Timing of exercise around Cytomel dosing?

Can_Do_Gal

Hi, I'm new. I was diagnosed with thyroid cancer 3 years ago, and had my thyroid out & radiation. So far the cancer part is going well - clean scans, etc. The replacement hormones, OTOH - yeesh! It's taken these 3 years to find a balance of meds where I feel halfway decent. I'm on my 4th endocrinologist, and thankfully he's amazing. I'm grateful he's willing to do the very non-typical things my body seems to need. Still, we've discussed lately that it looks likely that with today's medicine, I'm never going to be 100% again. At least I'm finally feeling up to doing something about the pounds I packed on while crazy hypo, though.

I must be the world's worst converter because even on Armour my Free T4 had to be too high to get my Free T3 high enough for me to function. So I'm back on separate T4 & T3. I take A LOT of Cytomel, and I'm wondering if I should time my workouts so it's "kicked in?" I'd like to get back to swimming, but for now thought I'd dust off the exercise bike. Although it would be convenient to exercise in that hour I'm waiting to eat breakfast after taking my T4 (and morning Cytomel), I'm wondering if that's a bad idea? I plan to ask my endo, too.

Fuzzipeg

My commiserations, anyone who has your issues do seem to have a bad time of it.

I don't know if you might find "Recovering with T3" by Paul Robinson helpful. He is writing from a Hashi point of view. He found he did better when he took his t3 as several doses spread through the day. He found slow release did nothing for him because it gave a flat level had his body responded to "regular" higher levels. He started his meds early to engage with his circadian rhythms. He likened the body's use of t3 as being, "like a stronger wave hitting the sea wall and splashing over", providing the impetus.

Our bodies are all different with our individual expressions of thyroid related problems. Is it possible you have and issues with your adrenal being "fatigued"? T4 to t3 conversion has so many points at which there can be issues. I have read those with Lyme's disease probably have conversion issues, relatively new information. Vit D deficiency, selenium even zink deficiency can be a problem, Finding good information relating to you alone is hard.

I'm pleased you have an endo who wants to work with you. All the best.

editorgrrl

Can_Do_Gal wrote: »

I take A LOT of Cytomel, and I'm wondering if I should time my workouts so it's "kicked in?"

Although it would be convenient to exercise in that hour I'm waiting to eat breakfast after taking my T4 (and morning Cytomel), I'm wondering if that's a bad idea? I plan to ask my endo, too.

My endocrinologist gave me zero guidance about exercise—just food & frequency. Cytomel has a short half-life, so it must be taken several times a day. (He wanted three, but we compromised on two.) You need to take it on an empty stomach, then wait at least half an hour before eating or drinking anything but water.

I don't think it matters when you exercise, but definitely ask your endo.

slieber

I exercise quite heavily. I get up in the middle of the night and take a combination of Synthroid and Cytomel. The Cytomel I take a middle of night is 50 MCG. My next dose is scheduled for around three or four in the afternoon. For the past several weeks, I have had a two hour ballet class every other day from 1:30 to 3:30 PM. I find that if I have a cup of coffee before class, I am fine until the end of class or close to the end of class. I usually take my next dose of Cytomel at about 3:30 to 4 PM, after class,nand I'm pretty good for the rest of the day. My dose on the second time is 100 MCG. I did try to break it up taking half before class and half after but that actually backfired. I have started taking Rhodiola before class as well and that does help. I do the same when I do my gym workouts. Those are done on the days I'm not in ballet class mostly.

Can_Do_Gal

Sorry for being rude & not replying. You guys gave me such great advice, but my teenagers have been hogging the computer & it wasn't possible to reply on my phone.

I should probably pick up "Recovering with T3" - I feel like I've read everything else. I'm confused about what slow release T3 he talks about, though. The only long acting T3 I'm aware of should be on the market in the next 6-12 months and I'm excited about it. The dips are a real problem for me, and it's a pain to dose 2x/day. I tested my adrenals last year, and had some issues but not as huge as I expected. Giving up (a lot of) coffee completely should have solved my mild high cortisol. I definitely don't have Lyme disease - have tested that, too. And I religiously take selenium, Vit D, etc.

According to my endo, while T4 needs to be taken on an empty stomach, Cytomel doesn't have the same absorbtion issues. He told me not to worry about it. I haven't noticed a difference in my levels.

