Hi
I'm new to this blog and I'm from the United States. I've had an underactive thyroid for over 20 years. I've been taken 125mcg of levoxyl. Recently they decreased my dose to 112mcg. My last results were TSH 0.108, T4, Free 2.14.
I've been reading about T3 and wondering why my doctor never has mentioned another medication. What is the controversy about taking T3?
The controversy about taking T3 either liothyroine or NDT is that T3 has a short half life (24 hours) and is more expensive. The body converts thyroxine (T4) to triiodothyronine (T3) and it is claimed you only need to give levothyroxine to patients as they will convert it to T3 (the active form) as they need it. Research has shown patients do not fully convert levothyroxine to T3 and that some patients need T3 to become well. The thyroid gland produces mostly T4 and a little T3. Some patients need some T3 to replace the T3 they no longer get from their thyroid. Some patients need higher doses of T3, the reason has not been discovered.
When studies have been carried out comparing results of T4 only vs T4 + T3 the results have been inconclusive. However, these studies have presumed the patients will only need the small amount secreted by the thyroid. In real life many patients get well on levothyroxine only but some patients definitely need some T3 in the mix. Doctors are concerned because the doses needed usually lead to an abnormally low TSH and they fear this represents over-treatment, that patients will be put at risk.
This is an explanation, I'm not advocating these views! I feel that if patients do not do well on levothyroxine only they should be offered T3 treatment titrated according to their response with careful monitoring. Endocrinologists want to titrate thyroid medication according to theory and not to patient response. This is bad science, if your theory does not fit real world data then the theory is wrong or insufficient. Endocrinologists blame the patient if they do not respond according to their theories.
Much easier to access alternatives in USA
See The Thyroid Pharmacist
Dr K news
Amy Myers
Chris Kresser
And many others, USA based specialists in looking at root cause of thyroid
If you have high thyroid antibodies then this is Hashimoto's also called autoimmune thyroid disease
Low vitamin levels and gluten intolerance likely
Here in UK T3 is charged to NHS at ridiculously high price (£1000 for 100 tablets) Yet in France and Germany its only £25-£30 for 100 tablets. So here in UK endocrinologists are being strongly discouraged from prescribing, or being pressured in to stopping prescriptions if all ready prescribed, despite these patients having clear clinical need
It could be that Big Pharma promoted levothyroxine and blood tests with monetary rewards to many doctors/endos particularly in the USA.. Therefore, levo overtook NDT (the original with all the hormones a healthy gland would have produced) and in the UK it has been withdrawn altogether and now it is T3 which has been withdrawn.
Several research teams have stated that a T3/T4 combination suits many who don't recover on levo alone.
Bear in mind that if we still have symptoms, we will probably be given 'other' prescriptions to control symptoms rather than a dose of thyroid hormones which relieves them.
The following doctor, now deceased, would never prescribe levo, only NDT or T3 for thyroid hormone resistant patients.
Blood tests have to be at the very earliest, fasting (you can drink water) and allow a gap of 24 hours between last dose of thyroid hormones and the test and take afterwards.
I had a doctor once who believed in a suppressed TSH for patients with Hashimoto's disease as he said that would calm the antibody activity down. However, a suppressed TSH to him was anywhere between 0.05 and 0.1. A TSH below 0.05 was "dangerous", according to him, although he could never explain why a TSH of 0.04 would be more dangerous than a TSH of 0.06...anyway, he explained to me that T3 would lower my TSH below 0.05, and therefore I should take T4 only. So there are a lot of crazy ideas when it comes to T3 drugs...however, I think it's clear that T3 does suppress the TSH, and many doctors are terrified when they see an out-of-range TSH...they seem to immediately think you'll end up with osteoporosis, heart disease and God knows what...sometimes I even wonder if doctors know that our thyroid glands produce some T3 when healthy, as they tend to treat T3 like a foreign substance that does not belong in a human body...!
Hi flea, I'm in the U.S. as well. My feeling is that a patient is much quicker to get through the system prescribing some form of levo or T4 and getting your TSH somewhere....ANYWHERE..in range and be done with you. It took me six years to get Armour which has been used for a 100 years until what Shaws mentions below. Armour is natural desiccated hormone and contains both T4 and T3 plus others. It is a disgrace that they make it so difficult to obtain. If you want to discuss further, send me a private message.
People take T3 for weight loss - and it caused heart problems as they were taking too much. That’s what I heard anyway. And doctors are used to associating low TSH with overactivity and the heart problems. They don’t understand that if you are taking the correct dose of T3 your thyroid doesn’t need stimulation so low TSH. As for combined levo and T3 I tried that, it seemed to work. There’s no point in doing that if you can’t convert at all but i imagine most people have some capacity to convert and it would smooth out your levels instead of the peaks you get using T3 only. I take NDT now by the way, much easier.
I'm am in California and have found an Endo who is not afraid to listen to my needs. I told her I am learning so much on this forum based in the U.K., and she respects that because she knows she has limited time to give each patient.
She explained to me that Liothyronine (T3) can cause Atrial Fibrillation and that is why she was reluctant to prescribe it, especially to me since she knows I have an arrhythmia - heart too slow at times and then too fast at other times. Also have Premature Ventricular Contractions from time to time.
My theory was/is that Levothyroxine has been part of the cause of the arrhythmia. When I severely lowered my dose last year, for a month or so I was free of heart issues and felt great, and no more once in a while dizziness. Then I crashed of course and felt like death, and had to start Levothyroxine all over again and now months later I'm better but still achy and listless.
Shaws, on this forum, explained that T3 resolved her heart palpitations and so I asked my Endo if I could try adding it with the Levothyroxine. She suggested 50 mcg Levo and 5 mcg T3. I haven't started yet, because I am waiting to see if gf, dairy free and other vitamin issues are part of the problem. If I still do not feel normal in the weeks/months to come, I will start with the Liothyronine. Doing it all at once, adding T3 and diet/vitamin experimentation doesn't allow me to see what exactly is the cause of just not feeling normal.
Here are my lasted April 23, 2018 test results for those interested:
I am on .88 mcg.
TSH 1.45 (0.40 - 4.50 mIU/L)
FT4 1.4 (0.8 - 1.8 ng/dl)
FT3 2.8 (2.3 - 4.2 pg/ml)
Because the FT3 seems to be on the low side, I am thinking I need to add Liothyronine. Also, some here may say I should take a higher dose of Levo since I am only taking .88. It was lowered a few years back because of palpitations, but didn't resolve them. But I felt no ill effects from being lowered. It was only after stopping completely that I have been struggling to feel normal. Any comments will be very appreciated.
Taking t3 and t4 
Low T3 and T4
Taking T3 and magnesium citrate together?
Back on T4/T3 combo after T3 only
T4 with T3?
