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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by anneL on April 27, 2005, at 13:53:35
My pdoc would like me to give Cytomel a try along with my Effexor as a means to help me with my sluggishness, too much daytime sleeping, depression, etc. I also take levothyroxine 0.15 mg. daily for hypothyroidism which is well-controlled. How effective is this strategy and what side effects might occur? Thanks, anneL
Posted by Pfinstegg on April 27, 2005, at 16:40:35
In reply to Cytomel along with my AD-Anyone with experience?, posted by anneL on April 27, 2005, at 13:53:35
I take both Synthroid (levothyroxine) and Cytomel. I'm not taking an AD now, but when I was taking Lexapro and Wellbutrin I didn't notice any difficulties- felt well physically, had normal blood work, etc.
I think it's very helpful to take part of your thyroid replacement as Cytomel (T3). It is the most active form, and not everyone converts T4 to T3 efficiently. I found it helped with depression. It's got a short half-life, so you need to take it both morning and afternoon. You should aim for a TSH of 0.5. At that level, you do have to watch for osteoporosis, even if you are young. It is preventable with regular DEXA scans, calcium, magnesium and Vit. D supplementation. Well worth a try!
Posted by Phillipa on April 27, 2005, at 18:40:21
In reply to Re: Cytomel along with my AD-Anyone with experience?, posted by Pfinstegg on April 27, 2005, at 16:40:35
Hate to tell you this but I have osteoporosis. This despite the calcium magnesium, excercise for years, lifting wts. I was told there was nothing I could do but take Actonel or Fosamax that the synthroid was the culpret. And I have to take that. I don't know if cytomel would affect it or not. Fondly, Phillipa
Posted by Pfinstegg on April 27, 2005, at 18:45:49
In reply to Re: Cytomel along with my AD-Anyone with experience? » Pfinstegg, posted by Phillipa on April 27, 2005, at 18:40:21
I don't know the answer to this for sure (an endo should), but, if you take half of your thyroid as Cytomel and half as Synthroid, you will most likely get a better antidepressant effect- and the total amount you take need not be any greater. Do you take Fosamax/Actonel now? Is your osteoporosis stable?
Posted by Phillipa on April 27, 2005, at 18:56:09
In reply to Re: Cytomel along with my AD-Anyone with experience? » Phillipa, posted by Pfinstegg on April 27, 2005, at 18:45:49
I've refused because I don't want to take another med. Stupid huh? But they keep coming up with meds that need to be withdrawn from the market. Fondly, Phillipa
Posted by Pfinstegg on April 27, 2005, at 19:04:41
In reply to Re: Cytomel along with my AD-Anyone with experience? » Pfinstegg, posted by Phillipa on April 27, 2005, at 18:56:09
I'm quite suspicious of new meds, too! But Cytomel is an "old med"- it's just the T3 (triiodothionine) form of thyroid replacement. I think that for our bodies to use Synthroid (T4), we have to change it into the T3 form, anyway. I've taken it (while cutting down the Synthroid by half- for five years. I have slight osteoporosis, also, but take Fosamax; it's gotten a bit better. no other problems with the Cytomel at all. It's just not anywhere near in, say, the Effexor category! It's more a natural substance which you body and brain need in very small amounts.
Posted by Phillipa on April 27, 2005, at 20:29:30
In reply to Re: Cytomel along with my AD-Anyone with experience? » Phillipa, posted by Pfinstegg on April 27, 2005, at 19:04:41
Are you really taking Fosamax? Doesn't it restrict your life with the inability to eat when you get up? In what way have you improved with it. Please help me to quit lying to myself and take this med. Can you take it once a week like Actonel? Fondly, Phillipa
Posted by Pfinstegg on April 27, 2005, at 20:36:47
In reply to Re: Cytomel along with my AD-Anyone with experience? » Pfinstegg, posted by Phillipa on April 27, 2005, at 20:29:30
I've taken both Actonel, and now Fosamax- it's so easy! Just once a week a half hour before breakfast, after which you sit up to read the newspaper, or walk around doing things. I've never had the least gastric or esophageal discomfort. My DEXA scan shows less osteoporosis that a year ago, which pleased me so much. I haven't had any fractures, nor lost any height. In addition to the calcium and magnesium, my internist recently upped my Vitamin D to 800 iu, saying that's the new standard. You should be fine with it!
Posted by Phillipa on April 27, 2005, at 21:26:50
In reply to Re: Cytomel along with my AD-Anyone with experience?, posted by Pfinstegg on April 27, 2005, at 20:36:47
1/2 hour? I thought it was an hour. And do you take it once a week like Actonel? Fondly, Phillipa
Posted by Phillipa on April 27, 2005, at 21:28:55
In reply to Re: Cytomel along with my AD-Anyone with experience?, posted by Pfinstegg on April 27, 2005, at 20:36:47
Sorry just reread your post and you do say once a week. I'm so glad it's working. Now I have to get up the courage to try something else. And you have improvement? If I might ask what is your age. If you like you can Babble me. Fondly, Phillipa
Posted by Pfinstegg on April 27, 2005, at 21:55:39
In reply to Re: Cytomel along with my AD-Anyone with experience? » Pfinstegg, posted by Phillipa on April 27, 2005, at 21:26:50
With both the Actonel and Fosamax, the instructions say "at least a half hour". That's all I do, and it has worked out very well. It's really not a nuisance (both meds are just once a week). I take it on Saturday morning, then take a shower and fix my hair- then it's time for breakfast! I don't have any feeling of being delayed or held up, which I wouldn't like.
