- Cytomel is a potent T3 thyroid medication that can significantly boost metabolism and support weight loss in patients who are genuinely T3-deficient, but it's not appropriate for everyone and requires careful dosing.
- Simply taking Cytomel won't produce weight loss without concurrent attention to diet, exercise, and other metabolic factors, just like any metabolism booster needs lifestyle support to work.
- T3 medication carries risks including heart palpitations, anxiety, and potential thyroid suppression if dosed incorrectly, so this requires working with a provider who understands T3 physiology.
- Some patients see dramatic improvements on T3 while others experience no benefit or side effects, making individual assessment and trial-and-adjust dosing essential to find your optimal dose.
- Cytomel is best considered as part of a comprehensive thyroid optimization plan after you've ruled out other deficiencies and hormonal imbalances that might be the real culprit in your weight struggle.
Cytomel may be one of the most effective thyroid medications on the market.
And because your thyroid plays a role in regulating your metabolism, it also happens to be one of the best for helping with weight loss.
Does that mean that every thyroid patient should be taking it?
No!
But it definitely means that it can and should be considered, especially if you are someone who is doing everything else right and still struggling to lose weight.
Before you run out and start taking it, here’s what you need to know:
How Cytomel Can Help You Lose Weight
Looking at available research on physiology, you can say with some degree of certainty that your thyroid controls about 50-60% of your basal metabolic rate (1) (pinpointing an exact amount is more difficult than you might think).
This is the rate at which you burn calories at rest and is one of the most important values when determining whether or not you will be successful when losing weight (2).
People with a higher metabolism will lose weight faster and more easily compared to someone with a lower metabolism. It’s pretty simple.
Because Cytomel contains the most powerful thyroid hormone, T3, it’s considered stronger when compared to more standard thyroid medications like levothyroxine.
So if you take it instead of levothyroxine, you are providing a much more significant boost to your thyroid and, therefore, your metabolism.
The end result? More weight loss.
But on top of this, thyroid patients who take Cytomel also see a benefit to fluid retention which is another common cause of weight gain among this population.
When you combine the increase in metabolism with a loss in water weight, many thyroid patients do see a drop on the scale when they start taking Cytomel even without diet and exercise.
Understanding how it works is fairly simple. Understanding how to use it safely is slightly more complex.
How To Use Cytomel Safely
Because Cytomel is stronger than T4-only thyroid medications, there are a few extra steps that should be taken if you plan on using it.
As someone with a thyroid problem, you’re probably well familiar with the need for thyroid lab tests which should be assessed regularly if you are taking any sort of thyroid medication.
This recommendation still applies if you are using Cytomel, but on top of the standard tests (TSH and free T4), a few extra are required.
These lab tests include:
These are not lab tests that are generally ordered by most doctors so you will likely need to specifically request them.
But when taking Cytomel, they are important to track to ensure you are never taking more than what would be considered normal or physiologic.
Again, because T3 is so powerful, taking more than you need can lead to problems such as bone loss (3) or even heart problems (4).
Don’t let these symptoms scare you because they are preventable as long as your dose is normal.
On top of these extra lab tests, you’ll also want to keep track of a few other metrics including:
- Your resting heart rate (5) – Your resting heart rate should stay under 70-80 beats per minute when taking Cytomel. If you see it increasing into the 90s or even the low 100s then your dose is too high.
- And your basal body temperature (6) – Your body temperature should never exceed 98.6 degrees. If you see it increasing higher than this then it’s an indication you are pushing yourself into a hyperthyroid state.
You don’t have to keep an eye on your body temperature or resting heart rate, but I do find them to be very helpful especially when you first start taking Cytomel and are trying to optimize your dose.
Once you determine if using Cytomel is right for you the next step is to figure out how much you need.
Cytomel Dosing For Weight Loss
Like any other hormone in the body, Cytomel isn’t going to help unless you are taking enough of it.
The balance that you must strike is finding a dose that is not too high, as to cause unwanted side effects, and not too low, as to cause no benefit at all, but somewhere in between.
For most people, this dose will be somewhere between 5 mcg and 20 mcg per day.
This dosing recommendation is based loosely on the physiologic production of T3 from the healthy thyroid gland which is around 10-25 mcg per day.
By the way, the healthy thyroid gland also produces around 90 to 100 mcg of T4 each day, which will come into play in just a minute so keep this value in mind.
If we start on the basis that we are trying to mimic what the healthy thyroid gland produces, we will automatically minimize the risk of unwanted side effects while maximizing benefits.
This is because we already know that the healthy body can tolerate this dose.
This range of 5 to 20 mcg is just a guideline, though, as there will be people who need more or less.
For perspective, I’ve seen people use as little as 1-2 mcg of T3 per day or as high as 70 mcg per day.
If you do decide to start taking Cytomel then make sure that you start at a low dose and slowly increase your dose (titrate) over time.
For instance:
A typical starting dose may be 5 mcg which then increases by 5 mcg every 10-14 days.
It’s been my experience that this slow increase over time allows for the body to adapt to the T3 thyroid hormone which further minimizes the risk of side effects.
And in the event that side effects do occur, you can always back down on your dose to a dose that previously worked for you.
Bottom line? Cytomel does come with some extra baggage in the form of side effects but the tradeoff is that it’s much more powerful.
Here’s how it compared to some other thyroid medications:
Cytomel vs Synthroid For Weight Loss
โAs far as weight loss is concerned, Cytomel will be superior to levothyroxine and Synthroid in almost every instance.
In terms of magnitude, T3 is roughly 80 to 100 times more potent than T4 which is what levothyroxine contains.
But instead of thinking about which one is better, I think it’s more useful to think of them as a complementary pair.
While it is true that some people do benefit from using only T3, referred to as T3 monotherapy, many people do even better on a combination of T4 and T3.
