The New "T3 Treatment" Thyroid Solution or Unethical Experiment?

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 – thyroxine, 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 alternatively with pure thyroxine (T4) or a lower dose of T4 plus triiodothyronine (T3). The article concluded that “treatment with thyroxine plus triiodothyronine 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 T3 or 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, it 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 likelihood 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: elderly 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 antidepressants. 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 experimental 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.

Sources
1. Levine, R.J. Ethics and Regulation of Clinical Research. (1988, Yale University Press, New Haven.)
2. Mastroianni, Anna C., Ruth Faden, and Daniel Federman, Editors, Women and Health Research: Ethical and Legal Issues of Including Women in Clinical Studies, Volume 1. (1994, National Academy Press, Washington.)
3. Rosenthal, M. Sara, The Thyroid Sourcebook for Women. (1999, Lowell House)
4. Rosenthal, M. Sara, The Thyroid Sourcebook, 4th edition. (2000, Lowell House)
5. Sherwin, Susan, Patient No Longer: Feminist Ethics and Health Care. (1984, Temple University Press, Philidelphia.)
Reprinted from SarahealthNews, copyright www.sarahealth.com, Inc.,2000

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