Posted by Pfinstegg on April 27, 2005, at 21:58:32
In reply to Re: Cytomel along with my AD-Anyone with experience?, posted by Pfinstegg on April 27, 2005, at 21:55:39
I haven't tried to master the Babble-message system (trying to avoid it!) But my age is 53.
Posted by Phillipa on April 27, 2005, at 22:18:56
In reply to Re: Cytomel along with my AD-Anyone with experience? » Pfinstegg, posted by Pfinstegg on April 27, 2005, at 21:58:32
Thanks, just trying to see where you are in the menopause thing. 52 seems to be the average. To send a Babblemail just look at the top of the post. You will see a person's name. If it is lit up mine on my computer is blue just click it and it will bring you to Babblemail. Then type a message and send it. That way you can talk with someone in private. If it is not lit up or black they don't receive Babblemail. Hope this helps. Fondly, Phillipa
Posted by Pfinstegg on April 27, 2005, at 22:36:05
In reply to Re: Cytomel along with my AD-Anyone with experience? » Pfinstegg, posted by Phillipa on April 27, 2005, at 22:18:56
Thanks for explaining how to use Babblemail!. No sign of menopause as yet. I had my second son just a few years ago, when I was 47- totally unexpected- and totally thrilling- and maybe that has postponed things a bit. My first one is 29, and about to be married! (with the little one as ring-bearer). I think the osteoporosis undoubtedly was caused by such active treatment for hypothyroidism, as you mentioned earlier.
Posted by anneL on April 28, 2005, at 9:07:45
In reply to Re: Cytomel along with my AD-Anyone with experience?, posted by Pfinstegg on April 27, 2005, at 16:40:35
My TSH is 0.88 on 0.15 mg. of levothyroxine daily. My pdoc advised me that endos and pdocs do not see eye-to-eye on the issue of adding Cytomel for AD augmentation. He wants me to continue my regular dose of levothyroxine and add Cytomel 10 mg. daily.
Posted by Pfinstegg on April 28, 2005, at 10:42:27
In reply to Re: Cytomel along with my AD-Anyone with experience? » Pfinstegg, posted by anneL on April 28, 2005, at 9:07:45
Just for comparison, I take Synthroid .05 mg daily, and Cytomel 5 micrograms (not milligrams) twice daily. My TSH runs around .38 to .50
Posted by anneL on April 29, 2005, at 11:42:04
In reply to Re: Cytomel along with my AD-Anyone with experience?, posted by Pfinstegg on April 27, 2005, at 16:40:35
Hi,
Thanks for correcting my mistake re mg. when it should be mcg. for Cytomel. Oops... big difference! Anyway, my pdocs strategy is slightly different than what you are currently doing. I am euthyroid on levothyoxine 0.15 mg. daily. He is adding Cytomel 10 mcg. daily (as a once a day dosing) and does not want me to readjust my levothyoxine. . . yet. My recent TSH is 0.88 and I don't want to become hyperthyroid with all that entails (nervousness, rapid heartrate) etc. I really am hoping for an improvement in my energy level and associated depression. What about the twice a day dosing? Any ideas? Thanks so much.
Posted by Pfinstegg on April 29, 2005, at 15:49:52
In reply to Re: Cytomel along with my AD-Anyone with experience?, posted by Pfinstegg on April 28, 2005, at 10:42:27
The thing about Cytomel is that it has a half-life of about three hours: that's why a lot of endos like to divide the doses. I think it's very helpful in depressive disorders to take a very small dose of Cytomel; you're starting, which is great- and can make any needed adjustments later. One thing that might help you and your doc is to notice whether you get an emotional lift of an hour or two after you take the Cytomel. I notice that- it's slight, but definitely there. It does wear off, so I appreciate being able to take another tiny dose at suppertime.
Posted by anneL on April 30, 2005, at 0:15:09
In reply to Re: Cytomel along with my AD-Anyone with experience? » Pfinstegg, posted by Pfinstegg on April 29, 2005, at 15:49:52
Hi,
Thanks for all the information. About maybe 1 1/2 hours after taking the Cytomel, maybe 2 hours, I did notice an "uplift". No anxiety, just an energy boost. Pleasant and a welcome change. I see what you mean by the short half-life. The energy did not last the entire day. I will stay the course on the one a day dosing and see my pdoc on 5/10 to evaluate this new addition. Thanks again! If you have any other info you feel would be helpful, please feel free. :) anneL
Posted by Pfinstegg on April 30, 2005, at 0:21:20
In reply to Re: Cytomel along with my AD-Anyone with experience? » Pfinstegg, posted by anneL on April 30, 2005, at 0:15:09
You're very welcome!
This is the end of the thread.
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