Will Tirosint or Cytomel help joint/muscle pain?

Hi friends -

I have been suffering from increasing joint and muscle pain (5 mos. post TT), and am considering asking to switch from Synthroid to Tirosint. However, my research turns up joint and muscle pain with Tirosint, too. In fact, "arthralgia" (joint pain) etc, seems to be a side effect of replacement/suppression in general, from levothyroxine.

Still, I like that Tirosint is supposed to be absorbed better, since I'm celiac and always on the edge digestion wise. No dyes or fillers appeals to me, too.

Assuming there's no brand that will be better, could this be a low Free T3 problem, or do we just suck it up because it's inescapable with suppression? Still waiting for a doctor to test my Free T3 - they say they have to send it out to a far away lab, blah blah, and it never comes back... :(

Has anyone had improvement with muscle and joint pain with Cytomel? If so, I will ask for that, too.



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While I don't think it is a low T3 symptom, I'm not really sure. Hypo is hypo, and that includes being T3 hypo. And joint pain is a symptom of being hypo.

But having said that, I will say that Synthroid greatly increased all kinds of muscle and joint pain in me. A week after going off Synthroid my pain was better and it continued to improve over the next month on another T4 with fewer "fillers." I would suspect the Synthroid first. A T3 issue would just be added insult.

As for Tirosint, you won't know until you try it and have been on it for at least 2 months. I could not tolerate it because of a persistent burning in the gut. But from what I've read, that is one of the less common side effects. Once it starts, though, it won't stop.

To be blunt, your doctor is lying. He is putting you off. If he were to ever really run a T3 on you, he would likely try to sneak a Total T3 by you, which will not tell you what you need to know about your body and conversion. Free T3 is a simple test and is run all the time by LabCorp with my fT4 and TSH. If you have time, money and the inclination, I would try a walk-in lab. It could be money well spent.

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Thanks, Cabro.

Walk in lab idea is a new concept for me, but I'll look for one. Not the same as Med Express, a walk in ER type place? Did get Total T3, when I asked for Free. It measured very low, but what to do with that info?! Geez.

Hate to start a meds merry go round if it's not going to work out anyway. (Sigh)

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In my state, those labs tend to be free standing buildings with a big sign, "Any Lab Test" beside their name. I'm not surprised you got the Total T3. It is a runaround and means your doctor doesn't understand T3. :-/ Good luck.

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I've been having joint and muscle pain too. Just mailed away for my 1st generic supply of t3/cytomel. To take 5mcg 2 a day. Hoping it will help me feel less fatigued and achey. More like myself. Time will tell. Good luck to everyone. I'm still on synthroid and looking for an endo too.

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Most likely joint pain and the like is a high Free t4 issue rather than a pure low Free t3 issue. High Free t4 is what endo's often feel they like to do because it suppresses the TSH and requires no followup visits. Unfortunately it leaves a person sick, and some more than others. I would not advise that method to anyone at all, and I suspect most physicians who have had thyca will know that is not a good method to get results on TSH suppression at same time as feeling well.

Take a look at your Free t's

If the Free t4 is 1.4 or 1.5 and over (US labs) you can gets lots of cramps, mood irritability and short temper, headache, body pain.

If the Free t3 is less than low 3's you will have lack of focus and attention, tiredness, hair issues, skin issues, and much more.

Also vitamins play into it, get the D up to 70, B-12 up to 800, iron up to 90 (female) or over 100 (male). Cortisol also plays a role.

@Luc8212012 Just be aware that generic T3 for me is a full 30% less effective at boosting my Free t3, it is that poor. You can take more or for lots more money buy the real cytomel for full effect. 10 mcg of generic t3 is about like say 7 mcg of real cytomel.

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Maybe that's why they gave me generic when I asked for brand.... Hoping new endo on 11/8 will listen. My free T4 was flagged high for the 1st time. I also have had further declines in health. Issues I've never had previously, before TT. Now I also have exhaustion, fatigue, brain fog, severe obstructive sleep apnea, . chest pains, palpitations, high blood pressure readings and fasting blood sugar has been on an upward trend. Most recently 5.8 glycohgb a1c and 133 fbs. Wearing a halter monitor and going for an echocardiogram and stress test tomorrow. CPAP machine coming Sat.

Ugh.... Wish there was no cancer, good or bad, and we all still had healthy thyroid glands.

Sorry, just so tired of it all.

Hoping I can start feeling better with adding T3 and lowering T4 and exercising, drop some weight and improve overall health status.

All the best to you and yours.

Thanks to all. I love you guys and gals and appreciate all your input, advice, etc.


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Luc - hope you start feeling better soon. Sounds like you have a lot going on with your health. It seems we are all bound to struggle now. I hope you can get to the bottom of your new issues and enjoy a healthier, happier future.

Thanks for the info, Biomed- i know you have to repeat info all the time, but it helps to hear about thses things in our own context. High Free T4 makes sense, my last test was high, and my dose was increased since then. So, if I can ever get both FreeT3 and FreeT4 done, maybe I'll see the whole picture. Perhaps lowering the T4 and adding Cytomel in the future will help.

One general question - how long should we wait to see if issues settle out or rebalance on their own? Or do they generally just keep going or get worse? I just wonder if I should wait, say 3 months, to see if my body adjusts, or am I just going to damage my body (nerves, joints, general pain/stress, etc).

