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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Questionmark on January 31, 2005, at 6:39:40
My pdoc prescribed Cytomel (a synthetic version of the T3 thyroid hormone) to augment my Nardil a couple weeks ago. i am not very hopeful, especially since i have been skinny as heck all my life (i'm 5'11" & about 155 lbs) and really do not think i have any thyroid hormone deficiency or whatever-- and i would like to gain weight and definitely not lose any more.
i was prescribed 25mcg for 4 days and then 50mcg/day subsequently, but i think that is too much too fast (which is common for pdocs to do/prescribe, in my experience) and so have just been taking ~12.5mcg/day.. and then alternating between 12.5mcg and 25mcg per day. So far i have noticed increased physical energy and motivation, but also slightly increased nervousness/anxiety. My appetite has been ravenous at times, too, which is nice, but i just hope that my metabolism isn't more than counteracting that.
i don't really have any specific questions, but if anyone could give any advice or past experience with Cytomel or any good info, i would appreciate it.
Posted by Tabitha on January 31, 2005, at 12:44:12
In reply to Early Cytomel (T3) experience, posted by Questionmark on January 31, 2005, at 6:39:40
I had a really good response to adding 25 mcg cytomel-- better sleep, digestion, energy, clearer thinking, better mood, and it fixed the general bloat/fluid retention I've had for several years. I think I was probably deficient in the hormone, though my last bloodwork was normal.
Regarding the weight loss issue-- I've found it has increased my metabolism and my appetite proportionally. If anything I've gained a couple pounds. I generally gain a bit when I'm less depressed though, because I eat better when I feel good.
I think you're wise to go slowly with the dose. If I got anxiety and nervousness from it I'd probably stop there and wait to see if it resolved. I tried doubling my dose one day (from 25 mcg to 50 mcg) and I definitely didn't feel good on that high a dose.
Posted by Questionmark on January 31, 2005, at 17:30:53
In reply to Re: Early Cytomel (T3) experience, posted by Tabitha on January 31, 2005, at 12:44:12
Posted by Mark H. on January 31, 2005, at 18:34:10
In reply to Early Cytomel (T3) experience, posted by Questionmark on January 31, 2005, at 6:39:40
Q,
As usual, I agree with Tabitha. I've taken 25mcg of Cytomel daily (morning only) as an adjunctive for about 10 years now, and it definitely strengthens and improves the impact of my anti-depressant. I've tried phasing it out and felt lousy. I've tried doubling it but felt anxious and tight through the chest. Personally, I'd never take it at night, since it is mildly stimulating.
Use of Cytomel (in this context) is generally not for thyroid deficiency, but rather to potentiate the effect of other medications. Its use as an adjunctive in the treatment of depressive disorders is well documented and accepted. Not to worry.
I hope it works out as well for you as it has for me. Listen to your body. You'll arrive at the right dosage for you.
Best wishes,
Mark H.
Posted by Questionmark on January 31, 2005, at 20:44:54
In reply to Re: Early Cytomel (T3) experience, posted by Mark H. on January 31, 2005, at 18:34:10
Thanks for the reply. i'm not sure, but i guess i assumed that thyroid hormone is, for the most part, only beneficial [in depression] for those who had at LEAST a minor thyroid hormone deficiency. But you're saying that it has been shown to be a good augmenting agent for depression even if one is not hypothyroidal (okay i may have just made that word up) to any extent? That's great.
It's also encouraging to me that you have found it to be so helpful for so long and that you are male (i was concerned that it may be less efficacious in males for whatever reason). Tabitha's post was quite encouraging as well. All those positive effects with minimal side effects-- not bad.
How do you think Cytomel has impacted your weight (and ability to gain or lose weight) over the years? Have you also found that it has seemed to have increased your "metabolism and appetite proportionally" (as Tabitha said)? Do you think i will be more likely to gain or lose weight from it (at 25mcg/day)?
Finally, does either of you (or anyone else) know if Cytomel is at all likely to cause withdrawal symptoms upon cessation-- and whether it can alter the activity of the thyroid gland permanently or long-term?
Thanks a lot, i appreciate it.
> Q,
>
> As usual, I agree with Tabitha. I've taken 25mcg of Cytomel daily (morning only) as an adjunctive for about 10 years now, and it definitely strengthens and improves the impact of my anti-depressant. I've tried phasing it out and felt lousy. I've tried doubling it but felt anxious and tight through the chest. Personally, I'd never take it at night, since it is mildly stimulating.
>
> Use of Cytomel (in this context) is generally not for thyroid deficiency, but rather to potentiate the effect of other medications. Its use as an adjunctive in the treatment of depressive disorders is well documented and accepted. Not to worry.
>
> I hope it works out as well for you as it has for me. Listen to your body. You'll arrive at the right dosage for you.
>
> Best wishes,
>
> Mark H.
