other metabolism and nutrition related information.
Dr. Pepper.
I had a partial thyroidectomy in 1991 and 2 years later started feeling really bad. I began taking 0.075 of Synthroid and have been taking it ever since. I have had my TSH checked at my doctor and it is 2.022 now. I feel really bad, I have a new demanding job and find myself falling asleep during meetings and even while talking to people. I am not depressed and am actually very happy with my life, but something is wrong. My doctor is checking a complete thyroid profile, but I wonder if I would benefit from adding Cytomel to my Synthroid?
I too am having the same problem after being diagnosed with hypothyroidism about 4 weeks ago. I am on .25 mcg of Levothyroxine and am experiencing severe fatigue and weight gain as well as feeling all around “sluggish”. I, too, am at a job where I need my mental facilities intact. I find myself falling asleep at 9:00 in the morning after being at work for an hour. I have a call into my physician about adding Cytomel to my Levothyroxine.
I have been on synthroid for Hashimotos thyroiditis for over 10 years. I am on 300MCG. l have experienced severe fatigue and chronic joint pain for most of my life. I also experience bouts of depression. Four weeks ago I was placed on 5mg of Cytomel along with the 300mcg of synthroid. I am happy to say that my fatigue is almost gone, I have lost weight, my depression is gone and my joint pain is almost gone. I have never felt better in my life. I feel better than when I was teenager. I am now 37 years old and feel like life is starting over for me.
I would be interested in trying this Cytomel. I am trying to go back to school and the mental faculties have increased a little since I started on Synthroid 88mg, but I still feel the depression and still need naps each day. I have improved in that I am not sleeping all day and all night. How long should I wait before trying this Cytomel? I am a new patient of yours and have wasted five years trying to get someone to even listen about my thyroid, that I don’t want to wait any longer than I must to feel good again. I didn’t even know that muscle aches were part of the symptons, but I do have them.
I went from 112 lbs to 180 lbs before I had my thyroid removed in February of 2003. I have been on Armour for 4 years now. In the past 16 months I have gone from 130 lbs to 170 lbs. Doctor says my labs are very good and shouldn’t be changed. I am extremely active and eat very healthy. I am currently taking care of our 5 acres and house by myself as my husband works out of county during the week. I have horses to ride, lawn to mow weekly, chickens, weedwacking of the 5 acres with a push weedwacker that I have to do 2 times a year. This alone takes about 2 weeks each time at 6 hours a day. I run or exercise daily. I eat a ton of fruits and raw/steamed veggies some chicken and drink water and coffee only. I don’t like sodas. So, with all of this information, would cytomel help me? Will it give me energy so I don’t have to take a nap by noon, cure the muscle fatigue and keep me from being so cold also? Any help with this would be great…….I am not a lazy person, nor do I sit around watching tv and eating junk food as doctors have accused me of this in the past.
Hey Darla, I just had to respond to your post. I’ve been gaining about 10-15 lbs every year with no explanation for the past several years. I am very active as well. I was so sick of being accused of overeating and being lazy. Not every person who has a weight problem is lazy…pleazzzzz! After getting numerous “normal” thyroid blood tests, but all the textbook symptoms of HYPO I finally found a doctor willing to listen to me and take my seriously. I went in with all my research on how my body may be showing the thyroid hormone in my blood stream, it may not be getting to my tissue and organs. She did some research of her own and to my immense surprise put me on 5mcg of cytomel. I have been on this since this past Thursday and already my face is no longer swollen and puffy and my hands and feet are warm for the first time in over 6 years. I highly recommend cytomel and can’t wait to see what the next symptom to disappear is. Good luck and never be afraid to show your doctor your research and that you may know a thing or two about your own body!!!
Suzann, Where did you find the information about the medication being in the blood but not the tissues and organs? I have done extensive research and have not seen anything about the medication getting into tissues. I would love to get rid of some 50lbs of excess weight. My doctor last suggested going to see nutritionist in order to get a diet to help me lose weight. Any information would help. Thanks for responding.
