This content was created by McCall McPherson. This content was uploaded by McCall McPherson. This is a YouTube video titled "Signs and symptoms of over-medication" (created 2024-04-04) consisting of a monologue by McCall McPherson about the dangers of excessive T3 (liothyronine/cytomel) dosing. McPherson describes clinical cases (patients on ~70–170 µg T3, including a post-thyroidectomy patient with no T4), warns that such dosing can be medically dangerous (reports a patient who had a stroke), and lists early symptoms (jitteriness, anxiety, palpitations, racing heart, sweating, diarrhea, hair loss, weight loss). She explains the phenomenon of medication "waves," the body’s compensatory responses (e.g., increased sex-hormone binding globulin) that can produce hypothyroid-like effects, and emphasizes safe prescribing and correct lab timing (testing while on medication) using an example T3 value of 33 versus her referenced typical range of ~3.6–4.2. The tone is clinical and directed at clinicians and patients concerned about thyroid management.
Chapters
So I want to talk to you guys about symptoms of over medication of T3 because I got this question a lot. When I presented the last case for a patient that transferred care on too much T3, she was on 70 micrograms of T3. I need to have a real conversation with y' all because someone is transferring and coming to see me next week on 170 micrograms of T3 with no T4 is no thyroid. They've had a thyroidectomy. And y', all, it is like grossly, medically negligently dangerous. And it frankly makes me so angry. If you are a clinician and you want to help people with their thyroid problems in a progressive way, you need to know what you're doing. And it's hard to mess up this bad. But it is happening and I am seeing it. It is not safe for anyone to be on 170 micrograms of cytomel, 100 micrograms of lyothyrenine, 70 micrograms of lyothyrenin is, is. It's a reflection that you are partnering with someone that does not know what they are doing. And it can. Honestly, in rare cases it's difficult to do, but it can become extremely dangerous. And in this case it is. I have personal, personally had a patient while waiting to see me have a stroke because of being over medicated on T3. You guys know me, I love T3. A hundred of percent of my patients are on some form of T3 unless they have graves. So I am not afraid. But it has to be done safely and effectively. If it's not, these are the symptoms you can experience early on. Jittery, anxiety, palpitations, feelings of a racing heart, sweating, diarrhea, hair loss, you can have weight loss. Then what ultimately happens is you can also ride the waves of your medication, especially if you don't have an ET4. It's freaking nutso that this person isn't on an ET4. Another story, meaning ride the waves of your medication. When it's on board, you feel okay and then you crash. And then if you take a second dose, you feel okay and then you crash. Eventually, what happens when you're grossly, medically, negligently over medicated is your body starts to try to protect you from having so much excess T3 and it starts shuffling it out as quickly as possible, driving up your sex hormone binding globulin to get rid of it. And it ends up feeling a lot like hypothyroidism. This person's T3 value, guys, is 33. It's not even, like, reasonably safe. Like, it's ridiculous. And this is why we test people on their freaking medication. So you can know what this person's T3 actually is when they're taking their medication. Because do you know what it would look like if she took her labs the morning before she took her medication? Her T3 would be 2.8, and it would look low, and she'd continue to get her medication increased. And her T3 value is 33. My range is 3.6 to 4.2 throughout the bulk of your day, so no.
