- Cytomel is the most powerful thyroid medication because it's pure T3, making it hundreds of times more active than T4. If dosed correctly, you should only experience positive effects like improved energy and mood, not negative side effects.
- Negative reactions to Cytomel are usually due to inactive ingredients like starch or gelatin rather than the active T3 hormone. If you react poorly, switching to compounded SR T3 or generic liothyronine often resolves the problem.
- A dose that's too high causes heart palpitations, rapid heart rate, anxiety, increased sweating, and dizziness. Increase your dose slowly to prevent these symptoms, and track your heart rate regularly while taking Cytomel.
- Cytomel can temporarily worsen hair loss for 3-4 months in about 10% of users as your hair follicles activate. This is temporary if you address nutrient deficiencies like zinc, selenium, and iron. If it persists beyond 6 months, lower your dose.
- Weight gain on Cytomel is rare (under 1%) and usually indicates a reaction to the binders rather than the medication failing. If this happens, switch to SR T3 or natural desiccated thyroid and ensure your adrenals are supported.
Cytomel is the most powerful thyroid medication which means that it can also have some powerful side effects.
If you’re taking Cytomel and wondering if you are experiencing side effects then sit tight because we are going to dive into everything you need to know about this medication.
For instance…
Did you know that Cytomel can help with weight loss but that it can also cause hair loss in certain patients?
Unfortunately, many doctors aren’t used to prescribing Cytomel so many patients are left to figure it out for themselves.
And that’s why I created this guide – to help:
- People who have just started taking Cytomel
- People who have been taking Cytomel and are wondering if their side effects are caused by the medication itself or by some other cause
- People who are curious to know if Cytomel can be used to help them improve their quality of life
- People who want to know if this medication will help them with weight loss
- People who are struggling with hair loss and believe it may be due to their medication
- Those who just want to know more about Cytomel, how it works, why it’s different, and what benefits it provides to the body
Positive Side Effects of Cytomel
First off:
If you didn’t already know, Cytomel is a thyroid medication used to treat people who have a sluggish thyroid.
But that’s not all it can do.
It can also be used off-label to treat certain psychiatric disorders such as treatment-resistant depression and treatment-resistant bipolar disorder.
For now, we are going to focus on how it helps to treat the thyroid but much of this information will be relevant to you regardless of why you are using it.
Cytomel is the brand name for the generic T3 medication known as liothyronine, but both medications contain the same active ingredient known as triiodothyronine.
It’s most frequently used to treat the following conditions:
- Hypothyroidism from all causes (including Hashimoto’s thyroiditis, subclinical hypothyroidism, thyroiditis, thyroidectomy, hemithyroidectomy, and TRH-pituitary dysfunction)
- Obesity
- Depression
- Bipolar disorder
And what you need to know about Cytomel is this:
It is the active form of thyroid hormone, meaning that it is the most powerful thyroid medication you can take.
As a quick primer:
T3 is the active thyroid hormone while T4 is considered to be the inactive thyroid metabolite.
Both are technically ‘active’ in the body but T3 is hundreds of times more active than T4 (1).
It should be differentiated from other thyroid medications like Armour thyroid, Nature-throid, WP thyroid, levothyroxine, and Synthroid.
One thing you need to understand about thyroid medications is that generally, you should NOT be experiencing negative side effects when you take these medications.
Why?
Because, presumably, you are taking the hormone to replace a deficiency inside of your body.
If all you are doing is replacing that deficiency then you shouldn’t experience negative symptoms only positive effects.
Assuming you aren’t reacting to any of the fillers or binders in the medication itself and you are on the right dose of thyroid medication for YOUR body, then several things should happen:
- Your hypothyroid symptoms should be improving
- Your weight should be dropping
- Your hair should be falling out less
- Your energy should improve
- Your mood should improve
- You should not be anxious or depressed
- Your sleep should improve
Basically, all of the symptoms you were experiencing due to hypothyroidism should be improving, not worsening.
If you are experiencing any other symptoms (especially negative side effects) then that may be an indication that you are reacting to the fillers or binders in the medication or that your dose is not correct.
We will talk about how to find out if your dose is too high or too low, but for now, we will focus on what to do if these fillers or binders are causing you side effects.
Inactive Ingredients in Cytomel
All medications contain a combination of both active and inactive ingredients.
The active ingredient is the ingredient that causes all of the physiologic benefits of the medication.
In this case, the active ingredient in Cytomel is triiodothyronine or L-T3.
The inactive ingredients help to stabilize the active ingredients and act as a carrier to prevent the breakdown of the active ingredient (2) in the stomach and so on.
They also are added to change the color, shape, or consistency of the capsule/pill.
The problem with these inactive ingredients is that certain patients may actually negatively react to them.
This may put you in a situation where you don’t react to the active ingredient (because you need it) but you may be reacting to the fillers/binders/inactive ingredients in the medication.
And determining what you are reacting to can be difficult at times.
For reference, Cytomel contains the following inactive ingredients:
- Calcium Sulfate
- Gelatin
- Starch
- Stearic Acid
- Sucrose
- Talc
It’s been my experience that many patients who use Cytomel and react negatively to it, are often reacting to inactive ingredients, especially starch or gelatin.
The good news, if you are one of those people who react negatively to the fillers, is that it is possible to compound the active ingredient into a formulation that contains fewer inactive ingredients.
Formulations such as sustained-release T3 can be created by compounding pharmacies.
It should be noted, however, that even the sustained release T3 formulation is not without faults.
Sustained release T3 (or SR T3) contains high amounts of methylcellulose (3) which can also cause similar problems and reactions in certain patients.
Bottom Line: If you are having negative reactions to Cytomel it may not be due to the active ingredient but instead due to the inactive ingredients.
The Complete List of Side Effects of Cytomel
This list will break down all of the possible reactions you may be experiencing while using Cytomel.
When it comes to side effects there are 3 main categories that you want to be looking at:
- Hypersensitivity reactions
- Overdosing
- Underdosing
Each category comes with a set of unique symptoms and understanding where you fit can help you determine if you need to switch medications or simply alter your dose.
1) Hypersensitivity Reactions
Hypersensitivity reactions are fairly common and can range from mild to severe, depending on the person.
These symptoms tend to come from the inactive ingredients, fillers, binders, preservatives, and dyes in the medication.
