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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 37. This is the beginning of the thread.
Posted by gardenergirl on July 7, 2004, at 8:05:32
Hi,
I am on a small dose of synthroid as my normal TSH without it is on the lowest end of the normal range. I take it to boost it closer to the center which may help me get pregnant. I have read that Cytomel is a good adjunct to depression, which I also have and take Nardil for.I understand Cytomel does not need the body to convert it to T3, and thus is used more efficiently.
What do y'all think? Anyone have opinions one way or the other?
Thanks,
gg
Posted by KaraS on July 7, 2004, at 8:55:32
In reply to Cytomel vs. Synthroid, any opinions?, posted by gardenergirl on July 7, 2004, at 8:05:32
> Hi,
> I am on a small dose of synthroid as my normal TSH without it is on the lowest end of the normal range. I take it to boost it closer to the center which may help me get pregnant. I have read that Cytomel is a good adjunct to depression, which I also have and take Nardil for.
>
> I understand Cytomel does not need the body to convert it to T3, and thus is used more efficiently.
>
> What do y'all think? Anyone have opinions one way or the other?
>
> Thanks,
> ggCytomel IS T3. I've done lots of reading on this topic as well as personal experimentation. I believe that the body does better when taking something more like the real thing - which in this case would have T2 and T3 in it. I have taken Levyoxyl (comparable to Synthroid) at times and Armour (natural dessicated thyroid from pigs which has T2 and T3 in it) and I feel that the Armour is superior. If I were you, I'd add Cytomel or switch to Armour. (It seems that the Cytomel or T3 supplementation is also more of effective in boosting antidepressants.)
P.S. The conventional medical establishment pushes the Synthroid and Levoxyl. They've been brainwashed by the big drug companies to think that their products are superior but if you do a lot of research (esp. read Mary Shomon's articles on thryoid at about.com or her books) you find that it's really not the case. Also, take a look at some of the problems that Synthroid and Levoxyl have had with product consistency.
Posted by Bill LL on July 7, 2004, at 9:01:59
In reply to Cytomel vs. Synthroid, any opinions?, posted by gardenergirl on July 7, 2004, at 8:05:32
Actually, when the thyroid level is low, TSH is high and visa versa. So before you started on synthroid, yout TSH was probably a bit higher than the normal range.
You are correct that T4 (synthroid) converts to T3 (cytomel). Therefore taking cytomel makes the conversion unnecessary.
Doctors have different opinions about which thyroid drugs are best. If you did not have depression, then synthroid would be more of a clear choice. But since you do, maybe it would help if you were given some T3 (although not all doctors are in agreement).
There are 2 thyroid drugs that have both T3 and T4. They are thyrolar and armour thyroid. Talk to your doctor to see what he/she thinks.
As I'm sure you already know, with a drug like Nardil (an MAOI drug) you have to be very careful with what you eat and with which drugs you take.
> Hi,
> I am on a small dose of synthroid as my normal TSH without it is on the lowest end of the normal range. I take it to boost it closer to the center which may help me get pregnant. I have read that Cytomel is a good adjunct to depression, which I also have and take Nardil for.
>
> I understand Cytomel does not need the body to convert it to T3, and thus is used more efficiently.
>
> What do y'all think? Anyone have opinions one way or the other?
>
> Thanks,
> gg
Posted by Ilene on July 7, 2004, at 11:33:23
In reply to Cytomel vs. Synthroid, any opinions?, posted by gardenergirl on July 7, 2004, at 8:05:32
> Hi,
> I am on a small dose of synthroid as my normal TSH without it is on the lowest end of the normal range. I take it to boost it closer to the center which may help me get pregnant. I have read that Cytomel is a good adjunct to depression, which I also have and take Nardil for.
>
> I understand Cytomel does not need the body to convert it to T3, and thus is used more efficiently.
>
> What do y'all think? Anyone have opinions one way or the other?
>
> Thanks,
> ggI'm taking Cytomel to augment Marplan, and it works well. This combination got me out of my deep, suicidal depression. I never took T4 so I can't offer a comparison. The only side effect I've noticed is that I can't drink coffee within a couple of hours of taking Cytomel or I get shaky and light-headed.
I.
PS: I moved! Can't say I moved *in*. Will post more later.