I have seen a nutritionist before….what a great education I got. Lost 30lbs…but it came back slowly. I still recommend it though. The information I told you about came from a book a friend of mine gave me. I believe every person who even think they might have a thyroid problem should read this book. “The Thyroid Diet” by Mary J. Shamon – http://www.thyroid-info.com. These days we need to be our own doctors. I believe everyone should seek professional medical help, but before you go educate yourself, be your own advocate. I did and I got results. Mary states in her book, “be persistent, but unemotional…..show the doctor articles about thyroid disease that reflect your symptoms”. She goes on to say you need to fully explain your symptoms. Don’t just say I have gained weight…..tell the doctor I only intake 1500 (or whatever your intake is) calories a day and I am still gaining weight. Or I sleep 10 hours every night and by dinnertime I am exhausted. I stress this enough to everyone. My last endo told me my problem is not endocrine related….no??? then why am I feeling better on T3 replacement? Get this book….it will change your life!
Dear Doctor Pepper
I have been on thyroxine for the last 13 years, since I was 23. I’ve been steady at 150mcg of Levothyroxine now for about 10 years. Recently I’ve been feeling really sluggish and suffering with brain fog. Went for a routine blood test and the results came back that I need to adjust to a higher dose, so now taking 200mcg daily. Do you think that I would benefit from trying cytomel along with my Levothyroxine? What would you recommend as a dosage of each taking into account that I’m currently on 200mcg of the Levothroxine.
I really look forward to your response on the matter and can hopefully get the treatment I need.
Lee
As you know I cannot provide medical advice electronically. But in general your story seems pretty familiar. If you search metabolism.com you will find many other people who have stories similar to yours, and responded well to the addition of Cytomel. Sometimes the dose of t4 (Synthroid) needs to be reduced when adding Cytomel to avoid side-effects of excess thyroid levels.
Other people with hypothyroidism have used Armour thyroid to great advantage under circumstances similar to yours. Armour contains t3 and t4 in a single tablet making it convenient and cost effective.
Fatigue is a common problem and can arise from numerous, nonthyroid abnormalities, some as simple as not sleeping well. Be sure to discuss your symptoms with your doctor to be sure all possibilities are explored before making any assumptions about the cause and treatment of this type of problem.
Hope this helps.
I have Hashimotos and thyroid problems for 5 years. I was on 112 mcg synthroid for a long time, then went hyper but still hypo symptoms. One doc said lower it to 100mcg ANOTHER SAID i HAD TO RAISE IT TO 125MCG. After searching and searching I found a Internal Medicine doc who heard me and put me on 100 mcg synthroid and added 10mcg Cytomel, for the first time in years I feel normal plus I had a extra 15 Ibs I could not lose no matter what. I have lost 7 lbs in two weeks. (I have just started my third week) I started out with 5 mcg cytomel and now I am up to 10. I am not freezing anymore the joint pains are gone and memory is back, and the puffy sagging eyes lids have vanished, what can I say I love it.
I had RAI do to graves disease and now I am hyporthyroid. I have been faithfully following weight watchers and exercising daily, twice a day. I do aerobics and resistance training.
I have not lost one pound and I am sooooooooooo discouraged. I take Levothyroxine 127 it was 125, 150 ,137 and I am sure when I go back it will be something different. Does not matter though. I am still not losing weight. Nor, can I find a doctor that will prescribe the cytomel. I live in the Chicago area south suburbs. Does any one know a doctor in this area that will prescribe cytomel. My doctor just will not do it. More than the weight, my bones hurt and my joints pop. I can’t remember stuff. My feet are always freezing. I actually had to quit my 23 year well paying job in this economey because of my lact of focus, concentration, depression etc. I really need a doctor that will listen to me and help me. It sounds like from what I have read that the cytomel will work for me.