Symptoms of hypersensitivity to Cytomel may include:
- Rash, hives, or itching
- Swelling of the Face or extremities
- Tingling sensation in the hands or face
- Nausea or vomiting
- Headaches
- Difficulty breathing (rare but serious)
- Tightness in the chest (rare but serious)
If you experience any of these symptoms, and if they persist even after changing or altering your dose, then you may need to switch medications entirely.
Your best options may be to switch to the generic liothyronine medication or switch to a compounded SR T3 formulation.
2) Excessive Dosing
Perhaps more common than hypersensitivity reactions are those reactions caused by the dose of the medication itself.
Cytomel, as the most powerful T3 medication, is prone to causing symptoms that may mimic hyperthyroidism if used in high doses.
These side effects are potentially very serious and if you experience any of them you should seek advice from the provider who gave you the medication.
Their presence indicates that you will need to adjust your dosing or go off of your medication completely.
In many cases, however, you may be able to simply adjust your dose downward to eliminate them.
Sometimes, even though the dose may be appropriate, you may be extra sensitive to small increases in T3.
You can prevent some of this by simply increasing your dose in a slow and controlled manner.
A slow titration upwards may prevent symptoms such as heart palpitations, anxiety, and so on.
If symptoms persist despite lowering your dose then make sure to check your nutrient status and make sure your adrenals have been addressed.
Symptoms that may indicate your Cytomel dose is too high include:
- Rapid heart rate (This is why I recommend tracking your heart rate while taking Cytomel or liothyronine)
- Tachycardia
- Irregular heart rate
- Palpitations (Sensation of rapid heart rate but heart rate remains normal)
- Shortness of breath
- Sensitivity to heat
- Weight gain <—– Rare, but can happen
- Hair loss <—– Typically temporary but sometimes it can persist
- Increased sweating
- Jittery sensation or increased anxiety
- Dizziness or lightheadedness
- Chest pain or chest discomfort
- Diarrhea or loose stools
3) Insufficient Dosing
Last, but still important, is the idea that you may be on the right medication but your dose may not be high enough.
If you experience symptoms from this condition then it’s important to realize that these symptoms are not caused by the medication itself but by a deficiency in thyroid hormone in your body.
The symptoms that indicate your dose is not high enough include the same symptoms that correlate with hypothyroidism.
The persistence of symptoms such as fatigue, weight gain, constipation, hair loss, and depression may be an indication that you need to continue increasing your dose.
Will Cytomel Cause Weight Gain?
While it doesn’t make any logical or intuitive sense that Cytomel could cause weight gain, I have seen it happen in a handful of patients.
In addition, it is also listed as a potential side effect of the medication:
You can take comfort in knowing that this side effect happens very rarely and I’ve only seen it a handful of times.
With an occurrence of about 1% or less, it’s not a side effect that you should worry about before you consider using this medication.
It’s not clear to me why Cytomel would cause weight gain but I suspect it’s likely a reaction to a filler or binder within the medication itself.
I believe this to be the case because all the patients I know who have gained weight on the medication still experienced an improvement in their hypothyroid symptoms and they only experienced a mild weight gain of 3-5 pounds.
This would lead me to believe that the medication is still working to enhance thyroid function in their body and that the weight gain is caused by some other variable.
If you do gain weight on Cytomel it is worth switching to SR T3 to see if the problem still persists or switching to Natural Desiccated Thyroid if that fails.
Will Cytomel Cause Hair Loss?
One of the main symptoms that patients with hypothyroidism struggle with is hair loss.
And, I don’t want to alarm you here but Cytomel can actually make hair loss worse.
Don’t let this scare you away from trying this medication though, because the hair loss associated with it is only temporary.
In some patients (around 10% by my estimation) Cytomel can temporarily make hair loss worse for about a 3-4 month period.
The good news is that this hair loss is temporary and should resolve on its own without any intervention on your part.
The problem with this symptom is that it may stop certain people from continuing with their medication because they don’t know that it’s temporary.
No one really knows for sure why it causes worsening hair loss but I believe it may be due to an increased demand on the hair follicles which is exacerbated by other nutrient deficiencies.
You can imagine a scenario in which there is a strong signal sent through your body that triggers the growth of hair, but unless you have the building blocks to create the hair it may make the problem worse.
Something similar may occur in individuals who suffer from hair loss when starting Cytomel.
If you fit into this category then you’ll want to take certain hair growth nutrients including zinc (5), selenium, iron, and so on.
You can find a list of reasons why thyroid patients experience hair loss and how to fix them here.
If your hair loss persists after 3-6 months and after replacing all of your nutrient deficiencies then it may be time to consider other options.
In these cases, it’s best to lower the dose of Cytomel or switch to SR T3 or NDT if possible.
Conclusion
Cytomel is the strongest of the thyroid medications because it contains T3 instead of T4 like most other medications.
It can be used in conjunction with other thyroid medications or by itself and it can also be compounded in various forms to delay its release into the bloodstream.
Side effects from Cytomel are generally caused by either a hypersensitivity reaction to the binders and fillers inside of the medication or due to the dosage being too high.
If you experience side effects due to the binders or fillers, you may be able to change medications to SR T3 to get around these side effects.
If you experience side effects due to your dose, then you may need to address underlying nutrient deficiencies before raising your dose.
If these symptoms still persist then it may be necessary to switch to NDT or T4 medications.
Now I want to hear from you:
Have you taken or are you currently taking Cytomel?
Have you experienced any adverse side effects?
Is it helping you feel better? Is it helping you to lose weight?
Why or why not?
Leave your comments or questions below!
Scientific References
#1. https://www.ncbi.nlm.nih.gov/books/NBK285568/
#2. https://www.ncbi.nlm.nih.gov/pubmed/9024461
#3. https://www.ncbi.nlm.nih.gov/pubmed/15389670
#4. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205882/
#5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3870206/
#6. http://www.ncbi.nlm.nih.gov/pubmed/402379
#7. http://www.ncbi.nlm.nih.gov/pubmed/16883675
#8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831161/
#9. http://www.ncbi.nlm.nih.gov/pubmed/9064969
#10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831161/
#11. https://www.ncbi.nlm.nih.gov/pubmed/10878749
#12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4350501/
Hi! I had total thyroidectomy 15 years ago – I’m 45. My naturopath has me on 125 mcg of levothyroxine and 25 mcg of liothyronine. She recently bumped that does up to 35 mcg – which I don’t seem to be handling well. My face is burning and flushed and I have a swollen chin. And I’m feeling an ‘icy/hot’ sensation in my legs/feet/arms/torso/neck & scalp. she doesn’t think my symptoms are from the T3 although they began when we increased the dose. And she had me increase it gradually over a period of weeks with increases of 2.5 mcg each week until I got to 35 mcg from 25. I felt much better at 25. So I’m going to ask her again if I can stay at 25 mcg. I’m just wondering if you suspect these side effects/symptoms are from the liothyronine? thank you!
