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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Jaynee on November 23, 2002, at 12:25:43
Here is a link to a medical journal that talks about Mental Illness. In the Nov issue, which isn't up on the net yet, but will be soon, mentioned triiodothyronine augmentation and being better than lithium augmentation for hard to treat depression.
My question is: Is triiodothyronine a thyroid medication. I have never heard of this.
Here is a link to the journal, it only has part 1 on the web, but part 2 should be out soon and this is the one that mentions triiodothyronine.
Posted by Pfinstegg on November 23, 2002, at 13:14:41
In reply to Journal mentions triiodothyronine augmentation, posted by Jaynee on November 23, 2002, at 12:25:43
Thanks for posting the reference to the new article. There was a previous article about using triiodothyronine for depression in the New England Journal of Medicine, published in 1999.
Our brains produce TSH (thyroid-stimulating hormone), which in turn instructs the thyroid gland to produce thyroxine (T4). Normally, our bodies turn some of the T4 into T3 (triiodothyronine), but in some people, this doesn't happen as much as it should. There's not a lot of research on it, but the consensus seems to be that T3 is essential for mood stabilization. With difficult-to-treat depression, The NEJM article recommended giving supplemental T3 as Cytomel, even if one's TSH, T4 and T3 are all within normal limits. I started doing that in August, and am definitely less depressed. I am also taking fish oil, lots of vitamins and tianeptine, so it is hard to know for sure if the Cytomel is actually helping- everything probably is! Taking 5mcg of Cytomel daily has lowered my TSH to about 0.5, the very lower limit of normal, but I don't notice any side effects from it. Another person who seemed to benefit from it is Chloe, who started taking it post-ECT. I haven't seen a recent post from her, but it seemed to be very helpful in preventing the "crashes" she was experiencing just prior to her maintenance ECT. I have noticed the same thing- an absence of "crashes".
If you have TRD, I think Cytomel is a very safe, reasonable medication to try- as long as you have good follow-up for your thyroid hormone levels.
Pfinstegg
Posted by Larry Hoover on November 23, 2002, at 13:16:44
In reply to Journal mentions triiodothyronine augmentation, posted by Jaynee on November 23, 2002, at 12:25:43
> My question is: Is triiodothyronine a thyroid medication. I have never heard of this.
>The short name for triiodothyronine is T3. It's the active thyroid hormone, formed from T4, thyroxine.
Just to really mess things up, it's also called liothyronine. One brand name is Cytomel.
It's more than a thyroid medication. It is artificial thyroid hormone.
Posted by SLS on November 24, 2002, at 0:13:04
In reply to Re: Journal mentions triiodothyronine augmentation, posted by Larry Hoover on November 23, 2002, at 13:16:44
Hi.
As described by Larry:T3 = triiodothyronine = liothyronine = Cytomel
T4 = tetraiodothyronine = thyroxine = Synthroid, Levoxyl
-
The thyroid gland secretes perhaps 25% of the circulating T3. The remaining T3 in the body is produced by the conversion of T4 to T3 in peripheral tissues. T3 is the more active of the two thyroid hormones.It should be understood that when treating depression, thyroid hormones are used as drugs, and are generally prescribed without regard to existing thyroid levels in the body.
T3 has been used to augment tricyclic antidepressants for over 20 years. I believe that the use of T3 instead of T4 became established as the result of early anecdotal reports. I'm not sure that any systematic investigation has been conducted comparing the relative efficacies of T4 and T3. I responded very differently on each. T3 made me horribly worse. I found T4 to be somewhat helpful.
Unfortunately, I believe T4 has been unjustifiably neglected in the treatment of affective disorders.
Sometimes, both T4 and T3 are prescribed in combination to augment antidepressants.
- Scott
Posted by Pfinstegg on November 24, 2002, at 1:00:07
In reply to Re: Journal mentions triiodothyronine augmentation, posted by SLS on November 24, 2002, at 0:13:04
Scott is right. I somehow forgot to mention that I take levothyroxine (T4) along with the Cytomel- big oversight! The NEJM article suggests taking both, as it more closely approximates how things should naturally be in your body. I do think low-dose T3-4 medication is worth considering seriously as an augmentation if you are treatment-resistant.
Pfinstegg
Posted by amber_spirit on November 26, 2002, at 13:28:38
In reply to Re: Journal mentions triiodothyronine augmentation, posted by Pfinstegg on November 24, 2002, at 1:00:07
Does anyone know of the ratio of T3 to T4 or where I might find it?
Thanks
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