Addition of T3 supplimentation to T4 in hypothyroidism

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I'm on a role today! So, based on this gem of a website (including don't tread on me flag) it would appear that people with hypothyroidism want their T3.

I've read and been taught that there is no clinical rationale to supplement T3 in the form of Liothyroxine or as desiccated animal preps. Is this still the current endocrinology thinking? The people I talk to LOVE to take t3 and freak when I suggest it's not needed and may actually complicate therapy and lead to increase AE. Do some patients really have impair conversion of T4 to T3 or is it just a mild simulate effect from the T3 that they crave?

 

[Quiksilver]

I like when it calls statins "band-aid medications."

 

[Carboxide]

Current guidelines for hypothyroidism suggest that T4 alone (levothyroxine) is better tolerated, easier to titrate and has fewer adverse effects. I haven't seen anything suggesting that people may have impaired conversion, and unless it's a specific gene deficit, it doesn't make sense.

The thing with T3, if I recall correctly, is that the half-life is pretty short. Also, it causes increased heart rate (among other things), so to dose it won't really have a lasting effect unless they're taking it multiple times per day (unlikely, in my experience). The other point to be made is that the meds out there that combine T3 and T4 don't even do it in anything CLOSE to the ratio that the normal human body produces - I think the combo products out there are like 1:4 T3:T4 and in the human body it's about four times that (1:16 or so; couldn't give you the exact number).

No, I'd say any reason that T3 is working better is probably placebo effect.

 

[pharmagirlie]

T4 will eventually be turned into T3 (which is the active hormone). But our body required both T3 and T4. So I dont see why combo T3:T4 (1:4) is frowned upon. I think it makes sense to have some active hormone of T3 rather than having to wait for the T4 to be converted to the active form.