Supplementing T3 not safe afterall?
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I think it's better to take T4 and T3 usually.
Yep, exactly.
"An effective way to use supplements is to take a combination T4-T3 dose, e.g., 40 mcg of T4 and 10 mcg of T3 once a day, and to use a few mcg of T3 at other times in the day. Keeping a 14-day chart of pulse rate and temperature allows you to see whether the dose is producing the desired response. If the figures aren't increasing at all after a few days, the dose can be increased, until a gradual daily increment can be seen, moving toward the goal at the rate of about 1/14 per day"
https://raypeat.com/articles/articles/thyroid.shtml -
@Master I don’t recall them talking about cycling thyroid. Peat says in the summer people tend to need less thyroid
But also how much t3 were these people taking? Taking more than 10mcg at once regularly can backfire when the liver starts expelling excess thyroid
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@Wkia said in Supplementing T3 not safe afterall?:
Hi, I'm new here and hoping that maybe I can ask about a study that I stumbled upon but have no acces to. Maybe someone else has.
Recently, after reading a lot about thyroid on another forum, I started to take T3 next to the levothyroxine which I have been taking as long as I remember because of hypothyroidism. It went really well, lot's of new energy and temperature went up so that made me really happy.
Maybe I should have stopped googling and reading about the subject then but I did'nt and so I stumbled upon this study from december 2022:'Heart Failure and Stroke Risks in Users of Liothyronine With or Without Levothyroxine Compared with Levothyroxine Alone: A Propensity Score-Matched Analysis'.
https://pubmed.ncbi.nlm.nih.gov/35570696/#:~:text=In addition%2C the risk of,and history of thyroid cancer.It's about 1434 T3 users (with or without T4) compared to 3908 LT4-only users.
It says that he risk of heart failure and the risk of stroke are considerably higher after T3 therapy.Can anyone tell how seriously this study should be taken?
I'm a bit worried now...Wasn’t this during the height of “died suddenly” when studies were appearing to explain away why people were having heart attacks?
Also this study was in thyroid cancer patients who probably couldn’t meet the increased dietary requirements to support t3 supplementation. Dr Peat has said that too much thyroid can enlarge the heart (see Thyroid: Misconceptions newsletter).
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Well Ray did say in the email exchanges one time that pure T3 was giving him arrhythmic-like conditions. And that when he added T4 to it, that situation stopped. So T4 does seem to play an element in thyroid maintenance.
But has anyone read the full report? Because I'm highly skeptical. I'm mostly skeptical due to how we clinically treat the nature of hypothyroidism itself. They didn't mention anything in the abstract about these people's TSH levels.
Remember, you are no longer considered "hypothyroid" once they get your TSH below 5.0 mIU/L. If they're telling you to maintain your T3 dose when your TSH is 4.5 mIU/L you are still damaging yourself. In fact pulse wave velocity the "gold standard" of measuring arterial stiffness does not begin to improve until it's under 2.5 mIU/L.
We need to know what these subject's TSH levels are.
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@Kvirion Yes I totally agree Kvirion, I'm going very slowly and I am monitoring the results. You can't be too careful.
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@Master said in Supplementing T3 not safe afterall?:
The major glaring issue is that they don't distinguish the difference in outcomes in patients that took just T3 and the patients that took T3 & T4. This is pretty significant
Yes it certainly is Master, so I can't imagine that they did not do that. Wish I could read the entire article.
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@Ecstatic_Hamster Me Neither Ecstatic Hamster, I have no intention of going off my T4 medication.
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@Master said in Supplementing T3 not safe afterall?:
As far as I'm aware, Peat, Haidut, and Danny all advocate cycling to some extent.
Do you know exactly how they did the cycling?
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@Peatly said in Supplementing T3 not safe afterall?:
Thyroid: Misconceptions newsletter
Thanks Peatly.
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This seems to be the consensus protocol from the forums:
- Start with T3 monotherapy, at a few micrograms, one to three times daily
- Closely monitor symptoms and vitals
- Slowly increase T3 dosage and frequency over weeks; daily adjustments should be avoided
- If/when sleep and cardiac issues show up, which they likely will, add in T4 in the evening
- Every couple weeks adjust dosage and frequency of T3/T4 until full symptom improvement
Best dosage and frequency (based, again, on my reading of forums and anecdata) is ~5mcgs T3 every 2-3 hours, with 20-60 mcgs T4 in the evening, in one or several dosages, with T3.
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Denis Wilson's protocol for T3 can call for 180mcg per day of T3 only. I have tried it.
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@cornwallis 5mcg every 2-3 hours is a huge, unphysiological dose for most hypothyroid people. I think nobody should start with more than 1mcg split into 2-3 doeses throughout the day as a first try.
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@Ecstatic_Hamster said in Supplementing T3 not safe afterall?:
Denis Wilson's protocol for T3 can call for 180mcg per day of T3 only. I have tried it.
Wilson’s protocol calls for cycling and short treatment correct? Curious what your results were. My mom tried Wilson’s protocol when I was young but couldn’t afford to continue.
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@moonpiemantooth yes it is short term but not necessarily. Some people can’t get off of thyroid, and after a bout with T3, they still need thyroid.
That was my case.
I’m much better off with T4 and T3.
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@Ecstatic_Hamster What does your thyroid protocol look like?
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@Wkia No I've been trying to find the quote, but Ray definitely said it's good to take a break from time to time.
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Nothing is safe anymore.
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“Broda Barnes tells some of the stories, for example, in the 1930s, he observed that thyroid deficiency, among other things, caused an extremely high rate of heart attacks and circulatory disease, infectious diseases, circulatory diseases and cancer were the main killers in a hypothyroid population. But when he started popularizing that, there was a reaction and JAMA published a story about a doctor who had given a patient who had just suffered a massive heart attack a supplement of, I think, two grains of armor thyroid starting right off on a full standard dose rather than working into it over a period of weeks and the patient died. And so that created the propaganda that natural thyroid could kill you with a heart attack.” Ray Peat
“A low thyroid person is breaking down the ATP because there's not enough magnesium to stabilize it, and if you don't have a good reserve of magnesium somewhere in your body, increasing the thyroid runs into a wall where there's not enough magnesium, and so it does nothing but increase stress. So making sure you're getting enough magnesium is essential when you're adjusting the thyroid.” Ray Peat
More discussion here
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@cornwallis 1.5 Cynoplus divided in three doses taken after meals.
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@Master Too bad but thanks anyway Master.