A new T3 derivative shows promise in treatment ... - Thyroid UK

Thyroid UK

122,480 members143,022 posts

A new T3 derivative shows promise in treatment with T3 and smaller FT3 spikes after taking it

diogenes profile image

Ths paper and abstract is downloadable. It demonstrates that the new T3 derivative has a good display of less vigorous FT3 spikes after taking it. This means that combination users and T3-only users have a better and more stable response. However, this compound will be patented and sold as rather high cost to patients. NDT probably has a similar effect, as most of its T4 and T3 are held in protein molecules, but of course there's no financial pressure to use it. Expect eventually NDT will be superseded.

Clinical ThyroidologyVol. 34, No. 1 HypothyroidismFree Access

Phase 1 Clinical Trial of Poly-Zinc-Liothyronine Demonstrates Slow-Release Serum T3 Kinetics

Elizabeth A. McAninch

Published Online:4 Jan 2022doi.org/10.1089/ct.2022;34....

Review of: Dumitrescu AM, Hanlon EC, Arosemena M, Duchon O, Ettleson MD, Giurcanu M, Bianco AC 2021 Extended absorption of liothyronine from poly-zinc-liothyronine (PZL): Results from a phase 1, double-blind, randomized, and controlled study in humans. Thyroid. Epub 2021 Oct 12. PMID: 34641706.

SUMMARY

Background

The standard of care for treatment of hypothyroidism is thyroid hormone replacement with levothyroxine (L-T4) (1). It is becoming more recognized that treatment with L-T4 plus liothyronine (L-T3), termed “combination therapy,” may improve symptoms for some patients who remain dissatisfied with L-T4 alone, despite doses that normalize the serum TSH (1,2). However, the pharmacokinetics of L-T3 have been a significant barrier to this approach, as once-daily L-T3 administration in hypothyroid subjects results supraphysiologic serum peaks and troughs (3); this is a significant excursion from the stable serum T3 levels exhibited in individuals with endogenous euthyroidism (4). Perhaps not surprisingly, in over a dozen clinical trials, combination therapy has not been shown to have definite superiority over L-T4 monotherapy (5,6), but the available L-T3 formulations used in these trials did not mimic physiologic, endogenous T3 supply well. Thus, in a consensus document from the American, European, and British Thyroid Associations, there is agreement among all 34 of 34 experts that new formulations of L-T3 are desirable to use in future clinical trials to assess combination therapy (2). Several groups of investigators are developing exciting new technologies to deliver L-T3 with improved pharmacokinetics. After showing promise in a rodent model (7), the authors of this study performed a Phase 1 clinical trial of a metal coordinated poly-zinc-liothyronine (PZL) (8).

Methods

This was a Phase 1 clinical trial of 12 healthy adult volunteers, ages 18 to 50 (4 women and 8 men). Subjects had no history of thyroid disease and no past history of gastrointestinal disorders. All participants had a normal electrocardiogram (ECG) and serum thyroid function tests (TFTs) at baseline.

Subjects were admitted as inpatients in the morning after an overnight fast. They were randomly assigned to treatment sequence arms and were given one dose of placebo, PZL containing 50 µg of T3, or sodium-T3 containing 50 µg of T3 in identical capsules coated for duodenal delivery. The subjects were observed for 48 hours, during which timed blood draws were used to determine pharmacokinetics, three examinations were performed each day, and ECG was performed prior to discharge. After 2-week washout periods, the sequence was repeated so that all participants received each treatment. An independent physician who was not blinded to treatment acted as the safety monitor. One participant was excluded after not completing all study arms; 11 participants completed all 3 arms of the trial.

Results

In the L-T3 arm, serum T3 levels rose from a baseline of approximately 110 ng/dl to a peak concentration (Cmax) of approximately 300 ng/dl between 2 and 3 hours after the dose (Figure 1A). After approximately 8 hours, serum T3 levels had decreased to half of Cmax. Serum T3 levels returned to baseline between 36 and 46 hours.

