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Does Cytomel (liothyronine sodium) cause side effects?
Cytomel (liothyronine sodium) is a synthetic (man-made) version of one of the two hormones made by the thyroid gland, triiodothyronine, used to treat individuals who are hypothyroid (do not produce enough thyroid hormones) and prevent various types of euthyroid goiters.
Thyroid hormones increase the metabolism (activity) of all cells in the body. In the fetus, newborn infant and child, thyroid hormones promote growth and development of tissues. In adults, thyroid hormones help to maintain the function of the brain, the use of food by the body, and body temperature.
Common side effects of Cytomel include
- nausea and
- irregular menstrual cycles.
Serious side effects of Cytomel include
- toxic (too high) levels of thyroid hormone (hyperthyroidism). Symptoms of hyperthyroidism include
Drug interactions of Cytomel include cholestyramine, which binds Cytomel and other thyroid in hormones in the intestine, reducing the absorption and levels of Cytomel. Thyroid hormones should not be administered for 4 to 5 hours after administering cholestyramine.
The administration of Cytomel increases the action of the blood-thinning drug, warfarin.
- By increasing the body's metabolism (elimination) of clotting factors, thyroid hormones reduce the body's ability to clot and enhance the effects of warfarin.
- Since this can lead to excessive bleeding, the dose of warfarin may need to be reduced.
Cytomel and other thyroid hormones may change the action of many drugs.
- Individuals who are hypothyroid have slower theophylline elimination.
- The elimination of theophylline and similar drugs increases as the dose of thyroid hormone increases.
- Therefore, when the concentration of thyroid hormone is returned to normal with Cytomel, the elimination of theophylline is increased.
- This reduces the concentration of theophylline in the body and can reduce the effectiveness of theophylline.
Thyroid hormones do not easily cross the placenta and, therefore, are safe for pregnant women to take.
What are the important side effects of Cytomel (liothyronine sodium)?
Liothyronine therapy generally is well-tolerated. If symptoms occur, they usually occur because there are toxic (too high) levels of thyroid hormone (hyperthyroidism).
Symptoms of hyperthyroidism include:
- chest pain,
- increased heart rate,
- excessive sweating,
- heat intolerance,
- weight loss,
- fever, and,
- rarely, cardiac arrest.
Women also may experience irregular menstrual cycles.
Since thyroid hormone affects heart rate and metabolism, the impact of treatment of thyroid hormone on the control of diseases such as
Cytomel (liothyronine sodium) side effects list for healthcare professionals
Adverse reactions, other than those indicative of hyperthyroidism because of therapeutic overdosage, either initially or during the maintenance period are rare. In rare instances, allergic skin reactions have been reported with Cytomel (liothyronine sodium) Tablets.
What drugs interact with Cytomel (liothyronine sodium)?
- Thyroid hormones appear to increase catabolism of vitamin K-dependent clotting factors.
- If oral anticoagulants are also being given, compensatory increases in clotting factor synthesis are impaired.
- Patients stabilized on oral anticoagulants who are found to require thyroid replacement therapy should be watched very closely when thyroid is started.
- If a patient is truly hypothyroid, it is likely that a reduction in anticoagulant dosage will be required.
- No special precautions appear to be necessary when oral anticoagulant therapy is begun in a patient already stabilized on maintenance thyroid replacement therapy.
Insulin Or Oral Hypoglycemics
- Initiating thyroid replacement therapy may cause increases in insulin or oral hypoglycemic requirements.
- The effects seen are poorly understood and depend upon a variety of factors such as dose and type of thyroid preparations and endocrine status of the patient.
- Patients receiving insulin or oral hypoglycemics should be closely watched during initiation of thyroid replacement therapy.
- Cholestyramine binds both T4 and T3 in the intestine, thus impairing absorption of these thyroid hormones.
- In vitro studies indicate that the binding is not easily removed.
- Therefore, 4 to 5 hours should elapse between administration of cholestyramine and thyroid hormones.
Estrogen, Oral Contraceptives
- Estrogens tend to increase serum thyroxine-binding globulin (TBg).
- In a patient with a nonfunctioning thyroid gland who is receiving thyroid replacement therapy, free levothyroxine may be decreased when estrogens are started thus increasing thyroid requirements.
- However, if the patient's thyroid gland has sufficient function, the decreased free thyroxine will result in a compensatory increase in thyroxine output by the thyroid.
- Therefore, patients without a functioning thyroid gland who are on thyroid replacement therapy may need to increase their thyroid dose if estrogens or estrogen-containing oral contraceptives are given.
- Use of thyroid products with imipramine and other tricyclic antidepressants may increase receptor sensitivity and enhance antidepressant activity; transient cardiac arrhythmias have been observed.
- Thyroid hormone activity may also be enhanced.
- Thyroid preparations may potentiate the toxic effects of digitalis.
- Thyroid hormonal replacement increases metabolic rate, which requires an increase in digitalis dosage.
