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Mary Shomon

Should Doctors Treat With T3 Thyroid Drugs Even When Thyroid Blood Tests are Normal?

By April 23, 2008

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Richard Podell, MD is an integrative physician with expertise in working with thyroid patients, as well as people with fibromyalgia, chronic fatigue syndrome and other immune-related diseases. Dr. Podell has put together an informative article discussing the difference between the conventional/mainstream view of thyroid diagnosis and treatment, and the more holistic, integrative approach he and some other practitioners espouse.

According to Dr. Podell:

"Many holistic, integrative and complementary alternative medicine physicians believe that many people are effectively hypothyroid (thyroid deficient) because they are unable to make the main active thyroid hormone - which is not T4 but the form found in Cytomel and Armour Thyroid, that is, T3."
Why would you need T3 treatment? Dr. Podell has some theories. According to him, some people are deficient in selenium, zinc, Vitamin A and/or Vitamin D, which can impair T4 to T3 conversion. He identifies a number of factors he feels can block T3 formation or aggravate thyroid dysfunction, including acute illness, excess cortisol due to physical and emotional stress, anxiety and chronic depression, goitrogenic vegetables, and foods high in iodine.

Dr. Podell explains some of the key signs that tell integrative practitioners a patient may need treatment: classic hyothyroidism symptoms; low basal body temperature; slow ankle reflexes; TSH level above 3; low free T4 or free T3 tests; and high Reverse T3.

Overall, the article is a helpful look at the approach that innovative thyroid doctors are taking to diagnosing and treating thyroid conditions. Well worth a read, if this is a direction you're interested in pursuing.

Photo: DrPodell.com

April 25, 2008 at 3:36 am
(1) ciara says:

i would get increased doses of T4 and my tsh level would go go from 5 on down to a 1.3, but i still felt sluggish. that’s when i was finally able to see a endocrinologist and ASKED to be put on cytomel. it has made all the difference in the world w my energy levels. right now, i’m getting a little too much thyroid hormone, so i need a retest. it could be the way i’m taking them since i sometimes forget and don’t always take at the same time everyday. at any rate, i can’t imagine ever going back to just T4 alone.

April 25, 2008 at 4:02 am
(2) Natalie says:

T3 is much better as sustained release as per the Wilson’s thyroid protocol on wilsonstemperaturesyndrome.com. I do much better on the compounded sustained release T3 than on Armour or synthroid, and Cytomel is not sustained release so it can cause unstead T3 levels.

April 25, 2008 at 4:34 am
(3) Sharon - Ohio says:

I am taking time released T3 compounded by a local apothecary. With the T3 supplement my synthroid meds have dropped from 225 mcg to 150 mcg.

My next adjustment to up the T3 and lower the synthroid will be in one week. My body temperataure is still in the 97s, but in the past was low as mid 95s. In the high percentage of cases low body temperature means low metabolism.

The best treatment of T3 is when it is time released. I am fortunate to have an apothecary nearby.

Read Wilson’s Temperature Syndrome.

April 25, 2008 at 10:58 am
(4) Ellen Williams says:

After having my thyroid removed in 4/04 and put on Synthroid and Levoxel life was horrible. After a doctor who I sold malpractice insurance to told me about Wilson Temperature Syndrome life changed dramatically.

Read more on the Wilson Temperature Syndrome website and learn how T/R Cytomel can change your life.

April 25, 2008 at 11:10 am
(5) Heather says:

I have been on thyroid meds.(synthyroid) for 16 years now. I asked my doctor if I could try Cytomel which is the t3. I was on it for two weeks and started spotting! This is something that has nevered happened to me before. I’am soon to be 46 so not sure if its my age or the t3. The doctor wants to wait six weeks and do a TSH test only! I’m puzzled because I think I should have the t3 done as well. The doctor also said if I’m getting too much meds. the spotting can result from this. Does anyone else know anything about this? Has it ever happened to you?

April 25, 2008 at 8:44 pm
(6) Kathleen says:

these comments and this article have been really informative… may I ask… are any of you (the contributors) without a thyroid… ?? my thyroid was removed in 2006 bc of papillary cancer.. I am currently on 175 of Synthryoid

April 26, 2008 at 2:44 am
(7) Judy says:

Kathleen, No Thyroid since 1978, cancer. Was on Thyrolar a few years and then on Armour since, except for a 2-year period I tried Synthryoid. And I think my dose of Synthryoid was 200. My dose of Armour is gr 4.
And yes, I am still taking FOUR gr 1 pills a day until the higher doses are back on the market again.

April 26, 2008 at 1:47 pm
(8) Karen Secrest says:

I used to take Cytomel in 1980′s but Dr moved and I haven’t been able to get it prescribed again because my T4 is always borderline normal. I felt great when I was taking it. Why are the MDs in my area so prejudiced against Cytomel?

April 26, 2008 at 9:51 pm
(9) Becca says:

There are great benefits of treating with both T3/T4. I am one person who has a real problem with converting T4 to T3. I have been hospitalized with my organs shutting down when biased medical professionals took my T3 away. I still have my thyroid and have never had an growths.

I question one thing Dr. Podell said about the T4/T3 ratio (60/40) in Armour Thyroid. I can only find literature to say that the ratio is 80/20 or more actually 81/19.

I hope Mary Shomon and/or Dr. Podell can clear this up. We all need any thyroid piece of info to be accurate and true.

Thanks, Becca

April 27, 2008 at 9:26 pm
(10) norma says:

When my Cytomel was increased I started spotting, then had a heavy period, bleeding occured for close to 3 weeks, but has now stopped. My dr. said it was not related but it did coincide with the increase.

April 28, 2008 at 11:13 am
(11) Tansy says:

I’m on 200 mcg every night and 300 mcg every morning of Eltroxin (T4).
Never had problems with spotting tho. Heather 46 is way to young for menopausal sm[ptims unles your family history has preature menopause.
That said, I switched from the pill, after 10 years,to an IUD and my period has gone from scanty (lasting a couple of hours) to gone. Will go back on the pill as I approach my 40′s but I do miss havign my period.

May 24, 2008 at 7:57 am
(12) Halldora Ingham says:

I have tried to access Dr. Podell’s article on T3,but a HTTP403 Forbidden notice appears suggesting that I may have to log into the website.There is no facility for this and I have been receiving your emails successfully for at least 18 months,how can I read the report,I need info before trying T3.
Thanks for all your work to provide us with such useful information, which is impossible to extact out of GPs in England. Halldora Ingham.

June 14, 2008 at 12:18 pm
(13) Carmella38 says:

My doctor said I have low 3t and has put me on Iondine. Anyone out there that takes iodine for a low thyroid?

June 5, 2009 at 9:33 pm
(14) Rubes Moore says:

Heather and Norma – I had the same thing. I started spotting after resuming Cytomel – I am 55 years old !!! It has to be related ! I feel 100% better taking Cytomel…I can’t believe the difference !

December 27, 2013 at 12:49 am
(15) Aftab Ali says:

Hi dear the day before yesterday i did my thyroid function test and my t3 level is raised while t4 and TSH is in normal value now i am worry about my t3 if any body have an idea please share with me thx

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