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Suggest The Ideal Dosage For Thyroxine Taken For Thyroid
Question: I have been on 125mg on Thyroxine for the last twenty years, I started to take 25mg of Cytomel T3 in January this year I then took 50mg of Cytomel T3 in Feb this year and then 75mg of Cytomel T3 in March this year and am still on 75mg of Cytomel T3. Since January I have lost three stone in weight with very little effort as I have not changed my eating habit at all I do not eat a great deal anyway and eat very healthy three meals a day lots of fruit and vegetables.
I asked my doctor if he would consider me taking T3 cytomel and he said because my tests show ok i do not need to, and yet becasue i have been taking it i have lost weight. Being over weight is a big problem to me and i do not want to put the weight back on so i am happy continuing on the T3 cytomel of 75mg as well as the 125mg of Thyroxine but i am asking you if you think i should adjust the values as my weight has now stayed the same during April. I have lost three stone but cannot loose anymore.
Can you please advise if i should lower or increase my Thyroxine T4 or my Cytomel T3. I will not go back to my doctor as he does not believe in Cytomel.
Please advise the best you can.
Many thanks XXXXXXX
I asked my doctor if he would consider me taking T3 cytomel and he said because my tests show ok i do not need to, and yet becasue i have been taking it i have lost weight. Being over weight is a big problem to me and i do not want to put the weight back on so i am happy continuing on the T3 cytomel of 75mg as well as the 125mg of Thyroxine but i am asking you if you think i should adjust the values as my weight has now stayed the same during April. I have lost three stone but cannot loose anymore.
Can you please advise if i should lower or increase my Thyroxine T4 or my Cytomel T3. I will not go back to my doctor as he does not believe in Cytomel.
Please advise the best you can.
Many thanks XXXXXXX
Brief Answer:
Cytomel is unsafe
Detailed Answer:
Sorry to note your symptoms.
1 When a person takes cytomel it is often seen that the T4 levels are on the lower side. This is because cytomel is T3
2 Cytomel is generally not recommended by thyroid experts as it is deemed unsafe
3 You will be best served by seeing an endocrinologist in person who will have the opportunity to examine you, and manage the complexities of hypothyroidism
4 Thyroid hormone preparations containing T3 alone or in combination with T4 include the following : T3 alone (eg, Cytomel), T4-T3 combination preparations (eg, Thyrolar), and desiccated thyroid (a mixture of T3 and T4 made from porcine thyroid glands, eg, Armour Thyroid).
For most patients with hypothyroidism, thyroid specialists (ie endocrinologists) do not suggest treatment with T3 containing preparations. Patients treated with currently available T3-containing preparations have wide fluctuations in blood T3 levels throughout the day due to its rapid absorption from the gut and its relatively short stay in the circulation.
In addition, blood T4 levels remain low in patients treated with T3, and relatively low in those treated with preparations containing both T3 and T4; while serum TSH in steady state conditions will reflect the adequacy of therapy, measurement of serum T4 may be confusing and lead to inappropriate changes in dose.
5 There are few legitimate uses of cytomel nowadays. One example is this : Temporary treatment with T3 is appropriate in patients with thyroid cancer who are to undergo radioiodine imaging and possible treatment. To shorten the period of hypothyroidism, the patient's T4 therapy is discontinued and T3 is substituted for three to four weeks until the T4 is cleared
6 When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH
Free T4
Anti Thyroid Peroxidase (TPO) antibodies
Anti Thyroglobulin antibodies
25 hydroxy Vitamin D
None of these tests require any fasting and can be done at any time of the day
Cytomel is unsafe
Detailed Answer:
Sorry to note your symptoms.
1 When a person takes cytomel it is often seen that the T4 levels are on the lower side. This is because cytomel is T3
2 Cytomel is generally not recommended by thyroid experts as it is deemed unsafe
3 You will be best served by seeing an endocrinologist in person who will have the opportunity to examine you, and manage the complexities of hypothyroidism
4 Thyroid hormone preparations containing T3 alone or in combination with T4 include the following : T3 alone (eg, Cytomel), T4-T3 combination preparations (eg, Thyrolar), and desiccated thyroid (a mixture of T3 and T4 made from porcine thyroid glands, eg, Armour Thyroid).
For most patients with hypothyroidism, thyroid specialists (ie endocrinologists) do not suggest treatment with T3 containing preparations. Patients treated with currently available T3-containing preparations have wide fluctuations in blood T3 levels throughout the day due to its rapid absorption from the gut and its relatively short stay in the circulation.
In addition, blood T4 levels remain low in patients treated with T3, and relatively low in those treated with preparations containing both T3 and T4; while serum TSH in steady state conditions will reflect the adequacy of therapy, measurement of serum T4 may be confusing and lead to inappropriate changes in dose.
5 There are few legitimate uses of cytomel nowadays. One example is this : Temporary treatment with T3 is appropriate in patients with thyroid cancer who are to undergo radioiodine imaging and possible treatment. To shorten the period of hypothyroidism, the patient's T4 therapy is discontinued and T3 is substituted for three to four weeks until the T4 is cleared
6 When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH
Free T4
Anti Thyroid Peroxidase (TPO) antibodies
Anti Thyroglobulin antibodies
25 hydroxy Vitamin D
None of these tests require any fasting and can be done at any time of the day
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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