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Liothyronine – Cytomel

Thyroid hormones are essential for our body’s metabolism, with synthetic options available to accommodate various medical needs. The primary types are T4 or levothyroxine, and T3 or liothyronine, primarily stored and produced in the thyroid gland.

Pharmaceutical thyroid hormones can be sourced from animal glands (bovine or ovine) or created synthetically, with strict regulations in the USA ensuring quality and iodine levels.

Cytomel (liothyronine sodium) is offered in tablet form and is significantly more potent than T4.

Φαρμακολογία

The mechanisms behind thyroid hormones remain complex; however, they are known to stimulate energy production by enhancing the metabolism of carbohydrates, fats, and proteins, as well as increasing oxygen consumption. Users of thyroid hormones often experience an elevated basal metabolic rate, impacting nearly every organ, including the brain. Their significance becomes evident, particularly in patients with deficiencies.

Δοσολογία

Thyroid hormones are readily absorbed from the gastrointestinal tract, with swift action typically occurring within hours, yet peak activity may take several days. Liothyronine binds to albumin in the bloodstream, prolonging its presence in the body.

Indications for thyroid hormones include:

• Hypothyroidism replacement therapy
• Post-thyroidectomy replacement therapy
• Treatment for goiters and thyroid nodules
• Diagnostic use in suppression tests for suspected hyperthyroidism
• Alternative for those allergic to porcine or bovine thyroid preparations

Body Builders και απώλεια βάρους

Thyroid hormone misuse has been prevalent among athletes seeking weight loss. Its ability to promote fat and carbohydrate combustion makes Cytomel an alluring choice for weight loss and performance enhancement across various sports. Athletes typically administer the hormone for 4-6 weeks, halting just before competitions, reporting effective fat burning and heightened energy.

However, reliance often includes other substances, complicating outcomes. Users are advised to commence with 25 ug/day, gradually increasing by 5-10 ug/day, with a noted maximum of 100 ug/day to minimize side effects. A crucial understanding for users is the potential for thyroid insufficiency post-therapy, necessitating careful dose tapering to restore natural function.

Consultation with a healthcare professional before using thyroid hormones for weight loss is strongly recommended.

Σημεία και συμπτώματα

Excessive thyroid hormone can lead to various side effects, including:

• Πονοκέφαλος
• Mood changes (irritability, anxiety)
• Increased sweating
• Heart irregularities
• Αίσθημα παλμών
• Πόνος στο στήθος
• Διάρροια
• Ανωμαλίες εμμήνου ρύσεως
• Worsening heart failure
• Σοκ

Severe overdose may mimic thyroid storm symptoms, while chronic overdosage reflects signs of hyperthyroidism.

Αντενδείξεις

Indications to avoid thyroid hormones include untreated adrenal insufficiency, active thyrotoxicosis, or known hypersensitivity to active ingredients, though true allergic reactions to liothyronine are rare.

Compounding Factors

Many seek thyroid hormones for weight loss, often in conjunction with other substances. Typical therapeutic doses often yield little effect, necessitating much higher doses which can pose serious risks, especially alongside weight loss supplements like ephedrine or growth hormones.

Patient conditions that require caution include adrenal insufficiency and diabetes, necessitating dose adjustments. Enhanced sensitivity to oral anticoagulants raises bleeding risks, warranting careful monitoring. Claims of efficacy in infertility treatment by non-medical sources lack scientific backing.

Individuals with pre-existing cardiovascular issues must consult a physician prior to therapy, emphasizing stringent dosage controls.

Επίπεδα

Thyroid hormone levels are easily monitored, with all sporting agencies, including the IOC and WADA, routinely screening athletes for thyroid hormone presence, employing highly sensitive radioimmunoassays for detection.

Αλληλεπιδράσεις φαρμάκων

Liothyronine may interact with several medications, including:

• Oral anticoagulants
• Insulin or oral hypoglycemics
• Cholestyramine
• Estrogen and oral contraceptives
• Tricyclic antidepressants
• Digitalis

In these scenarios, physician oversight ensures that thyroid hormone dosage remains safe, with regular follow-ups advised.

Θεραπεία της υπερδοσολογίας

In cases of suspected thyroid hormone overdose, hospital admission is essential. Management includes halting the hormone, monitoring the patient, and potentially pausing treatment for 4-8 weeks to facilitate recovery. Supportive care is the mainstay since no specific antidote exists. Inducing vomiting is contraindicated due to aspiration risks, with severe cases requiring ICU care and possibly mechanical ventilation. Treatment generally emphasizes hydration, oxygenation, and monitoring; beta blockers may be administered if necessary.

Δοσολογία

Liothyronine is prescribed as a once-daily tablet, with dosing tailored to hypothyroidism severity. Initiation should employ the lowest effective dose due to its rapid action. The introductory dosage for Cytomel is set at 5 mcg/day, incrementally raised by no more than 5 mcg/day at 2-3 week intervals. High starting doses or rapid increases may worsen cardiac conditions. Most individuals respond optimally to doses between 50-75 ug/day. Intravenous liothyronine is available and deployed for conditions like myxedema coma, a severe hypothyroid complication primarily affecting elderly women.

Liothyronine is offered in 5, 25, and 50 ug tablets—all necessitating a physician’s prescription in the USA.