Posted by Allie Blue on July 7, 2004, at 13:20:57
In reply to Re: Cytomel vs. Synthroid, any opinions?, posted by Ilene on July 7, 2004, at 11:33:23
> > Hi,
> > I am on a small dose of synthroid as my normal TSH without it is on the lowest end of the normal range. I take it to boost it closer to the center which may help me get pregnant. I have read that Cytomel is a good adjunct to depression, which I also have and take Nardil for.
> >
> > I understand Cytomel does not need the body to convert it to T3, and thus is used more efficiently.
> >
> > What do y'all think? Anyone have opinions one way or the other?
> >
> > Thanks,
> > gg
>
> I'm taking Cytomel to augment Marplan, and it works well. This combination got me out of my deep, suicidal depression. I never took T4 so I can't offer a comparison. The only side effect I've noticed is that I can't drink coffee within a couple of hours of taking Cytomel or I get shaky and light-headed.
>
> I.
>
> PS: I moved! Can't say I moved *in*. Will post more later.
>
> How much cytomel do you take and do you take it three times a day? How long have you been taking it? How long did it take to notice an improvement? Thanks for the information.
>
Posted by Ilene on July 7, 2004, at 21:28:27
In reply to Re: Cytomel vs. Synthroid, any opinions?, posted by Allie Blue on July 7, 2004, at 13:20:57
> > How much cytomel do you take and do you take it three times a day? How long have you been taking it? How long did it take to notice an improvement? Thanks for the information.
> >
>
>
I take 25 mcg in the morning. I was taking another 12.5 in the afternoon, but my doctors thought it was affecting my thyroid too much. The 25 seems to be okay.I've been taking it since about April. It didn't take too long to notice an improvement. A couple of weeks, maybe.
I.
Posted by gardenergirl on July 7, 2004, at 21:32:42
In reply to Re: Cytomel vs. Synthroid, any opinions?, posted by Ilene on July 7, 2004, at 11:33:23
Posted by KaraS on July 8, 2004, at 0:36:49
In reply to Re: Cytomel vs. Synthroid, any opinions?, posted by KaraS on July 7, 2004, at 8:55:32
> > Hi,
> > I am on a small dose of synthroid as my normal TSH without it is on the lowest end of the normal range. I take it to boost it closer to the center which may help me get pregnant. I have read that Cytomel is a good adjunct to depression, which I also have and take Nardil for.
> >
> > I understand Cytomel does not need the body to convert it to T3, and thus is used more efficiently.
> >
> > What do y'all think? Anyone have opinions one way or the other?
> >
> > Thanks,
> > gg
>
> Cytomel IS T3. I've done lots of reading on this topic as well as personal experimentation. I believe that the body does better when taking something more like the real thing - which in this case would have T2 and T3 in it. I have taken Levyoxyl (comparable to Synthroid) at times and Armour (natural dessicated thyroid from pigs which has T2 and T3 in it) and I feel that the Armour is superior. If I were you, I'd add Cytomel or switch to Armour. (It seems that the Cytomel or T3 supplementation is also more of effective in boosting antidepressants.)
>
> P.S. The conventional medical establishment pushes the Synthroid and Levoxyl. They've been brainwashed by the big drug companies to think that their products are superior but if you do a lot of research (esp. read Mary Shomon's articles on thryoid at about.com or her books) you find that it's really not the case. Also, take a look at some of the problems that Synthroid and Levoxyl have had with product consistency.I meant to say in my post above that Armour has T3 and T4 with small amounts of T2. Some say that T2, which our thyroids produce, is good for metabolism and other things. Conventional western medicine seems to think that it doesn't matter at all and it's not included in synthetic preparations like synthroid or levoxyl.
I've never tried taking Cytomel. Sometime in the future I'll have to go off of the Armour and try it to see if taking just the T3 has more of an antidepressant effect. I'd be really curious to see what others have experienced with it.