Figure 1.

Figure 1. Intestinal absorption of sodium T3 capsules versus poly-zinc-liothyronine (PZL).

(A) When T3 was administered once daily in healthy, euthyroid participants, serum T3 levels rose to a transient supratherapeutic peak, about 2 to 3 hours after ingestion. After approximately 8 hours, serum T3 levels had decreased to half of the peak concentrations, and they returned to baseline between hours 36 and 46. (B) When PZL was administered once daily, serum T3 levels rose to a relatively lesser peak between hours 2 and 8. Serum T3 concentrations still exceeded half of the peak concentration by 24 hours and returned to baseline by 46 hours.

Created by Elizabeth A. McAninch MD.

In the PZL arm, serum T3 levels rose from baseline of approximately 110 ng/dl to a Cmax of approximately 220 ng/dl between 2 and 8 hours after the dose (Figure 1B). By 24 hours, serum T3 concentration still exceeded half of Cmax. Serum T3 levels returned to baseline by 46 hours.

In the placebo arm, serum T3 levels were relatively stable, ranging from approximately 100-115ng/dL. Serum TSH was similarly reduced in the L-T3 and PZL arms and decreased by approximately 40% at 9 hours and by approximately 70% by 24 hours, disrupting the circadian rhythmicity observed with the placebo.

No differences in heart rate, blood pressure, or sleep outcomes were seen between the three arms. There were no serious adverse events in any treatment arm. Mild adverse events were evenly distributed among arms and resolved without complications; none were definitely linked to L-T3 or PZL use.

Conclusions

In this Phase 1 clinical trial, euthyroid adults treated with PZL demonstrated a slower-release serum T3 profile illustrated by a lower T3 serum peak compared with participants treated with L-T3, and maintenance of serum T3 concentrations above those for placebo for a longer duration. These findings are consistent with delayed but continued intestinal absorption of PZL use, compared with L-T3.

COMMENTARY

In this small placebo-controlled study of PZL versus L-T3, there were no adverse reactions and adverse events were similar in all treatment arms. This is consistent with other recent studies that have not demonstrated harm with L-T3 use at doses that maintain a normal serum TSH (6,9,10). This will, of course, continue to be the source of further interest if PZL moves to the next phases of clinical trials, and I interpret these findings with cautious optimism.

That the NIH funded this study may provide further evidence, and hope for our patients, that there is better acknowledgment of residual symptomatology in a minority of persons with hypothyroidism and that none of the currently available treatment methods provide absolutely physiologic thyroid replacement. Hypothyroidism has high prevalence, and thus is a public health topic of great value deserving of improved solutions, in my opinion. PZL represents one new technological attempt to improve T3 pharmacokinetics (7,8).

My clinical practice is perhaps biased due to my documented research and clinical interest in the field because in the contemporary (internet) era, patients can easily access research, medical journalism, and peer support groups. Thus, it is not uncommon for me to encounter a hypothyroid patient with residual symptoms that may be attributed to hypothyroidism, despite treatment with L-T4 monotherapy that normalizes the serum TSH concentration. In the absence of contraindications, I often offer n-of-1 therapeutic trials with L-T4+L-T3 combination therapy, during which patients may either: (a) report a positive response, (b) report no symptomatic differences, or (c) feel worse, which typically is associated with palpitations, anxiety or bothersome bursts of energy followed by fatigue, depending on the timing of the L-T3 doses. I have not found a strong clinical predictor of which patient will have which response. The multiple-times-per-day dosing regimen is a downside to L-T3, as well as not being able to provide a definite outline of the risks of intermittent supratherapeutic serum T3 levels. It is unknown whether clinical trials, or n-of-1 therapeutic trials in our practices, performed with a slow-release formulation, such as PZL in the current study (8), will show superiority to L-T4 alone.

Figures

References

Related

65 Replies
helvella profile image
helvellaAdministrator

Any further news on other suggested approaches?