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Hi, Everyone, Just reporting my experience which might be helpful in your search for health. My experience also supports what BioMedEE has said above. Last month, MD adjusted (lowered) my Armour Thyroid from 90 mg to 60 mg daily and added Cytomel 12.5 mg daily. Within 2 weeks, my joint aches and muscle cramping were GONE! In that same time frame, I also completed some online reading and found Dr. James Wilson, DC, ND in AZ and Dr. David Brownstein, MD, ND, Canada to recommend intervention for the triangular association between the 1) thyroid gland, 2) kidneys/adrenal glands (which sit on top of the kidneys) and the 3) gonads (prostate, uterus, ovaries). I started taking Dr. Brownstein's Thyroid Support which has adrenal glandular supplementation, iodine and other ingredients to support the thyroid. I have found my energy levels are improved and sleeping better and dreaming which I haven't remembered doing in years! I was already taking Vitamin D3, MD prescribed bio-identical hormone replacement and take 1/2 serving of either Garden of Life RAW meal (organic meal supplement with 100% of daily requirements) with 2 tsp. Chlorella and 2 tsp. Spirulina OR 1/2 serving of End Fatigue by Dr. Teitlebaum, specifically designed for chronic fatigue associated with low thyroid. Either works well for me. Gluten free (wheat free) and Dairy free diets has really improved energy and reduced brain fog for me. I get plenty of fresh, raw vegetables in daily with some fruits, fish and lean meats and usually brown rice or GF, homemade products. As an FYI side note, companies use bromine in the production process of wheat which creates a serious problem for low thyroid patients. Bromine- replaces Iodine- at the cellular level and creates iodine depletion and the t3 cannot "dock" on the cell. BioMedEE might be a better resource on that cellular level process than me; but, that's the short of it. Many thanks especially to BioMedEE for his insights and willingness to share his knowledge. Good luck to all for better health and I will be keeping you in my prayers. Making small changes over time=improved health. All the best!

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Wow - fascinating. PatriciaRN! I will look into those. Doing all with my diet that you are, and I figure that's the baseline of health. Now to learn more about the triangle, additional support. etc. Thank you. Have had very serious uterus and ovary issues, and have wondered about the connection. I think it's time to appreciate and coddle the poor old adrenals. Don't know anything about them!

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My endo is very open-minded but he will not prescribe Cytomel with Armour or other NDT. He said there is a risk of T3 overdose that he isn't willing to take. I hope you continue to do well.

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Zheni, Consider asking your health practitioner, MD to do a blood work panel to check your female hormone level. There are medical studies that demonstrate that women on bio-identical hormone replacement have lower incidence of uterine and breast cancer than the control group on no replacement therapy. Synthetic hormone replacement has risks for a higher incidence of breast and uterine cancers. One reliable test for the adrenal glands is the saliva test for cortisol levels over a 24 hour period as opposed to the cortisol blood test. That is the one my MD preferred. The triangle between the thyroid, adrenals/kidneys and gonads is well documented. I even found that association in my pathophysiology books from graduate studies in nursing though there was no clinical intervention described. Clinical treatment options will continue to emerge as more practitioners become familiar with care in this area. Thanks Cabro. I go in next week for my first round of blood work on Armour Thyroid and Cytomel. I am interested to see the results.

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Thanks everyone. Patricia, please let us know how your levels are once your results are in.

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Hi, Luc8212012, I was reading this a.m. in "Overcoming Thyroid Disorders" by David Brownstein, MD about the use of Cytomel, t3. Cytomel is a rapidly absorbed substance with an almost 95% absorption rate which can cause a "roller coaster" effect and precipitate symptoms of anxiety, palpitations, tachycardia followed by fatigue. Compounded, slow release preparations in low doses are found to be much more effective and easier to tolerate than Cytomel if symptoms arise. Cytomel is effective to improve symptoms of depression, mood and cognitive performance. It is also recommended that Adrenal function studies precede Cytomel and Thyroid supplementation. I will let you know after I visit with my MD in November. All the best!

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Great. Thanks again!

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Hi, Everyone and Happy Holidays to all! Just following up about my blood work and MD visit in November. After taking Cytomel for 3 months, my t3 levels were perfectly in range and my reverse t3 was very low in the normal range. No trouble with Adrenal burn-out with the Actinal, an adrenal glandular support product by Dr. David Brownstein. Sleeping well, no panic or anxiety attacks as reported by others. I feel well and am blessed. No brain fog or fatigue and more energy than I have experienced in 14 years. Probably, one of the benefits I like best, is that my exercise tolerance has improved 3-4 fold! Before Cytomel with the Adrenal Support, I could not maintain any exercise regimen without a rapid decline in a few days. I wear an SparkPeople.com activity tracker that measures the step, distance and time I exercise aerobically on a daily basis and downloads via jump drive to my computer. The reports show a daily, weekly, monthly basis my levels of exertion, calories burned, wellness goals met, etc. Adding Cytomel with Actinal has been a real break though for my health. I am most grateful and appreciate the input provided by many very caring people on this site. All the best to you and may you be blessed with good health.

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I forgot to mention that the joint pain and muscle spasms are significantly improved after 1 month on Cytomel with Actinal, an Adrenal Support. That was a welcome effect I was not expecting.

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I'm feeling better after reducing synthroid and adding the generic cytomel 5mcg twice a day. Go for labs in Feb. The only thing is that the right side of my neck sometimes aches. Thanks for all the great information PatriciaRN! I'm so glad you are doing so well and have shared what is working for us to try if/when we're ready. Xoxo

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