And it’s this combination of T4 and T3 that I think you will really start to see significant benefits to your health and weight.
In fact, I would say the majority of thyroid patients need some combination of T4, T3, and T2 because this mimics the natural production of thyroid hormone from your thyroid gland.
And if we look at someone with a healthy thyroid gland, we see that their metabolism and weight are both normal.
From a practical standpoint, this looks like taking two different medications at the same time:
Both Cytomel and Synthroid, in this case.
This is the case for Synthroid and levothyroxine but what about NDT?
Cytomel vs NDT For Weight Loss
This one is a little different than the levothyroxine example because NDT formulations, like Armour Thyroid and NP thyroid, come with both T4 and T3 built into them.
NDT contains a static combination of both T4 and T3 to the tune of 38 mcg of T4 and 9 mcg of T3 in each unit (termed a grain).
This ratio puts us pretty close to the 80:20 ratio that was mentioned previously when combining levothyroxine and Cytomel together, so they are very similar.
For this reason, the answer regarding which one is better has more to do with dose and personal preference than anything else.
I’ve found that some people, for whatever reason, do better on Cytomel and some do better on NDT formulations.
If you spend time on social media or the internet in general, you will find groups of people who advocate and evangelize both.
But don’t fall for the hype either way. One is not inherently better than the other even when you start throwing around terms like “natural” or “synthetic”.
The reality is that both can work and both can help you lose weight. Which one you choose is more a matter of preference, tolerance, and trial and error.
The next thing we need to talk about is side effects.
Side Effects
If you are planning on taking Cytomel then you should be aware of its potential to cause side effects.
These side effects tend to be dose-dependent so whether or not you will see good or bad side effects depends on how much you are taking.
The higher your dose the more likely you are to see weight loss but also the more likely you are to experience hyperthyroid symptoms.
For those who start taking it, here are some common side effects that you may see:
- Hair loss
- Heart palpitations
- Increased heart rate
- Increased body temperature, hot flashes, or warm flushes
- Weight loss (most common) weight gain (uncommon but does happen)
- Jittery sensation or increased anxiety
- Headaches
- Loose stool or diarrhea
Let me be clear in stating that these are the negative side effects that may occur only if you are taking more than you need.
If you are taking the exact amount that your body requires, which is always the goal, you should not experience these negative side effects.
Instead, you should experience these positive ones instead:
- Weight loss
- Increased energy
- Decreased hair loss
- Increased cognition and improved memory
- Decreased brain fog
- Improved sleep
Again, whether you experience positive or negative side effects has everything to do with how much you are taking so make sure to spend time optimizing your dose.
Cytomel is definitely one of my personal favorite thyroid medications because it’s far more powerful than alternatives like levothyroxine.
But this power does come with some added responsibility and it will only work if you dose it correctly.
If you can nail down both of these things, though, it will go a long way to helping you effortlessly lose that extra weight caused by low thyroid function.
By the way, if you are a thyroid patient trying to lose weight, make sure to check out this article next.
It walks you through how to use T2 thyroid hormone which, much like T3, is stronger than T4 when it comes to boosting metabolism and most thyroid patients have no idea that it even exists.
Scientific References
#1. https://www.ncbi.nlm.nih.gov/books/NBK500006/
#2. https://www.ncbi.nlm.nih.gov/books/NBK572145/
#3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230461/
#4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3832836/
#5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558494/
#6. https://pubmed.ncbi.nlm.nih.gov/8808101/
Additional references:
#1. http://www.ncbi.nlm.nih.gov/pubmed/16883675
#2. http://www.ncbi.nlm.nih.gov/pubmed/24692351
#3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205882/
#4. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169863/
#5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3148220/
#6. https://www.ncbi.nlm.nih.gov/pubmed/402379
#7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5451035/
#8. https://www.ncbi.nlm.nih.gov/pubmed/28138133
#9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737508/
#10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318631/
Fabulous info. Thanks very much. Hope I find a doctor who,will give me t3. Tasmania, Australia is difficult to find open minded doctors.
I have a nodual (0.63×0.73 cm) on my thyroid and have been slowly gaining more weight even with exercise and low cal diet. I would like to try a low dose 5mcg of C3 to see if this would help. Any thoughts on this?
Hi Dr Childs,
.I started on T3 Jan 8 along with 105 mg NDT. Raised T3 by 5mcg every five days and quickly found I needed to reduce NDT to 60 mg. currently on 69 NDT and 30 mcg T3. No weight loss. Feel more “alert” if that makes sense. Tried to increase to 30 mcg T3 and it appears to be too much. I am still on 25 mg cortef trying to heal my adrenal glands. So maybe weight loss is not achievable until I am off cortef?
Hello and thanks
I have hypothyroidism as well as chronic pain etc I am on 75mcg of Levothyroxine and 10 mcg of Cytomel. I eat well but over the past years Iโve gain 40 to 50 pounds
And watch my diet well as well as am active. Nothing works to lose weight and thought about raising t3 and maybe lowering Levothyroxine.i give up? Will raising T3 to say 25 to 30 mcg and keeping Levothyroxine same or ? Iโm gonna talk to my doc but would love your input before I talk to him so Iโm more knowledgeable. I learned a lot from your site now I need to put into action! Thanks again
Ken
Dear Dr. Childs;
I have been struggling and gaining weight since I was given floxie antibiotics to save my life. I am now trying t3 sr compounded in addition to compounded t4/t3 with the t3 at 1 mcg to 100mcg t4. All my labs and my symptoms scream I need more t3 but, my body can’t take more of either t3 or t4. I get such bad heart palps and can’t walk up the slightest hill w/o stopping every few feet. My doctor after 3 years of trying every med and possibility says I am hopeless and has taken away my hope of losing weight and getting better. Can you explain better how to tritate up. I am now kinda self medicating doing adding 5 mcg of sr t3 every three days. And, somewhat tolerating that. Will I be able to go higher and how. My doctor just shrugs his shoulders when I say what else can we try. Do you have any suggestions I can give to him? Or a way to not scare myself. I also have tried every form and type of probiotic, and fermented food. I know my absorbtion is a problem. But, that too seems hopeless. Before my antibiotic nightmare I was on 200 armour. I can’t take naturthroid or any of the ready made thyroid meds. Compounded is all I can tolerate. Thank you for any suggestions and help.