Such as:

Sustained Release T3 Therapy: Animal Models and Translational Applications

slow release tablets

liquid formulations

use of T3-related/hybrid molecules such as T3 sulfate, poly-zinc-T3 and glucagon-T3

nanoparticles containing T3

subcutaneous implant of T3-containing matrices

frontiersin.org/articles/10...

diogenes profile image
diogenes in reply to helvella

Not really. It demands USA chutzpah and their let's-go-for-it philosophy + of course ready money to fund the work.

LindaC profile image
LindaC in reply to helvella

If my recollection is accurate, compounding pharmacies in the US make up slow-release T3. At the time I was questioning this, I also seem to recall Dr John Lowe not being in favour?

helvella profile image
helvellaAdministrator in reply to LindaC

There have been claims of slow release T3 being made to order.

I am very sceptical. The main reason being that the approach seems simplistic.

Take some T3, take some slow release substance, put them together. Hope.

Of course, they might have struck lucky and produced a good combination. But I'd be much happier if someone had done comprehensive research. Assessing the behaviour of the combination, how it disintegrates, disperses, dissolves, where in the gut, evenness, etc. And whether it behaves the same in everyone.

Further, I wouldn't want to inadvertently or accidentally take too much slow release T3.

LindaC profile image
LindaC in reply to helvella

Absolutely - accepted and agree! I also think John Lowe mentioned it potentially hanging around in the gut...!? Sadly so many are put in desperate situations due to endo_lunacy ;-) One day, eh? Oh, Happy New Year to you and all. 💚 💝

Lets see what happens when they give it to some people with hypothyroidism. (mind you i bet they won't let them have 50mcg)

I was poking about online last night and read that there is no benefit to be gained from less than 40 mcg T3

helvella profile image
helvellaAdministrator in reply to MorecambeBay

All depends on where you read!

Others have claimed tiny doses - like 2 micrograms - are all that are required by many.

I think I'll reserve judgement - and allow that anything from zero to 200 micrograms could be needed. As always, depending on the individual.

Any dose over 40 mcg and I’m overmedicated - any thing below 40 mcg and I’m like a sloth. It’s always been thus, whether I’m carrying some extra weight or not. (Dose twice a day)

This is why I don’t believe in using weight, BMI of taking off your clothes. There must be something more to it than these factors

helvella profile image
helvellaAdministrator in reply to MorecambeBay

I am very sceptical about using weight. Did you ever read the document that goes along with my spreadsheet of levothyroxine dose calculations?

The very fact we have so many formulas, which disagree, sometimes profoundly, with each other undermines everything to do with dosing by weight.

Of course I read it ☺️. The irony is that weight is usually used as an initial dosing criterion with the promise that you’ll be monitored for increases by other symptoms at your reviews.

All I can say is that the only way you’d get an increased dose is you were Nellie the Elephant.

TSH110 profile image
TSH110 in reply to MorecambeBay

I had a right go at the thyroid nurse when she said that. I asked how it was a close relative who was tiny and weighed a lot less than than I did yet was put on 50mcg more than me. It’s just a darn lottery. They make it up as they go along.

TSH110 profile image
TSH110 in reply to MorecambeBay

Even then it’s hard! I put on 5 stone on Levo but oddly my dose was never increased! All that weight has gone on NDT

TSH110 profile image
TSH110 in reply to helvella

As if all we are is just a big lump of stuff and that’s all that matters how much it weighs. It beggars belief

How do you space your 2 doses MorecambeBay? I am currently using 3 and not liking it at all. I'm sure 2 a day were better for me.

I used to use 3 and it wasn’t great. I now dose at about 7.30 or when I get up and again at about 8.30 pm. I don’t miss a lunch time dose at all.

Thanks.