Hi Westin,
What is a typical starting dose for Cytomel? My doc prescribed 25mg. and I got an awful headache. I’ve been on Armour for 20 years with a suppressed TSH.
Much thanks!
Hi Allie,
The starting dose is generally up to the physician and what they are comfortable with. I will generally start anywhere from 5mcg to 25mcg (depending on the history, what meds they are on, etc.). If there is any concern then it’s probably a good idea to start at a lower dose.
Hi
I had been on Synthroid 150 ugr for years. I am 44. I experienced extreme paralyzing fatigue and weight gain. Although I exercised a lot and watched what I ate, I actually recorded everything I ate. I still do.
2 years ago endocrinologist put me on Synthroid 100ugr and 12.5 Cytomel instead of 150 ugr. Not quickly, but after a few months, my fatigue improved so much that I felt like I got a new chance in life. My weight gain didn’t change, but at least I could maintain it but I couldn’t lose any. I tried every diet or cleanse possible, nothing worked, I guess because my calorie intake is not much anyways.
2-3 months ago, my fatigue was back, I had heart palpitation, foggy days, which I could not concentrate or remember, severe constipation, and I started gaining weight again. I went to my family doctor, TSH test was ok. He told me “IT IS IN YOUR HEAD!”
It got worse with feeling pressure in my throat; I gained 8 pounds in 3 weeks. If I list the exercises I do, you won’t believe it. I even started going to fitness classes 6 am, which I thought maybe it helps. I do intermittent fasting 5 days a week.
I did another blood test 3 days ago. It showed my TSH is very low!!! Although I have all the symptoms of Hypo. Doctor reduced my Synthroid to 75 ugr and still 12.5 Cytomel. Although I should be happy that I am taking less drug, I am devastated as I am so scared to gain weight more.
All my other Hormones were normal (Except T3 or T4, I wasn’t tested for them). I am supposed to go for a blood test in 6 weeks with TSH and Free T3, T4. I am so scared that by then I am obese.
Do you think 45 mg Cytomel and 25 ugr of Synthroid is a better combination maybe rather than Synthroid 75ugr and 12.5 mg Cytomel? I read all these research articles but none of them says anything about the best dosage of the combination. Which is better? T3>T4 or T4>T3
I am just so tired, physically and emotionally. I put so much effort and use so much energy to just be normal and I don’t get anywhere. I read your articles and they are the best so that is why I thought to reach out.
Thank you for your help
Y
Hello, I’ve been on Cytomel Pfizer for 3 years now, I feel better relief from my Hypothyroidism BUT sometimes my eyes swell up with fluid. Also I will get fluid on my ankles and fingers. All over really but those areas are very apparent. It’s uncomfortable but very worrying. I used to think I needed more when this happens but increasing the dose slightly would make it worse and I immediately reduced my Cytomel only to see the fluid come down. This is very scary for me. I don’t know if it’s something serious like fluid congestion from overdose or a reaction to the fillers.
I’ve been hypo for 20 years. I don’t do well on thyroxine at all. And ndt’s are not great. I have regular b12 injections for Pernicious Aneamia. I’m gluten free lactose-free, never drank or smoked. Also, I can’t lose any weight.
I take 62.50 mcg Cytomel
Tsh 0.01
Ft3 5.6
I’m in the UK
Thank you, if you can shed any light on this problem I appreciate it.
Hi Elizajo,
If you notice swelling that is responsive to changes in your cytomel dosing then it is likely related to your thyroid. I would also check out this article which goes over some of the potential risks of TSH suppression: https://www.restartmed.com/suppressed-tsh/
Hi there, I’m on Cytomel 62.50 mgc day. I get severe swelling on my eyelids and face, also ankles and fingers and it’s related to my dose. I thought it was because it wasn’t enough but it subsides if I reduce my dose. Is it a sign of overmedication. Oedema. Or fillers.
Thanks
hdxlh19961997@aol.com
So it’s possible for someone to take just t3 alone as a treatment and be fine? I’ve tried 2 different ndt in the passed and hair loss increased for over 6 months and my rt3 was over 15. My NP recently prescribe 5mcg of just t3 and frankly in a little scared to try it as I’ve read many people have massive hair loss (which I can’t afford) and I’ve read t3 only should not be the only treatment for being hypo I’m in range for labs however low end for t3 Does taking 5mcg of just t3 as a treatment sound acceptable to you? I’m in dire need of guidance. My shbg is on the lower end as well I’m 49 never any thyroid issues before.
Hi Tina,
Yes, it’s possible to be on T3 thyroid medication by itself.
I am currently taking 5mcg of Cytomel and have only been taking it for 5 days and I’ve noticed that I have a pain in my side seems to be my kidneys, is there a side effect for this drug? I am also taking b12 sublingual 2,500 daily, would the b12 be affecting my kidneys and is there a way to relieve the pain. Thank you
I’ve been taking synthroid since 2005 and just witching the past 6 months my doctor added cytomel to my regimen and I have noticed an increase in hair loss to the point that I will be bald by the end of the year. Do you think this is due to the cytomel? Or could it be due to something else. I have never had any issues with hair loss like this in the past.
Hi Andria,
Cytomel can cause hair loss so it’s possible that it is related to the medication.
Is generic Cytomel as effective? I take 10mcg. I have afib ay times. Take 50mg metoprolol. Is it interfering with Cytomel? I’m a mess.
Hi Lisa,
Yes, generic still works quite well. And yes, your beta blocker may be interfering with your thyroid function.
I just added 5mcg of Cytomel for a Total of 25mcg about a week ago. 15mcg in the am, 10mcg in the afternoon. After adding this last 5mcg I feel great EXCEPT my heart rate is considerably faster. About 90 best per minute where I’m usually 60. Will my body adjust to the increase dosage, should I cut it back to 2.5mcg or stop completely? Besides the heart rate, by adding this last 5mcg, almost all of my hypo symptoms have resolved!! I want to keep feeling this good but don’t want to have a heart attack
Hi Megan,
It’s not a good idea to put strain on the heart with excessive T3 as it may lead to cardiac enlargement or other heart problems. You can learn more about this idea here: https://www.restartmed.com/suppressed-tsh/
Hi Dr. Child’s
I am a 65.5-year-old who has been on Thyroid Meds since I was 28. Started on Synthroid then a few years later Cytomel was added.
