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T3 drugs: Everything you need to know

November 12, 2022 12 min read

If you're living with hypothyroidism, you're probably constantly on the lookout for new medications to help ease your symptoms. And in your search for the right thyroid hormone medication, you might have come across T3. But what exactly is T3, and how does it work?  This article will tell you everything you need to know about T3 medications, including what they are, how they work, how they help thyroid disease, and what their potential side effects are. 

The basics of thyroid hormones

Before we go into detail about T3 drugs, it's helpful to know the basics about the thyroid gland and its hormones.

The thyroid gland is a butterfly-shaped endocrine gland normally located in the lower front of the neck. The thyroid's job is to make thyroid hormone, which is secreted into the blood and then carried to every tissue in the body. The thyroid hormone helps the body use energy, stay warm, and keep the brain, heart, muscles, and other organs working as they should.

When your thyroid works normally, it produces around 80% T4 (thyroid hormone thyroxine) and 20% T3 (thyroid hormone triiodothyronine). T4 is much more abundant, but it's a relatively inactive hormone, meaning it doesn't really impact your cells. Your body converts T4 into T3 to use it. T3 is the highly active thyroid hormone. Its role is to deliver oxygen and energy to your cells, glands, tissues, and organs.

If something interferes with your thyroid function and causes your thyroid hormone production to go out of balance, you may experience many negative consequences. When your thyroid doesn't produce enough T4 or T3, it may indicate that you have hypothyroidism or underactive thyroid. Conversely, when your thyroid produces too much T4 or T3, you may have hyperthyroidism or overactive thyroid.

What are T3 drugs?

When you have hypothyroidism, you need medications to replace the missing thyroid hormone in your body. The goal is to increase the low thyroid hormone by mimicking the way your hormones act.

T3 drugs are medications that contain the active form of thyroid hormone triiodothyronine or T3. It increases the T3 levels in your bloodstream. While it's not a cure for hypothyroidism, it can help manage the symptoms.

T3 can be found in various thyroid hormone medications, including:

Liothyronine

When someone says T3 medication, most often, they mean liothyronine or the synthetic version of T3. It's often known by the brand name Cytomel and Triostat. Since T3 is the active hormone, pure synthetic T3 medications are incredibly powerful. Many consider it the strongest of all thyroid medications.

Natural desiccated thyroid (NDT)

T3 hormones are also found in natural desiccated thyroid (NDT). It's made from the dried thyroid gland of porcine (pigs) and contains T4 and T3. What makes NDT stand out is that it also has tiny amounts of other nutrients, proteins, minerals, and less active hormones like T1 and T2.

Because it contains both T4 and T3, many people consider it the best treatment option available. It's also preferred because it provides a much more natural way to replace the missing hormones in your body than synthetic options. NDT, such as VitaliThy, is available to purchase online.

Combined synthetic T4+T3

Liotrix, mostly known by the brand name Thyrolar, is a combination of synthetic T3 and T4. It contains a 4:1 mixture of levothyroxine (T4) and liothyronine (T3) to help increase the hormones that your body normally produces. Liotrix was created based on NDT. It was made in an effort to provide a synthetic version of NDT. And because it's synthetic, it's cheaper to manufacture and more profitable for companies compared to the natural form of thyroid hormones. Unfortunately, Liotrix is no longer available on the market in many countries.

It's important to remember, however, that even though Liotrix has been withdrawn, this does not mean that it was unsafe or of poor quality. The decision was purely based on financial reasons: It's more profitable for pharmaceutical companies to sell two drugs than one. This way, the industry can make more money off patients since they need to buy synthetic T3 and T4 separately. Thus, the discontinuation should not reflect on the drug itself.  Liotrix is still available in many parts of the world. In Europe, it's known as Novothyral.

When might T3 be helpful?