Hi Dr. Childs,
I noted in your post (nice post btw, thank you) that you referenced RT3 > 15 was problematic and likely cause for medicating. My RT3 is 13.2 ng/dL and FT3 2.1 pg/mL, yet my naturopath just diagnosed me with RT3 disorder and wants me on lyothyronine…I’m all about feeling better, but am also concerned because this particular practitioner diagnoses most of his patients with thyroid disorders, by his own admission. Are these numbers truly problematic? Besides some unpleasant symptoms I’d love to solve for, I’m a healthy 32 year old athlete. Medicating for life is a serious prospect…thanks for any thoughts, truly.
I have been on synthetic 112s. Dr added 5mcg caramel to start off just in the morning for now. I could not handle even a fourth of pill. Had rapid heartbeat and anxiety. Went to an 8th of a pill, which I can handle. Heart rate is 78 texting and temps went up to 98.6. Most of my intense aches and pains sent away and I have a sense of well being. This is week 3 on it and I want to increase. I notice some aching and energy decrease. If I increase, will my temps go too high? I am always sensitive to meds. My iron levels are good. Waiting on rf3 test next month. I feel I need the t3. My ft3 levels have always been low normal. Any thoughts? Do I just need more time?
Dr. Childs, When i was first diagnosed with hyperthyorid 15 years ago my Dr. put me on Synthroid and cytomel. I lost some weight and i felt great. But 4 years ago he took me off every thing and put me on just Armour. Ever since that time i have put on almost 20 pounds, have been feeling out of it, and my labs have been up and down. An integrated doctor got me off Armour and put me on .75mg Synthroid (later changed to Levothyroxin) and .10 mcg Cytomel. When my insurance didn’t want to cover cytomel I started taking the Liothyronine and I got very sick from it so I went back to cytomel. Today, a year later I decided to try the generic again by taking 05 mcg of cytomel and 05 mcg of the generic form to ease into it. Do you think mixing the two forms of Cytomel is OK to do until my body gets used to it? I hope I don’t get sick again!
Hello Dr.
I’m on .75 mcg of levoxyl. Added in 10mg cytomel a few months with little change to weight (5’2″, 122 lbs, but this reflects a recent 5 pound weight increase I can’t lose). Increase cytomel to 15mg and my T3 levels were elevated (4.5) so my cytomel was reduced back to 10 mcg.
Would I benefit from reducing my levoxl and increasing the cytomel again? thank you.
For healthy people that cycle T3 (bodybuilders). how long should you be on and off T3 so in order not to damage your own natural thyroid glands.
I have read on another website that NDT can make some people irritable and angry. I feel this is how it affects me, but my N.D. thinks NDT is the best treatment for most people. I was on SR T3 and felt more positive with more energy, but he told me that SR T3 is very dangerous and I could end up in the hospital. So I’m back to being depressed, angry and irritable on WP Thyroid. Am I only imagining this?
Hi Susie,
Your symptoms are your symptoms and no one can tell you how you are feeling. There is no such thing as the “best” thyroid medication so SR T3 may be the best option for you.
You can learn more about thyroid medications here: https://www.restartmed.com/thyroid-medication/
Dr. Childs,
Thank you for your informative articles. I had a full removal of my thyroid 2 years ago and was on Levothryoxine 112. My weight was at 110-115 then. My thryoid levels were low so my doctor switched me to 125 mg Levo and my weight has increased to 140. I have been 100-115 my whole life. I am really trying to figure out what the best route to go is to go back to my normal weight or at least get my medication to cause weight loss and not weight gain. Please guide me. Thank you
I am currently on 150mcg of Levothyroxine, had thyroid cancer, so had surgery to remove my thyroid when I was 32. Now will be 62 in a month. Never even heard of Cytomel till a couple days ago while looking through facebook. I am probably about 60 lbs overweight have tried many different diets, lose weight and of course always comes back! Do you think adding Cytomel would be an option at my age to finally lose the unwanted weight? At my last cholesterol blood test LDL somewhat high 138, low tolerance to cold, don’t sleep well a lot of nights. And at what dosage should I start?
Reading through all the articles and posts from everyone I would like to find a doctor that would listen to me. I have all the symptoms but seem to fall into their mile wide “guidelines”. I have tried everything to lose weight, my last resort has been to join a Crossfit program…Intense workout…I joined in January and to this day have not lost a pound and I watch what I eat…healthy eating! Where/whom in my area can I go to that can help me without costing a fortune. I know the T3 would be very helpful if I could just get someone to listen. Or is it something I can order online? Thank you
Hi Calista,
Unfortunately, each therapy and dose should be individualized to the patient. I can only give guidelines to help with the process, but I figure guidelines are better than nothing! At this time I don’t know of a way to get this type of treatment without paying out of pocket, just the reality of the situation right now. Insurance doesn’t pay for these types of services which is a big part of the problem. I suspect that within 10 years or so this will be more mainstream, but currently, and for the foreseeable future, it doesn’t seem to be the case.
You can try to find physicians to help you with this resource: https://www.restartmed.com/thyroid-doctor/
Hi- My 18 yr old daughter has gut imbalances that led to leaky gut & Hashimotos. Her T H S is normal with low out of range T3 & low in range T4. She has hypothyroid symptoms- weight gain, constipation, cold hands/feet, mood swings. She started on 30 mg of Armour & it took her T3 to 3.1. The Endo reluctantly raised her to 45 mg Armour. Leptin number is 17. Fasting insulin is 11. Checking on the 8 a.m Cortisol, not sure it has been run. Some Candida overgrowth & probable gut bacteria being treated holistically. What type of Dr will treat this- I live in Northern NJ? I need to get her to someone who understands this! Thanks for your help.