I generally have no issues…this year my Cytomel was raised to the highest level I had ever taken. 10 mcg in the am and 15 in the pm. I had been experiencing fluctuating mania off and on for several months prior to the change in the Cytomel. I had been taking 10 & 10.
I never had problems when I took 5 &10 with either 50 mcg if Synthroid or even 100. After the last change of dosage, I went into a tailspin, thinking I was having a major BiPolar episode. I saw my Meds Doctor and he ascertained that I was experiencing a “ Thyroid Induced Mania. He had me stop the Cytomel immediately! He felt the dosage was way too high…one of my first doctors who was the head of the Endocrinology Dept at one of the largest teaching hospitals on LI, once told me…”you should not only go by the numbers but more importantly by how the patient feels!!!”
I am back on both Synthroid 100mcg and 5 & 10 on the Cytomel. I am noticing that my palms are flushed( warm and pink). Could this mean my Cytomel dosage should be dropped back to 5 & 5?
I also recently started taking my Thyroid Meds at night. I don’t want to wait 30 min for my am Coffee. I take it 3 hours after Dinner. Then wait at least an hour to take my sleep supplements.
For the first time, I am having a very hard time trying to lose approx 10 lbs. In the past all it took was dropping my carbs, sugar drinking more water and walking. Doing all these things now and can’t seem to lose anything! Could being off my Meds for a few weeks cause this?
Thank you
Hi Nina,
I suppose it’s possible that going off of your medication could be contributing but it sounds like it’s something different. You’ll want to assess your complete thyroid panel to see if your demand for thyroid function has changed recently. You can learn more about that here: https://www.restartmed.com/normal-thyroid-levels/
Dear Dr. Childs,
I just started T3 the generic name brand, for a low T3 though I have a normal T 4. I have just seen a functional medicine doctor and had a battery of labs. He said I was not converting T4 to T3. I am somewhat chronically overweight but mostly want to do this to bring my T3 levels up. However, I have been experiencing an upset stomach since taking this medicine for the 1st time today, 5 μg.
Any tips on how to get by the GI upset? Will this pass?I have been prescribed 5 μg 1 to 2 twice A-day.
I also started bio T natural pellets with estrogen and just a small p.o. amt of progesterone gel caps at night.
Hi Shannon,
Sometimes T3 is hard on the stomach. Even though it may reduce absorption, you may need to ultimately try taking it with food. But just realize that this strategy does impact the absorption of both T3 and T4 so you should do it under physician supervision.
Hi! I am currently on Cytomel Tab 5 mcg, as well as Synthroid 112mcg. I’ve been on thyroid medication since 2004, recently added Cytomel around 2016. My weight is my biggest problem ( obese category ), fatigue, body aches, dry mouth, no energy, to name a few. I’m not sure if I’m on the right dosage or medications. I don’t feel any different or better in all these years. Any advice from you would be greatly appreciated, Thank you.
Hi Bobbie,
Just using cytomel won’t be enough unless you titrate your dose to what your body needs. You can do that by attempting to optimize your free T3 and total T3 levels to the ranges listed here: https://www.restartmed.com/normal-thyroid-levels/
I have been using Synthroid and Cytomel for a long time. My doctor says my thyroid test shows that I’m at the hyperthyroidism level now. I am getting too much thyroid medication for my system now. So he told me to titrate it down by taking half one day and next a whole one for six weeks then get tested again. If it still shows I’m getting too much I take half a day for six weeks and be tested again, and so on and so on until I’m not using Cytomel at all. For some reason the phlebotomist and him said it had been told to them that Drs. are trying to get patients off this medication. They gave me no reason why.
The symptoms of hyperthyroidism I’m having are awful. Especially since I have bipolar and fibromyalgia, which of course have the same symptoms. I’m considering calling my Doctor and asking if I can titrate down faster.
I have just lost a whole lot of weight (for my health). If I stop taking Cytomel will I gain weight? Also you mentioned giving this medication to people who have bipolar and fibromyalgia. If I stop taking the Cytomel will my bipolar and fibromyalgia get worse.
Hope you can help me with my questions. Thank you very much for giving me the opportunity to try and get answers to my questions.
Hi Karen,
It’s really difficult to say for sure because I don’t know your personal history. I would say that most people who stop T3 (if they need it) may gain weight back and start to feel worse, but that isn’t necessarily the case in everyone. If your dose is too high, however, then dropping your dose to a normal level shouldn’t cause those symptoms.
My free t4 is 1.0, my total t3 is 93, my TSH is 3.480, and my reverse t3 is 12. I sometimes have episodes where my heart rate increases to 125 but not extremely often and panic attacks. My doctor just added liothyronine 5 mcg to my Tirosint 50 mcg. Will this make my increased heart rate or panic attack episodes more frequent or worse?
Hi Lisa,
It’s possible, but it’s also possible that it could help reduce the frequency of your tachycardic episodes! It just depends on what is causing them.
Dr. Childs,
I am a complete mess. It’s been a steady decline in my health since I turned 40. (I am 47 now). I am anything but normal with thyroid replacement. In a nutshell here is my story. At 23yrs I had Graves, did the ablation and do ok for 10 yrs or so. Mid 30’s other issues-adrenal and no progesterone left. In my early 40’s estrogen is gone now and I got into big trouble with replacement with Synthroid – I no longer converted and my reverse t3 was making me sick. I got on Dr. Wilson’s protocol for the SR t3. My life was instantly better! In the last 2 years I was placed on estrogen because that was gone too (with progesterone replacement since I was 35yrs). I have started many supplements ranging from turmeric, omega 3’s, ACV, digestive enzymes, probiotic, selenium, HCL, Cinndrome X and I was feeling like a million bucks. My current SR t3 is 42.5mcg in the morning and 37 mcg at night. Two issues- My heart has started racing (since April) , heat bothers my heart too, as well as small amounts of alcohol-it races anywhere from 100-160 bpm when I do any of the above. Secondly, I am gaining MORE WEIGHT (I HAVE LOST NONE SINCE I STARTED THE SR T3). I have made diet eliminations and I am gaining, gaining and gaining. I excercise 4-5 x’s a week. I just had labs drawn and its horrific. My tsh is now 24.9 – which explains the weight gain (from 4.6/ 9 months ago) and my free T3 is 2.63. I am strictly on the sr t3-no t4 due to my conversion issues. What in the world has happened? I have been reading everything I can with sr t3 replacement. A couple of possibitlies – that some people require more of a “punch” to get the replacement hormone into the cells than SR can provide and that immediate release x 1 dosing a day dose best. Another possibility is that my estradiol patch could be causing issues. So I am thinking I should try and get my PCP to place me on IR T3 to see if I can get this mess straightened out. What are your thoughts on going from SR replacement to IR?? It seems crazy to get the T3 only one time daily since I take twice daily now. Please help with this nightmare. On my last leg with it for sure.
