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Do You Need T3 as Well as T4 for Your Thyroid Problem?

Some people with low thyroid function find they feel better if they take both thyroid hormones. Could that help you manage your thyroid problem?

You may never have thought much about your thyroid gland. Unlike your heart or your intestines, it’s inconspicuous. Its effect on your body is profound, but symptoms of your thyroid problem may be non-specific. Fatigue, low energy and trouble losing weight are common symptoms, but they don’t always indicate a hypothyroid condition. Even worse, you may not improve if you take the standard treatment.

How Should You Treat Your Thyroid Problem?

Q. Your column explaining why standard thyroid treatment doesn’t always work was enlightening. The standard approach sure didn’t work for me.

I asked my doctor to switch me from levothyroxine to natural thyroid (Armour or Nature-Throid, etc.) but she refused. So I changed doctors, choosing one who would prescribe natural thyroid.

Six months later, all the knots in my back were gone, I had no more muscle pain, and I was back down to my lifelong weight (130 lbs from 165 lbs). I felt like my old self. My wit was back, and I no longer felt stupid or foggy. Why is it so hard for doctors to recognize that sometimes people need more than just T4? Not all of us can convert it to T3.

The Story on T4 and T3:

A. In the mid- to late-20th century, doctors adopted levothyroxine (synthetic T4) as the sole treatment for hypothyroidism. (You may recognize the most common brand name, Synthroid.)

It wasn’t until the 21st century that research showed some people are less efficient in converting T4 to the active form of thyroid hormone, triiodothyronine or T3. Genetic differences help explain this (Current Opinion in Endocrinology, Diabetes, and Obesity, Oct. 2018).

Researchers are considering ways to provide such patients with sustained levels of T3 (Frontiers in Endocrinology, Aug. 13, 2019). 

Could Desiccated Thyroid Gland Help Your Thyroid Problem?

As a result, some doctors are starting to rethink whether it makes sense in some cases to prescribe desiccated thyroid gland (Annals of Internal Medicine, Jan. 5, 2016).  Drugs such as Armour Thyroid or Nature-Throid contain T3 as well as T4. Many people report feeling better on such a product. If you think it might be helpful for your thyroid problem, you may want to discuss the possibility with your primary care provider. Consider sharing this article with some technical details (Thyroid, April 11, 2020). 

Learn More:

You can learn lots more about this topic as well as about interpreting thyroid test results in our eGuide to Thyroid Hormones. You may also wish to listen to our interviews with Dr. Antonio Bianco, a leading researcher on the conversion of T4 to T3, and Ayurvedic practitioner Marianne Teitelbaum who has written about natural treatments. They are both in Show 1196: What to Do If Thyroid Treatment Doesn’t Work for You.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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