I sometimes read about the people here who take 2 x 5mcg with some Levo and feel fantastic and it makes me want to cry. I'm now on 45mcg T3 and feel no better. I feel better for a day when I increase it, in fact the last increase gave me 4 days of improvement before dropping right back down to the start again, in fact worse, as I'm more tired.

helvella profile image
helvellaAdministrator in reply to FancyPants54

You are far from alone is saying something like that.

Afraid without personal experience, it is hard to understand. But believe, and have sympathy with you? No problem.

Thanks. Having people believe me is a big deal. My friends can be heartless, often. They forget how I used to be. How could that fit, happy, lively woman suddenly become a champion hypochondriac? Not possible. But I think they think that's what has happened. If they see me out struggling for a little walk they say condescending things like "you just need to do this every day and go a little further each day" etc. I used to walk the fields for miles with little effort. I don't need their pep talks. I need them to understand that when I say I have no energy and that my legs and feet hurt so much I could cry, that I really mean it. But no. Just need to exercise more apparently!

I can’t count the number of times I’ve heard that.. is all your pain thyroid related?

I think so yes. My legs and feet can be unbearable. My legs feel like lead and get heavier if I try to walk at a normal pace (although that issue has been a little better recently, I find I can walk at a better pace, but I can't walk far). If I walk too far or stand still chatting to someone my lower back seems to stiffen and hurt like hell until I sit down and that affects my legs too. My feet sting and burn and hurt so much. I can't feel the same sensations with my toes and balls of my feet. They are both highly sensitised and numb at the same time, which is weir as heck. I'm sure this is all thyroid related. My HRT is nicely settled now, so it's not lack of oestrogen.

I’ve gone through many years of this sort of pain. It’s been put down to poor dosing of thyroid hormones, oestrogen deficiency, stress and depression, peripheral neuropathy, fibromyalgia …..

About a year ago I went to see a Pain Consultant. I told her I was sick of not knowing what was causing the pain. The effect of the pain on my life was much as yours and I’d been dosed with lots of medication that had no effect whatsoever.

This lovely lady asked whether I wanted to know what caused the pain or whether I wanted it ‘gone’

Of course I wanted it ‘gone’. She gave me pain patches - change every week - and I’m now almost pain free and as happy as a pig in muck. I know that these patches are expensive, as is some of my other medication, but Doctors are there to make us feel better and give us a quality of life, not save up for the surgery party.

I really believe that we should have unsalaried GPs paid directly by the NHS and not their partnership. Perhaps then we’d get the same service that we get from locums

so pleased to hear the pain patches are helpful xx

I feel for you. I felt issues with my back, neck and shoulders. They just don’t seem to cope some days. I have to sit really well propped up to kind of take the strain of being upright. Again, I can’t explain it properly. It’s as though my muscles don’t work. But sometimes they do 🤷‍♀️Pushing myself to do more doesn’t help and I get more fatigued with the added bonus of migraines. You can pretend I’m your friend - I won’t ever mock you or tell you to keep going and it will subside ☺️

TSH110 profile image
TSH110 in reply to FancyPants54

Those are all things I have had, which are much improved since treatment but not completely banished.

if it helps , I believe you too , x

I really do think it's thyroid related for me. I've never been optimal. The best I've had in years now is the Levo not making me feel too much worse. On a day when I adjust a dose up/down, whatever, it's as if it tricks my body and then I have a good day. I can stride out and my legs and feet don't hurt. As soon as that energy wears off the next day the pain is back. My backache when doing housework/gardening tasks takes longer to arrive in the morning after my biggest dose of the day but is faster and faster as the day progresses and the dose sizes reduce. It's odd, but that's how it happens. I need to do stuff before the morning dose wears off.

TSH110 profile image
TSH110 in reply to tattybogle

Me too been there felt that and its hideous. I nearly died because the medical profession persuaded me I was just a hypochondriac.

FancyPants54 profile image
FancyPants54 in reply to TSH110

It's so unfair how we are treated, by just about everyone. Thank goodness I have a very caring and understanding husband.

TSH110 profile image
TSH110 in reply to FancyPants54

Yes you are really lucky there - a rock eh?!