I have just recently being switched from 60 mcg NDT to 25mcg Cytomel + 88mcg levothyroxine. All I can say is that it took me nearly 8 years of advocating for myself and finding the right MD before someone finally agreed to try Cytomel.
A lot of doctors resort to a conventional treatment of hypothyrodism with levothyrpxine and steer clear from Cytomel. I can understand why, it is a very powerful drug after all and needs to be used with extreme caution.
It is so frustrating though that they won’t even consider to talk about it even when hypothyrodism symptoms keep persisting for years.
My lab is due within next couple of weeks as we obviously would want to monitor T3, T4 and TSH levels closely, but so far I am already seeing a great improvement. Perhaps it is a placebo effect, but I finally do not feel cold all the time and hurray, I actually feel energetic first time for who knows how many years. My sleep has improved dramatically in the last couple of weeks, no more waking up few times at night which is amazing on its own.
I personally take Synthroid at night before going to bed, at least 2 hours after my last meal and Cytomel in a morning. So far it works well for me, just waiting for the lab results.
I love the fact that Cytomel can be taken with food, that allows me to eat my breakfast without any issues. It was always a pain to take Synthroid in a morning and then wait for an hour to eat or even (the horror!) to have coffee.
Does the coffee affects Cytomel absoption at all? I’ll have to talk about it with the pharmacist because I figured if you can take it with food, coffee should not be an issue like with Synthroid, but I could be wrong.
Could the whey isolate potentially interfere with Cytomel absorption? It seems to me that all dairy would be off limits for few hours after taking the medication due to its calcium content. Is it the case for the whey and soy protein powders as well?
Hi Kendra,
This article has a list of medications and supplements which can potentially block thyroid medication absorption: https://www.restartmed.com/medications-thyroid-problems/
Hello,
I have been on t4 meds 100mcg but my t3 is never optimal and always low end of normal around 3.5 to 4.5 ( Normal ft3 is 3.5 to 6.5 with 5.5 above being optimal. my t4 is in normal range but MY tsh is always above the roof and my hypo symptoms are mostly light headed , fear, lack of interest, energy and off balance feeling as if I am standing but going left n right in my head….the moment I hv Xanax or have an alcoholic drink , I am a much better person when it comes to energy , moods , interest etc….
I may have a reverse t3 issue….If I introduce t3 med of cytomel then how much do I need to start with to bring it to optimum levels….I wish it to bring ft3 levels between 5.8-6
. Do I need to cut down on t4 meds to introduce t3 meds? If I reduce my t4 to 75mcg then how much of t3 do I start with..and if I keep my t4 meds at 100mcg then at what mcg of t3 cytomel do I start with ? Can I take both t3 and t4 together in morning empty stomach like how I always do for my t4 meds ? Thanks a ton
Dr. Childs,
what would be the best thing to use to break up a 100mcg pill into smaller doses? At first I thought distilled water would work, but now I am not so sure. Would the water work OK? What about an Oil like olive, coconut, or mct?
Thank you,
Sarah
I have been on Cytomel (T3) only treatment for hypothyroidism for many years now. Currently I am on 75mcg of Cytomel daily. I have been crashing in the afternoons and recently learned that Cytomel can cause insulin resistance. Which I suspect is what causes some of your patients to gain weight. My question is that when I dropped my dose of T3 down to 50 mcg I felt dizzy when walking outside and even feel a little nausea. It this withdrawal or under dosing or something else?
Hi John,
I would read this post for a more detailed understanding of how thyroid medication impacts insulin resistance: https://www.restartmed.com/hypothyroidism-high-blood-sugar/
In regards to your symptoms, it could absolutely be dose-related or it could be related to other hormones such as cortisol. You’ll need to start with testing to figure out which it is.
I had my thyroid removed 6 days ago and was immediately put on 1.5 Liothyronine 25mcg pills per day (so ~37.5mcg every morning). Previous to surgery my resting bpm, according to my Fitbit, was 74-80. Since starting the Liothyronine it has jumped to 85. Where it used to be 54-60 when asleep, I’m now at 80. Sitting on the couch watch tv and it’s 102. I’m not experiencing any other symptoms (yet?), but this one has me a bit freaked out. I don’t see my dr for another 1.5 weeks. Will this level off on its own? Is there something more I can do?
Background:
I’m 43 years old and about 225 lbs. I was hyperthyroid (Graves) previous to surgery. Hurthle cells on one side couldn’t be confirmed as benign via biopsy, so my doctor wanted it out. I take 5 gr of Ferrous Gluconate every other evening.
I was hoping you could clarify something regarding the hypersensitivity. I have been following your blog and thank you for all of your help. I have been blessed with a PA who is listening to all the information I am bringing her from you and she has started me on levo and lab improved to a little over 2 so far but symptoms stayed the same. She then added 5mcq of liothyronine in addition to levo. I felt a pretty quick change in energy just from that first 6 weeks on the med but then the boost in energy subsided. My overall issues were weight gain, very tired, hair loss, and cold. I felt less cold, hair is ok, but I was still very tired and not losing weight after changes in diet/exercise. I wanted to get to a good level to address all of these issues so she increased it to 10mcg for only a few days so far. I now have a rash over my left hip???? I never struggle with any skin issues so this is very strange for me. The plan was to revisit every 2 weeks for lab work and then to increase as long as I was tolerating the meds and labs looked good. Should I continue on this path if a rash is present or does that mean I should just go back down to 5mcg?
