If you prefer natural desiccated thyroid (NDT / DTE) over synthetic thyroid hormone I know you might bristle at my word “artificial.”
Animal-derived vs. synthesized — that’s not an argument I get into here.
What I argue here is that at a more fundamental level, taking any ORAL thyroid hormone is NOT the same as secreting and converting hormone within your own body every minute of every day.
This is an important biological fact with huge biological implications for testing and therapy.
It’s important for patients, doctors, and the medical system to agree about this as a starting point before we get into finer points of debate regarding whether synthetic or animal-derived thyroid molecules are better and what ratio of T3 to T4 is more natural.
Hormone therapy is a prosthetic.
If you lose an arm or a leg, our society will help you to obtain a prosthesis, a fake arm or leg.
In a similar way, thyroid hormone therapy of any type replaces a living, adaptable gland with regular, static doses of hormone molecules.
Hormone therapy will never be the same as a real thyroid gland and “normal” thyroid hormone metabolism.
Because it is artificial, it can distort hormone levels. Any mode is capable of causing deficiency, excess or imbalance among TSH, T4 and T3.
The standard L-T4, various combinations of T4/T3, and even the rarer but effective T3 monotherapies — they ALL distort the TSH, T4 and T3 relationship in different ways.
These artificial distortions make testing just the pituitary TSH hormone unreasonable.
Not testing T4 and T3 levels, especially the most important thyroid hormone, T3, means refusing to monitor a significant risk to patients’ health.
Let’s at least make the prosthetic work properly.
We can engineer this prosthetic to fit the individual as long as we have access to the appropriate T3 and T4 tests and the appropriate T3 and T4 medications.
We always need both of these tests, and we often need both of these tools.
Our doctors certainly can, and have, radically improved thyroid patients’ health by measuring and regulating their thyroid hormones, T3 and T4, in relation to their effects on signs and symptoms of hypothyroidism.
Working together, a patient and doctor can discover where “optimal” T3 levels are for the individual patient. In combination therapy, each patient may need a different ratio between T3 and T4 to achieve their optimal balance in bloodstream.
Testing only TSH and using only one hormone T4 is a choice to use only one eye and one hand to fix a broken machine with two levers. Medicine will remain blind and powerless to influence a patient’s vital T3 levels, because the hormone TSH alone is often blind and powerless to influence a patient’s vital T3 levels. The hormone T4 alone may be unable create sufficient T3 levels in a patient.
If it’s broken, we can fix it. It will never be the same as a real gland, but it can be adjusted.
Let’s optimize thyroid therapy.