Supplementing T3 not safe afterall?
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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... -
@Wkia Such studies provide a bit reductionistic approach...
Most probably many/most of the people in this study had low thyroid because of a mix of bad diet, chronic stress, genetics, an unhealthy environment, etc... Adding just T3 was like adding fuel to a fire... Probably many of them used this extra thyroid energy to do/eat more bad stuff...
Ray always stressed that diet and lifestyle should be addressed first before starting any T4 and especially T3 therapy...
It's also nicely and concisely described in this video https://twitter.com/natelawrence_/status/1766186130985107582
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hard to say. This is a "retrospective" study, and there are many hidden confounders.
The T3 peeps, maybe they were sicker to begin with. I can't really see how they accounted for that.
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@Kvirion Wow. Fantastic piece by Nate Lawrence.
Thanks for posting it!!! -
@Kvirion Thanks Kvirion, so that would mean that my fairly healthy life style and my being a picky eater (meaning a.o. nothing processed and as little pufa as possible) for many years, would keep me safe from possibly harmful effects of T3.
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@Ecstatic_Hamster Thanks Ecstatic Hamster, I can't see that either but because its about a large number of patients I thought that, taken all together, they might have average health/sickness but that of course would be an assumption.
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@Wkia said in Supplementing T3 not safe afterall?:
my fairly healthy life style and my being a picky eater (meaning a.o. nothing processed and as little pufa as possible) for many years, would keep me safe from possibly harmful effects of T3.
Yes, good, it looks so. Probably, the best approach would be still: Think. Perceive. Act. I.e. starting with the lowest (split) possible dose, and increasing it slowly - constantly observing the body's reactions (temperature, pulse, stress levels, etc.) to it.
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I can't find the full paper it seems, but as others pointed out there are several issues with this paper.
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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 because it's entirely possible that there were no ill effects or even positive effects of T3 & T4 administration but T3 alone dragged down the stats overall.
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They seem to reference that this was only the case for patients that were taking T3 therapy for over a year:
"heart failure was higher in LT3 users with a history of thyroid cancer and those who underwent ≥52 weeks of LT3 therapy."
" the risk of stroke was higher in LT3 users without thyroid cancer history and those who underwent ≥52 weeks of LT3 therapy."
As far as I'm aware, Peat, Haidut, and Danny all advocate cycling to some extent.
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I am not a fan of just T3 over the long haul, and I recall Dr. Peat saying he had his heart irregularly beating when he was only on T3. I think it's better to take T4 and T3 usually.
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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.