Hi I was wondering if you had advise for me. I’ve been on 50mcg of t4 for a year with little benefit. It did help water retention but not energy, hair loss, or memory. So I started t3 5mcg and did great until the second week my chest hurt and had high heart rates. Resting rate was 107-133! Super high for me. I am so saddened because I felt so good on the t3. What do you suggest? Thank you, Mary
Hi! Can frequent urination which starts in an hour after taking thyroid medication and going on for couple of hours be the side effect of T3? Could it be an exess of T4, or both? My son has elevated rt3. He is taking 75 mg Synthroid, 90 mcg Nature Throid and 5mcg slow release t3 twice a day . He has all symptoms of hypo – depression, especially in the evening, constipation, dry skin memory problems etc. Plus this unbearable frequent urination in the morning. What are your thoughts? Thank you.
I have been treated with time-release T3 for Wilson’s temperature syndrome for the past nine months, and the improvement has been dramatic. I have been on a number of doses of T3, from 7.5mcg to 75mcg. During that time I have found that my appetite was greater on the high doses. I mention this because of the discussion in the article that some people do gain weight on T3, and this could be the reason. I did gain weight a few pounds on the protocol myself.
Hi Susan,
Typically, the increase in appetite is also associated with an increase in metabolism (which is why the appetite increases in the first place) so it should be weight neutral. My feeling is that the weight gain associated with T3 is probably fairly complex and has to do with multiple issues but appetite may be part of that equation.
I have been on 75mcg of Synthroid and never felt good but was told I was in the normal range. Went to another doctor to be put on T3 since my doctor refused. Had no energy, gained 20lbs and had aches in my legs. The doctor left my synthroid at 75mcg and added 5mcg of T3. I started feeling better after a few weeks and had two great never felt better weeks only to have it completely stop and back to the old symptoms. Now he left me on 75mcg of synthroid and reduced my Cytomel to half of the 5mcg. Still feel horrible and no energy and now legs and arms ache. Why would he reduce my Cytomel? I’m so confused on this. I thought he would increase my Cytomel or reduce my synthroid. I don’t understand at all. Please if you can tell me why he might have done this and how long before seeing results reducing the Cytomel. Been a week and no energy and still hurting. I just want to have a life again.
Hi Lissa,
Most doctors base thyroid medication dosing off of the TSH. My best guess is that your TSH was low so your doctor reduced your thyroid dose to try and bring it up. Obviously, this isn’t ideal as it will cause worsening symptoms (such as those you are experiencing) but this happens if your doctor focuses only on the TSH. You can learn more about why this is not a good idea here: https://www.restartmed.com/tsh-isnt-the-best-test-for-evaluating-your-thyroid/
I had thyroidectomy due to thyroid cancer 6 years ago and since there were/are still 2 small nodules left , my Endo tried to stop the growth of the nodules by high doses of Synthroid (apparently was a successful approach).
I have been on 100mcg,125mcg,137mcg,165mcg of Synthroid over last 6 years.
for the past 2 years I have been soooo out of energy and not feeling good and finally my Endo put me on Cytomel 5mcg 2 times a day and she told me that the effect of Cytomel stays in the body only for 5-6 hours and if I take it only in the morning , I will feel tired later in the afternoon which is really true.
I have been taking it for last 2 weeks in combination with 137mcg Synthroid, the Cytomel effects I felt so far is:
1- Excessive sweating and feeling hot ( at the gym and on regular base)
2- Bad Headaches for the first week
3-Insomnia ( this really bothers me as I wake up at 2 am and cannot go back to sleep)
4-my energy level and mode improved
I just lowered my Synthroid ( as per my Endo instruction to keep the Synthroid level unchanged for first 2 weeks) to 125mcg .
Is the Insomnia due to Cytomel or the Synthroid ?
Thank you for all the great information! I have taken Armor Thyroid for over 20 years. Over the past 4 years I have noticed it is not as effective, and I gained 20 pounds in 3 months last winter and couldn’t get off the couch. No motivation. My nurse practitioner just added Cytomel. I think I’m beginning feel better. More energy and motivation, less brain fog, etc. I have noticed that I have been getting acne. Hard lumps with no core. I never have acne. I also take Bio identical hormones. Could you address how Cytomel can interact with HRT and should I reduce my HRT levels while taking Cytomel?
I have been put at a low dose if cytomel which is 5mcg morning and 5 mcg afternoon, before that I used to take Synthroid 75 4 days a week and Synthroid 50 mcg for the rest of the week (3 days) my free t4 was high normal but free t3 were low normal (3.8 pmol/l) lab reference is (3.5-6.5).
After a few days of starting cytomel, my body got swollen, had pain in all joints and my body was too hot, was sweating at night time.
So my doctor suggested to take half a tablet of 5mcg for a week then increase it to 1 whole tablet for 2 weeks then see if I can tolerate adding the other 5mcg tablet afternoon.
Now I’m on the 1/2 5mcg tablet and again started to notice swelling and painful joints and my heart rate is getting a bit higher.
I don’t know what to do should I stop it completely?
Aloha,
I had my thyroid removed in 2012.
Since then it has been an emotional rollercoaster ride.
For years my synthroid medication has been adjusted between 100mcg to 125 mcg and 112mcg..
due to my TSH being up and down and up and down..
For the past 7 months I’ve been on 112mcg of synthroid and have not had to adjust my meds but my
On 5/30/19 my TSH was at 0.08 t4- 1.5
And on 8/4/19 TSH 0.17 t4- 1.5
But currently I have put on a few pounds with little change in my diet..
So I asked to have cytomel added to my regimen..
So she changed my
Synthroid to 75mcg
And added Cytomel 25mcg
I have been taking it for 2 Weeks and I think I my dose of cytomel maybe to high?
I am uncertain because it’s only been two weeks..
Currently I feel
Withdrawn and I don’t like that feeling..
I have read that my endo should be testing a few different thyroid test but the only labs that are ever down is
My TSH and T4..
Please help me..
Hello Dr. Childs-
I was diagnosed with Hashimoto’s Hypothyroidism in 2012 and was placed on treatment with Synthroid, which initially improved my symptoms tremendously. In 2013, I was also diagnosed with panic disorder, PTSD, and OCD and placed on a treatment with SSRIs and Clonazepam. I stopped SSRIs in 2018 and tapered off Clonazepam only taking it rarely as needed for anxiety or panic attacks.
