Cytomel (Liothyronine Sodium) - Summary

CYTOMEL SUMMARY

CYTOMEL^®
brand of liothyronine sodium tablets

Thyroid hormone drugs are natural or synthetic preparations containing tetraiodothyronine (T₄, levothyroxine) sodium or triiodothyronine (T₃, liothyronine) sodium or both. T₄ and T₃ are produced in the human thyroid gland by the iodination and coupling of the amino acid tyrosine. T₄ contains four iodine atoms and is formed by the coupling of two molecules of diiodotyrosine (DIT). T₃ contains three atoms of iodine and is formed by the coupling of one molecule of DIT with one molecule of monoiodotyrosine (MIT). Both hormones are stored in the thyroid colloid as thyroglobulin.

Thyroid hormone drugs are indicated:

1. As replacement or supplemental therapy in patients with hypothyroidism of any etiology, except transient hypothyroidism during the recovery phase of subacute thyroiditis. This category includes cretinism, myxedema and ordinary hypothyroidism in patients of any age (pediatric patients, adults, the elderly), or state (including pregnancy); primary hypothyroidism resulting from functional deficiency, primary atrophy, partial or total absence of thyroid gland, or the effects of surgery, radiation, or drugs, with or without the presence of goiter; and secondary (pituitary) or tertiary (hypothalamic) hypothyroidism (see WARNINGS).
2. As pituitary thyroid-stimulating hormone (TSH) suppressants, in the treatment or prevention of various types of euthyroid goiters, including thyroid nodules, subacute or chronic lymphocytic thyroiditis (Hashimoto's) and multinodular goiter.
3. As diagnostic agents in suppression tests to differentiate suspected mild hyperthyroidism or thyroid gland autonomy.

Cytomel (liothyronine sodium) Tablets can be used in patients allergic to desiccated thyroid or thyroid extract derived from pork or beef.

See all indications & dosage >>

NEWS HIGHLIGHTS

Published Studies Related to Cytomel (Liothyronine)

Efficacy of combined levothyroxine and liothyronine as compared with levothyroxine monotherapy in primary hypothyroidism: a randomized controlled trial. [2009]
OBJECTIVES: To examine the efficacy of combination therapy with levothyroxine and liothyronine in improvement of general health, psychological problems, and metabolic status in primary hypothyroidism... CONCLUSIONS: The data do not support the hypothesis that combined therapy improves the well-being and general health of patients.

Combined treatment with sertraline and liothyronine in major depression: a randomized, double-blind, placebo-controlled trial. [2007.06]
BACKGROUND: Antidepressant treatments that achieve a higher remission rate than those currently available are urgently needed. The thyroid hormone triiodothyronine may potentiate antidepressant effects. OBJECTIVE: To determine the antidepressant efficacy and safety of liothyronine sodium (triiodothyronine) when administered concurrently with the selective serotonin reuptake inhibitor sertraline hydrochloride to patients with major depressive disorder... CONCLUSIONS: These results demonstrate enhancement of the antidepressant effect of sertraline by concurrent treatment with liothyronine without a significant increase in adverse effects. The antidepressant effect of liothyronine may be directly linked to thyroid function.

Comparative bioavailability of different formulations of levothyroxine and liothyronine in healthy volunteers. [2006.12]
OBJECTIVE: To evaluate the relative bioavailability of T4 sodium and liothyronine sodium (T3), administered in single doses as oral solution (drops) and tablet forms, according to two separate study protocols... CONCLUSIONS: The bioavailability of the two oral solutions (T4-Ibsa and T3-Ibsa oral solutions) and the corresponding tablet forms (Eutirox 100 and Ti-tre tablets) were confirmed and they can be considered bioequivalent and therapeutically interchangeable.

Substitution of liothyronine at a 1:5 ratio for a portion of levothyroxine: effect on fatigue, symptoms of depression, and working memory versus treatment with levothyroxine alone. [2005.07]
OBJECTIVE: To attempt to confirm a previous report of superior effectiveness of using two thyroid hormones rather than one hormone to treat hypothyroidism... CONCLUSION: With regard to the outcomes measured, substitution of LT(3) at a 1:5 ratio for a portion of baseline LT(4) yielded no better results than did treatment with the original dose of LT(4) alone.

Combined therapy with levothyroxine and liothyronine in two ratios, compared with levothyroxine monotherapy in primary hypothyroidism: a double-blind, randomized, controlled clinical trial. [2005.05]
Controversy remains about the value of combined treatment with levothyroxine (LT4) and liothyronine (LT3), compared with LT4 alone in primary hypothyroidism. We compared combined treatment with LT4 and LT3 in a ratio of 5:1 or 10:1 with LT4 monotherapy... Decrease in body weight was associated with satisfaction with study medication.

more studies >>

Clinical Trials Related to Cytomel (Liothyronine)

Triiodothyronine (T3) Supplementation in the Treatment of Bipolar and Unipolar Depression. [Completed]
The purpose of this project is to determine whether concurrent treatment of patients with major depression (unipolar or bipolar) with triiodothyronine (T3) and sertraline, will lead to a stronger and/or more rapid antidepressant effect than treatment with sertraline alone.

