It is important to have a balance of opinions but I do have to respectfully disagree with you
that people who require both T4 and T3 represent a minority of people with atypical symptoms
and atypical treatment. I have read too many books, medical articles,
web sites, blogs and thyroid patient forums to believe that this only affects a minority of
thyroid sufferers. I have been looking for the reference and can't find it, but I read one interview
with a doctor who said 90% of his patients do better on a T4/T3 medication rather than on T4
Here is an excerpt from Stephen Langer's book Solved: The Riddle of Illness that I think is very
Unfortunately, steady and efficient conversion of T4 to T3 is not automatic, a slam-dunk.
In this age of stress, the adrenal glands of many-if not most- people are overworked and
weakened. Even mild adrenal insufficiency can slow down his conversion. The adrenal glands
must be strengthened for thyroid supplementation to be effective.
In a journal article, "The Diagnosis and Treatment of Hypothyroidism," Michael Schacter, MD,
FACAM, stated essentially this same fact. If this T4 conversion doesn't happen, the patient
experiences symptoms of an overactive thyroid gland: rapid heartbeat, palpitations, and
increased sweating.(3) Symptoms of a weak adrenal system include allergies, asthma,
breathing difficulties, acne, eczema, psoriasis, lupus, flaky dry skin, arthritic pains, and wide
emotional swings. Previously, low production of T4 was thought to be a major cause of hypo-
thyroidism. Now Dr. Schacter asserts that it is due, in large part, to an inability to convert
the less active T4 to the more active T3. Beyond tired adrenal glands, he feels a valid cause
could be weight loss or low protein diets lacking the amino acid tyrosine and iodine, essential
to secreting thyroid hormone. Additionally, insufficient selenium could block T4 from
converting to T3.
And Dr. Langer goes on:
On her thyroid Web site (www.thyroid-info.com), Mary Shomonwrites:
For years, patients have been told that all they need is levothyroxine treatment to
get them into normal TSH (thyroid stimulating hormone) range, and thyroid treatment
is considered complete. Time and again, people who still suffered with symptoms-
including fatigue, depression, cognitive problems, and more- were told that once their
thyroid range was normal , these problems were no longer related to the thyroid.
Instead, they were now depression, stress, PMS, or simply in your head. Patients who
had done well on Armour, then switched to Synthroid, for example, and complained of
not feeling well, were told they were getting old.(4)
Ever since research demonstrated that the T4/T3 combination is more effective than T4
alone, the thousands of medical doctors once branded as mavericks have been proved
right by no less a mainstream authority than the New England Journal of Medicine.
I am happy that the T4 works well for you. I just think that it is important for people to know
that if they feel better but are still having problems on T4, that they might want to consider
talking to their doctors about adding a little T3 or trying a natural thyroid such as Armour.