In October 2019, I had my regular visit with my endocrinologist when I expressed to him that I was still experiencing significant fatigue and inability to lose weight despite active attempts. My bloodwork then was: TSH 1.84, T3 0.88, T4 1.33. He suggested we try an alteration to the thyroid medication: the Synthroid dose was decreased from 100mcg to 75 and Cytomel 0.5 was added. In December, my labs were: TSH 1.21, T3 0.95, T4 1.00.
In January 2020, I started having severe anxiety and panic attacks again without a specific trigger. They have been progressively getting worse.
My question is: is it possible that my current anxiety and panic attacks to be, in fact, side effects of Cytomel? If this hypothesis is true, how quickly would my symptoms improve once I stop Cytomel? I sent a message to my endocrinologist and asked to have another set of labs done (he initially suggested a reassessment in the spring) and I am awaiting a response. Meanwhile, I just wanted to ask for your medical opinion.
Thank you for reading and I am looking forward to your response.
Delia
Hi Delia,
Yes, Cytomel can cause panic attacks and anxiety and it goes away rapidly upon cessation of the medication (if it’s related).
Hi! I have been on Armour Thyroid for 11 years and my doctor recently added the smallest amount of Cytomel to my regimen to battle fatigue. For the first two weeks my energy, mood, libido and sense of well being reverted to the best it’s been in a decade. I am 46 and use progesterone cream for perimenopause symptoms. I am now 2 weeks before my period and the cramps have returned! The T3 literally took away this pain the day of, only to return. I know the addition of T3 causes menstural “changes” but is menstural cramping 2 weeks out a common symptom? P.S. My RT3 and T4 are on the low end… Thank you
Hi J,
Menstrual cramps on T3 is very common.
Last year, my endo suggested that I have partial peripheral thyroid resistance and prescribed a large dose (50mcg twice daily) of Cytomel.
For years I’d been unable to lose about 20 pounds of extra weight. My body just seemed to want to store fat no matter how much I exercised or dieted (I was even fasting twice a week!). I’d been to a host of doctors and while my thyroid tests were always “normal” I did have a doc who tried other thyroid meds (Armour) in increasing doses, but with no effect.
To my astonishment, the Cytomel worked. Amazingly. Within weeks the weight was off and I was eating like a normal person again. I couldn’t believe it, after all those years.
But now, 7 months later, all of my problems have suddenly come back with a vengeance. I’ve gained the weight back, practically overnight it seems. My efforts to combat it with restrictive dieting are again doing nothing for me. I’m getting other hypo-ish symptoms – shedding hair (have to take it out of the shower drain every morning), get a hot/flushing feeling in my face all the time now etc.
My endo has said to try raising the dose to 75 mcg/twice daily. I started that the other day. So far there is zero apparent relief from this. He says he has patients who go much higher and that this can happen with thyroid resistance. But I am deeply worried that there is something more broken in me that has made this stop working and that there’s no getting it back and that the weight is here to stay.
My question is about adding Cytomel onto T4. Do you usually lower the patients amount of T4 before adding Cytomel? My FT4 levels are 1.7, which seems to be optimal however if you add cytomel on top of that will it raise the FT4? My FT3 has dropped to 2.6-2.8 and I seem to feel better when those FT3 levels are higher. My Dr recommended taking 2.5 mcg of cytomel. This seems pretty low. When I try to switch back to Synthetic T4 combined with cytomel after a few days I’m back to feeling terrible like I did on T4 only. Does it take awhile for the T3 to move up and to feel better? Thanks
When I first started liothyronine I felt amazing. Then the panic and anxiety set in and now it seems that I can even take the T3 without a horrible panic attack. I don’t know what to do at this point. Would it be the fillers? Could it be I should’ve titrated more slowly? I was originally on 10mcg, then 15mcg, back down to 2.5 twice a day then all the way down to 1mcg for the whole day.
Hi
I began to experience weight gain of approximately 4-5 lbs per year over a 4 year period with mo change in diet or exercise. Endocrinologist chalked it up to my age at that time— late 50s— and hormonal changes. Saw a functional medicine MD who began me on keto diet where i had great success—
Lost 13 lbs and never felt better. Slept better. Joint pain disappeared. While thyroid labs were in reference ranges she felt I needed a T3 boost and prescribed 5mg daily of Cytomel. I had all the low thyroid symptoms too. I have taken both
compounded and regular brands. About a year or so later began to put weight on again, felt the joint pain worsen, hair fall out again. Resumed keto diet as before with no success whatsoever. In fact, it caused me to gain weight. Just had recent labs drawn and T3, T4, AND TSH all
LOW. Just at low end of lab references ranges. I’m meeting w my PCP and functional medicine MD next week re this and would like second or third opinions so I am armed with information. I have all the classic s/s of hypothyroidism and my hair loss has worsened suddenly
I do not suffer from depression, thankfully. But joint pain, dry eyes and mouth are back.
Any insight greatly appreciated
Do you have references for the possible weight gain caused if dose of cytomel is too high? I have no thyroid due to cancer, and have been increasing my dosage of cytomel to get in “range” for FT3. My TSH is very low, FT4 also on the low end of normal, FT3 in the higher end of the range. But I am gaining weight, tired, loosing hair…many hypo symptoms…but I am also short of breathe. My pulmonologist and cardiologist think I am over medicated. I am starting to agree…it was the weight gain that was throwing me off as I had assumed that was due to too low a dosage of Cytomel, not too high.
Hi there,
Are the hypersensitivity reactions from the methocel in SR compounded Cytomel an allergic reactions? I recently trialed an SR Cytomel for the first time and experienced tingly/burning through my hand, arms and head. Will I have the same reaction at a lower dose? I can treat same with Benadryl but feel that if I try again at a lower dose the reaction will be worse as it would be a second exposure. What are your thoughts?
Can you explain the difference between generic vs cytomel as they are both embossed with KPI 115? The generic is distributed by Greenstone LLC, which is a subsidiary of Pfizer, however KPI is King pharmaceutical. What is going on here?
I picked up a new bottle of the Liothyronine substituted for Cytomel. I noticed the first day that I took 10mcg split and felt tired. I usually only take 5 mcg and that’s enough. Second day started with 2.5mcg and third day I knew something was wrong. Usually, from even 2.5 mcg I will feel some relief and normal body temp rise to 98.6. By the third day I was so cold and body temp dropping. I called the pharmacy and explained that I was not getting any therapeutic response and something was very off. You can’t take liothyronine and not have some response and I wasn’t having the same response as previous refills. The pharmacist agreed and said he’d give me another bottle. I switched from NP Thyroid back to synthetics so I could control the amount of T3 and consistency but now I’m having issues with the potency of synthetic T3. I have not had any issues with absorption of this T3 previously and it is the same maker. Is this something that happens?