FancyPants54 profile image
FancyPants54 in reply to TSH110

Absolutely. He loves to cook so he does it all. Bread, baking, dinners every day. All the food shopping (mind you it's all delivered so not so difficult). He's really untidy though, but none of us are perfect. I'd not swap him for the world.

TSH110 profile image
TSH110 in reply to FancyPants54

😁 sounds great

TSH110 profile image
TSH110 in reply to FancyPants54

Change your friends that’s what I say - they aren’t friends at all.

FancyPants54 profile image
FancyPants54 in reply to TSH110

They are just handy. It's a small village. One lives next door, one around the corner. I know they are OK or surface stuff but not so much use for anything meaningful. I've learnt that over the years and now I am aware of it I can deal with it. I was a little anguished at the start as to why they were so unsympathetic, but I expect it now.

TSH110 profile image
TSH110 in reply to FancyPants54

But it’s not good for you to be getting that negative message from them. I hope you have some sympathetic friends to balance it out. It’s a very hard thing to go through you need a lot of support with this darn disorder. Thank god for this forum. There are some jolly decent and kind folk on here who understand what it’s like to go through. I wish I had kept a diary but I was too ill to manage that or I’d try and write a book about it!

FancyPants54 profile image
FancyPants54 in reply to TSH110

I used to have a lot of casual friends because I was heavily involved in non-professional theatre. But they soon fell away when I was no longer able to do what I had done. I have 2 old school friends, don't hear from them very often at all. In fact I sent them both nice little gifts at Christmas and haven't heard back from either. One has just lost her Mum though. So no. I don't have friends. But I'm OK with that. The casual friends were exhausting. At least with these 2 I know what they are like and I still hide a lot from them. There's no point trying to explain. I'm a single child, as is my husband. We are and have always been happy on our own. We are content to be in the house together but I haven't seen him for hours. He's up in his office and I'm in mine, doing our own things. It's very companionable to know he's here if I need him but he's happy doing his own thing as am I. This illness has taught me a lot about people. Not much of it complimentary. We have a lot of village friends that we might go out to dinner with now and then in normal times, we were part of a small supper club. And the village runs a bar twice a month which we used to like going too. But we've not been because of Covid. Those things will be there again one day. That means we keep up with village life and don't get forgotten.

TSH110 profile image
TSH110 in reply to FancyPants54

Sounds sensible to me

I just think they should spend less time fiddling about trying to reinvent it as 'slower release' , and more time investigating whether 'normal' T3 makes people who feel crap on levo feel any better .

They seem to be spending billions of £/$'s developing something new ,to solve what appears (to me) be a bit of a 'non' problem.

I'm just cynical, so i can't help wondering if it's more about developing opportunities to make loads more £'s in the future from new formulations of T3, than it is about any real need to reduce the 'spike'.

Still, at least they are looking at it . so as my Dad would say, "it's better than a smack round the face with a wet fish"

I think it's all about money :

Big Pharma are the one's holding the purse strings and if they spend money it is to make money with another drug that they can then patent -

Everyone's a winner in some shape or form, whether it works better or not - who knows, who cares ?

The patient is a last piece of the puzzle and if it doesn't work well, it's likely something else anyway as your bloods are in range. - and we've all heard this old chestnut and offered anti depressants ?????

Whilst we are constrained by guidelines that are ' not fit for purpose " it's all pie in the sky and likely unaffordable on the NHS.

After all we can't easily even obtain the current treatment options through the NHS so what's one more :

TSH110 profile image
TSH110 in reply to tattybogle

Or even better give us a proper choice of thyroid hormone treatments, including NDT, and let us be the arbiters of what is our best treatment. I bet NDT /combination therapy would be the winners against Levothyroxine. But whatever, we should be the ones to decide. You’d think it were rocket science but it’s far too simple for those white coats to contemplate - freedom of choice for us 😱 they wave their arms in horror. Why do we need to be protected from ourselves and having real treatment options as if we are stupid little children incapable of making our own decisions on what’s good for our health.

tattybogle profile image
tattybogle in reply to TSH110

my simple little bear brain says ...... surely it would lead to more productive /intelligent research if they :

1) Let everyone try everything until they felt better .