Posted by SLS on July 8, 2004, at 16:27:27
In reply to Re: Cytomel vs. Synthroid, any opinions?, posted by KaraS on July 8, 2004, at 0:36:49
For my depression, T4 worked better than T3. T3 actually made it much worse. I am most probably bipolar. Perhaps T4 is better for bipolar disorder than for unipolar disorder. High doses of T4 have been used with some success to treat rapid cycling presentations. Actually, I'm not sure that T3 is any better for depression than T4. It may be that it was the first thyroid hormone chosen arbitrarily in the early studies to investigate. Subsequent work relied on the earlier work without considering the posibility that T4 was of equal or perhaps greater value. I believe that T4 does possess biological properties other than acting as a substrate for its conversion to T4. Maybe someone else can comment on this.
- Scott
Posted by SLS on July 8, 2004, at 16:41:35
In reply to Re: Cytomel vs. Synthroid, any opinions?, posted by SLS on July 8, 2004, at 16:27:27
Silly error.
Should read:
I believe that T4 does possess biological properties other than acting as a substrate for its conversion to T3. Maybe someone else can comment on this.
- Scott
Posted by Pfinstegg on July 8, 2004, at 19:10:43
In reply to Re: Cytomel vs. Synthroid, any opinions? Oops, posted by SLS on July 8, 2004, at 16:41:35
There was an article in the New England Journal of Medicine in 1999 saying that, because some people do not convert T4 ( Synthroid) into T3 (the form that is actually used by the body), that, in people with unipolar depression which is not totally responsive to medication, adding T3 to T4 may help with controlling the depression. It may also simply aid in better thyroid function, for the same reason.
In your situation, where you are taking it in order to enhance your chances of getting pregnant (is that right?), I am puzzled by one thing. When you take T4 or T3, the result is that your TSH is LOWERED. It doesn't raise it. Usually, those two medications are only given when someone's TSH is high or borderline high. Having a low TSH means that you have a well-functioning thyroid, so I'm not clear on the reason you are being given it. If your TSH becomes very low (under 0.5), you have an increased risk for osteoporosis. Has your doctor explained his reasons clearly to you?
Posted by Pfinstegg on July 8, 2004, at 19:29:00
In reply to Re: Cytomel vs. Synthroid, any opinions? Oops » SLS, posted by Pfinstegg on July 8, 2004, at 19:10:43
Oops! Above is for GardenerGirl.
Posted by gardenergirl on July 9, 2004, at 0:39:59
In reply to Re: Cytomel vs. Synthroid, any opinions?, posted by Pfinstegg on July 8, 2004, at 19:29:00
You know, I am puzzled now, too. It's been over a year since I've been on it. My levels are testing more central normal now...in the 2's. I'll have to talk with my doc. about this. Actually, someone else prescribed it who was covering for my doc. when he was called up to serve during the early part of the war. So we may have to rethink the whole thing.
Thanks for catching that and for your input.
gg
Posted by gardenergirl on July 9, 2004, at 0:44:39
In reply to Re: Cytomel vs. Synthroid, any opinions?, posted by Pfinstegg on July 8, 2004, at 19:29:00
Come to think of it, maybe my first TSH was around 6....which would be high TSH indicating low thyroid function, right? Oh, the memory and logic don't work so well this late at night with a sinus infection.
But I think when I was saying low, I was thinking thyroid function, not TSH. But I'll check week after next. I'd better start a list for that appt.
Thanks,
gg
Posted by SLS on July 9, 2004, at 1:11:51
In reply to Cytomel vs. Synthroid, any opinions?, posted by gardenergirl on July 7, 2004, at 8:05:32
Hi GG.
I did a bit of research on the Net in the hopes that I could find information comparing the efficacy of T4 versus T3 when used to treat unipolar depression. There really are no direct comparisons. However, one abstract that I can't find right now reported an abnormality in T3 measurements, but not T4. I wish I could find the darned thing. Anyway, it made for a pretty compelling case for using Cytomel. The great majority of the successful use of thyroid hormone augmentation of antidepressants reported in the literature is of T3. Since you are already taking T4, I would take advantage of the opportunity to try a T3/T4 combinatioin.
The following link describes a case of bipolar disorder for which such a combination of T3/T4 was used. The website offers some good information about thyroid function and mood illness in general.
http://www.psycheducation.org/thyroid/combostory.htm
http://www.psycheducation.org/thyroid/studies.htm
As often happens, however, there are researchers who report conflicting results:
All in all, I would probably go for adding T3 to the T4 if I were in your position.I hope this is of some help. Let us know what you decide and how you do.
