T3 with T4 - T3 value & long term use risks

[janetdmp]

Is it true that triiodothyronine (T3), is added to existing treatments, such as SSRIs, in the treatment of depressive disorders? Could the well-being feeling people have when taking T3 in addition to thyroxine (T4) for an underactive thyroid be due to the anti-depressive values it has rather than T3 replacement therapy? If this is the case, with long term use, what are the risks and implications of T3 overdose?

[Kiwi]

There are risks associated with taking T4 and T3 and I've read a doctor's reply on here referring to it. I know there are risks but I've also read that T4 with T3 is a standard treatment in the USA and other developed countries so I don't know why the UK is so different. It's not some unknown barely used medication, it's used by lots of people across the world.

Personally I've just started taking T3 with my T4. I was on 200mcg T4 and now I'm on (this is my second day) 150mcg T4 and 20mcg T3.

I am feeling considerably better although I know this could be a placebo effect and that T4 has a much longer half life than T3 so I have to wait to see how my body and symptoms settle down. The things that have improved are my brain fog, decision making ability, anxiety and depression. It's like an oppressive weight has been lifted from my mind. I will cross my fingers this continues.

There are risks with treatments and the doctor said a wise motto "First do no harm". Sometimes there is harm in not giving treatment too.

On T4 only I was improved from when I was on no medication but I was having trouble taking care of myself. I didn't have enough energy (mental and physical) to wash, make food, clothes, get outside the house and see people, I could only do some of these and had to choose which. I struggled with the basics of life. I could manage to do some and did the best that I could. I'm on benefits and out of work. If I can continue to feel better, maybe even improve more? with T3 then I can start to get my life back. I want to work and take part in life again. If adding T3 into my medication makes me feel better (and again, I'll wait and see it's only been 2 days) then I will take the added risks because without it I barely have a life worth living.

[ipman]

Is it true that triiodothyronine (T3), is added to existing treatments, such as SSRIs, in the treatment of depressive disorders? Could the well-being feeling people have when taking T3 in addition to thyroxine (T4) for an underactive thyroid be due to the anti-depressive values it has rather than T3 replacement therapy? If this is the case, with long term use, what are the risks and implications of T3 overdose?

Monkey here. The organ grinder tells me that T3 certainly does have an anti-depressant effect. She only realised she had been feeling depressed when she started on T3. I wouldn't say that she had a depressive disorder as such - she just felt down because her memory was no longer reliable and she couldn't multi-task like she used to (anyone know the Peggy Lee song "I'm a woman". That was my wife before her thyroid problem; fortunately she's nearly back to how she used to be). T3 has been shown to affect the brain and I think that's probably what's happening when it has an anti-depressant effect. However, it doesn't just affect the brain. It also affects other parts of the body and, in our experience, can eliminate aches and pains (back and posterior in my wife's case). In other words, it has a physiological effect as well as a mental effect.

If you overdose on T3 and become thyrotoxic, you will soon know about it and want to cut back. The point to keep in mind is that T3 is a powerful agent and shouldn't be used in a cavalier manner. Hopefully anyone using it will be doing so under close medical supervision and not have to resort to self-medication. Having said that, did you know that body builders take 100 microgram doses of T3 in the few weeks before a competition in order to fine tune their musculature. But then they're nuts of course!

ipman

[taliesin]

I was reluctantly put on T4 - starting on 25 mcg June 2010 - and by the time I had changed GP's to what I thought would be a more receptive surgery I was on 75mcg a day. Still having symptoms but there was a slight improvement despite the fact that the weight that I had put on would not go despite healthy diet and trying to drag myself through some exercise apart from walking the dog.
The new surgery went into panic as I had no diagnosis - despite a gynae endo saying that my symptoms were not related to menapause - but highly suggestive of a thyroid disorder (incidently, he told me that both his wife and daughter were hypothyroid). I was told to reduce my meds or even better cease taking them, regardless of the effect that it would have had on my health and wellbeing. I agreed to reduce to 50 a day and to see an Endo - I saw a very dismissive man who sent me for the same raft of tests that everyone else else gets - short synachthen, DEXA bone scan and thryoid levels. No response after and found out that he had merely discharged me from his clinic when I chased up outcomes! My GP had a letter but hadn't thought to contact me - and said everything was normal and that if I wished to continue of my own volition to take the thyroxine then that was it.
SHortly afterwards and having spent considerable time researching and discerning info including support from TPA I saw a private specialist and started to self treat on T3.

And now - well I have stopped the T4 and just take a therapuetic dose of T3 and I have lost 2 stone and I have more energy to enjoy life again. The aches and pains have gone and I sleep better - my hair is thickening up again and well I could go on. I still have to be careful not to over do things and take some time to rest but I am 85% there.