Is this thing on?
I’m looking forward to my doc visit with a PCP that actually holistically looks at the entire body. I’ve been diagnosed with hypersomnia. My T2 diabetes has turned into Late-Onset Type 1. It was discovered around 5 years ago that my T3 was 2.2, and so, my naturopathic doc put me on Nature-Throid. OMG. I was awake for the first time ever. Then, my endo here took me off of Nature-Throid. The thyroid symptoms are ever increasing again. My T3 is back to 2.2. My RT3 is at 39. My TSH and T4 are normal, as are other types of thyroid tests. I can’t lose weight. Despite not eating much (I’m rarely even hungry), I’m rapidly gaining weight. My skin is dry. My hair is falling out. I show all the symptoms of having underactive thyroid, which from what I understand, is due to the RT3. I’m really, really hoping my new PCP will be able to put me on Cytomel. I’m tired of regular docs telling me I just have to live like this. I’ve been tired my whole life, since I was very young. I suspect some of this might be due to genetics and the DIO-1, 2 and 3, but I have to see a geneticist first to confirm.
Dr.
Before being hyperthyroidism, with 7 nodules, them due iode radiation, so now I take 100mc levothyroxine because now I’m hypothyroidism, i gained 40pounds in 2 years, never feel energy, extremely inflammation, dont sleep well. I tried to lose weight nothing work. Please help me.
Just started to see if it does anything positive. Nothing in anyway has helped give back t4t3 short of 3 yrs. Should have been given sr t3 long time ago. Took 20 mcg lio….twice today. No side effects.
I was recently started on cytomel (generic) after insurance refused to cover the NP thyroid I’d been taking for years. I begrudgingly agreed to try generic cytomel. Boy was I surprised. Within 6 weeks I’d dropped 12 pounds without changing my mostly healthy diet. My energy was restored to levels unseen since my 20s. (I’m 52) for about 3 weeks o felt great. Then slowly started going back to baseline energy level and lower mood. Had labs checked and TSH With reflex to FT4 was 1.45. Free T3 was 7.1. My health care provider wasn’t sure what to make of it and just kind of shrugged it off. She scheduled me to be seen again in a month. How high is TOO high with FT3?
Hi Penny,
It’s person dependent so I can’t really give you a value that you should be worried about. It also depends on whether or not your results are accurate: https://www.restartmed.com/thyroid-testing/
Taking T3 can impact your lab tests unless you use it correctly prior to getting your labs drawn. You can learn more in the article above.
I have been on 30 mcg of cytomel, big improvement in muscle pain, energy levels, constipation, depression better. was in ER last night, CVP’s tachycardia, increase in BP, was dedhydrated but did not know it also I use a lot of salt and my potassium was low. I don’t know if my cardiac symptoms were a result of the dehydration or the cytomel or both! Should I continue to take cytomel
Donna. 5/20/2023–
Hi Dr. Childs. I have been having problems w/ thyroid since age of 34. I am now close to 62 yrs old. I went to a Doc, as I only want to sleep, she had me do a full blood workup. I had NO TSH turn up at all, I kept telling the Doc that my thyroid glad had ultra sound when I was 34 and the gland was like swiss cheese! I just told my new doc, she then put me on cytomel and levothyroxine. (I also take antidepressant for depression/anxiety, and panic. What is happening now, is nausea, diarrhea, headache, itching, and VERY tired. My Blood pressure was taken and it was high for the first time in my life. I usually have blood pressure that are 116/70. (or about the same) This last BP was 145/80. NEVER have I had a BP like this. EVER! I know I don’t have a working thyroid, and what is left inside my neck is dead disease! It’s been a long time living w/ this. Before taking Cytomel I felt way better. Headache galore, and very tired. The Cytomel did not ‘lift me up’ like the Doc had said it would. I’m really thinking and believing I need to see an endocrinologist. This is just not working. I have Fibromyalgia also. Do you think I should have that swiss cheese taken out of my neck/body? I feel horrid. I just started this Cytomel, and it’s just not helping me feel good at all. If anything, I feel worse. Thank you, Donna.
Hi Donna,
It’s usually not a good idea to take your thyroid out unless it’s absolutely necessary. Those who get it removed often regret it, especially when it isn’t necessary. Thyroid removal just makes balancing thyroid medication dosing more difficult.
I have Hashimoto , I’ve been taking Cytomel since 2016 (0.25mcg/day) and I’ve also been on Syntroid since 2008 (0.88mcg/day) .
I’ve been feeling really good taking both medication, but my TSH lab results have been gradually lowering until they reached >0,00 and it’s been like that since 2018-19, I’m afraid that lowering my dose/stoping the medication (cytomel) would cause weight gain or increase my hypothyroidism symptoms. But I’ve been experiencing high cortisol / difficulty (impossibility) to lose weight/ losing a lot more hair for the past 1-2 year and I’m wondering if that could be related to Cytomel?
Hi Maude,
It’s possible that Cytomel could be contributing to hair loss and cortisol dysfunction, especially if you are taking more than needed. It’s unlikely that it’s causing weight gain, though.
Can Cytomel cause acid reflux or lower throat irritation?
Hi Darlene,
I have seen Cytomel cause indigestion before (and possibly stomach ulcers), but I can’t recall it causing acid reflux.
I am on 132 mg of porcine thyroid , 200 mg of prog, and .5 bi-est (with dmsoadded)
I have:
Hair loss (patches and thinning)
Depression
Anxiety
Itching
Weight gain
Constipation (abated vis aloe supplements)
I “make “ my own multivitamin by taking many pills. . Sigh
Includes b complex
Extra methyl’s (i am mthfr)
Zinc
Selen
Hair supplement
NAD
Chorella
Aloe
Mag cit (1g)
Mag glycinate…400 mg
Beef liver/kidney/adr extract
D3+k2 (5k)
Dopatone (by apex)
L theanine (BW 40 and 600 mg)..i alternate with the Theanine
I am 72 and need help. My DO is great and willing to learn but I need someone who KNOWS what to do
Recommendations? Ty