Good luck!
- Scott
Posted by KaraS on July 9, 2004, at 3:28:27
In reply to Re: Cytomel vs. Synthroid, any opinions?, posted by SLS on July 8, 2004, at 16:27:27
> For my depression, T4 worked better than T3. T3 actually made it much worse. I am most probably bipolar. Perhaps T4 is better for bipolar disorder than for unipolar disorder. High doses of T4 have been used with some success to treat rapid cycling presentations. Actually, I'm not sure that T3 is any better for depression than T4. It may be that it was the first thyroid hormone chosen arbitrarily in the early studies to investigate. Subsequent work relied on the earlier work without considering the posibility that T4 was of equal or perhaps greater value. I believe that T4 does possess biological properties other than acting as a substrate for its conversion to T4. Maybe someone else can comment on this.
>
>
> - Scott
>
Scott,
I didn't know that about T3 not being good for bipolar disorder. Maybe there is no one size fits all answer here just like there is no one antidepressant that is best for everyone. I'm curious as to whether you've tried something like Armour that has both T3 and T4 etc. There are some doctors who believe that the T3 in Armour is too high (it's about 25%) and that you should take an amount that is closer to what humans naturally produce (more in the 5-10% range). I wonder what effect that would have on you.
Kara
Posted by SLS on July 9, 2004, at 8:22:48
In reply to Re: Cytomel vs. Synthroid, any opinions?, posted by KaraS on July 9, 2004, at 3:28:27
Hi Kara
> I didn't know that about T3 not being good for bipolar disorder.
I don't know whether it is or not, but it certainly is not good for whatever it is I suffer from. My case is very atypical.
> Maybe there is no one size fits all answer here just like there is no one antidepressant that is best for everyone.
Yeah. These things with the brain are a real pain in the butt.
> I'm curious as to whether you've tried something like Armour that has both T3 and T4 etc.
No. But according to the website I found and posted above, that is an excellent idea.
> There are some doctors who believe that the T3 in Armour is too high (it's about 25%) and that you should take an amount that is closer to what humans naturally produce (more in the 5-10% range). I wonder what effect that would have on you.
Me too. Thanks for caring. :-)
Be well.
- Scott
Posted by Sad Panda on July 9, 2004, at 11:19:42
In reply to Re: Cytomel vs. Synthroid, any opinions? » gardenergirl, posted by SLS on July 9, 2004, at 1:11:51
I take 300mcg of T4 myself, it raised both my T3 & T4 levels & lowered my TSH. T3 is only given here when T4 fails, the biggest difference between the two is the price. :)
Cheers,
Panda.
Posted by Pfinstegg on July 9, 2004, at 12:57:33
In reply to Re: Cytomel vs. Synthroid, any opinions? » Pfinstegg, posted by gardenergirl on July 9, 2004, at 0:44:39
Oh, O.K! If your TSH was as high as 6, you should definitely be taking T4 and T3. I think the upper limit of normal has recently been revised downwards, so that a TSH of even 3.5 or 4 may be indications for treatment. Levels that high can definitely contribute to infertility, so that's a good move on the part of your doctor. If you have a TSH of 2- that's completely normal. It could even safely go to about 1.
I have atypical depression, like you. I was also hypothyroid -TSH of around 5. I took synthroid at first, but after reading the NEJM article, I asked my endocrinologist if I could take half of the replacement dosage as Cytomel. I think it really helped, although it's hard to say, because I also started taking a combination of low-dose Lexapro and Wellbutrin, had several courses of TMS, and began psychoanalysis! But, in any event, the depression is under excellent control now. I really thank God for Babble, as it's where I learned about TMS and Cytomel, as well as about people who were taking sub-therapeutic doses of AD's and finding them side-effect free and helpful enough.
I do hope to hear that the replacement T4-T3 helps in your goal to become pregnant. As a note of encouragement, I did not have any difficulty getting pregnant when my thyroid was normal- it got abnormal after my son was born. I think your doctor is doing exactly the right thing.
