Study Points for Inclusion of T3 in Hypothyroidism Treatment

T3 could finally be included in the treatment of hypothyroidism thanks to a study conducted by the Miller School Of Medicine, University of Miami. The objective of this study was to compare the effects of treatment using a combination of T3 and T4 and treatments using just T4. 

Pre Pharma, treatment was by disiccated thyroid, a natural product from the thyroid of pigs and sheep. This product has both T3 and T4 and works extremely well. Now treatment is generally just T4.

I have quoted the findings below as found.

One of the key endocrine glands, the thyroid produces hormones – primarily thyroxine (T4) and triiodothyronine (T3) – that regulate important processes in the body, such as growth, cardiovascular function, cognition and metabolism. An underactive thyroid can lead to sluggishness, weight gain, and mental fatigue, a condition called hypothyroidism. In contrast, an overactive thyroid can result in hyperthyroidism, with symptoms that may include weight loss, rapid heartbeat, anxiety and agitation. While patients with hypothyroidism are treated with levothyroxine (the pharmaceutical form of T4)


In the laboratory study, the Miller School research team focused on the role of an enzyme called Type II deiodinase (D2) produced in the hypothalamus and pituitary that converts the less active T4 to the highly active T3 hormone. “The question is important for clinicians, because plasma T4 must be converted to T3 in order to be detected by the pituitary gland and decrease TSH secretion,” Bianco said. “We wanted to understand the relative roles played by pituitary versus hypothalamic D2 in the thyroid hormone-mediated feedback mechanism.”


Using new mouse strains developed at the Miller School as an experimental model, Bianco and his team found that inactivating the D2 enzyme in the pituitary gland produced major changes in TRH, TSH and T4 levels, but did not affect T3 levels in the plasma. “This finding clearly shows that the body’s endocrine system is wired to keep plasma T3 in the normal range,” he said. “It also points to the importance of T3 as a clinical indicator in the follow-up of hypothyroid patients who are being treated with levothyroxine.”

Bianco noted that clinicians today, following guidelines set by the American Thyroid Association, use TSH and T4 levels in the blood as the key indicators of thyroid health of hypothyroid patients treated with levothyroxine. “Only rarely will physicians obtain T3 levels directly in the diagnosis or treatment of hypothyroid patients,” he said.

But Bianco believes that paying closer attention to plasma T3 could lead to better quality of life for patients with lower-functioning thyroids – a finding supported by his previous studies, as well as work by other researchers. Bianco believes a focus on plasma T3 as a diagnostic indicator could also stimulate pharmaceutical companies to develop better drug delivery systems to normalize plasma levels of T3.

“We know that about 20 percent of hypothyroid patients treated with levothyroxine are not happy despite having normal plasma T4 and TSH levels,” Bianco said, “and many of these patients exhibit lower plasma levels of T3. Other hypothyroid patients don’t complain to their doctors, but could potentially benefit as well from more effective treatments that normalize plasma T3, potentially making it easier to lose weight or maintain their mental focus.”

Other study co-authors were Gabor Wittmann, Ph.D., and Ronald Lechan, M.D. Ph.D., of Tufts Medical Center, Boston; Joao Werneck-de-Castro, Ph.D., Federal University of Rio de Janeiro; and Gereben Balazs, Ph.D., and Csaba Fekete, Ph.D., Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary.

University of Miami, Miller School of Medicine

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