T Nation

Stay on Cytomel or Taper Off?


Age: 32
Height: 5’8
Weight: 180-185
Estimated body fat 10-12%

Have not been on tnation in a while, so hopefully I am on the right forum here. Thanks for any input.
Approximately 32 year old male here, have been on Cytomel 25mcg for approx. two years. Was prescribed (I believe) for a non-primary hypothyroidism, primary depression/anxiety, as well as for general metabolic boost, as well as energy, mental focus etc.

I was never diagnosed with hypo, but TSH had been perhaps as high as low 3’s, (I cannot recall at the moment, but can search for bloodwork for you fellas).

After being on it for a bit and getting regular bloodwork though the psych/endo/functional guy who had RX’d (he was all three), I know my TSH had dropped a fair bit, maybe as low as into the mid 1’s.

At one point I was prescribed and tried levothyroxine as well (cannot remember dosage), but it made me quite amped up and I stopped taking it. At times the cytomel did the same, but I got used to it (was on Fluoxetine for much of the same time period, so that lowered the anxiety).

Currently I’m not taking any RXs other than the occasional xanax, ativan, and atenolol (all taken relatively rarely).

I am trying to determine whether or not I can / should lower the cytomel dose as I am no longer seeing the functional doc and my doc in town says if I am going to continue on cytomel i should get my TSH etc. levels tested as he believes 25mcg is a high dose of T3. (I’m not sure I think he’s right btw).

I am in between insurance coverages and as such I’m trying to determine whether or not it’s safe to continue on cytomel, or I should just taper right down. I have been taking 15mcg for the past week or so and have been generally inconsistent with my dosing. Part of this is being absent minded and part of it is deliberate: the prescription is expensive now that I don’t have insurance and the doc saying I should get my blood work done has concerned me a bit.

Basically I don’t want to destroy my thyroid by continuing on, but I also don’t want to taper off this stuff if it’s going to wreck me further unless I’m doing under doctor supervision. Also have a nasty anxiety disorder that’s currently not being well controlled with fluoxetine so I’m hyper concerned about detrimental mental effects of continuing (or not) the cytomel - at least until I can get a new doc and new blood work, which will probably be another couple months on at this point.

Any input on how I should proceed, or anything I should be aware of is helpful. Thanks.


Please follow these links in 2nd post of 1st forum topic:

  • advice for new guys
  • thyroid basics explained

Please get a good oral thermometer and use body temperatures as a dosing guide.

If you get cold it can be:

  • not enough T3 in your system
  • taper too fast and natural production has not kicked in or can’t

What is your history of [not]using iodized salt and/or vitamins that list iodine+selenium?

Thyroid labs:
TSH should be closer to 1.0
T3, T4, fT3, fT4 should be near midrange or a bit higher

fT3 is what gets the job done.
If fT3 is low, or getting blocked by rT3, you will notice a lower energy level and some loss of mental clarity.


Thanks for reply Ksman. You have commented on a couple of my other posts in the past and really know your stuff.

For you or anyone else:

I was supplementing with selenium for quite some time, up until a couple of months ago. Intention is to start again and / or add Brazil nuts.

Tried an iodine supplement briefly (will confirm name when I can take a look). Was never on it consistently but the doctor had prescribed it in conjunction with the T3. I thought I had some sort of reaction to it (increase puffiness?) which is why I stopped.

Have not done AM oral temp in some time but I will take a look. I think that had slowly improved over time with supplements and T3, up from a somewhat low waking number.

Typically take plenty of B12 (2000mcg sublingual)

I am currently taking 15mcg of the T3 (dropped down from 25mcg on my own with no taper a couple months ago). Thinking of continuing to take indefinitely or at least until I can get reinsured and get blood work.

Can tapering off this be done safely? Is it relatively safe to stay on it indefinitely?

(I have currently not noticed any major difference coming down from 25 to 15. If anything I felt too stimulated on 25mcg)


Can cytomel be successfully tapered off, assuming one has not had their thyroid removed? Is the “natural shut down myth” really a myth?

I have noticed a harder time losing weight since going from 25 to 15mcg, but have not noticed much in the way of other symptoms. Looking to get a little more feedback before returning to the physician - or, potentially, going it alone.


You can only try and see.

As for your trying to find the right dose, body temperature might have been the best thing to use as a guide.

Were you using time release T3 or fast acting?


PERRIGO Liothyronine, generic for Cytomel, 5mcg is the prescription I have been taking. I believe (assume) it is not time release as it seems to hit me pretty fast (within minutes) and there is no indication on the label that says otherwise.

I did try to go off the prescription back in November, dropping from 25mcg to zero, for a span of a week to a week and a half and did notice some drop off in energy levels and some pronounced mood changes, although I’m not sure if either were truly due to the withdrawal…

Other than monitoring body temp, and (I’m assuming) paying attention to energy levels, is there anything else I can use to get a read on general health if I continue to taper down from 15mcg (or even just decide to sit at this dose for a while)?

Thanks KSman or anyone else for input


Your energy levels and alertness are good guide, but those can vary anyways. Body temperatures are a good second measure.