Posted by Mark H. on February 1, 2005, at 18:20:44
In reply to Re: Early Cytomel (T3) experience » Mark H., posted by Questionmark on January 31, 2005, at 20:44:54
Hi Q,
I'm no expert, but I think Cytomel's augmenting effect will likely increase your appetite, depending on what else you're taking with it. I've gained about 40 pounds in the last six years (I was also very thin for most of my adult life). So the increase in metabolism has not offset the increase in appetite for me.
Cytomel (like everything we take for depression) is serious medicine. See this link for more information about it:
http://www.drugs.com/PDR/Cytomel_Tablets.html
I don't know whether Cytomel alters thyroid production in the long term, but I suspect it might. I don't think cessation causes withdrawal symptoms per se, but if you feel better while taking it, you might feel less well when you don't.
Speaking strictly for myself, I've come to terms with the fact that I'll likely be on all my meds for the rest of my life, so I'm not concerned with discontinuation.
I hope others will chime in with their experiences as well.
Best wishes,
Mark H.
Posted by Maxime on February 1, 2005, at 19:42:21
In reply to Re: Early Cytomel (T3) experience » Questionmark, posted by Mark H. on February 1, 2005, at 18:20:44
T3 should DECREASE your appetite and you should lose weight on it. It is prescribed when you are hypothyroid which means your thryoid is not producing enough of the hormone. I am hypothyroid and I have to take synthroid which is T4 and the body is suppose to convert it to T3 thus speeding up the metabolism.
I'm in the proper range now thyroid wise, but I have yet to lose the weight I gained from being hypothyroid.
Maxime
Posted by Questionmark on February 3, 2005, at 15:59:17
In reply to Re: Early Cytomel (T3) experience » Questionmark, posted by Mark H. on February 1, 2005, at 18:20:44
From Mark H:
> Hi Q,
>
> I'm no expert, but I think Cytomel's augmenting effect will likely increase your appetite, depending on what else you're taking with it. I've gained about 40 pounds in the last six years (I was also very thin for most of my adult life).(Woah! Yes! That's encouraging. Man, i hope it works that way for me. .. How early on after starting Cytomel did you start to gain weight, and how much?)
> So the increase in metabolism has not offset the increase in appetite for me.
>
> Cytomel (like everything we take for depression) is serious medicine. See this link for more information about it:
>
> http://www.drugs.com/PDR/Cytomel_Tablets.html
>
> I don't know whether Cytomel alters thyroid production in the long term, but I suspect it might. I don't think cessation causes withdrawal symptoms per se, but if you feel better while taking it, you might feel less well when you don't.
>
> Speaking strictly for myself, I've come to terms with the fact that I'll likely be on all my meds for the rest of my life, so I'm not concerned with discontinuation.
>
> I hope others will chime in with their experiences as well.
>
> Best wishes,
>
> Mark H.Thanks Mark.
From Maxime:
"T3 should DECREASE your appetite and you should lose weight on it. It is prescribed when you are hypothyroid which means your thryoid is not producing enough of the hormone. I am hypothyroid and I have to take synthroid which is T4 and the body is suppose to convert it to T3 thus speeding up the metabolism.I'm in the proper range now thyroid wise, but I have yet to lose the weight I gained from being hypothyroid.
Maxime"
Yeah, i knew that the thyroid hormones are prescribed when one has hypothyroidism, and i knew that they increase one's metabolism significantly. But i wasn't sure whether taking one of them (especially for someone who is not hypo- or hyperthyroid or overweight-- such as myself, who is just taking it for depression augmentation) would increase or decrease one's appetite. i wasn't sure because my aunt-- and many others i believe-- who had hyperthyroidism had a raging appetite (though still stayed very slim), and i thought that those with hyPO- often have a tendency to be overweight though still not have a very strong appetite. Is this the case?
Good luck with that though. And thanks for replying.
Posted by Mark H. on February 3, 2005, at 19:36:13
In reply to Re: Early Cytomel (T3) experience, posted by Questionmark on February 3, 2005, at 15:59:17
> > (Woah! Yes! That's encouraging. Man, i hope it works that way for me. .. How early on after starting Cytomel did you start to gain weight, and how much?)
Hi Q,
I think the weight gain I experienced was due to the fact that I'm taking Effexor (and later added a bit of Zyprexa), both of which seem to increase appetite for me. The T3 augmentation has just made them more effective -- instead of taking 375mg of Effexor a day (which I tried for a year back in 1994), I only have to take 150mg a day but with the same anti-depressant benefit.
I guess I should note that I'm also augmenting with pindolol (a beta-blocker) and methylphenidate ("Ritalin," a stimulant), because I was having trouble staying awake during the day. The combination of all of the above turned my depression around, and I started gaining about 10 pounds a year, which is not too bad.
I'm sorry I don't know much about Nardil. If it increases your appetite, then I think it is likely that the Cytomel will increase it more so. Of course Maxime is right that if you took a lot of T3, you'd tend to lose weight, but I don't think that's an issue at 25mcg a day.