Hello Frances,
I see Dr. Mark Stolar at Northwestern Internists on the Northwestern medical campus in downtown Chicago. He was the only doc who would give me Armour. Now, since Armour is not available, he has me on a combo of Synthroid 1x per day and Cytomel 2 x per day.
Hope this helps.
i was wondering if you could give me a name of an Endocrinologist in the St. Louis or Cape Girardeau that would talk to me about Cytomel..I have been on Levoxly for 7 years now, I have gained 30 pounds the last 2 years..I feel very jittery, anxiuos, and overwhelmed at times. i have been reading about Cytomel and I feel I may benefit from that, but my current physician will not prescribe it for me. I have discussed with her my concerns with my syptoms with her, but she said it is my age.
I have Health Link insurance hopefully i can get a doc that accepts the insurance.
Hi Tonya!
I live in the Cape area and couldn’t find a doctor at all to listen to me in Cape or St. Louis. Finally after 4 years of feeling physically and emotionally ruined by doctors telling me that I had nothing wrong with my thyroid (even when presented with two ultrasounds confirming Hashimoto’s) I found a doctor in St. Louis who seems to be concerned with how I am feeling along with the bloodwork. Remember normal labs are not necessarily normal for everyone as a whole. We are all individuals and should be treated that way. I am currrently taking 100mcg. of levothyroxine daily and my new doctor just added 5 mcg. of cytomel. I haven’t started it yet but tomorrow will be the first day. I am so excited and hopeful that it will help. I was always around 115lbs. until this all started now I am at 155lbs and have gotten as high as 162. Her name is Dr. Naseer in St. Louis. You can search her on the web. I too had a lot of your symptoms along with hair loss, constipation muscle aches, flushing episodes in the middle of the night preventing good sleep, then exhausted during the day. I have also had muscle tremors and low body temperature. The anxiety was so bad I thought I was going mad. It sounds like you’re a local gal. Good luck to you and email me if you wish. It is kinda nice to have someone to talk to who understands your situation.
I am so sick and tired of telling my story over and over again but decided to share it on this website in hopes of some sort of resolution. About 5 years ago, my thyroid quit and I gained 70 pounds. I worked out before and after this occurred, so that was not an issue. When they FINALLY figured out what was wrong, I had hopes the taking and getting my thyroid levels right, eating right and working out I would get back to normal. Well that was not the case at all. I actually became rather obsessed with working out and was working out about 3 hours a day, eating less than 1200 calories a day only to lose about 4 pounds over a year period. Then I quit, ate whatever I wanted, and nothing happened. I didn’t gain any weight back. I started up again about 6 months later and was jogging and walking 3 times per week. I did lose about 20 pounds but gained it all back. I am now at an all time high. I am ready to start working out again, regardless of any results but want to talk to my Dr. about Cytomel. I have pretty much given up and don’t think I will ever get back to my normal self. I am in good spirits and have decided to just accept myself for what I am….I don’t think it is fair and I don’t like that I have to be so overweight while I was normal all my life. It is just not fair I just can not believe that this can not be fixed. Its so frustrating. I am not a saint, I do indulge from time to time, but only on the weekends. My mother who is about 100 pounds eats twice or more than I do, doesn’t do a thing and maintains. Every one I know maintains their weight with a little fluxuation. I just don’t understand how a person can gain 70 pounds and there is nothing I can do about it. Sometimes I think I need to quit work and go to a fat farm for 6 months and only work out 24-7. Nothing works. I need help and guidance.
My problem is I cannot find a doctor that will prescribe T3. I live in the southern suburbs of Chicago. Any suggestions?. I have so far been to 3 endocrinologist and one internal medicine doctor. I don’t work any more because of problems with depression, concentration and memory loss. I can not afford to keep paying for these doctor visits and repeated blood test for nothing. And, I can’t afford to keep buying bigger and bigger clothes. I am miserable.
I just read a post that gave me a doctors name. THANK YOU SUSAN.Let me call the doctor right now.!