Dear Dr. Childs,
I had TT due to Graves Disease in 2011. After 2 years of horror, I found a doctor who prescribed t3. I am on 150 ug t4 plus 25 ug t3 spread in 5 portions over 24 hrs. My free t4 and t3 are in the upper thirds and my TSH 0.0x for 4 yrs now. Do I have to watch out for bone loss? Or does this only apply to t4 overdoses?
Thank you very much!
Hello Dr. Childs,
I have been on a medication roller coaster! I’m currently on 25 Synthroid,15 cytomel. And other medications for adverse reactions to Femara, 60 mg cymbalta, testosterone, progesterone, and a host of supplements. I’ve gained 30lbs in the last 6 yrs. My Dr has recommended increasing the Cytomel to 20, then 25 and so on till I reach my goal of energy and weight loss. The hair loss is depressing!
I am currently taking 25 cytomel and I am feeling very fatigued. I’m sleeping 9 to 10 hours a night. Help!
Lynn
Hello. My 19-year-old daughter is really a mess. She plays college bball and has gained 10# over the last year…when she actually should be losing weight due to her training level and calorie intake. Her FT3 is 2.3, T3 88, T4 7.8 and FT4 is 1.1 and RT3 is 17.4. Her ferritin is horribly low-8.1, but her iron is “okay” but could be higher-41. Now that she isn’t exercising in the past 5 days due to the low ferritin, she has gained 2 pounds! I hate to think what her weight would be if she wasn’t an athlete. For the past 5 months, her average caloric intake is about 1300-1500 per day. I told her it is not enough on the days she has 2 hours of bball practice. She also sweats profusely while exercising..always has. Her other symptoms over the last few months are that her hands and feet are very cold, she has become increasingly tired-which is not like her, she has swelling in her ankles/lower calves. We have an appt tomorrow w/a functional doctor, so I’m hoping I’ll be listened to instead of ignored. She was also low on Vitamin D and her iron saturation was flagged low at 12. I have started her on Vit D w/K2, Vitamin C, Super B, and Iron. Her energy has improved over the last 2 days but something has to be going on w/this weight gain. Her caloric intake is low…but she does eat-just a lot of low-calorie foods such as fruit, chicken, turkey, yogurt. She did drastically cut her red meat intake over the last 5 mos., so that might be why her ferritin fell so much. I would greatly appreciate your opinion. Her antibodies were both negative for Hashi/etc. Bilirubin was 0.3, so not flagged low..but on the lower end of normal range. RBC was 3.9, also in the lower end of the range. WBC 8.5 on the range of 3.8-10.8, so that seems okay. Hemoglobin 12 on a range of 11.7-15.5. Ultrasound of thyroid was normal-both normal, equal size and no nodules. Thank you!
When adding T3 to your current thyroid medication would you only go by basal temps and heart rate to determine if you are taking enough? or would you also take into account the lab ranges that are provided on blood tests? Can you go outside of the FT3/FT4 lab ranges and still be ok as long as your BBT and heart rate is in the normal range?
Thanks, Dr. Childs for providing all your knowledge and information online. It is a shame that all physicians do not take the same approach to care as you have….anyway.
I am still struggling with hypothyroid issues and unable to lose weight even though I am on Cytomel 5mcg and compounded NatureThryoid 19mg/4.5. My doctor would not alter any of my medication with my recent April 2018 results. I am under enormous stress in needing to move my business location in the next 6 months. 6 months ago revT3 was 11 on same meds. Could stress be the cause of increase revT3? Also I am on several other supplements…12.5mg iodine, designs for health metabolic synergy
TSH=1.87
T3free=3.2
T4free=1.4
Total T4=6.1
RevT3=22
H1cAB=5.5
I am thinking I could have insulin resistance, leptin resistance or both.
Testosterone total=23
Testosterone free=2.1
Testosterone Bioavail=4.2
Will your product Thryoid conversion booster help??? what about the Adrenal reset supplement??? Maybe I need those two plus the Berberine 500+?
Looking for a solution.
thanks
Hi Yvonne,
It sounds like you are on the right track! Yes, those supplements would probably benefit you given your situation. At the very least, given that you are under stress, you should be on an adrenal supplement.
Hello doc,
I take 300 mcg of levothyroxine and 50mcg of Cytomel. I have excessive sweating, especially at night. My hands sometimes are shaking and I have headaches. My family doctor wants to increase the Cytomel to 75mcg. Will this make my symptoms worse with adding more cytomel?
Hi Jodi,
It sounds like you may be taking too much thyroid hormone based on your symptoms.
Hi. Does Cytomel affect your personality? Making you more aggressive.
Hi Chris,
I’ve never seen it cause that particular issue.
I am on a compounded thyroid, but feeling tired and weight gain. Would you recommend cytomel? getting levels checked again.
Hi Debra,
You wouldn’t want to start cytomel unless you know that you need it, so you will want to check your free T3 and total T3 first. If they are not optimal then it would be reasonable to add it.
Hope this helps!