I really know what you mean, Q. In 1997, before starting the above regimen, I was struggling with my meds and got really bad flu at the same time, and my weight went down to 135 pounds (at 6 foot 3). It was such a relief to finally find the right combination of meds and gain some weight. I've been stable for the past year or two at 190 pounds without doing anything different, and now I'd actually like to lose about 25 pounds. (I still eat a pint of Ben & Jerry's every day.)
Good luck to you!
Mark H.
Posted by Maxime on February 4, 2005, at 22:21:17
In reply to Re: Early Cytomel (T3) experience, posted by Questionmark on February 3, 2005, at 15:59:17
Yes, I am having a hard time losing the weight I gained from being hypo and I hardly eat anything at all. It certainly hasn't helped my anorexic tendencies. I already have severe body image problems. The extra weight makes me restrict even more and yet the weight stays. I am a "mental mess".
Maxime
>
> Yeah, i knew that the thyroid hormones are prescribed when one has hypothyroidism, and i knew that they increase one's metabolism significantly. But i wasn't sure whether taking one of them (especially for someone who is not hypo- or hyperthyroid or overweight-- such as myself, who is just taking it for depression augmentation) would increase or decrease one's appetite. i wasn't sure because my aunt-- and many others i believe-- who had hyperthyroidism had a raging appetite (though still stayed very slim), and i thought that those with hyPO- often have a tendency to be overweight though still not have a very strong appetite. Is this the case?
> Good luck with that though. And thanks for replying.
Posted by Questionmark on February 6, 2005, at 0:40:54
In reply to Re: Early Cytomel (T3) experience, posted by Mark H. on February 3, 2005, at 19:36:13
> Hi Q,
>
> I think the weight gain I experienced was due to the fact that I'm taking Effexor (and later added a bit of Zyprexa), both of which seem to increase appetite for me. The T3 augmentation has just made them more effective -- instead of taking 375mg of Effexor a day (which I tried for a year back in 1994), I only have to take 150mg a day but with the same anti-depressant benefit.
>
> I guess I should note that I'm also augmenting with pindolol (a beta-blocker) and methylphenidate ("Ritalin," a stimulant), because I was having trouble staying awake during the day. The combination of all of the above turned my depression around, and I started gaining about 10 pounds a year, which is not too bad.
>--- Oh, that makes a little more sense in that you were on Effexor and, especially Zyprexa. What dose of Zyprexa were you on and for how long (if you don't mind answering these redundant questions)?
That's great that you were able to lower your Effexor dose so much when you got on the T3 though. Can i also ask what your doses & regimen of pindolol and methylphenidate are? That's interesting your on the latter, too, since that totally kills my appetite (and many others').
> I'm sorry I don't know much about Nardil. If it increases your appetite, then I think it is likely that the Cytomel will increase it more so.--- Awesome.
> Of course Maxime is right that if you took a lot of T3, you'd tend to lose weight, but I don't think that's an issue at 25mcg a day.
>Right. Okay, good. i hope not.
> I really know what you mean, Q. In 1997, before starting the above regimen, I was struggling with my meds and got really bad flu at the same time, and my weight went down to 135 pounds (at 6 foot 3). It was such a relief to finally find the right combination of meds and gain some weight.
--- Ouch. Yeah, i bet. That's great though.
> I've been stable for the past year or two at 190 pounds without doing anything different, and now I'd actually like to lose about 25 pounds. (I still eat a pint of Ben & Jerry's every day.)
>Wow, that's excellent. What a great med combo you found for yourself.
> Good luck to you!
>
> Mark H.Thanks again. i hope your good fortune continues-- as it certainly sounds like it will.
Posted by Mark H. on February 7, 2005, at 10:35:10
In reply to Re: Early Cytomel (T3) experience » Mark H., posted by Questionmark on February 6, 2005, at 0:40:54
Hi Q,
Here's my current regimen, which has remained unchanged for about the last three years:
Morning:
Cytomel 25 mcg
pindolol 2.5 mg
methylphenidate 40 mg
Effexor 150 mgEvening:
Zyprexa 2.5 mg
clonazepam 0.25 mg
pindolol 5 mgOver the last 7-1/2 years, I've needed to gradually increase the methylphenidate from an inital dosage of 5 mg to the current prescribed level of 40 to 60 mg a day (usually 40 mg).
I started taking 5 mg of Zyprexa during a particularly agitated hypomanic period a few years ago. I liked its overall effect on my mood, but I felt a bit fuzzy during the day at that level, so I reduced it to 2.5 mg, which feels just right for me.
My diagnosis is bipolar II. I no longer experience hypomania, but my depression deepens significantly twice a year, so I'm still on a cycle. The medication regimen keeps me functional and enables me to hold down a good job.
I hope you find just the right combination for you! Thanks for your interest.
With warm regards,
Mark H.
Posted by Questionmark on February 9, 2005, at 22:47:31
In reply to Re: Early Cytomel (T3) experience » Questionmark, posted by Mark H. on February 7, 2005, at 10:35:10
This is the end of the thread.
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