Treating high RT3 with T3. How much is too much?

[CROM]

I noticed that actual endocrinologists who treat patients for elevated RT3 using Cytomel often prescribe T3 dosages between 10 to 15 mcg per day.

Then I see other people who say they get 50+ mcg prescribed.

How do you determine what dose to use? Is there a danger taking 25 or 40 mcg?

 

[Vtail]

My RT3 was 23 and I had mind fog and would get very tired in the afternoons. My doc started me on Cytomel at 25 mcg, then after blood work increased it to 50 mcg. Currently my RT3 is 8 and I feel much better. No adverse side effects that I can tell from the 50 mcg daily. I break the pills in half and split the dose throughout the day. Usually 6am, 10am, 2pm and 6pm. Sometimes I miss a dose depending on how hectic things are, and don't notice any difference.

 

[CROM]

My RT3 was 23 and I had mind fog and would get very tired in the afternoons. My doc started me on Cytomel at 25 mcg, then after blood work increased it to 50 mcg. Currently my RT3 is 8 and I feel much better. No adverse side effects that I can tell from the 50 mcg daily. I break the pills in half and split the dose throughout the day. Usually 6am, 10am, 2pm and 6pm. Sometimes I miss a dose depending on how hectic things are, and don't notice any difference.

Thanks for the info. Did you feel like your metabolism increased? Were you trying to lose weight or just doing it to feel better? If you were doing it to lose weight did you experience weight loss?

 

[Vtail]

T

Thanks for the info. Did you feel like your metabolism increased? Were you trying to lose weight or just doing it to feel better? If you were doing it to lose weight did you experience weight loss?

I started Cytomel to address the mind fog and fatigue, which was becoming debilitating. The weight issue was a nice benefit that I did not expect. I would never be considered fat, but have always struggled to maintain weight. I could easily gain 5 lbs in a weekend of eating/drinking and then it would take 2-3 weeks to lose it. Now (with the Cytomel) I don't put on the pounds as easily, and I find that I actually have to eat a little more each day to stop from losing weight.

 

[CROM]

Good to hear stories like yours. I have mind fog, RT30 and also gain weight just looking at food. I feel like doctors under dose me when I take Cytomel. Thanks for sharing.

 

[slicktop]

Just for reference, when I started cytomel through Defy, they sent me a weeks worth of 5mg, a weeks of 10mg, and then a bottle of 15mg caps to get me started, with instructions to titrate up to 25mg caps as required. I've stayed at 15mg so far but I have blood work due in a couple weeks and will increase to 20mg if needed.

 

[Vtail]

Just for reference, when I started cytomel through Defy, they sent me a weeks worth of 5mg, a weeks of 10mg, and then a bottle of 15mg caps to get me started, with instructions to titrate up to 25mg caps as required. I've stayed at 15mg so far but I have blood work due in a couple weeks and will increase to 20mg if needed.

Are you doing the extended release?

 

[slicktop]

Are you doing the extended release?

Compounded slow release liothyronine from Empower, yes.

 

[Vtail]

Compounded slow release liothyronine from Empower, yes.

That's what I started with. It worked great for about 6 months, then I started to feel fatigued in the early afternoons. It was as though I started to develop a tolerance to it, although my lab values remained consistent. So I asked the doc to switch me to Cytomel. I like the ability to split the dosage, and my energy level seems better throughout the day. I've now been on Cytomel for about 3 months, and so far so good.

 

[Cataceous]

My impression is that relatively low doses of 5-10 mcg have the advantage of contributing to natural production without shutting it down. Going higher basically means replacement of natural production and more danger in stopping suddenly, correct?

... they sent me a weeks worth of 5mg, a weeks of 10mg, and then a bottle of 15mg caps to get me started, with instructions to titrate up to 25mg caps as required. I've stayed at 15mg so far but I have blood work due in a couple weeks and will increase to 20mg if needed.

Maybe nobody would really think you mean "mg" rather then "mcg", but everyone should know the difference is potentially lethal.

 

[slicktop]

My impression is that relatively low doses of 5-10 mcg have the advantage of contributing to natural production without shutting it down. Going higher basically means replacement of natural production and more danger in stopping suddenly, correct?


Maybe nobody would really think you mean "mg" rather then "mcg", but everyone should know the difference is potentially lethal.