Posted by KaraS on July 9, 2004, at 19:02:25
In reply to Re: Cytomel vs. Synthroid, any opinions? » gardenergirl, posted by Pfinstegg on July 9, 2004, at 12:57:33
Good advice and it's so nice to read about a success story! One thing I wanted to add though is that some of the more progressive thyroid doctors are now saying that a TSH level of 0.5-2.00 is probably where you should be particularly for those with anergic depression. They suggest that even someone with TSH just over 2.00 could benefit from a small amount of added thyroid hormone.
Actually there's another thing I wanted to add which is that there are other thyroid tests besides the TSH. These measure things like T3 levels, uptake %, conversion levels of T4 to T3, antibody levels (as in Hashimoto's thyroiditis) etc. Just another thing to keep in mind because you can have a good TSH number but still have thyroid problems if some of these other factors are off.
Posted by Pfinstegg on July 9, 2004, at 19:46:31
In reply to Re: Cytomel vs. Synthroid, any opinions?, posted by KaraS on July 9, 2004, at 19:02:25
Thanks! I'm going to print out your post and bring it to my next endo appointment, just to be sure we're covering all the bases!
Posted by gardenergirl on July 10, 2004, at 9:35:46
In reply to Re: Cytomel vs. Synthroid, any opinions? » KaraS, posted by Pfinstegg on July 9, 2004, at 19:46:31
Okay, if I am understanding what everyone has said, then the syntroid is giving me T4 and I should consider that I may need T3 as well. Now here is the question. Are y'all saying I should ADD cytomel to the synthroid? or take it instead? Or try Armour (sp?) as it has both? I'm getting a bit confused again.
Thanks,
gg
Posted by Sad Panda on July 10, 2004, at 9:59:44
In reply to Ok, question just to make sure I understand, posted by gardenergirl on July 10, 2004, at 9:35:46
> Okay, if I am understanding what everyone has said, then the syntroid is giving me T4 and I should consider that I may need T3 as well. Now here is the question. Are y'all saying I should ADD cytomel to the synthroid? or take it instead? Or try Armour (sp?) as it has both? I'm getting a bit confused again.
>
> Thanks,
>
> gg
>Hi GardenGirl,
I would add T3 to T4. Your thyroid makes a little T3 & a lot of T4. Most of your body's cells convert T4 to T3 as required for their own usage, but some cells can't do this & rely on your Thyroid's T3 output. Doctors prescribe T4 first before adding T3 because a big bottle of T4 costs $10 while a small bottle of T3 costs closer to $80 (in this country). Ultimately, your blood test is the guide.
Cheers,
Panda.
Posted by Pfinstegg on July 10, 2004, at 10:00:02
In reply to Ok, question just to make sure I understand, posted by gardenergirl on July 10, 2004, at 9:35:46
You'll probably get different answers to your question- some people like to use Armour, which has T3 and 4 in it, but some people don't, because it's made from slaughtered beef, and they are slightly concerned about contaminants, including the remote change of BSE.
I do think you are on very safe ground if you take half of the suppement as T4 (synthroid, or levothyroxin), and half as T3 (Cytomel). This way, you can be sure that your body is getting enough T3, which is the form it actually uses. It may also have an antidepressant effect in addition to the Nardil- it's been helpful to me in that way. To ensure the maximum chances of becoming pregnant. you would want your TSH between 0.5 and 2, so it's worth getting regular checks for that. Actually, for the AD effect, my endocrinologist wanted mine between 0.4 and 1. You might be able to find out on the web what TSH level is considered most favorable for getting pregnant. I haven't looked, but I'm sure it's out there somewhere!
Posted by SLS on July 10, 2004, at 11:16:23
In reply to Ok, question just to make sure I understand, posted by gardenergirl on July 10, 2004, at 9:35:46
Hi.
To treat hypothyroidism, a really good endocrinologist will also look at the ratio between T3 and T4 and prescribe accordingly. However, this is not always true when treating depression. Sometimes, supratherapeutic (hyperthyroid) dosages of T3 or T4 are used, regardless of baseline thyroid status. However, this is a strategy that I think would be contraindicated during pregnancy.
There is a synthetic T3/T4 combination product called Thyrolar (Liotrix) available in the US, but I don't know if it makes sense to take something where the ratio is fixed. It's probably expensive, anyway.
You would probably have to add only a small amount of Cytomel to the T4 you are already taking to glean benefit.
- Scott
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