According to experts, 10 to 20% of hypothyroid individuals fail to respond completely to T4-only (levothyroxine, Synthroid) treatment. Dr. Anthony Bianco, the president of the American Thyroid Association, and his associates believe this is due to genetic variations in the way thyroid hormone is converted in the body from T4 into T3. T3 is the much more potent form of thyroid hormone and unless the cells of the body receive enough T3, normal function cannot be achieved and symptoms of low thyroid such as fatigue, mental fogginess, constipation, muscle aches etc, persist. Based on the research conducted by Dr. Bianco and colleagues it is thought that in those with the genetic trait making T4 treatment ineffective, blood tests would show low T3 levels. Continue reading
Metabolism.com received this message from one of our readers. Her story seems typical of the sort of dilemma so many people face today. The best advice usually comes from others who face the same problem. It would be helpful to hear what others would do in her situation.
Tara’s message: “I was diagnosed with Grave’s Disease in 2009, I had RAI in 2011, after my daughter turned 3 months. Being pregnant with Severe Grave’s was the scariest thing in my life at the time. I gained weight prior to my pregnancy, during, and after RAI. My family doctor told me no matter how much you ate while severe Hyperthyroid you should have been anorexic, so something else is wrong. ” Continue reading
Why Patients Aren’t Receiving the Most Effective Treatment for Hypothyroidism
By Gary Pepper, M.D.
For the past 3 to 4 decades endocrinologists worldwide have adhered to the belief that only synthetic T4 (the most abundant of 4 thyroid hormones produced by the thyroid) is appropriate therapy for a sluggish thyroid even though it is known that a substantial number of those treated with T4 only continue to suffer from persistent symptoms of the disease. This may be because under normal conditions the thyroid produces two principle hormones T4 and T3. In 2013 an NIH study showed that 50% of those with hypothyroidism preferred treatment which includes T3 and our group reported that 78% of a subgroup of patients preferred T3 containing medication to treat hypothyroidism . Continue reading
Our member, Ella, has analyzed her own T4 plus T3 thyroid replacement needs and offers a terrific explanation of how she arrived at her conclusions. Follow her thinking in her message to metabolism.com
Mainstream endocrinologists seem to be moving grudgingly toward acceptance of combination T4 plus T3 therapy for hypothyroidism. A great example of the mixed feelings harbored by endocrinologists in this regard is the title of a recent editorial, “ Combo (treatment) a Last Resort for Hypothyroidism” . Although the author, Dr. Bruce Jancin of the University of Colorado, recognized the value of combination T4 plus T3 therapy, he did so with the least possible enthusiasm. In his article the doctor acknowledged the weakness of scientific studies showing negative results with combination therapy and pointed out the findings of the Watts Study which provides a genetic rationale for why some people need to have T3 added to T4 to return to proper thyroid hormone balance. Continue reading
A long time member of metabolism.com, Eric Pritchard, has been a determined critic of “T4 only” treatment of hypothyroidism. In his latest comment Eric shows that scientists were aware of the inadequacy of “T4 only” treatment since 1947! I wanted to give everyone a chance to read his comment so I am posting to the main blog. Thanks again for your insight Eric.
Submitted on 2012/03/25 at 6:11 pm
Endocrinologists have a hard time with the symptoms of hypothyroidism in the same sort of way that New York City folks believing that there is anything worthwhile west of the Hudson River. However, there are very relevant functions to the thyroid hormone effectiveness that exist beyond the boundaries of the classical endocrine system. This potential was given initial credence by Drs. Kirk and Kvroning in 1947 when they published a note saying that not all patients’ symptoms were managed by thyroxine (T4). This was collaborated in 1954 by Dr. Means. Drs. Gross and Pitt-Rivers discovered triiodothyronine (T3) and found it far more active than T4, which is now called a pro-hormone. The concept of euthyroid (your thyroid is OK) hypometabolism (but you are dragging anyway) was demonstrated by Dr. Goldberg in 1960. Drs. Refetoff and Braverman, circa 1970, discovered the connections between the thyroid gland and symptom producing cells, namely the cellular reception of hormones and the conversion of T4 to T3 outside of the endocrine system, which produces 80% of the body’s requirement for the active hormone, T3.
Another issue that is dismissed is the necessity of supporting chemistry to function properly. For example, every thyroid hormone replacement counter-indicates is use if the adrenals are insufficient.
So there is far more going on than endocrinology is willing to promote. That is why there are 1.7 million patients suffering in spite of T4 therapy. That is why there are still more patients suffering from false negative diagnoses for the symptoms of hypothyroidism.