2)Then group all those who felt better with treatment 'x' together .

3) Then look at each groups characteristics to see what they have in common .

...... that's how i'd try to find data on 'which group of people treatment 'x ' would be most likely to help'

And presumably, grouping them all together like that might give some decent insights into 'why'

but what do i know .. i just make tents out of sticks and string . :)

TSH110 profile image
TSH110 in reply to tattybogle

I’d be happy to volunteer as a subject of your research! Mad isn’t it that all the people here have loads to offer medical science and it’s advancement but they just ignore us and look at the healthy as if they will provide answers to our problems! Only if we whipped out their thyroids. It’s crazy.

TSH110 profile image
TSH110 in reply to tattybogle

There’s a few I’d like to slap around the face with a wet 🐠 I can tell you! It would be a great method of protest except it probably counts as GHB or a guppy hake bream assault

tattybogle profile image
tattybogle in reply to TSH110

LOL.

Hopefully you mean GBH .. think GHB is a naughty illegal substance that makes you forget what happened to you last night ....

TSH110 profile image
TSH110 in reply to tattybogle

You’re right swap the bream for the hake and viceversa will you tat!!! Well spotted

TSH110 profile image
TSH110 in reply to tattybogle

Too old for any experience of that mind altering substance But not too old to slap a wet fish in someone’s choppers!!!

We’re all different in many ways. For me, with no thyroid gland, 10mcg added to my dose of T4 makes an enormous difference!

I have no thyroid either. For some reason I’m intolerant of T4.

TSH110 profile image
TSH110 in reply to MorecambeBay

How can anyone make such an absurd statement. Who the hell knows given we are all so individual. It certainly makes my life more bearable on NDT and that’s only about 13mcg T3 so it’s absolute rot if you ask me - but when do they ever ask people with thyroid disorder anything at all?

TSH110 profile image
TSH110 in reply to tattybogle

I bet they won’t let us have it at all when antidepressants are all we are supposed to need!

"This is consistent with other recent studies that have not demonstrated harm with L-T3 use at doses that maintain a normal serum TSH (6,9,10)."Again TSH is flagged up here...

Why has FT3 not been used instead, since it is the hormone that has the potential to be active once it reaches the nuclei of the cells?

I need high dose T3-only (currently 93.75mcg, has been 200mcg) to function, I take this in a single dose at bedtime.

Multiple dosing did not work

My resting heart rate is around 70bpm

Recent heart scan showed no problems

I've never been aware of any energy flares, palpitations when I've checked ....even in the middle of the night.

I now believe that I have a form of Thyroid Hormone Resistance causing Cellular Hypothyroidism...but only because I had no option other than to search this out for myself. I know I'm not alone in this!

Medics had fixed ideas and could not help...endo suggested LT4-only which I'd taken for over 20 years....yet my health deteriorating badly.

Perhaps open minds are a prerequisite!!

I have not found a strong clinical predictor of which patient will have which response.

Might this be because we are all different with different treatment needs and identifying a strong clinical predictor can be akin to looking for a needle in a haystack.

A bigger magnet required!

Would it not be supratherapeutic cellular levels that would cause problems rather than "supratherapeutic serum T3 levels", given that T3 does not become active until it enters the cell's nuclei

That the NIH funded this study may provide further evidence, and hope for our patients, that there is better acknowledgment of residual symptomatology in a minority of persons with hypothyroidism and that none of the currently available treatment methods provide absolutely physiologic thyroid replacement

This at least is very true, " none of the currently available treatment methods" did anything to provide me with "physiologic thyroid replacement" ... that only happened after introducing a supraphysiological dose of T3. And I'm fairly certain "absolutely" might precede that latter phrase!