If I hadn't had the presence of mind and the ability to make decisions about my body - then I would still be a barely living overweight shadow of myself - and for a young woman to look in the mirror and see a fat, old, puffy faced with thinning hair person looking back at them - it is sould destroying - and to have medical professionals telling you that there is nothing wrong except menapause or depression etc and you have to get on with it - would just about finish someone off!
THE POINT IS TO TAKE STOCK OF WHAT IS BEING PUT ON THIS WEBSITE AND UNDERSTAND THAT IF THINGS DO NOT CHANGE THEN THERE WILL BE MANY CASES OF THE NHS BEING SUED FOR NEGLIGENCE - WHEN THOSE PEOPLE WHO END UP INCAPACITATED IN BED AND HAVE TO RECEIVE HELP FROM SOCIAL CARE - I SHOULD IMAGINE AS VULNERABLE ADULTS THEY COULD BE RAISING SAFEGUARDING CONCERNS ABOUT HOW THEY ARE BEING NEGLECTED!!!!!!!
This is not just a few women with nothing better to do than have a whinge or the 'alternative brigade' campaigning for rights. All are genuine people with thyroid issues and their families and carers - for those who are still lucky to have them around.

[Dr Petros Perros]

DEAR JANETDMP, THE WELLBEING DESCRIBED BY SOME PEOPLE MAY HAVE SEVERALM POSSIBLE EXPLANATIONS:

1. AS YOU SUGGEST AN EFFECT ON MOOD (THE EVIDENCE FROM THE PSYCHIATRIC LIETERATURE IS NOT GREAT BUT THERE IS A SUGGESTION THAT THE ADDITION OF T3 ENHANCES THE EFFICACY OF SOME ANTIDEPRESSNT MEDICATIONS).

2. IT COULD BE DUE TO THE HYPERTHYROID STATE THAT MAY BE INDUCED BY T3. ALTHOUGH MOST PEOPLE WITH AN OVERACTIVE THYROID GAND (SAY DUE TO GRAVES’ DISEASE) FEEL UNWELL, SOME FEEL ENERGETIC. PART OF THIS MAY BE THE FACT THAT IN THE HYPERTHYROID STATE PEOPLE LOSE WEIGHT EVEN THOUGH THEY CAN OVEREAT.

3. IT COULD BE A PLACEBO EFFECT. MANY OF THE TRIALS LOOKING AT THE EFFECST OF T4 VERSUS COMBINATIONS OF T4 AND T3 FOUND THAT BOTH GROUPS EXPERIENCED IMPROVEMENT IN WELLBEING WHICH LASTED A FEW MONTHS, THEN DISAPPEARED.

4. IT IS POSSIBLE THAT THERE IS A MINORITY SUBGROUP OF PEOPLE WITH HYPOTHYROIDISM THAT TRULY BENEFIT FROM T3. THE EVIDENCE SO FAR INDICATES THAT IF THAT IS SO, THEN THIS IS A RARITY.

THE RISKS OF OVERTREATMENT WITH THYROID HORMONES ARE OSTEOPOROSIS AND HEART PROBLEMS.

[Dr Petros Perros]

DEAR Taliesin,

I AM SORRY TO HEAR THAT YOUR NHS EXPERIENCE WAS NOT GOOD. ESPECIALLY IT SEEMS THAT COMMUNICATION WAS NOT GREAT. ONE OF THE RECENT CHANGES IN THE NHS IS THAT DOCTORS ARE STRONGLY ENCOURAGED TO COPY CORRESPONDENCE BETWEEN THEMSELVES TO PATIENTY, AND THIS IS NOW HAPPENING WIDELY WITHIN THE NHS. IT SEEMS TO ME THAT YOU PRESENTED WITH UNEXPLAINED SYMPTOMS SUGGESTIVE OF THYROID POBLEMS BUT THE CLINICAL EXAMINATION AND THE TESTS REFUTED THIS DIAGNOSIS. YOUR ENDOCRINOLOGIST THEN WENT ON TO INVESTIGATE YOUR SYMPTOMS FURTHER AND EXCLUDED OTHER IMPORTANT CONDITIONS THAT CAN PRESENT WITH SIMILAR SYMPTOMS. THIS WAS ENTIRELY APPROPRIATE. YOU ARE NOW SELF TREATING WITH T3 AND YOU FEEL SIGNIFICANTLY BETTER. I AM VERY PLEASED TO HEAR THAT. I THINK THERE ARE ISSUES STILL HERE THAT ARE UNRESOLVED. FIRSTLY IS YOUR HEALTH BEING COMPROMISED IN THE LONG-RUN BY THIS TREATMENT? AS I MENTIONED ABOVE SOME PEOPLE WITH AN OVERACTIVE THYROID FEEL BETTER, BUT THIS IS AN UNHEALTHY SITUATION AND YOUR HEALTH MAY BE COMPRPMISED IN YEARS TO COME. SECONDLY, SOMETIMES PEOPLE GO THROUGH A BAD PHASE FOR WHATEVER REASON AND THEN THEY GET BETTER (FOR NO APPARENT REASON). COULD IT BE THAT GOING ON T3 WAS COINCIDENTAL AND YOU MAY BE ABLE TO MAINTIAN YOUR WELL-BEING WITHOUT IT? I FEEL THESE ARE ISSUES THAT REQUIRE SOME THOUGHT AND DISCUSSION.