The American Thyroid Association (ATA) has long maintained that the only form of thyroid medication that should be used to treat hypothyroidism is levothyroxine (Synthroid), and that alternative forms, such as Armour, the natural thyroid which contains T3 and T4, and Cytomel (T3 alone), don’t have enough research behind them to recommend their use. Yet, many patients taking Synthroid for hypothyroidism complain to their doctors that they still feel terrible, despite taking the “correct” form of thyroid medication and the correct dosages.
Many of the frustrated patients that have switched from Synthroid to alternative forms do ultimately find relief, but these cases are rarely acknowledged by the ATA. So it was with great interest that I read about a recent presentation at the American Association of Clinical Endocrinologists (AACE) conference that reported positive results for a group of patients that made the switch. The overwhelming majority of this group with hypothyroidism experienced a significant improvement in their symptoms when they switched from long-term Synthroid treatment to combination T4 and T3 therapy. It’s promising to see that a mainstream, standard medical association is looking at the benefits of T3 with its implications in the importance of peripheral hormone conversion.
The physician who spoke on this topic presented data he gathered from reviewing the charts of patients who had been on Synthroid for at least five years, yet still experienced hypothyroid symptoms. Many of them even increased their doses as an attempt (unsuccessfully) to resolve their symptoms. From these charts, he identified a group of patients that switched to Armour or added Cytomel to their Synthroid, and monitored their progress to see if their symptoms improved.
Of all the patients being monitored in this chart review, the majority of (69 people) were switched to Armour, and a smaller group (13 people) added Cytomel T3 to the Synthroid they were taking. They were followed for about two years, and answered a questionnaire to track how they were feeling. Almost everyone experienced a significant improvement in symptoms and great imporvement in quality of life. In the group that added Armour, 94% reported feeling better, and 100% of the people that added Cytomel felt better.
The researcher stated “with combination therapy, they did see an improvement in terms of how they were feeling: they were able to do more activities, they were able to be more active with their grandchildren, with other people, do their normal things around the house, and they felt like their mood was stable, and reported just feeling happier.”
Previous studies have evaluated combination therapy, but results were mixed, likely because certain types of patients were involved in the study who should have been excluded for various reasons. In the opinion of the current researcher, their findings had a high rate of success because they were specific about which types of patients would benefit from the combination therapy, and they tracked their progress for a long enough time period to show results. All of these benefits were achieved without generating significant hyperthyroidism or related side effects.
In my experience, I have seen patient well-being and comfort correlate much better to body temperature readings than to any blood test. Although the TSH test helps us see where to apply our effort in getting the body temperature to normal, the real results come when we normalize body temperatures. In my experience, it’s normal body temperatures, whether acheived by Synthroid, Cytomel, Armour, or sustained release T3, that make people feel better.
Reference:
American Association of Clinical Endocrinologists
Tariq A “Combination of T3 and T4 therapy for improving hypothyroidism and overall quality of life” AACE 2016; Abstract 1153.
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