Just my two cents, but 25mcg is enough T3 for what a person who has had their thyroid removed would take. I have Hashimoto’s and I know thyroid. How long have you been taking the Cytomel? The thyroid gland is like any other gland. You start supplementing to the point where you suppress your TSH for a long period of time, you thyroid gland stops producing, just like testes would if you supplemented with enough testosterone.

I put a post out here earlier hoping to get a response, and still have not. I take these sites with a grain of salt. Just curious, are you a bodybuilder? I know bodybuilders (not all) take huge amounts of Cytomel because Cytomel is pure T3, which is the active thyroid hormone. Levothyroxine is T4, and your body converts T4 to T3 as it needs too. If your labs show TSH of 6.1, yes, that would be considered for treatment by an endo. And your endo would not give you Cytomel or T3. He’d give you T4 such as Synthroid, Tirosint, Levoxyl. Your given T3 for really two reasons…if you have issues where you cannot properly convert T4 into T3 (which is rare), or after you have had a thyroidectomy. Whats amazing is that you are taking straight T3 (25mcg) and still show a high TSH. I’m not certain why, but my guess is your FT4 is low, and so your brain secretes TSH (thyroid stimulating hormone) to tell your thyroid to make more hormone…T4! Not T3. Your body takes the T4 and converts into T3 for use. If you have too much in your system, you body, the T3 is converted into RT3 (reverse T3) which then causes a problem for your cells because the RT3 attaches to the T3 receptors and can’t let any in.

Selenium is used for one thing…the conversion of T4 to T3. It has nothing to do with T3 getting into your cells as far as I know. But I’ll defer to Ksman.

I think you really need to find out if you are truly hypothyroid. And the ONLY way to do that is stop taking any thyroid meds for 12 weeks. T3 leaves your system in a hurry, maybe two days at most. But T4 stays in your system for weeks…it has a half life of 7 days…so do the math. 12 weeks is a good number. Then have your blood tested and get TSH, FT3, FT4, Total T4, Total T3. And while you are at it, asked to be tested for thyroid anti-bodies. If they are over 35, you have Hashimoto’s and your body is destroying your thyroid. Your next question will be…“How can I stop that from happening”. The answer is you can’t…you can only manage it…your thyroid is dying. Thyroid issues are super genetic…so if your mom or dad has it, very highly likely you will get it.

You need injections. All this crap about how to administer it in my opinion is complete bullshit! Injections work…and most docs want to inject. I know guys who actually needed it, and it was like night and day. Afraid of needles? Get over it…it’s a needle. Patches, pellets, creams, gels? That’s just companies trying to market a new way of administering something that docs have been doing for years.

I’m right where you are…48 years old, in great shape (guarantee I’m in better shape than 80% of the people out here), thyroid issues that are very hard to manage, and low testosterone. I’m about to go on a 3-6 month trial period, but not going to until I find out much more about it.

I’d be curious to know what KSman’s background is…he is very knowledable it seems on a lot of stuff. But some of the stuff concerning the subject of thyroid I’d question. If you think thyroid is a small piece of the puzzle (not saying you do), you’re wrong. There is a reason that T4 meds like Synthroid are the one of the top 3 scripts written in the U.S. year in and year out. Look it up.

Your foggy because your hypo. Your body temp will flucuate and it will never always be 98.6. Some people are normal at 98.1. Temp is a great indicator that something might be going on.


Wanted to throw up an update here as I recently got back some info and also have another question that I thought about putting in a new thread, but seems close enough to this topic here to post.

In response to 907k’s comments, since I think having just gone back and reading through this here, there’s some pretty relevant stuff in there:

Surprisingly (or not, I’m not sure), my testosterone has always been above average or even quite high (956 on the 300-800ng/dl test). Never taken steroids, although at that time (2 plus years ago now, I was consistent with zinc supplementation and taking the 25mcg T3, which I assume could help).

I got my T3 tested a little while back (finally). I had been off the liothyronine for a period of two weeks at that point (taking 15mcg still, prior to the brief stop), and had only ever tried levothyroxine for a few weeks a couple years back - never taken it since.

The T3 came back at 2.4
There were two or three other tests (thyroid) that were done, but I have to go online and get those results, then I can add them in here.

My MDs thought was that I could probably continue the T3 at that dose indefinitely (15mcg), based on those numbers, but I do want to see an endo in the near future here.

I have been feeling just absolutely fried lately with stress and anxiety (not currently treating that properly), so I’m hoping that it wouldn’t be the liothyronine grinding away at my system. I’m assuming it’s lack of sleep, stress, and anxiety since those are naturally high lately, and a 2.4 T3 level recently being off the liothyronine for two weeks means, (i assume) 15mcg isn’t taking my TSH that low and shifting me hyper. My energy is typically pretty good, not over the top.

The other question I had for some of you guys is in regard to the supplement phosphatidylserine. I took a few obscure ones like this when I was seeing the functional MD for a while, and the idea behind this one was, I believe to reduce stress and lower AM cortisol.

I’m curious if this is something that one can generally just take (in the AM?) regardless of whether or not they actually test their current cortisol levels? It seemed to really reduce my reactivity to stress, and seemed to be pretty powerful when combined with with an SSRI for anxiety to the point where you feel like nothing stresses you out at all.