Effect of T4-T3 Combination Therapy Versus T4 Monotherapy in Patients With Hypothyroidism [Completed]
To compare the effect of T4-T3 combination therapy versus T4 monotherapy in patients with autoimmune hypothyroidism, on stable T4-substitution therapy

Liothyronine (T3) for Bipolar Depression [Recruiting]
This study evaluates the efficacy of the thyroid hormone T3 for depression in patients with bipolar disorder. In this study patients will be randomized to receive T3 or placebo.

Augmentation of the Antidepressant Action of Sertraline With Triiodothyronine (T3)and Reboxetine: Clinical Efficacy, Adverse Effects and Predictors of Response. [Not yet recruiting]

In this project we aim to further refine indications for the use of the thyroid hormone - T3

for patients suffering from depression. We aim to identify a sub-group of patients who are more likely to respond to T3 and establish the time in the treatment course when T3 should be added. The results of this project could have significant, direct clinical implications.

Combined Levothyroxine/Liothyronine Supplementation in Hypothyroid Patients With Brain Tumors [Recruiting]
Primary Objectives:

1. Assess whether combined treatment with Levothyroxine and Liothyronine improves learning and memory.

2. Explore the relationship between T3 treatment and other domains of cognitive function, quality of life, and mood.

more trials >>

PATIENT REVIEWS / RATINGS / COMMENTS

Cytomel review by 56 year old female patient
		Rating
Overall rating:
Effectiveness:		Highly Effective
Side effects:		No Side Effects
		Treatment Info
Condition / reason:		hypothyroidism
Dosage & duration:		5 mcg (dosage frequency: 2 per day) for the period of still taking it - 4 years
Other conditions:		none
Other drugs taken:		Levoxyl
		Reported Results
Benefits:		Levoxyl improved lab results, but I still felt tired, had dry skin and some constipation. Adding Cytomel fine tuned treatment and all symptoms resolved.
Side effects:		There were none - all I felt was better.
Comments:		I took 100 mg Levoxyl, which provides a thyroid hormone called T4. It's success depends on the body's ability to convert T4 to T3; adding Cytomel proves T3 (the active hormone) directly. I now take 10 mcg Cytomel along with 100 mg Levoxyl and symptoms of low thyroid have resolved.

Cytomel review by 45 year old female patient
		Rating
Overall rating:
Effectiveness:		Considerably Effective
Side effects:		No Side Effects
		Treatment Info
Condition / reason:		Hypothyroid - Hashimoto's disease
Dosage & duration:		5mcg tablet taken 2 times per day for the period of still taking it (5 years so far)
Other conditions:		very tired, no energy, foggy memory
Other drugs taken:		Levothyroxine 112mcg; omeprazole 20mg; advair 250-50; maxair; fluticasone 50 mcg; Intal Inhaler
		Reported Results
Benefits:		Increased energy and memory. Levothyroxine treatment alone was not working well. The combination works much better.
Side effects:		None
Comments:		Since being diagnosed with hypothyroidism, my doctor’s would treat with basically the Levothyroxine. The levels would be increased until I was “in the range”, but I never felt quite right. I was still very tired and my memory, especially short-term, was really bad. I went to a couple endocrinologists, with the first one diagnosing the hypothyroidism as a result of Hashimoto’s disease. Even with this diagnosis, the first endocrinologist did not suggest other treatments and I continued to suffer with excessive tiredness and memory problems. I decided to go for a second opinion, and this endocrinologist told me that some individuals react better with a combination treatment of Levothyroxine and Cytomel. This seemed to turn me around. The memory and tiredness have gotten better, still not optimal. It seems as long as one is “in the range”, doctors are hesitant to push the envelope. I would like to see physicians listen to their patients and adjust the meds until they feel better, not just go “by the range”.

Cytomel review by 45 year old female patient
		Rating
Overall rating:
Effectiveness:		Considerably Effective
Side effects:		No Side Effects
		Treatment Info
Condition / reason:		Hypothyroid - Hashimoto's disease
Dosage & duration:		5mcg tablet taken 2 times per day for the period of still taking it (5 years so far)
Other conditions:		very tired, no energy, foggy memory
Other drugs taken:		Levothyroxine 112mcg; omeprazole 20mg; advair 250-50; maxair; fluticasone 50 mcg; Intal Inhaler
		Reported Results
Benefits:		Increased energy and memory. Levothyroxine treatment alone was not working well. The combination works much better.
Side effects:		None
Comments:		Since being diagnosed with hypothyroidism, my doctor’s would treat with basically the Levothyroxine. The levels would be increased until I was “in the range”, but I never felt quite right. I was still very tired and my memory, especially short-term, was really bad. I went to a couple endocrinologists, with the first one diagnosing the hypothyroidism as a result of Hashimoto’s disease. Even with this diagnosis, the first endocrinologist did not suggest other treatments and I continued to suffer with excessive tiredness and memory problems. I decided to go for a second opinion, and this endocrinologist told me that some individuals react better with a combination treatment of Levothyroxine and Cytomel. This seemed to turn me around. The memory and tiredness have gotten better, still not optimal. It seems as long as one is “in the range”, doctors are hesitant to push the envelope. I would like to see physicians listen to their patients and adjust the meds until they feel better, not just go “by the range”.