Slieber, I've never met anyone on as much Cytomel as me, let alone more. I've tried Rhodiola, and I agree it does help. Thanks for the info on your exercise & Cytomel. For now, I've been swimming later in the day so I've got Cytomel in me. Maybe I'll just experiment and go first thing.

slieber

Just for reference, today I had a two hour delay class. In that class about halfway through, I had to take one half of my Cytomel dose. I took the other half of the dose after class. I did make it through. It wasn't easy. I also took the Rhodiola before class.

I was mistaken in the MCG though. Apparently, if you check the bottle, it's really 5 to 10 mcg of the Cytomel. So I take a total of 15 mcg per day, in addition to synthroid. My doc said the same thing about the T3 absorption.

Fuzzipeg

It seems sustained release t3 may only be available from a compounder at the moment. I have seen references to it from 2009 here in the UK but it needs, like most things, to be imported by someone who treats to need rather than NHS Dictate. The were comments about it not fluctuating with the normal cycle of use. Possibly a background supplemented level for some may achieve the required peeks only if the patient is able to produce enough t3 of their own in this situation.

Differentiated, separate doses method is probably better able to replicate this cycle. Its what suits someone best. T3 only can work for people like Paul Robinson.

Can_Do_Gal

Slieber, that makes a lot more sense. I thought I'd heard that 100 mcg was the absolute highest allowed dose, at least in the US. I was honestly wondering why you hadn't had a heart attack. I'm scratching my head wondering what could be done about your situation, too. So frustrating that it's hard to make it through a class. I'm just starting back exercising, so I'm only up to swimming 30 minutes a day so far. I'm hoping I don't have issues when I start pushing harder. I do produce some T3 on my own, was at 2.2 or so before Cytomel. I just seem to need to be near the top of the range - I was nonfunctional at that level.

Fuzzipeg, elsewhere online I've encountered people who are in a final trial of an extended release T3 here in the US. Last I heard, it is expected to be released in 6 or so months. That doesn't help you with the NHS, of course. It's not easy to get T3 here in the US, either. But at least once you manage to find an endo who "believes" in T3 (eye roll), they are allowed to prescribe it.

editorgrrl

Can_Do_Gal wrote: »

It's not easy to get T3 here in the US, either. But at least once you manage to find an endo who "believes" in T3 (eye roll), they are allowed to prescribe it.

I'm in the US. It took me a year & a half to persuade my endocrinologist to give me Cytomel—even though my T3 was really low. (When I first asked about it, he snapped, "Who have you been talking to?!")

Can_Do_Gal wrote: »

According to my endo, while T4 needs to be taken on an empty stomach, Cytomel doesn't have the same absorbtion issues. He told me not to worry about it. I haven't noticed a difference in my levels.

My endocrinologist gave me no instructions, so I took the first dose with my Synthroid and the second whenever. When he found out, he said I had to follow the same protocol—empty stomach + wait 30–60 minutes before eating or drinking anything but water. All that fasting was really difficult for me, so he eventually said I could wait 15 minutes after taking it—but it still has to be on an empty stomach. (I take 15mcg, if that makes any difference.)

Fuzzipeg

I've given up hope of any real help from the NHS. I've had enough of the tinnitus, chemical and salicylate sensitivity and the 101 other health issues I have. I have already stated my intention to seek my own salvation by what ever means. I was assured by an eminent Professor of immunology that my symptoms are consistent with long and untreated hypothyroidism. Using funds from my house, I'm now following up amalgam replacements with more sustained success than with any increment in t4. In parallel I consulted a Nutritionist in the hope of discovering the perfect supplements for myself and discovered so much more was available through her.

I'm throwing so much at this, I've only ever wanted to be really well. We will provide my NHS doctor and Endo all the test results we obtain and the opportunity to treat anything we can't address with supplements and anything more in her arsenal, more dietary changes added to those I've already made to achieve the health I currently have. If they don't take me seriously! I go the private road, I've already defined it. Then when I have my health sorted, and can move freely in public places without fear of being ill. I make a complaint through the Patient Liaison Service and more. Its the pits that as individuals we have to resort to this because there is a conspiracy supporting malevolent mistreatment of all thyroid patients from the top, diagnosed and those refused investigations as I was for years. I'm so very very angry.