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!