My body was shutting down but I was told I had Fibromyalgia and Chronic Fatigue Syndrome ...I lived with this happening for decades but in the end I was so convinced it was somehow connected to the hypothyroidism that had been earlier diagnosed.

I told my then disbelieving GP that I was going to find the answer myself...I was desperate.

Had I not discovered a link to the life changing TUK forum on an NHS website thyroid page I may not be here ranting today.

Are they looking in a normal haystack for the lost needle because not all patients need a T3 dose that is "within a normal range".

Try the wobbly haystack at the back of the stack yard...it's been sitting there for a long time and knows a thing or two!

In my extremely amateurish way I see more and more posts on here that suggest this possibility...and no way forward apart from the patient taking control.

Why do "they" appear so afraid of T3?

Money...perhaps, but it seems to be more than just money.

Do they really need to reinvent the wheel?

tattybogle profile image
tattybogle in reply to DippyDame

"Try the wobbly haystack at the back of the stack yard!!"

What a brilliant picture :)

can just imagine loads of 'whitecoats' in wellies with their heads stuck in a haystack

"Oi !" shouts the wonky donkey

"you're all lookin in the wrong haystack"

Lol

JGBH profile image
JGBH in reply to DippyDame

Well said! Indeed why do they appear to refuse giving patients the best possible treatment? Your accurate comments should be published in a medical journal.

Thank You So Much diogenes for bring to our forum the latest up dates with our thyroid journey meds. I am very happy to see that T3 is getting at last some recognition that it so much needed and denied for so many still. I think that many of us would agree to sign up to be the lab rats for T3 and it's benefits.

Work in progress and that's very hopeful for many of us .

Thank You.

I want to be a mouse

linda96

Hi Diogenes,

I hope they don't try and phase out Liothyronine as I am 100% convinced that some of us with severe problems need the high peaks from standard T3 to correct the cellular action of T3. Have the authors ever mooted that Liothyronine might not be required?

Many thanks,

Paul

They still follow the TSH-must-be-in the reference range on treatment. Just because they are producing T3 derivatives with smoother blood response doesn't mean in the medium term that T3 will not be given. The new compound additionally has got the potential of a lucrative return on investment, and treatment costs could mimic those of the worst period in the UK for T3 use. It will be encased in patents. So unless the price is right T3 will be continually preferred especially if the T3 dosage spikes aren't really a detriment in getting a successful treatment regime.

It would be great if you are right Diogenes. I don't like the idea of endos making profits out of new drugs (if that is actually true). It could be too tempting for them to want to prescribe this new one if it is the case that they will benefit from it.

Thanks once again for the information.

Paul

Me too...Without Lio I'd be up a creek without a paddle!!

I’ve been on T3 since 2007, T3 mono since 2010. I don’t recall any ‘spikes’, palpitations or such. My problems always reappeared when I tried to reintroduce T4. So eventually, just gradually, upped the T3, along with Dr P’s help, and my then accommodating GP. (Sadly now retired) I take 60mcg pd of the German brand. Sometimes, especially during winter, I find I need a bit more and occasionally I’ll take 80. I sometimes think I might need even more but obviously it is difficult to come by. We are all different and have different needs. Possibly due to our varying genetics. That is why T4 mono is not right for all. Might be for some but not all. My worry would be, this new option will all offered alongside T4 mono or nothing else. I never see research, or hear discussions that take into consideration those who need or are doing well on T3 mono. Combination will not suit all those who don’t get on with T4 mono. It is like the same mistakes made over again...all packaged under one option. Or maybe two now.

TSH110 profile image
TSH110 in reply to UrsaP

If only it were three with NDT.

Many thanks for this information.

Interesting but I can’t see how NDT will be improved upon given it’s as close to nature’s recipe as you can get. I sincerely hope it isn't superceded by some man made substance that will probably cost so much only a few will ever access it.

You may also like...