T3 Vs T4 / T3 Treatment Controversy
It's a huge controversy in the thyroid world whether thyroid hormone replacement should consist of just T4 (i.e., a levothyroxine drug like Synthroid) or whether patients actually need both T4 AND T3, i.e., triiodothyronine (Cytomel), compounded T3, or desiccated thyroid like Armour thyroid. Find out more about this ongoing controversy.
The T4/T3 Thyroid Drug Controversy
The use of T4 and T3 together as a thyroid hormone replacement treatment for hypothyroidism -- an underactive thyroid -- is controversial, given that the standard treatment is levothyroxine (T4) alone. The addition of T3 to the levothyroxine/T4-only treatment is, however, a topic of ongoing research and discussion. This treatment controversy is explored in a number of articles here at the About.c…
The use of T4 and T3 together as a thyroid hormone replacement treatment for hypothyroidism -- an underactive thyroid -- is controversial, given that the standard treatment is levothyroxine (T4) alone. The addition of T3 to the levothyroxine/T4-only treatment is, however, a topic of ongoing research and discussion. This treatment controversy is explored in a number of articles here at the About.c…
Endocrine Society Press Release - October 2003
Press release from the Endocrine Society announcing the research results.
Press release from the Endocrine Society announcing the research results.
Journal of Clinical Endocrinology & Metabolism Abstract
Walsh, John P. et. al. "Combined Thyroxine/Liothyronine Treatment Does Not Improve Well-Being, Quality of Life, or Cognitive Function Compared to Thyroxine Alone: A Randomized Controlled Trial in Patients with Primary Hypothyroidism," J Clin Endocrinol Metab 2003 88: 4543-4550
Walsh, John P. et. al. "Combined Thyroxine/Liothyronine Treatment Does Not Improve Well-Being, Quality of Life, or Cognitive Function Compared to Thyroxine Alone: A Randomized Controlled Trial in Patients with Primary Hypothyroidism," J Clin Endocrinol Metab 2003 88: 4543-4550
Book Excerpt: Living Well With Hypothyroidism
"Thyroid patients have wasted enough valuable time not feeling well...We already have the research findings that can help many people. And we have the anecdotal knowledge of thousands upon thousands of thyroid patients and their doctors who are able to live well with the use of T3 drugs" (p. 154)
"Thyroid patients have wasted enough valuable time not feeling well...We already have the research findings that can help many people. And we have the anecdotal knowledge of thousands upon thousands of thyroid patients and their doctors who are able to live well with the use of T3 drugs" (p. 154)
Combined T4/T3 Therapy: Placebo or Tomato? An Assessment
Research article, with citations, by Kenneth Woliner, MD, from October 2003.
Research article, with citations, by Kenneth Woliner, MD, from October 2003.
Hypothyroidism Diagnosis and Treatment: Article
Detailed article, by Ted Friedman, MD, on hypothyroidism diagnosis and treatment.
Detailed article, by Ted Friedman, MD, on hypothyroidism diagnosis and treatment.
Jacob Teitelbaum, MD
"All the study shows is that if you treat people poorly with any treatment, you'll get a poor result..."
"All the study shows is that if you treat people poorly with any treatment, you'll get a poor result..."
Glenn Rothfeld, MD -- Commentary
"...there are 20 million (conservative estimate!) people with hypothyroidism, and a study would have to be big enough to give good advice to that many people"
"...there are 20 million (conservative estimate!) people with hypothyroidism, and a study would have to be big enough to give good advice to that many people"
Joseph Mercola, DO -- Commentary
"We start all new patients hypothyroid patients on Armour thyroid, and switch most of those who have been on levothyroxine for the previous three years to Armour."
"We start all new patients hypothyroid patients on Armour thyroid, and switch most of those who have been on levothyroxine for the previous three years to Armour."
Ken Blanchard, MD Commentary
Any T4/T3 study that does not give T4/T3 in about a 98%/2% T3 T4/T3 ratio and does not give T3 in time-release form will not come close to reproducing normal thyroid physiology...
Any T4/T3 study that does not give T4/T3 in about a 98%/2% T3 T4/T3 ratio and does not give T3 in time-release form will not come close to reproducing normal thyroid physiology...
Richard Shames, MD, Karilee Shames, RN, PhD Commentary
"It doesn't matter if 100, or 1000, studies show that most people do better with thyroxine alone. There are always some people in any of those studies that did better on thyroxine with T3 added."
"It doesn't matter if 100, or 1000, studies show that most people do better with thyroxine alone. There are always some people in any of those studies that did better on thyroxine with T3 added."
Roby Mitchell, MD -- Commentary
"No clinician who routinely uses T3 therapy would buy either of these studies read or unread as they just don't match up with clinical experience."
"No clinician who routinely uses T3 therapy would buy either of these studies read or unread as they just don't match up with clinical experience."
Dr. Barry Durrant-Peatfield -- Commentary
"We all know our patients do better on Armour...The fact that many patients do okay on T4 alone is no credit to us physicians."
"We all know our patients do better on Armour...The fact that many patients do okay on T4 alone is no credit to us physicians."
David Brownstein, MD Commentary
"I have not found that much benefit with just adding T3. But I have found the desiccated thyroid much more effective..."
"I have not found that much benefit with just adding T3. But I have found the desiccated thyroid much more effective..."
Free T3: Understanding Thyroid Lab Tests
Background article on Free T3 testing and monitoring, by Ken Woliner, MD
Background article on Free T3 testing and monitoring, by Ken Woliner, MD
New England Journal Reports on T3 Studies -- February 1999
Key journal articles that pointed to benefits of adding T3 to thyroid hormone replacement regimen.
Key journal articles that pointed to benefits of adding T3 to thyroid hormone replacement regimen.
Fibromyalgia, T3, and Their Relationship to Hypothyroidism
Dr. John Lowe looks at the T3 connection to hypometabolism, fibromyalgia and thyroid conditions.
Dr. John Lowe looks at the T3 connection to hypometabolism, fibromyalgia and thyroid conditions.