[arandall20]

in reply to: Over 60 years old and Cytomel #1062474

4/6/11

I just want to give an update of my saga regarding my endocrinologist’s decision to remove my Cytomel dosage and leave me only on Synthroid. The reasoning was due to my age (63) as a geriatric patient, I may develop cardiac problems, especially atrial fibrillation.

The trial lasted three months and now I am back on the Cytomel with Synthroid. Although my free T4 increased from 0.6 to 0.9, my TSH became more hypothyroid, with extreme fatigue and other symptoms. My TSH went from 2.9 to 3.8. I was placed back on the medication dosage that I was taking in January. Then in July there will be a decision what will be done next as my beginning TSH was not ideal then. (I will have labs again before the next visit.) However, I will not agree to remove the Cytomel unless I am having cardiac symptoms. I do not have any signs of cardiovascular disease currently or for the almost nine years that I have taken Cytomel.

I think the learning experience for me has been understanding thyroid hormones better. Unfortunately no one can predict how my physiology at the cellular level operates. No one can predict how well I convert T4 to T3. Then no one can predict how my cells’ receptors that are sensitive to T4 respond, and exactly what happens when the T3 enters my cells. The clinical study regarding the use of T3 and T4 published in the European Journal of Endocrinology in December 2009 infers that there may be a subgroup of patients who need T3 supplementation due to genetic makeup. Further research would be needed in this area.

Thanks again to Bobbi and Shirley for their information.

Ann

[arandall20]

in reply to: Over 60 years old and Cytomel #1062473

Shirley:

Thanks again. Regarding a reference, I also could not find one. I have done Internet searching for several days. I have been a member of the Graves’ Disease Foundation since 2002, so decided to ask here if anyone had any personal experience.

I will be seeing my family practitioner tomorrow for another issue, so will discuss the situation with her. I do not know if she will want to interact with the endo. As it stands now, I have an appointment with the endo’s nurse practitioner on 4/4/11 and with the endo on 5/11/11. I will update you if there are any changes in my medication.
I do appreciate your help. If others have any comments, please feel free to add them.

Ann

[arandall20]

in reply to: Over 60 years old and Cytomel #1062471

3/15/2011
First thanks to Bobbi for her explanation and her experience with Cytomel.

To Shirley:

I have been completely off of Cytomel since 2/4/11. My last labs were on 12/30/10 and my next are due on 4/4/11. My TSH was 2.9 changing from 0.8 one year previous. My T4 was 0.6 on both tests. All of these numbers are within normal limits. T3 was not assessed.

My Cytomel dosage had been, for eight plus years, 5 mcg twice per day in addition to Synthroid. I did not ask to be placed on Cytomel. My prior endocrinologist prescribed it when Synthroid alone did not make me feel well. My current endo weaned me off Cytomel going from twice daily dosage to once daily dosage to every other day and then stopping. That process took about a month. By the fourth day of the process, I began feeling worse. By the time that I was off completely I really started feeling unhealthy. I feel as if I am in a state of malaise with little energy. My Synthroid has been increased twice, with current dosage at 88 mcg.

I think your endo’s suggestion of a baseline EKG and cardiac echo may be a good one. My cardiac labs in January (cholesterol, triglyceride, etc.) were normal. I do have a medical background as retired occupational therapist so can understand the risks. My endo is assuming that I will have cardiac disease. I may never. I want quality of life, and how I feel right now is far from quality.

Do you have a reference for the rationale not to prescribe Cytomel, or a brief summary of what you learned at the conference about it?

Thanks for your reply. I will keep you posted.

Ann

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