Developing ideas for safe T3 supplementation - Thyroid UK

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Developing ideas for safe T3 supplementation


A new paper by Bianco duscussing the practical options for giving T3 safely to patients without the large swings in levels that T3 by itself shows. Some of these ideas if practical will push T3 use more into the mainstream. The paper is not yet out in full but should be in the next month. Below is the summary:


Provisionally accepted The full-text will be published soon.

Front. Endocrinol. | doi: 10.3389/fendo.2019.00544

Sustained release T3 therapy: animal models and translational applications

Thaer Idrees, John Price, Thomas Piccariello and Antonio C. Bianco

19 Replies

Link to the abstract :

LT3 tablets taken orally result in a substantial peak of circulating T3 that is dissipated during the next next several hours, which is markedly distinct from the relative stability of T3 levels in normal individuals.

Can I re-write this? My changes are underlined.

LT4 tablets taken orally result in a substantial peak of circulating T4 that is dissipated during the next next several hours, which is markedly distinct from the relative stability of T4 levels in normal individuals.

I've never understood why so many doctors get their knickers in a twist over T3, when they must know that healthy people have T3 flowing through their veins 24 hours a day. I admit that T3 will peak in the bloodstream after taking a dose. But the same is true of T4, and they are completely blasé about that.

diogenes in reply to humanbean

No I'm afraid you can't rewrite like that. The changes in LT4 after dosing are modest compared with those for T3. This is because the lifetime of a T3 dose is 1/8 that for T4 so the T3 spikes are larger. Not that it matters so much, as the T3 effect is smoothed out by the time it takes for cells to respond.

humanbean in reply to diogenes

Ok, thanks, I did wonder whether I was barking up the wrong tree.

If someone was taking both T4 and T3 and felt well on that, most people end up taking small doses of T3 compared to T4, so wouldn't the peaks be closer to the same size? If someone takes T3 only then I could understand the peaks being high then.

diogenes in reply to humanbean

Less T4 would raise its spike a little, but the long lifetime of T4 compared with T3 would still dominate the answer.

UrsaP in reply to diogenes

I take 60 t3 a day, and take it all in one go. I can’t say I have ever noticed peaks and troughs. I did notice when on T4 that I could be up there one minute and floored the next. T3 is much more settled for me.

NWA6 in reply to UrsaP

I’ve never noticed any peaks and troughs either. When I first introduced T3 I was very ‘happy’ but one would be after a long period of low and lethargy. Like having a drink of water after a long period of thirst.

I don’t know why the medical profession is tiptoeing around T3 so much. For the right people it’s a wonder drug.

UrsaP in reply to NWA6

Agree. It did take me 18mths when I first went on T3 to find the right balance, but that was reintroducing T4 and taking vitamins and minerals. I also think that the adrenals had a lot to answer for at the time. But once settled, T3 very steady. Only time meds go out of sync is when I’m under a lot of stress. But at least now I know what does it. But even then I don’t get the ‘highs’ on T3. No palpitations or anything like that. So definitely better than T4 ever was.

Greekchick in reply to NWA6

My experience is the same with T3, Paula, and I’m not even on the optimal dose yet.

NWA6 in reply to Greekchick

I did not introduce slowly, my prescription was for 15mcg per day with a slight reduction in Levo. I added the whole 15mcg from the day I received the T3. Ok so I spilt it into 3 doses and I can’t be sure that the constant smile on my face wasn’t psychological and not a reaction to a surge of T3 but I never had any palpitations or raving heart or the ‘wired’ feeling. I slept that night for the first time in months and woke up feeling refreshed. My RHB increased to a more positive level. I just had no adverse reaction at all. I know some people can be sensitive but I just didn’t want to fanny about with increases. Maybe I got lucky or maybe introducing it in one go was the best way for me 🤷‍♀️

Greekchick in reply to NWA6

T3 in divided doses makes me feel great - the anxiety I still feel is from being surgically hypothyroid and not yet having found my sweet spot of meds - but I’m getting there! T3 added to my T4 made all the difference. I have to add it a little at a time because I have severe reactions to large doses of anything, but I call it my happy pill. We thyroid patients truly are experiments of one - we are all so different and each of us responds differenly to the same hormones. And they want to fit us into a one size fits all approach. There is no logic at all to that. But when has logic ever had anything to do with it? 🤷🏻‍♀️

NWA6 in reply to Greekchick

So true! I’m glad you’re getting there! It certainly is a happy pill!

Hillwoman in reply to Greekchick

Same here. All I notice, occasionally, is a small increase in heart rate, of brief duration.

The basic commercial problem with this work is that if it succeeds, there will be patents issued and accordingly the cost of the new product will be higher than it need be. T3 on its own is still acceptable so long as the temporary spikes in blood are only sluggishly followed by body response, which I believe is the case. So I think the basic hurdle to get over is medicine accepting using T3 in any form, not adding bells and whistles to avoid a nonexistent problem. NDT itself may be a delayed input kind of product.

crw2ddd in reply to diogenes

I have pondered many times why there isn't a thyroid hormone patch? Other hormones can be delivered this way, why not thyroid?

diogenes in reply to crw2ddd

Because it doesn't get through the skin efficiently.

Could we inject it like B12 or insulin?

Yes. A nice little pump with a reservoir containing T4/T3 in solution could be attached to a vein, and a constant supply of hormone steadily pumped in just like the living thyroid supplies the hormones.

helvellaAdministrator in reply to diogenes

What has been in my mind from my very earliest days of thinking about the thyroid.

Woukd be rather nice if the dosing could be based on more or less the same factors as in healthy people but that is a big ask.

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