Hello Dr Childs,
Thank you in advance for sharing your knowledge. I was diagnosed in 2015 with graves after 9 months of high dose prednisone for a viral joint infection. I had the physical symptoms, but the Endo did not check my TSI antibodies. I was on 10mg methimemazole for five months before labs weโre checked. I went hypo with a TSH of 11.9. I stopped methimemazole and did nothing for a year. In April of 2017 my labs we checked again and my TSH was 55.2 and my TPO antibodies were 1378. I was diagnosed with Hashimoto thyroiditis with benign nodules and started on 50mcg of levo. I am now on 100mcg of levo and am due for labs in a weeks. That will be the six week mark of increase to 100mcg from 75mcg. My labs on the 50mcg starting dose this March was TSH 3.89 FT4-1.3 and FT3-2.77.I started 75mcg 3 months ago and my labs were still not normal for Hashimoto my TSH was 2.66 (.7-5.2) FT4 was 1.5 (.9-1.7) FT3 was 2.89 (2.57-4.43) reverse T3 was 20. I asked for Cytomel, but I am the opposite of the nomal weight gain. Iโm 5โ9 and my weight has dropped from 123 to 105pd. I eat and and canโt gain any weight. This has made my doctor reluctant to prescribe Cytomel, so they increased my levo to 100mcg and will recheck labs next week. My heart rate runs high, but has done that well before I had thyroid problems. During work it runs about 110 to 120 and resting is between 70 and 80. What are your thoughts on cytomel for me. I have fibromyalgia but thatโs a wimp compared to this thyroid stuff. Iโve continued to work full time, but I am alway exhausted. I have Raynauds and dry eye disease (narrow angle glaucoma) dry nose and mouth. I just want some energy and 20pds back on me, Iโve read that low FT3 can cause stomach acid and make it hard for my body to absorb nutrients. Your knowledge would be greatly appreciated. Thank you,
Hi Katie,
If you have a specific question I would be happy to try and point you in the right direction.
ellie.cocks@yahoo.co.uk Hi, I have read your article a couple of times and I am wondering where it is best to get the tests done. It is all so complicated and takes a lot of understanding and Iโm not sure my general gp would have the knowledge or the time to look into it properly. Could you recommend the best place to go for tests please.
Hi Ellie,
You can find more resources on how to find a doctor here: https://www.restartmed.com/thyroid-doctor/
Hi Dr. Childs,
I have been following your blogs with interest since discovering that I have a low thyroid issue. My doctor has prescribed Cytomel for me at 25mcg taking half in the morning and a half in the evening.
After one month on Cytomel, I have lost 5 pounds and feel that I have more energy and less brain fog.
At my recheck, my doctor then prescribed Victoza to help with my weight loss. I just started this today at .6 and have my next visit scheduled for next week. I am looking forward to seeing how this hormone therapy works for me and even more so after reading your blogs. (I had tried different diets in the past with poor results).
Thank you for your blogs as it really helped clarify what my doctor was doing and why. They are well written and really help the average person to understand what is going on with their bodies and why hormone therapy is important. (also helped because I was a little nervous to start all of this).
I was searching the internet for answers and yours explained it the best! Thank you!
Hi Yvette,
Glad that you found it helpful!
I had thyroid gland removed due to multi-nodular goiter that was not cancerous 2015. I tried levothyroixine but felt terrible. I finally found a doctor willing to prescribe natural dessicated thyroid med (currently I’m taking 60 mg) and after 6 weeks am experiencing improvement, which of your supplements would help me?
Hi Kathy,
If you are just getting started then Thyroid Adrenal Reset Complex + T3 Conversion Booster will probably be your best bet! From there you can determine if you need probiotics and so on.
I have been taking Synthroid for 9 months without much change in my hypothyroid symptoms. I have permanent liver damage. After questioning my GP about the possibility of my damaged liver not converting the T4 to T3 properly, he put me on Cytomel.
My period has been delayed for 12 days now and I am trying to figure out why the cytomel has affected me this way.
I would appreciate any thoughts or topics I should research. Thank you.
Hi Sheri,
It’s fairly normal for T3 medication to do that, I believe it has to do with the regulation of the cycle that occurs with more potent T3 doses.
Hello Dr. Westin Childs,
I was diagnosed with Hypothyroid disease in 2005. I started on Synthroid and did not feel well. I have been on Armour Thyroid for over 12 years now. My dose is 30mg (1/2 GR) and 15mg (1/4 GR) 2x per day. My thyroid levels of free T3 and free T4 are usually in the normal range and my TSH is always very low. However, I have struggled with losing weight and with a lack of energy and other low thyroid symptoms for quite a while. I spoke to my endocrinologist who agreed to try me on Levothyroxine 125 mg once every morning and Generic Cytomel 5 mg 1/2 BID. His reasoning is that using this two in combination he can adjust my T3 and T4 dosage whereas with the Armour thyroid they are both in one pill so you cannot adjust them separately. Do you think this will help me? It’s kind of scary since I have been on Armour for so long. Armour has taken away many of my hypothyroid symptoms except for the weight, brain fog, and lack of energy. My energy seems to come in spurts.. I have good days and bad days. I have also returned to a gluten free diet as I believe I have a gluten sensitivity. I was tested and do not have an allergy to gluten but was told that I could still have a sensitivity to it which can cause inflammation and bloating.
I would appreciate any thoughts you have.
Thank you,
Ms. Carolyn
Hi Carolyn,
It’s reasonable to use T4 + T3 medications in place of NDT for the reasons your endo listed. Titration and dose really depend on the individual.
Dear Dr. Childs I have left 2 other comments but cannot find them on this blog. I have them on the series of thyroid videos. How can I find the comments I left so I can read if they’ve been answered? I have to decide whether I want to take 5 mcg of Cytomel because the D.O. I’ve been seeing changed her mind about giving me both NP Thyroid and Cytomel. I see everyone leaving their lab numbers here, but didn’t know if I was supposed to pay a fee to do that? I did purchase the 97.00 membership but I need help faster than exercising is going to help me, diet and exercise take time. I do eat organic and not much but I don’t lose the weight and started on this lab testing but there are so many different doctors telling me I am not thyroid yet I feel bad and don’t know if I should take the cytomel or not. I was told to either take it on an empty stomach or with food but be consistent if I take it. I don’t want to lose my hair! I don’t want my facial collagen to collapse if I need to go off of it like when I was on 60 mg NP Thyroid for only 2 days! It may seem hard to believe but there are no knowledgeable doctors where I live and if there are, they don’t accept insurance. Much thanks for all you do. This comment section keeps moving when I move it up to submit.
