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I have an update to my saga in seeking alternative treatment for persistent symptoms of hypothyroidism — you can read about it in the third installment in the series on hypothyroidism. I’m currently on Synthroid, a T4 hormone replacement and the most commonly prescribed drug for hypothyroidism, and my TSH levels are well within the normal range, but I still have lingering symptoms. After exchanging several phone calls with the nurse, the nurse finally had the doctor call me directly. I remained calm and rational, and explained to her that because the recent increase in Synthroid did not work, I’d like to try either Thyrolar (which works on T3 and T4) or add in Cytomel (which works on T3). To my surprise, the doctor replied “Okay, let’s add in the Cytomel. Which pharmacy would you like me to call the prescription into?” I’m starting off with a low dosage of Cytomel tomorrow, and I’ll keep you posted on how its working.

Most endocrinologists are reluctant to prescribe T3 drugs, so I count myself lucky indeed that the very first endocrinologist I saw agreed to do just that. Most doctors rely solely on T4 treatment, even though its use is not scientifically-based, and most feel treatment is adequate if TSH levels read normal, even as the patient continues to complain about persistent symptoms. If you’re treating your hypothyroidism with T4 hormone replacement and it’s not working, find a doctor who is open to the idea of at least a trial run of T3 treatment. There are many good reasons why you should.

John C. Lowe, M.D.:

Doctors commonly prescribe a variety of drugs to control hypothyroid symptoms that continue despite patients’ use of T4. In stark contrast to T3, most of these drugs have long lists of potentially harmful effects. The safety of T3 use starkly contrasts with the risks of using the other drugs. ..this [T4 only] mandate is not scientifically based. Instead, it’s based on a powerful marketing campaign of a major pharmaceutical company….As a result, they [conventional endocrinologists and other doctors] ‘ve deprived themselves of clinical experience with any thyroid preparation other than T4. ……T4 does not increase the metabolism of many patients’ tissues, no matter how high the dosage. Only a thyroid hormone preparation that contains T3 will accelerate these patients’ metabolism. Hence, when T4 therapy normalizes TSH blood levels of many patients, it leaves their metabolism subnormal.

Ralph J. Luciani, DO, MS, PhD, MD:

Synthetic T4 (Synthroid) will not work if the enzyme required to convert T4 to T3 is not normal. Often patients are placed on Synthroid or a similar drug for low thyroid and feel no different even though the TSH levels become normal. The reason is obvious. Their T4 is not converting adequately to the active T3 hormone or not enough T3 is getting into cells for whatever reason. The blood test looks great — the patient feels lousy.

Kenneth Blanchard, MD, PhD:

The standard medical view is that T3 is unnecessary because T4 is converted to T3 in the body. But many patients taking the standard 100% T4 hormone report chronic fatigue, depression, menstrual abnormalities, fibromyalgia, irritable bowel syndrome, restless legs and other complaints, and these complaints are almost always better when some T3 is added….The use of T3 has been standard in my practice since 1990….

Richard Shames, MD, and Karilee Halo Shames, RN, PhD:

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. There are some people who do better on T3 alone. There are some who do better on Armour thyroid alone. There are some who do better with a mix of Armour and thyroxine. None of the studies of these questions will ever be 100% in any one direction. People are just too different. Nothing is black and white.

Does anyone here currently take or have you ever taken T3 drugs for your hypothyroidism? Post your experiences with it below.