The standard treatment for hypothyroidism is levothyroxine, or the synthetic version of T4, such as Synthroid and Tirosint. Levothyroxine is often seen as the 'safest' option because it lasts a very long time in your bloodstream and is remarkably stable. Therefore, the side effects are not severe if you forget to take a dose or take too much. However, T4-only treatment is not for everyone. Many people may find adding T3 to be more effective. A study found that up to 20% of people who take T4-only thyroid medication may still experience hypothyroid symptoms even when they're taking the right dosage.

Those who still have symptoms of hypothyroidism despite taking T4 likely have issues activating or converting T4 to T3. And this is where taking T3 might help. Since T3 is already an active thyroid hormone, your body doesn't have to activate or convert it. This means that your body can practically use it upon absorption. 

You can choose a combination of levothyroxine and liothyronine or take NDT, which already contains T3 and T4. Be sure to talk to your doctor first before adding or changing your thyroid medication.

Symptoms you might need T3

So, how would you know if you might need T3? If you still experience symptoms of hypothyroidism even after takingT4 only medications regularly, it might be a sign that you have insufficient T3. The symptoms can include weight gain, fatigue, hair loss, dry skin, constipation, irregular menstrual periods, depression, concentration and memory problems, joint aches, and elevated cholesterol. If you experience any of these symptoms, consider having blood tests to measure your T3 level.

What are the benefits of using T3?

Since T3 medications don't need an activation or conversion step in the body, it comes with the following benefits:

Easier weight loss -Some hypothyroid patients find it easier to lose weight when they're taking pure T3 (liothyronine) or even thyroid medications that contain both T3 and T4, like NDT. One reason why hypothyroid patients find it easier to lose weight on T3 is that it helps to increase the basal metabolic rate. This means that more calories are burned at rest. 

Reduce hypothyroidism symptoms -For those who still struggle with unresolved hypothyroidism symptoms despite taking T4-only medication like levothyroxine, taking T3 can significantly help them feel better. The medication can help improve your overall metabolism, energy levels, mood, and well-being. It may also ease other symptoms that may persist despite taking levothyroxine, such as hair loss, brain fog, sleeping problems, and fatigue. Moreover, you might notice less joint pain and more muscle strength after taking T3 regularly.

Improve other hormone imbalances -The thyroid hormone can affect other hormones in your body. And hypothyroidism may help cause leptin and insulin resistance. While levothyroxine may help increase your thyroid hormone levels, it probably won't treat other hormone imbalances. T3 medications, on the other hand, have been shown to help reduce both leptin resistance and insulin resistance.

How long does it take to feel better on T3?

Everybody responds to T3 differently. While some people may feel the effects of T3 medications right away, others may need several weeks. The most important thing is to follow your doctor's orders on how and when to take your medications. You might need regular exams and occasional blood tests to check how your body responds to the medication.

How is T3 added to your thyroid hormone replacement therapy?

There are several ways you can add T3 to your thyroid hormone replacement regimen. The first option is to take pure synthetic T3 (liothyronine), such as Cytomel or generic liothyronine, and stop other thyroid medicines, such as levothyroxine. Alternatively, you might consider taking NDT, such as Armour Thyroid and VitaliThy, instead of liothyronine. NDT contains natural T3 and T4.

Is it okay to take levothyroxine and liothyronine together?

There is much controversy surrounding the question of whether or not it is okay to take levothyroxine and liothyronine together or in combination therapy. Some say that doing so can lead to serious health complications, while others claim it is safe. 

Those who are against taking levothyroxine and liothyronine together claim that doing so can cause serious health problems. They say that taking these two drugs together can cause an imbalance in the levels of thyroid hormones in the body, which can lead to problems such as weight gain, fatigue, and depression. Additionally, they claim that taking these two drugs together can also increase the risk of developing heart disease and other cardiovascular problems.

On the other hand, some doctors argue that the two medications work better when they're taken together. Furthermore, more hypothyroid patients preferred to take levothyroxine and liothyronine together instead of only one.

