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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…

Clinical Trial to Compare Natural Desiccated Thyroid to Levothyroxine
The National Institutes of Health has announced a new clinical trial to compare natural desiccated thyroid treatment to levothyroxine in relief of symptoms in hypothyroid patients.

Losing Weight with Hypothyroidism
An Overview of Losing Weight with Hypothyroidism, from Mary Shomon, Thyroid Guide, patient advocate and author of New York Times best-selling book The Thyroid Diet, and the updated Thyroid Diet Revolution, as well as other books and guides on thyroid disease, autoimmune disease, hormones and weight loss.

10 Things to Know About Thyroid Disease and Fatigue
There are a number of important things to know about the key connection between fatigue and thyroid conditions, and ten of the most important ones are outlined here.

Whose Health is It Anyway, Tony?
Anthony Weetman is a conventional endocrinologist who has, in one short editorial essay, summarized everything that is totally wrong with endocrinologists. Weetman arrogantly proclaims in the March 2006 issue of Clinical Endocrinology that patients with thyroid symptoms who insist they have a thyroid condition despite so-called "normal" test...

Thyroid Cheers and Jeers: 2012 Edition
2012 Thyroid Cheers and Jeers: A Look Back at the Key Thyroid News - and Negative Developments - for Thyroid Patients and Thyroid Disease in 2012

Editorial: Endocrinologists Misrepresenting Natural Thyroid Drugs
A look at how the endocrinology world continues to present misinformation about natural thyroid drugs, and misrepresent the value of natural desiccated thyroid drugs for hypothyroidism treatment.

How To Get Your Thyroid Lab Tests Done More Quickly and Accurately
Some tips on how to go to a laboratory for thyroid and other blood tests, and have the process go more quickly, and be more accurate.

2012 Hypothyroidism Guidelines Cause Controversy
The 2012 Clinical Practice Guidelines for Hypothyroidism in Adults, produced by the American Association of Clinical Endocrinologists AACE and the American Thyroid Association ATA, are controversial for some thyroid patients and practitioners.

When Patients Won't Take Their Thyroid Medication
People who have thyroid conditions -- including hypothyroidism, and hyperthyroidism / Hashimoto's and Graves' disease -- sometimes choose to not take their prescription medications for various reasons. Patient advocate Mary Shomon looks at some of the common reasons, along with the health implications that go along with failing to take prescribed thyroid medications.

Thyroid Patients: Do You Need T3 or Natural Desiccated Thyroid?
If you are hypothyroid and taking a thyroid replacement hormone drug, do you need T3 or natural desiccated thyroid? A look at these treatment options for people with hypothyroidism.

The Best Ways to Treat an Underactive Thyroid and Hypothyroidism
A number of the nation's leading experts on hormonal health have shared their thoughts about what constitutes optimal treatment for hypothyroidism. The varying approaches presented by these practitioners present a picture of optimal treatment for an underactive thyroid -- hypothyroidism -- from the perspective of some of the top conventional,...

Endocrine Society Press Release - October 2003
Press release from the Endocrine Society announcing the research results.

A Tribute to Dr. John Lowe
A tribute to researcher, writer, practitioner and advocate John Lowe, DC, founder and editor of Thyroid Science, and expert on fibromyalgia and thyroid issues.

Thyroid Disease: One Size Does Not Fit All
A look at how the concept of thyroid disease, as well as diagnosis and treatment, is not a cookie-cutter, one-size-fits-all process.

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

Combined T4/T3 Therapy: Placebo or Tomato? An Assessment
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.

Jacob Teitelbaum, MD
"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"

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."

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...

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."

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."

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."

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..."

Free T3: Understanding Thyroid Lab Tests
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.

Fibromyalgia, T3, and Their Relationship to Hypothyroidism
Dr. John Lowe looks at the T3 connection to hypometabolism, fibromyalgia and thyroid conditions.

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)

The Role of Reverse T3 Testing in Thyroid Treatment
A look at the controversial role of measuring Reverse T3 - RT3, Reverse Triiodothyronine -- and how it is used by integrative physicians in diagnosing, treating and managing hypothyroidism, an underactive thyroid, as well as cellular hypothyroidism.

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