- When administered to patients on a thyroid preparation, this parenteral anesthetic may cause hypertension and tachycardia.
- Use with caution and be prepared to treat hypertension, if necessary.
- Thyroxine increases the adrenergic effect of catecholamines such as epinephrine and norepinephrine.
- Therefore, injection of these agents into patients receiving thyroid preparations increases the risk of precipitating coronary insufficiency, especially in patients with coronary artery disease.
- Careful observation is required.
Drug And Laboratory Test Interactions
The following drugs or moieties are known to interfere with laboratory tests performed in patients on thyroid hormone therapy:
- oral contraceptives containing estrogens,
- iodine-containing preparations and
- the numerous preparations containing salicylates.
Changes in TBg concentration should be taken into consideration in the interpretation of T4 and T3 values. In such cases, the unbound (free) hormone should be measured.
- Pregnancy, estrogens and estrogen-containing oral contraceptives increase TBg concentrations.
- TBg may also be increased during infectious hepatitis.
- Decreases in TBg concentrations are observed in nephrosis, acromegaly and after androgen or corticosteroid therapy.
- Familial hyper- or hypo-thyroxine-binding-globulinemias have been described.
- The incidence of TBg deficiency approximates 1 in 9000.
- The binding of thyroxine by thyroxine-binding prealbumin (TBPA) is inhibited by salicylates.
Medicinal or dietary iodine interferes with all in vivo tests of radioiodine uptake, producing low uptakes which may not be reflective of a true decrease in hormone synthesis.
The persistence of clinical and laboratory evidence of hypothyroidism in spite of adequate dosage replacement indicates either poor patient compliance, poor absorption, excessive fecal loss, or inactivity of the preparation. Intracellular resistance to thyroid hormone is quite rare.
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Related Disease Conditions
Thyroid Disorders Symptoms and Signs
Thyroid diseases and disorders are caused because the body either makes too much or too little thyroid hormones, which are necessary for vital functions of the body. Thyroid disease and disorder symptoms and signs depend on the type of the thyroid problem. Examples include heat or cold intolerance, sweating, weight loss or gain, palpitations, fatigue, dry skin, constipation, brittle hair, joint aches and pains, heart palpitations, edema, feeling bloated, puffiness in the face, reduced menstrual flow, changes in the frequency of bowel movements and habits, high cholesterol, hoarseness, brittle hair, difficulty swallowing, shortness of breath, a visible lump or swelling in the neck, tremors, memory problems, depression, nervousness, agitation, irritability, or poor concentration. Thyroid problems are more common in women.
Hyperthyroidism is an excess of thyroid hormone due to an overactive thyroid gland. Symptoms can include increased heart rate, weight loss, heart palpitations, frequent bowel movements, depression, fatigue, fine or brittle hair, sleep problems, thinning skin, and irregular vaginal bleeding. Graves' disease is the most common cause of hyperthyroidism. Many other health problems or taking excess thyroid hormone medication can cause an overactive thyroid gland. Treatment for the condition is with medication, radioactive iodine, thyroid surgery (rarely), or reducing the dose of thyroid hormone. No diet has been shown to treat hyperthyroidism or its symptoms and signs.
There are several types of thyroid disorders including hypothyroidism, hyperthyroidism, goiters, thyroid nodules, and thyroid cancer. Symptoms vary by condition. Diagnosis is made with blood tests, scans, ultrasound, or biopsy. Treatments depend on the disorder and can include medication or surgery.
Hypothyroidism is any state in which thyroid hormone production is below normal. Normally, the rate of thyroid hormone production is controlled by the brain by the pituitary gland. Hypothyroidism is a very common condition and the symptoms of hypothyroidism are often subtle, but may include, constipation, memory loss, hair loss, and depression. There are a variety of causes of hypothyroidism, and treatment depends on the cause.
Hypothyroidism During Pregnancy
Hypothyroidism during pregnancy can be treated with synthetic thyroid hormones to maintain the proper thyroid hormone balance. Hypothyroidism symptoms and signs include fatigue, weight gain, lethargy, and constipation. Treatment of hypothyroidism in pregnant women is important because inadequate levels of thyroid hormones may affect the fetus and child during growth and development.
Hashimoto's thyroiditis or chronic lymphocytic thyroiditis, is an autoimmune disorder causing inflammation of the thyroid gland. Hashimoto's thyroiditis is a type of hypothyroidism, and is the most common cause of hypothyroidism in the US. Symptoms of Hashimoto's thyroiditis may include dry skin, fatigue, weight gain, feeling cold, excessive sleepiness, dry skin, dry coarse hair, difficulty swallowing, a lump in the front of the throat, muscle cramps, mood changes, vague aches and pains, problems concentrating, leg swelling, constipation, and depression. There is no cure for Hashimoto’s thyroiditis. Diet changes, natural supplements, vitamins, or other natural products will not treat Hashimoto’s thyroiditis. Treatment for the autoimmune disorder is with thyroid hormone replacement therapy, which will be necessary for the rest of the person’s life.