How do you take T3 drugs?

Liothyronine should be taken by mouth with plenty of water. Take it once a day at the same time every day. You may be instructed to take it on an empty stomach, usually 30 minutes before or 2 hours after food, for better absorption. However, some liothyronine, like Cytomel,can be taken with or without food. 

If you miss a dose, you can take it as soon as you remember. That said, you shouldn't take the missed dose if it's too close to your next dose. Doubling up on doses is recommended. Again, it's very important that you follow the instructions given by your doctor. 

Different people will have different doses of liothyronine. Adults with hypothyroidism usually start from 25 micrograms (mcg) a day. The dose can be adjusted as needed, but it typically won't be more than 75 mcg a day. Elders and children may start from 5 mcg a day, then adjust as needed. Your doctor may ask you to do a number of blood tests until you are on the right dose. The goal is to find the lowest possible dose that effectively treats your hypothyroidism.

Multi-dosing synthetic T3

Liothyronine may not last a long time in your body. Although the recommendation is to take it once a day, your hypothyroidism symptoms may be back before it’s time for your next dose. This is why multi-dosing, or splitting one dose into two to three smaller doses taken throughout the day, is better for many people. In fact, it has been shown to be more effective than taking a single dose. Here are some reasons why:

  • When the medication is taken in smaller doses, it is easier for the body to absorb and use.

  • Multi-dosing allows for a more consistent and steady level of T3 in the bloodstream throughout the day, which leads to fewer side effects and greater efficacy. 

  • Multi-dosing T3 medications give the patient more control over their symptoms and allow them to adjust their dosage as needed.

Is too much T3 dangerous?

Too much T3 can be dangerous for your body. Therefore, you shouldn't take more than the recommended dose of liothyronine. Cytomel can result in myocardial infarction (lack of blood flow to your heart muscle), irregular heartbeat, and chest discomfort when taken in extreme doses. These side effects can get worse and become life-threatening if left untreated or if you don't lower your dose. Toxicity often develops over time when an excessive amount of the medicine builds up in the bloodstream. Consequently, symptoms might show up later.

If you think you've taken too much liothyronine, notify your doctor right away. If you experience any serious side effects, you may need immediate medical evaluation.

What are the side effects of T3?

Like all kinds of medications, there are some side effects of T3 medications you need to be aware of. The most common side effects of liothyronine are similar to hyperthyroidism symptoms:

  • Nervousness

  • Headache

  • Irregular heart rhythm

  • Heart palpitations

  • Muscle weakness

  • Shortness of breath

  • Irritability

  • insomnia 

  • Increased appetite

  • Hair loss

  • Menstrual problems

  • Diarrhea

  • Heat intolerance.

Since T3 medications stimulate bone resorption, they may also lead to bone complications. Moreover, another issue with T3 medication is that it might deprive your body of its ability to manage the conversion of T4 to T3. If you experience any of these side effects, it's important that you contact your doctor.

What should you do if you find liothyronine to be overstimulating?

If you find that your liothyronine is overstimulating, it's best that you talk to your doctor first. In most cases, you might be advised to stop taking the medication, or the dose will be lowered. Alternatively, your doctor may replace liothyronine with another medication, such as a time-released compounded T3 medication. You might also try multi-dosing your medication. Another option is to replace your liothyronine with NDT, such as VitaliThy.

Keep in mind that you shouldn't stop taking liothyronine or start adding another medication whenever you want. Doing so needs careful consideration, so always discuss it with your doctor first.

When is T3 not recommended?

Liothyronine is generally safe for most people. Both children and adults can take it. A certain group of people, however, needs to use this medication with special care and supervision or need to avoid it altogether. These include:

  • People 65 and older -If you're 65 years old or older, you should take liothyronine with caution. This is because older people are more likely to develop cardiac reactions, such as changes in heart rate and chest pain. This is why older people who want to take this medication should start with a lower dose.