I honestly didn't even *realize* it was mcg instead of mg until you just said it! I had to go on the Empower site to check! That's a big ol' capsule absolutely full of something, I don't know what, to only hold 15mcg of medicine. Makes me wonder what all the filler is.

 

[TorontoTRT]

10 mcg daily brought my ft3 from borderline low normal to slightly above top range. It lowered my rt3 10 points. Lowered ft4 from 15 to 12. And TSH from 1.00 to 0.84.

 

[BuzzSaw]

Even though I had a full thyroid panel done a couple of years ago, it kept showing reasonably high levels of rT3 (causes unknown, as there are several possible reasons, ie anemic, low ferritin levels, stress, rapid weight loss can trigger high rT3, etc).

So I recently got hold of Cytomel T3 (came in 25 mcg tablets), and found that just taking 10 mcg really helped (any higher, and I ended up with strange symptoms). I've stopped taking it as I ran out (and had no funds to buy more).

Anyway, I've just done a full thyroid panel today so hope to see how my thyroid is doing.

 

[Vtail]

found that just taking 10 mcg really helped (any higher, and I ended up with strange symptoms).

Just curious - What sort of strange symptoms? I take 50 mcg/day and feel fine.

 

[BuzzSaw]

Just curious - What sort of strange symptoms? I take 50 mcg/day and feel fine.

Became a bit manic, and a bit spaced out.

 

[TorontoTRT]

Numbers will return to normal if you stop the Cytomel. I think half life is 18 hours.

 

[LakeGuy81]

I had an RT3 of 24.4 (9.2-24.1) on my last lab with Defy, but they didn't say to do anything or prescribe anything. Can anyone else describe symptoms and causes of high RT3? I am curious if I should dig into this issue further. I also recently had a slightly high T4 (Free) of 1.9 (.7-1.8) on a thyroid lab during my annual physical with GP. All other thyroid numbers have been in normal range, except I do have some antibodies as well (Hashimotos). I have not seen an endocrinologist yet, but have been thinking about it.

 

[CROM]

I had an RT3 of 24.4 (9.2-24.1) on my last lab with Defy, but they didn't say to do anything or prescribe anything. Can anyone else describe symptoms and causes of high RT3? I am curious if I should dig into this issue further. I also recently had a slightly high T4 (Free) of 1.9 (.7-1.8) on a thyroid lab during my annual physical with GP. All other thyroid numbers have been in normal range, except I do have some antibodies as well (Hashimotos). I have not seen an endocrinologist yet, but have been thinking about it.

I’m not sure if anyone knows the true role of RT3. It’s said that a low carb/low calorie diet (starvation diet) will elevate RT3. When RT3 is high the metabolism slows down.

Internet articles suggest that RT3 blocks T3 thyroid receptors and thus prevents T3 from speeding up the metabolism. So a few doctors prescribe Cytomel (T3) and this somehow lowers RT3. From my understanding the lower your RT3 goes the faster your metabolism is (or something to that effect).

A lot of people have claimed that lowering their RT3 using T3 made them feel much better overall, like increased energy. Bodybuilders have used T3 for decades to burn fat in preparation for a show.

Keep in mind that there are no peer-reviewed papers that prove RT3 slows the metabolism. I think I’ve read that chronic heart failure, stress and inflammation are other possible causes of high RT3.

 

[Vtail]

Can anyone else describe symptoms and causes of high RT3?

My primary reason for starting TRT was brain fog and low energy in the afternoons (I'm 56). TRT didn't do anything for that, although it did relieve alot of aches and pains I was having and physically I feel much better. But the continuing brain fog led me to testing for thyroid levels, and it turned out my RT3 was 24 and Free T3 was on the low side. My doc started me on T3 and almost immediately the brain fog lifted and my energy returned. So if I were you I would definitely keep digging. This site has a wealth of information on optimizing your thyroid levels.

 

[BuzzSaw]

@Vtail

Glad it worked out in the end!

I think that TRT docs are starting to see the link bewteen the thyroid and low T (one can mimic the other).

Slightly related, but the no 1 thyroid disorder (afaik) is Hashimotos (autoimmune disorder). I've always suspected that I have this, and now don't eat anything with gluten/dairy.

It's been over a week of this new diet, and it's difficult to describe the changes but it's quite positive. I urge anyone on here that suspects that they have some kind of autoimmune disorder to give it a try for a month and see how they get on.