Thyroid nodules are the most common endocrine problem in the United States. The term thyroid nodule refers to any abnormal growth that forms a lump in the thyroid gland. The vast majority of thyroid nodules are benign.
There are four major types of thyroid cancer: papillary, follicular, medullary, and anaplastic thyroid cancer. Tumors on the thyroid are referred to as thyroid nodules. Symptoms of thyroid cancer include swollen lymph nodes, pain in the throat, difficulty swallowing, hoarseness, and a lump near the Adam's apple. Treatment usually involves chemotherapy, surgery, radioactive iodine, hormone treatment or external radiation and depends upon the type of thyroid cancer, the patient's age, the tumor size, and whether the cancer has metastasized.
The thyroid gland is a butterfly-shaped gland located in the front of the neck. The thyroid gland produces important thyroid hormones, which are produced by the pituitary gland. There are six types of thyroid problems. Home remedies, medications, surgery, lifestyle changes, and surgery. Usually, most types of thyroid problems can be managed with home remedies, medications, lifestyle changes (diet, yoga), and surgery.
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What Happens If Hypothyroidism Is Left Untreated?
If hypothyroidism is not treated, it can lead to various complications.
Thyroiditis is the inflammation of the thyroid gland. The inflamed thyroid gland can release an excess of thyroid hormones into the blood stream, resulting in a temporary hyperthyroid state. Some forms of thyroiditis can be diagnosed based on tenderness and enlargement of the thyroid gland. A thyroid scan sometimes is used in making the diagnosis. Thyroiditis can also be diagnosed with a biopsy of the thyroid gland.
Hyperparathyroidism is a disorder of the parathyroid glands. There are two types of hyperparathyroidism, primary and secondary. When the parathyroid glands produce too much hormone, hyperparathyroidism is the resulting condition. Most cases of hyperparathyroidism have no evident cause. Signs and symptoms of hyperparathyroidism include fatigue, weakness, depression, loss of appetite, nausea, vomiting, constipation, or confusion. Increased calcium and phosphorous excretion may cause kidney stones. The main treatment of hyperparathyroidism is surgery (parathyroidectomy).
What Are the Warning Signs of Thyroid Cancer?
Thyroid cancer arises from the cells of the thyroid gland. The thyroid is a butterfly-shaped gland located in the front of the neck, just below Adam's apple. Warning signs of thyroid cancer include a lump in the neck, trouble swallowing, trouble breathing, voice changes, cough, weight loss, and palpitations.
In hypoparathyroidism, the parathyroid gland does not produce enough parathyroid hormone. Causes of hypoparathyroidism include injury to the parathyroid glands, autoimmune disorder association, or may be present ab birth. Symptoms of hypoparathyroidism include: tingling fingers, toes, and lips, brittle nails, dry, coarse skin, dry hair; memory loss, headaches, severe muscle cramps, cataracts, malformed teeth, and convulsions. Treatment of hypoparathyroidism is to restore the calcium and phosphorus to normal levels in the body.
What Are the Complications of Thyroid Problems?
The thyroid is a small, butterfly-shaped gland located at the anterior (front) aspect of the neck. Thyroid hormones regulate metabolism, body temperature, heartbeat and the digestive system. Hypothyroidism occurs when the thyroid gland is unable to produce sufficient levels of thyroid hormones. Hyperthyroidism occurs when the thyroid gland produces excess levels of thyroid hormones. Thyroid problems can begin at any age and women are more affected than men. The clinical presentation and complications of hypothyroidism and hyperthyroidism are different.
Causes for Hypothyroidism
Hypothyroidism may be caused by several reasons. The causes are broadly divided into primary and secondary causes.
What Happens to Your Body When You Have Thyroid Cancer?
Thyroid cancer arises from the cells of the thyroid gland. The thyroid is a butterfly-shaped gland located in the front of the neck, just below Adam's apple. Common symptoms and signs of thyroid cancer may include a lump in the neck, trouble swallowing, trouble breathing, voice changes, cough, weight loss, and palpitations.
Complications Of Hypothyroidism: Fertility, Weight And More
The thyroid gland is a small butterfly-shaped gland located in the front of the neck. Hypothyroidism is a medical condition in which the thyroid gland becomes underactive.
What Causes Hypothyroidism?
Hypothyroidism results when the thyroid gland fails to produce enough hormones. Hypothyroidism may be due to a number of factors.
What Effect Does Hypothyroidism Have on the Body?
Hypothyroidism is a condition where low levels of thyroid hormones affect various body parts. The thyroid gland is a small butterfly-shaped endocrine gland (a gland that secretes a substance called a hormone into the bloodstream). It is normally located in the front of the neck. It produces the thyroid hormones, which are released into the blood and then carried to various tissues in the body.
Treatment & Diagnosis
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