Re: TSH and Cytomel

[Guest guest]

Hi All, I'm currently taking cytomel 25 mcg twice a day. My problem with

this is that I forget to take the 2nd pill until I start feeling tired, and

then I remember to take it. I stop taking it on the 15th. I'm on the lid,

and will have RAI 225 mCi on the 30th.

Lois

TT-11/98-papilary with lymph node involvement

Completion TT-2/99

RAI 150 mCi 4/99

lymph nodes removed 7/99

RAI 200 mCi 9/99

2 years cancer free

10/02-MRND with removal of 27 lymph nodes-

15 positive.

1/30/03 225 mCi

[Guest guest]

> Can your TSH rise while taking Cytomel while waiting fot RAI? Could

> I be going hypo?

Yep.

It takes about 6-8 weeks, normally, for T4 to get totally in or out of

your system. It takes Cytomel (T3) about a week.

As the T4 is leaving your system, taking cytomel will offset the hypo

symptoms and make you feel MORE normal, but it is not like taking T4.

Because Cytomel is a short acting hormone, you also may feel more

peaks and valleys in how you feel each day. Some group members have

found that by splitting the tablets in half, and taking them 4 times a

day (assuming you're taking two 25mcg tablets a day, which is what we

are generally prescribed), you will feel more " even " .

Because the only reason for the Cytomel is for your comfort, to offset

the hypo symptoms as the T4 drains from your system, you can adjust

the timing, split them up, or adjust the total dose DOWN (DO NOT TAKE

MORE than your doctor has prescribed per day). This is very different

from T4, which must be taken regularly and in very specific doses to

suppress your TSH accurately. I sometimes didn't take Cytomel in the

evenings, or took just a half tablet instead of a whole one.

Cheers,

Alisa

Currently - 140mcg Levoxyl

2/15/2002: Nodule found 2/27/2002: FNA

3/4/2002: Hysterectomy/oopherectomy-possible ovarian cancer - BENIGN!!

4/9/2002: TT - Stage 2 pap 2.5 x 2 x 1.6 cm nodule, dx Hashimotos

5/28/2002: WBS (2 mCi) and 100 mCi RAI --- 6/6/2002: WBS - No mets

12/16/02: WBS (5 mCi): clean scan - no thyroid tissue in body!!!

Age: 49 -- Location: near Seattle WA --- Check out my posts:

Radioactive Girl - http://groups.yahoo.com/group/Thyca/message/19472

My LID - http://groups.yahoo.com/group/Thyca/message/15872

My RAI - http://groups.yahoo.com/group/Thyca/message/15873

LID thoughts, tips, ideas -

http://groups.yahoo.com/group/Thyca/message/25430

[Guest guest]

,

You do get a rising TSH while on cytomel. The dose is low enough to

allow that. Understand that the use of cytomel is self regulating. You

are not " required " to take a certain amount on any day other than to

not exceed 50mg. You can even go without if you choose. If you were

previously on a thyroid replacement it is usually best to wait around

5 days to begin the cytomel, allowing the T4 to fall off a bit. If you

were never on meds previously beginning the cytomel is when you feel

you need it.

I am going to include the cytomel rollercoaster here for you to read.

It was written by a thycan who had done her homework here on the list.

Good luck and keep asking questions!!

Gail

dx: 1968, TT, pap. & foll. well differentiated

w/hurthle cell, RAI, rad.neck dissection,lung surgery,

hashimoto, tg antibody 575, iodine resistant,existing

thyca nodules in lungs. Last surgery 1972

~~~~~~~~~~~~

CYTOMEL ROLLERCOASTER

I'm on Cytomel right now, for the first time, and it has been quite a

rollercoaster. I can understand why some doctors don't prescribe it.

My doctor told me: one pill (25 mcg) the first week, two pills the

second week, three pills the third and fourth week. If I had followed

that plan I would have been flying in " hyper-space " .

Luckily I had read enough on this list over the past year to know

what to do. For any newbies who might be reading, here are the tips

I've collected:

1. The purpose of Cytomel is to help you feel better than going

" cold turkey " off your Synthroid. You can always lower your dose if

the Cytomel is making you feel bad or hyper.

2. Be aware of the earliest signs of hypo/hyper symptoms. (For me,

starting hypo feels like my body and brain shifted into low gear and

are moving very slowly. Hyper feels like a triple espresso: jittery,

overly irritated by ordinary things, fast heart rate, bowel motility.)

3. Gradually increase Cytomel over the weeks as the Synthroid

gradually leaves your body. Increase or decrease dose by 1/2 a pill

as your body needs it, not on a fixed schedule.

4. Some find it helps to split the daily dose between morning and

afternoon.

5. I can feel a difference the same day I change dosage, but know

that the full effect of the change isn't felt for a few days. (Half

life of 18 to 24 hours means steady state is reached in 4.5 to 6 days.)

6. Before starting on Cytomel, you should be off Synthroid or

post-surgery for awhile (one week?) to let the Synthroid level drop

down first.

I started out with one (25 mcg) pill, after three days was jittery

and screaming at kids. Cut back to 1/2 pill and felt better. In a

couple days I was dragging, so back up to one pill. Felt very good

for a week, then starting to slow down, so up to 1-1/2 pills. Feeling

good for a few days. Last night I was freezing all night and dragging

this morning, so up to 2 pills and feeling better this evening. After

a few days I increased again to 2-1/2 pills per day and stayed at that

dose for the remaining two weeks. (After going off Cytomel completely

I felt calmer and quite good for the first few days, making me think

that perhaps 2-1/2 pills was actually a little too high a dose.)

My endo says he gives Cytomel to everyone except some non-English

speaking patients since it is too hard to explain the changing dose to

them. He felt it was especially important to use Cytomel following TT

since your body would not be able to recover from the surgery as well

if you were becoming hypo while still healing.

~~~~~~~~~~~~~~~~

> Can your TSH rise while taking Cytomel while waiting fot RAI? Could I

> be going hypo?

>

> I hate to keep pestering the doctor with phone calls complaining

> about how I do not feel right, partially because I am afraid they are

> going to think I am a whiner. Plus, then they make me drive 45

> minutes to the office for blood work.

>

>

> TT 11/27/02

> Waiting for RAI mid February