Treating hypothyroidism with combination T3 and T4 therapy seems promising new therapy. This article looks at some of the unknown risks of T3 therapy, and explores whether those who have received the therapy were fully informed about the risks of T3.
A
Brief History of T3
There are two thyroid hormones produced
by the thyroid gland – thyrox-ine, known as T4 (four iodine atoms), and
triiodothyronine, known as T3 (three iodine atoms). If you were to break
down exactly how much T4 and T3 is secreted by your thyroid, you’d find
that 90% of the thyroid output is T4, and only 10% is T3. Although these
hormones have the same effect in your body, T3 is four times as powerful
as T4 and works eight times as fast. It’s akin to a juice in a bottle and
frozen concentrate. T4 can also “turn into” T3 by shedding an iodine atom
if your body requires some thyroid hormone – fast!
Over the years,
many of my readers have written to me about just not “feeling right” on
their thyroid hormone pills, even though their TSH levels were normal,
and they were apparently on the right dosage. An article published in the
February 11, 1999 issue of the New England Journal of Medicine reported
on some dramatic findings for thyroid
patients. Apparently, when the thyroid
hormone with 3 iodine atoms (T3), known as triiodothyronine, was added
to their regular thyroid hormone replacement pill (which is thyroxine,
or T4, the thyroid hormone with 4 iodine atoms), people felt much better.
A cocktail of T3 and T4 helped relieve depression, brain fog, fatigue and
other hypothyroid symptoms. In this study, 33 patients with severe hypothyroidism
were treated alterna-tively with pure thyroxine (T4) or a lower dose of
T4 plus triiodothyronine
(T3). The article concluded that “treatment
with thyroxine plus triiodothy-ronine
improved the quality of life for most
[hypothyroid] patients.”
This may explain
why some patients have felt better on alternative thyroid drugs such as
the natural Armour Thyroid, Westhroid and Naturethroid, which contain T4
and T3 naturally, and the synthetic T4/T3 drug Thyrolar. T3 can also be
added to your regular thyroid hormone pill as simply an additional pill,
known as Cytomel(r), which is simply pure T3or triiodothyronine. This comes
as surprising, and welcome news for many thyroid patients who thought they
were suffering from phantom hypothyroid symptoms.
A survey conducted by The Thyroid Foundation
of America found that 59% of survey participants complained of persisting
hypothyroid symptoms, such as muscle aches, lethargy, and/or depression.
Potential
Harms Of T3 Therapy and Research
T3 may indeed prove to be the best available
therapy for hypothyroid patients, but to date, it is not considered standard
therapy yet, and in countries like Canada, is still considered experimental
and remains unavailable. There are good reasons to be cautious about new
drugs, or research that may exploit vulnerable populations – especially
women.
As of this writing,
my concern with experimental T3 therapy is that women may find themselves
harmed once more, given that the majority of thyroid patients are women.
Susan Sherwin, author of Patient No Longer: Feminist Ethics and
Health Care, a professor of medical ethics, writes: “In case after
case we find that women receive treatments that have been falsely represented
as safe...with no warnings or explanations...”
(Sherwin: 168). According to the American
Foundation for Thyroid Patients, anecdotes abound from female thyroid patients
who experience severe side-effects from T3 therapy, who state that they
were never informed about risks of T3 therapy. This is of enormous concern.
According to Sherwin, “Women’s relatively
powerless positions in society make it a matter of particular importance
that we guard against the like-lihood that their health is sacrificed to
the financial interests of the [researcher]” (Sherwin: 169).
Risks
of T3 Therapy
Like many new therapies, T3 therapy has
not been tested on many groups of people, who in the past were abused in
medical research: eld-erly people, minority groups, and women. For example,
studies that looked at heart disease excluded women, and now we’re seeing
that heart disease manifests differently in women than men. As a result
of
medical ignorance surrounding women’s
heart disease, many women have needlessly died, sent home with their heart
attack symptoms.
Therefore, serious
questions remain about whether T3 works differently in men than women,
particularly postmenopausal women, whose risks of heart disease increase
because of estrogen loss. The published study using T3 therapy was conducted
on a small sample of thyroid patients (33) who were of the average age
of 46 years, and were only taking T3 therapy for ten weeks. So, what we
don’t know about T3 therapy are
answers to the following questions:
1. What are the long term effects of
T3 therapy?
2. How does T3 affect people 65 years
and older?
3. How does T3 affect women past menopause
who are not taking
hormone replacement therapy?
4. How does T3 affect women past menopause
who ARE taking
hormone replacement therapy?
5. How does T3 affect children?
6. How does T3 affect pregnant women
or women who are
breastfeeding?
7. How does T3 affect people of different
races and ethnic
backgrounds?
8. How does T3 therapy affect people
with other health problems,
such as heart disease, diabetes, or
people who have undergone
cancer therapy?
9. How does T3 therapy interact with
other drugs?
Until we know the answers to these questions,
T3 therapy remains experimental therapy. That doesn’t mean you can’t take
advantage of this therapy if you feel you have something to gain; it simply
means that you must be informed of the unknown risks before you go on this
treatment.
T3 therapy can
benefit some people, but harm others – particularly elderly patients with
other health problems. For example, T3 therapy can cause you to become
hyperthyroid. It is also not recommended in people taking certain antide-pressants.
Unfortunately, people anxious to receive
promising new therapy may find themselves unwitting human subjects in medical
research. Informed consent is one way to guard against possible harms associated
with xperimental therapies. Informed consent means that when you are being
given a treatment – experimental or standard – your doctor ought to be
disclosing, first and foremost, whether the treatment is experimental
or standard.
Sara Rosenthal's Web
Site
American Foundation of Thyroid Patients