Hi
I have listened to all your podcasts and they are brilliant. I am 38 extremely active and have been trying medication for hypothyroidism for a year. I donโt ink my doctor wanted to give me any. I have steadily been gaining 20 lbs over 2 years. Am terrified..will this end. .how can I stop this? Iโm not sure if it is more thyroid or metabolic adaptation. Do you have suggestions? My last TSH was low… if this is the case shouldnโt I be losing weight, with low calories, exercise and my t3 and free t3 in normal? Thank you! Iโm terrified.
Hi Nikki,
Having a low TSH does not mean you are hyperthyroid (contrary to what you’ve been told and what most physicians think). There is a difference between lowering your TSH due to thyroid medication and having a low TSH due to endogenous hyperthyroidism. The best thing you can do is try to optimize your lab tests within these ranges: https://www.restartmed.com/normal-thyroid-levels/
I am currently on 88 levothyroxine and 10 cytomel. I have recently started having horrible headaches and gaining weight. My tsh is extremely low while t4 is normal but going down and t3 is now optimal. Reverse t3 is optimal as well. Still no relief of fatigue and other symptoms. Any suggestions?
Hi Natasha,
It may not be your dose but the medications you are using. You may find more relief with cleaner medications such as Tirosint. In addition, it’s possible that your weight gain is unrelated to your thyroid if your thyroid has been optimized. I would look into those things first.
Hello Doctor, I have been on generic Cytomel off and on because it makes me sick to my stomach. I didn’t notice any good or bad affect on my weight but it was on 5 mg. to my 75 mg Synthroid, so I couldn’t give it much time. However, I did get very nauseated taking the medication in the afternoon. I don’t take at night b/c of the other meds that can be rough on my system as well (Fish oil and magnesium). I also take Metformin 500 in afternoon. Do you have any suggestions on why it is making me nauseated and how to avoid such? None of the other symptoms listed concern me, just nausea. Thanks!
Best concise write-up about the connection between nutrition hypothyroidism! Thank you so much.
I am reading in many places that high cholesterol always points to hypothyroidism. I am 78 yrs old. My cholesterol has been slowly rising since menopause. Does that mean that my hypothyroidism actually started at that point?
THANKS
Hi Magda,
I’m glad you enjoyed it! High cholesterol certainly doesn’t always indicate thyroid disease but it is a common cause of high cholesterol. But many other factors can both cause and contribute to high cholesterol.
Hello, I have enjoyed reading your blog about Cytomel. I currently take Synthroid and could stand to lose a few pounds as well. As a powerlifter, the only concern I have is some warnings I have seen about the medication causing a loss in muscle mass. Is this a true side effect and if so can taking testosterone combat the effects. I also do HRT 200mg per week of testosterone. I am curious because reading your blog made it seem like something my body may need but I read don’t want to give up muscle mass.
Hi Jayme,
A decline in muscle mass would only be seen if you were using too much and putting your body into a hyperthyroid or catabolic state.
Hi Dr Childs
Sorry, I realise I’m a bit late to comment. I’ve been reading a lot of your articles and find it really helpful, thank you so much. I’ve been on T4 for more than a decade now but I’m still tired, foggy and I can’t shift any weight even though I’ve been following a strict 1600 calorie keto diet for the last 18 months.
My TSH is in range but I still think its high at 3.69
I just wanted to ask, if I’ve been taking 100mcg of T4 and I want to consider adding 20-25 T3, should I reduce my T4 by a quarter or half or simply add the T3?
Thanks again,
Heidi
Hi Heidi,
Each person responds differently to T3 so, unfortunately, there is no “standard” to apply in this situation.
Hi Dr. Westin Childs
I’m currently on T3 due to hypothyroidism.
But I do not know why I’m gaining a tremendous amount of weight.
Is there any scientific reasoning to the cause of this?
Hi Ellis,
My best guess would be that you aren’t using enough T3. Make sure to test all of your thyroid lab tests and ensure they are in the optimal range: https://www.restartmed.com/normal-thyroid-levels/
Where in Kansas city Missouri do I find a dr like yourself to help my husband for his problems?
Hi Diana,
You can use this resource to help: https://www.restartmed.com/thyroid-doctor/
I am currently on both T4 and T3 hormones after a total thyroidectomy in 2009. I recently started running but suffer from extremely high heart-rates. I ran a 10K this past weekend and went way over my max heart rate at 189 bpm. I need some advice and help, please. Will my heart rate lower the fitter I get? I struggle to breathe under these circumstances Any help or advice welcome.
Hi Chrisna,
I would take a look at your thyroid labs to make sure that you aren’t taking too much thyroid hormone as tachycardia is a symptom of taking excessive thyroid medication. And if your heart rate is caused by your thyroid medication then getting more fit will not reduce it.
Dear Dr. Childs,
Yet another very interesting article! I just love your articles and find the advice you give great.
I just read in another one of your articles that you can add T3 to NDT in patients with insulin and leptin resistance. In your example you added 25 mcg of T3 in a slow titration to an existing dose of 3 grains of NDT daily. How do you usually add T3 to NDT, when the patient is already used to getting some T3 from the NDT? Do you add higher doses of T3 from the beginning, or do you start low and go slow in that case as well?
Hi Catherine,
I don’t have any articles right now about how to dose thyroid medication, but I will consider writing about them in the future. There’s a liability that comes with information such as that so I’ve mostly avoided it.
Hello Dr. Childs,
Thank you so very much for all your time, work and information; I find it fascinating and very helpful!
