Tag Archives: cytomel

In Treatment of Hypothyroidism Need For t3 Could Be Genetic


Do you wonder if you need t3 (Cytomel, triiodothyronine, liothyronine) added to your thyroid hormone treatment to feel normal again? The answer could be in your genes.

Recent discoveries reviewed by Antonio C. Bianco, M.D., Ph.D. at the recent American Thyroid Association meeting, reveal how genetic differences influence the effectiveness of thyroid hormone replacement. Dr. Bianco’s lecture focused on studies pinpointing inborn differences in the way people metabolism thyroid hormone to explain why t3 treatment of hypothyroidism is probably required by some to restore normal functioning of their brain, muscle and heart.

The most frustrating problem for people with hypothyroidism is being unable to convince their doctor that treatment with Synthroid, Levoxyl or similar pure t4 product, isn’t working. Continued symptoms of fatigue, weakness, inability to concentrate or think clearly, and inability to lose weight despite really trying, result in tension between the doctor and the “complainer”. When assessing the adequacy of thyroid hormone replacement therapy most doctors rely on the blood tests known as the Thyroid Function Panel. Typically this includes a measurement of t4, t3, t3RU, and TSH. Some panels may also include free t4 or free t3 measurements. If the hormone levels on these tests are “within normal limits” the doctor will often insist that the treatment is a success but it is the patient who fails to recognize this. A minority of endocrinologists know many of these “failures” can be turned into success by the addition of t3, the less utilized but much more powerful form of thyroid hormone.

Most of the biological effects of thyroid hormone in the body are due to the action of t3. The most common forms of thyroid hormone replacement however, involve giving t4 in the form of Synthroid, Levoxyl, levothyroxine etc. The t3 required by our tissues is produced by specific enzymes which convert t4 to t3 in the cells of the liver, kidney, brain, muscle, heart etc. These converting enzymes are known as deiodinases and under normal conditions they are responsible for about 80% of the body’s t3. The process
by which t3 is produced from t4 is known as peripheral conversion.

It has long been the contention of the leaders in thyroid disorders that based on their arithmetic, t4 replacement is sufficient to provide all the t3 the body needs via peripheral conversion and giving t3 supplementation doesn’t make good medical sense. Now, based on the new information provided by researchers like Dr. Bianco, the “arithmetic guys” will, in my opinion, need to revise their thinking finally allowing the way for acceptance of t3 replacement approaches.

I will continue the explanation of the new breakthrough in genetic control of thyroid hormone replacement treatment in Part 2 of this post.

Wall Street Journal Reporter Helps Bring Clarity to Thyroid Treatment Controversy


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On April 11, 2016 an article, Doctors Hear Patients’ Calls for New Approaches to Hypothyroidism, appeared in the Wall Street Journal regarding the growing influence of patient preference on treatment selection for hypothyroidism (sluggish thyroid). The article was written by the WSJ health columnist Melinda Beck. I might have missed it but thanks to a motivated patient I received a copy within a week after its publication.  With a glance I knew this report could be a highly significant addition in the on-going debate between specialists treating hypothyroidism (endocrinologists) and advocates of alternative approaches. Continue reading

Ella Offers a Great Explanation of Combination T4/T3 Therapy for Hypothyroidism


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

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National Organizations Fail to Recognize New Approach for Treatment of Hypothyroidism


The 2013 guidelines issued by the American Association of Clinical Endocrinologists and the American Thyroid Association reiterated their long standing opinion that only a single hormone, T4 (Synthroid, levothyroxine) is advised for treatment of  hypothyroidism. These key organizations

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Margie Reports Her Success with Armour Thyroid


Hello, Everyone

I was diagnosed Hypothyroid 10 years ago, I have two sisters and several aunts with the same problem. I was prescribed synthroid and it was a Godsend for the first three years even though I was up and down, however I began to be more and more tired and just generally did not feel good, my dosage was up and down, finally doctor prescribed cytomel to go with it. still no good my bones hurt all the time especially my hip going down my leg and in the middle of my upper back, my beautiful teeth damaged. I finally told my Doctor to either give me the Armour or I was going to find another Doctor who would, He did and shazamm all symptoms disappeared, I feel great Like before I ever had this problem, I Thank God for Armour, and I also avoid flouride, chlorine

Will T-3 Help Dana with her weight, hair, skin and mood?


Although we often speak of the metabolic effects of thyroid hormone, we are really referring to the fact that this hormone helps to regulate the function of every system in the body. A system that is often a source of concern is known as the integument; the hair, skin and nails. The effects of disease is often first noticed due to effects on the integument and thyroid disease is one of the most likely to show up here. Brittle hair that sheds easily, and skin that is dry, itchy and flaky are often noticed early in hypothyroidism. Here is Dana’s story and I’m hoping that the addition of T3 will help her lose her excess weight and also reverse the deterioration she is experiencing in her integument, and her nervous system (mood).

Dana writes:

I was diagnosed as hypo a few years ago and my doctor just added 25 mcg of liothyronine (Cytomel) along with 100 mcg of Synthroid. In the past year I have gained 35+ pounds and it’s been alomost impossible to take it off. Last year I competed in my very first fitness/ figure competion. At 135lbs I came in 2nd place. I play softball and basketball on competitve level teams for the psat 15 years and I run about 3-4 times a week. I eat relatively healthy and have recent gone gluten-free, soy free, and nitrate free. Today is my very first day on the combined T3/T4 thereapy. I steppeed on my scale and it said 174lbs. Im hopeful that not only my weight will decrease but my hair will stopp shedding, dry skin/ scalp, joint pain, hopelessness and depression, and fatigue will all go away. I know patience is the key so I will be patient and wait.

My response:

Hi Dana

As you read here, some people are unable to return to normal thyroid equilibrium on t4-treatment alone; this may be due to an inherited form of enzyme defect preventing the normal conversion of the t4 hormone into the more potent t3 hormone; I am happy you found a doctor who will prescribe T3. Sometimes this needs to be given twice daily since t3 is a short acting hormone and the benefit may wear off within 6 to 8 hours. Some people don’t notice this while others definately do.
Good luck with your treatment. Also remember, thyroid hormone allows you to lose weight normally but doesn’t make weight “melt off”. You still have to do the right things with diet and exercise but at least your efforts should start paying off.
Good luck.

Gary Pepper, M.D.
Editor-in-chief, metabolism.com