  • People who have an underlying cardiovascular disease -If you have high blood pressure, a previous heart attack or stroke, congestive heart failure, coronary artery disease, and heart arrhythmias, liothyronine is generally not recommended for you. This medication may put you at a greater risk of developing cardiac reactions. If you want to try this medication, your doctor may start by prescribing a low dose.

  • Pregnant women -Having a sufficient level of T3 in the blood during pregnancy is essential for your baby's development. But while T3 is needed for your body, T3 medications are usually not the first choice for pregnant women. That is unless you're already on thyroid hormone replacement treatment with T3 prior to pregnancy.

Can I take T3 to help with weight loss even when I don't have a thyroid disease?

Since T3 medications can help people thyroid patients lose weight, many people think that it's a weight loss tool. But this isn't true. Liothyronine, like other thyroid medications, is only meant for people with a thyroid disease. 

If you don't have a thyroid disease, taking T3 medication is unlikely to help you lose weight. T3 is a thyroid hormone that helps regulate metabolism. When your metabolism is working properly, the body is able to convert food into energy more efficiently. As a result, it may help people with hypothyroidism lose weight. However, if you don't have hypothyroidism, your metabolism is probably already working fine, so taking T3 medication is unlikely to help you lose weight.

Taking T3 when you don't have hypothyroidism can actually be harmful to your health. You may experience side effects like rapid heart rate, irregular heart rhythms, and loss of bone density. It's also possible to experience symptoms of heart failure, such as swelling, shortness of breath, and even weight gain.

What if your doctor wouldn't prescribe T3?

According to official guidelines of the American Thyroid Association for the treatment of hypothyroidism, only levothyroxine is recommended. As a result, many doctors just don't feel comfortable prescribing liothyronine like Cytomel or NDT, even though they are safe when taken properly. Some doctors may even refuse to test your T3 levels.

In this case, you might consider getting an NDT supplement, such as VitaliThy. It contains the same active ingredient as 60mg (1 grain) of Armour Thyroid or NP Thyroid. Unlike conventional synthetic medications that contain only one form of thyroid hormone (only T4 or T3), VitaliThy has all the hormones that thyroid glands would ordinarily make. These include T4, T3, T2, T1, and Calcitonin. Each thyroid hormone present in VitaliThy plays a key role in your body. They work synergistically together to give your body a variety of advantages.

Conclusion

T3 drugs are hypothyroidism medications that contain the active form of thyroid hormone (T3). It works by increasing the T3 levels in your blood, thus, balancing your thyroid hormone levels and easing your hypothyroid symptoms. It's available in a synthetic form known as liothyronine (Cytomel), which is considered the most powerful thyroid medication. T3 is also present in the natural desiccated thyroid (NDT), which contains the natural form of both T3 and T4. Another thyroid medication that contains T3 is liotrix, a combination of synthetic T3 and T4. However, liotrix is not widely available anymore since most manufacturers have discontinued the medication.

There are many benefits to taking T3 medications. For example, it may help those who still struggle with unresolved hypothyroidism symptoms despite taking T4-only medications like levothyroxine. It's also associated with easier weight loss compared to other thyroid medications. However, it shouldn't be used as a weight loss tool, especially for people who don't have hypothyroidism.

Liothyronine is very safe to use as long as you take it properly and in the right dose. However, some doctors may refuse to prescribe liothyronine and even NDT medications to thyroid patients because they're following the guidelines from the American Thyroid Association. The best alternative, in this case, is taking an NDT supplement like VitaliThy. Since VitaliThy is made of dried porcine glands, it contains all the thyroid hormones that your thyroid gland normally produces. These include T4, T3, T2, T1, and Calcitonin. That's why it can reduce your hypothyroidism symptoms and even help with insulin resistance, allowing you to lead a healthy and happy life.

Wojciech Majda
Wojciech Majda


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