I am 42-year-old female, initially diagnosed with hypothyroidism in 2012 (midway into my 2nd pregnancy). I believe I induced some degree of my thyroid disorder due to excessive exercise and dieting from 2007 – 2010. At one point I weighed 118# which at 5’7″ is low. In 2012 I was started on levothyroxine and felt ok, I never had any significant symptoms except cold intolerance and fatigue (which I attributed to pregnancy). I did have a low resting HR (40-44) but attributed that to lots of cardio.
After some basic research, I decided to switch to Armour thyroid and felt somewhat better. I also went on to have 2 further pregnancies with no complications. I eat an extremely clean, low carb diet and exercise 3-5x/week but not excessively as before.
Jan 2019 – body temp 96.8, RHR 60
TSH 3, FT4 0.81, FT3 5.3, RT3 19 – on armour 90mg/day – wt 135#
Feb 2019 – started cytomel 25mcg x1 week, then increased to 50mcg/day
March 2019 – bod temp 97, RHR 64 – wt 139#
TSH 0.13, T4 0.69, RT3 – 10 – FT3 still pending, vit D – 34
I am wondering in cytomel is not the drug for me, I do not feel significantly improved and my weight is climbing despite a clean diet and exercise program.
Hi Mary,
It’s true that Cytomel does not work for every single person, but you also need to make sure that your dose was ideal before you ditch the cytomel for good.
I’ve been on a T4/T3 combo for 20+ years – my Free T3 is low (under 2) and my RT3 is around 20. My TSH bounces all over the place and Free T4 is normal. My body temperature is a steady 96.4 degrees and my resting heart rate is around 50.
My blood pressure is consistently around 90/60. I’m on 180g of Armour (I can’t take NP, it makes my gums bleed) My old doc missed 2 labs in a row with an abnormal thyroid so I recently changed docs and have asked him about supplementing T3 and he’s open to it, especially with my Free T3 being so low. He had me try an OTC supplement and it did nothing, so I see him tomorrow and will ask for a stronger prescription. I’ve been under extreme stress over the past 9 months and have gained 30 lbs after a car accident has left me sedentary. I’m very conscious about the food I eat and consume between 1200 and 1350 calories a day, which shouldn’t cause weight gain. I’m 5’9″ and 190 lbs (now – I was 162 at the time of the car accident). I don’t eat any grains, sugar, or carbs in general other than certain vegetables which I cook thoroughly. The rest of my food intake is primarily protein, with a minimal amount of fat (around 60g of fat per day) In your opinion, would the addition of T3 be a good option for me?
Hi Reese,
It would probably be easier to alter your dose of T4/T3 (unless you are taking NDT) than adding T3 to your existing regimen. It’s also never a good idea to restrict your calories if you have thyroid disease because it will always result in worsening thyroid function and metabolic damage and the inability to lose weight (which appears to already be the case).
Had poorly differentiated cancer removed almost 2 years ago. Recent sonogram–NO CANCER.
Had a poorly differentiated thyroid cancer removed about 2 years ago. Recent sonogram–NO CANCER. Seeing a doctor at U. of Va. and taking alternating doses of 125 mcg and 113 mcg levothyroxin. I have asked for a T3 and free T3. He says that is in the tissue. Feel like I need T3 added. I tire easily and have trouble remembering as well as sleeping. I am 89 years young, very active, no medical problems. NO ONE HAS EVER COME
CLOSE TO GUESSING MY AGE. Read another article just like yours by a pharmacist who has done intensive research and she agrees with you about possibly needing both T4 and T3. Thinking about taking your advice on my own and adding T3–checking temp and heart rate. I don’t feel as well as I should–BUT I DO FEEL OK
I am eating less, but find it easy to add weight–195-200 lbs at 5ft 10in. I take my med at 11:30 PM to avoid Ca and food in AM. Best time to take T3? Will start with 10 mcg daily and go to 20 mcg in 2 weeks. Your thoughts? Any harm trying?
Hi James,
The risk of using T3 is quite low compared to the potential benefits, but I wouldn’t say there is zero risk. Just make sure to dose based on your labs and symptoms and you should be good to go. I typically have people take T3 at night and T4 in the morning, it’s just something I think that works best for most people.
Dr. Childs,
First of all, thank you for your wonderful articles and advice!
I am currently desperate enough to self-diagnose and self-treat. Not recommended, I know, but what do you do if you cannot find a doctor to listen to you? (I’m in Europe where doctors like you are few and far between)
I spent ten years on levothyroxine only, taking as much as 200 mcg daily without much improvement (I was diagnosed with Hashimoto’s in 2001). In 2012, I found a doctor working with NDT. I started on Armour and was later switched to Erfa when the former was out of stock.
I did well on Erfa until last year when I was put on short-term cortisone treatment for autoimmune encephalitis. I was put on 1 g of methylprednisolone IV for five days, then went on 100 mcg of Solupred for a week, decreased it to 80 mg the second week and then decreased it by 20 mg every week until I had weaned off it completely.
I felt much more hungry while on cortisone, with terrible carb cravings, and put on ca 10 lbs while on it. But told myself I’d be able to lose that fairly easily once I had weaned off it (after all, I had managed to lose 60 lbs on Erfa).
But it turned out not to be so easy. When the cravings wouldn’t go away my family doctor ordered labs which showed fasting insulin and blood sugar levels close to the upper normal limit. My family doctor suggested I try Metformin although not technically diabetic, but as a preventive measure. However, having read about Berberine being as effective as Metformin in this regard, I decided to try it first. But it did nothing for me. Neither did alpha lipoid acid, cinnamon, or gymnema sylvestre.
Recently, my family doctor suggested I go off NDT and back on T4 only as my cravings suggested I was overmedicated, along with a suppressed TSH (my family doctor, unlike the alternative doctor who prescribes NDT does only test the TSH, not the free Ts). My TSH, on 3 grains of Erfa, was <0.01 so my family doctor concluded I was hyperthyroid.
