Free T3 peaks and valleys in T3 and NDT therapy

Lack of knowledge about Free T3 peaks and valleys contributes to failure and frustration in T3-based therapies, including desiccated thyroid and T3-T4 combination therapy. On patient support groups, I often see conversations that go like this: "My FT3 result was over reference range, FT4 low in range, and my TSH was low, so my doctor …

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Stop spreading the unscientific myth about the normal T4:T3 ratio!

Sigh. Just sigh. Even some of our best thyroid patient advocates can unknowingly share misinformation about thyroid therapy. Mary Shomon's thyroid articles on Verywell.com are usually to be trusted. But yesterday I was saddened to see that an article supposedly authored by Mary Shomon was spreading unscientific myths about "normal" thyroid secretion ratios being 13:1 …

Continue reading Stop spreading the unscientific myth about the normal T4:T3 ratio!

L-T3 pharmaceutical equivalency, Part 2: New thyroid science

What does NEW thyroid science have to say on the topic of thyroid pharmaceutical equivalency? How many micrograms of L-T3 Liothyronine (i.e. Cytomel) are equivalent to L-T4 Levothyroxine (i.e. Synthroid)? Thyroid hormone pharmaceutical monographs currently provide very rigid and low-ratio equivalency statements: ERFA Canada says "Desiccated thyroid 60 mg is usually considered equivalent to ... …

Continue reading L-T3 pharmaceutical equivalency, Part 2: New thyroid science

No, 25 mcg of L-T3 Liothyronine isn’t equivalent to 100 mcg L-T4

In thyroid therapy, how many micrograms of Cytomel (T3) are equivalent to how many micrograms of Synthroid (T4)? Equivalency statements in the product monographs for Pfizer Canada's Cytomel and for ERFA Canada's "Thyroid" (NDT brand) claim that a 25 mcg dose of Liothyronine sodium (L-T3) is "considered equivalent" to 100 mcg / μg (0.1 mg) …

Continue reading No, 25 mcg of L-T3 Liothyronine isn’t equivalent to 100 mcg L-T4

Flexible-Ratio T3, T4, and NDT Combination Thyroid Therapy

Here I bring thyroid science into a discussion of effectively adapting and managing the most flexible form of thyroid therapy, T4-T3 combination therapy. This is a model capable of adapting to an individual's unique thyroid disability and response to thyroid medication. Finding an individual's optimal combination therapy is medically necessary when T4 monotherapy fails due …

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The mini-T3-mono-combination therapy model vs NDT and others

I'd like to talk about contemporary researchers' rigid and limited approach to combination therapy. This is the model whose many limitations I point out with the ridiculously long label "mini-T3-mono-combination" therapy. I'll go over some of the history behind this model, the source of the rigid ratios that we learned about in our series on …

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Question Pilo’s 1990 study. It can be misused to limit your T3 supply.

In this series, I am examining two T4-T3 thyroid hormone ratios that have been circulating in thyroid medical literature for decades. The first ratio is the “molar ratio” of T4 and T3 hormone secretion from the thyroid gland. The second ratio is the theory that the human body derives 20% of its T3 hormone supply from …

Continue reading Question Pilo’s 1990 study. It can be misused to limit your T3 supply.