II. Indications

  1. Not generally recommended (no proven benefit and associated risk)
  2. Adjunct to Levothyroxine in Hypothyroidism
    1. Lethargy or memory deficits despite normal TSH

III. Adverse Effects

  1. Risk of Cardiovascular Risks when combined with Levothyroxine

IV. Efficacy

  1. May improve neuropsychiatric symptoms
  2. Changes after replacing T3 and T4
    1. Improved mood and energy
    2. Decreased confusion, fear, and irritability
    3. No difference in TSH normalization
  3. Studies suggests no benefit
    1. Clyde (2003) JAMA 290:2952-8 [PubMed]

V. Dosing (with Thyroxine dosing)

  1. Start: 1:14 ratio of Liothyronine to Levothyroxine (e.g. 5 mcg Liothyronine to 75 mcg Levothyroxine)
  2. Typical: 12.5 to 25 mcg orally daily
  3. Maximum: 100 ug orally daily

VI. References

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Related Studies

Cost: Medications

liothyronine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
LIOTHYRONINE SOD 25 MCG TAB Generic $0.37 each
LIOTHYRONINE SOD 5 MCG TAB Generic $0.29 each
LIOTHYRONINE SOD 50 MCG TAB Generic $0.53 each
cytomel (on 1/1/2023 at Medicaid.Gov Survey of pharmacy drug pricing)
CYTOMEL 5 MCG TABLET Generic $0.29 each