However, since going back on T4 only, things have gotten much worse. I now feel hungry all the time, and even wake up during the night from my stomach growling. I literally eat for two and keep gaining weight, a couple of lbs a week. I now weigh 220 pounds (5.8ft) and look and feel terrible (bloated, puffy face, abdominal fat making me look like I was four months' pregnant…).
I have been wondering for quite some time if I have leptin resistance in addition to insulin resistance, since going on T4 only (and a higher dose of T4 than I was getting on NDT, now on 150 mcg of T4 daily vs 114 mcg daily on NDT) only made my cravings worse. Normally, if I suffered from drug-induced hyperthyroidism on NDT, I'd imagine I'd feel better on T4 only. BTW, the dose of 150 mcg was calculated based on the following formula: 1.6 mcg of T4 per kilogram of body weight.
I have read that you have successfully treated many patients with leptin resistance. I am planning to raise this with my alternative physician to see if I can get him to prescribe T3. I doubt he has ever heard of leptin resistance, but he is open-minded and unconventional and, unlike most doctors, doesn't pay attention to my TSH but rather goes by my FTs, mainly my FT3 levels, when on NDT.
What I wanted to know is: is there an average dose of T3 required in order for patients to successfully recover from leptin resistance? I realize everyone is different, but would you say most people require 5, 10, 25, or closer to 50 mcg of T3 daily (just to give me an idea)?
Also, do you recommend patients go off T4 completely, or just reduce their daily dose of T4?
I really hope to get this doctor on board, but the better prepared I am, the more likely I am to succeed, which is why any input from you would be most welcome.
Catherine
Hi
I gained 4 stone thanks to the menopause and am very unhappy about this. I have read about how the bodybuilders lose weight and flab by using T3 and clenbuterol. Would you recommend this, it seems as though clenbuterol is a taboo word? Thanks, Tracey
Hi Tracey,
No, I would not recommend using T3 unless you need it because you have hypothyroidism or low thyroid function. Using hormones unnecessarily is an easy way to cause harm to your endocrine system.
Hello- thanks so much for this information. I started on 25mcg of Levothyroxine about 6 months ago even though my levels were โnormalโ I had symptoms of hypothyroidism…hair loss, fatigue, puffy face, dry skin but Iโve gained 10 pounds in the last 6 months and developed debilitating fatigue. My doctor wants to add 10 mcg dose of t3- but Iโm thinking I should just go on a thyroid support supplement and get off of any prescribed meds. Any thoughts? Feeling miserable.
Hi Julie,
That’s a reasonable approach. I would take a look at this article for more information: https://www.restartmed.com/natural-thyroid-remedies/
Hi Dr. Westin. Thanks for all of the information. I have just purchased your weight loss program. I am 55, multiple autoimmune issues as well as Hashimotoโs, diabetic, insulin and Leptin resistant. I now believe I am also thyroid resistant. I have been keto for a year with much success. I have 15 -20 lbs to go. Many of my labs are either still too low (vit D, b-12, DHEA, progesterone, testosterone, estradiol) or too high (homocysteine, reverse t-3,). I have been on Levoxyl and Cytomel for many many years and recently my dr increased my Cytomel dose. It is my glucose and especially by fasting glucose (over as high as 140โs) and my fasting insulin (14.5) that has me heavier than I should be and has me most concerned. I have tried metformin before and I currently take LDN at 4.5 mg. I will be asking my dr TOMORROW for Victoza to add with my metformin and LDN, and I will ask to increase my LDN to 13.5. I will also seek to add b-12 shots weekly. I am also buying your recommended supplements. I feel like I am close to cracking the code. But I am tired too. I have been at this for a very long time.
Hi April,
It sounds like you are definitely on the right track! Just be sure to follow the videos to make sure you don’t increase your doses too quickly and you should see results.
So Iโve finally lost back to 102 but I think itโs mostly due to the Cytomel as I havenโt changed my clean lower-carb organic diet in years.
However, when I tested my thyroid they said I had low
TSH .006
Low
T4 Free Direct. 25
And wanted to see my T3 a little higher
3.0
So they increased my T3 to 50 mcg
But put me back on T4 75 mcg
Hair started falling out and feeling tired again so we are cutting the 75 in half.
My question is, does it matter if TSH and T4 numbers are low if I was feeling better just taking the T3?
I donโt like the symptoms associated with the Synthroid.
If you could just guide me with the knowledge of why I need higher T4 numbers or TSH Iโd appreciate it.
My RT3 did fall from 29 to 5.2 and my TPO was 21 (0-34) which they didnโt think indicated Hashimoto.
Getting retested this week so any guidance will help.
Thank you!
Hello,
I am 68 yrs old living with Hashimotoโs for at least 20 years, maybe longer.
Presently I take 125mcg of Tirosint. Weight is a big problem for me as over the 20+ yrs it has become nearly impossible to take off weight no matter what I do. It is now affecting the rest of my body. Would I benefit from taking Cytomel & how can I convince my doctor to prescribe it if it might be helpful to me.
Rosemarie
Hello Dr. Childs,
I have been reading this site for the past few years trying to figure out my thyroid issues. Multiple doctors. Currently taking 100mcg Synthroid and 10mcg cytomel one time per day. Most recent labs indicate:
TSH: .11 (ref: .40-4.10)
Free T3: 2.8 (ref: 2.2-4.2)
T-4 Free: 1.79 (ref: .80-1.90)
T3, Reverse: 25.2 (ref: 9-27)
I feel tired all the time. Weight gain over the past several years despite strong diet and periods of extreme exercise than none because ultimately feel discouraged. Any thoughts you have would be greatly appreciated. Wondering if cytomel alone would help or lowering the Synthroid.
Kind Regards,
Angela