The Thyroid is responsible for producing T4 thyroid hormone naturally in the body. A certain amount of this – dependant on the needs of the body – is converted into T3 hormone, which acts as a ‘fine tuner’ for the body functions which use thyroid hormones to regulate themselves – the metabolism, digestion, temperature controls and so on. 

Old Fashioned Treatments 

In the early days of thyroid treatments, which was as long ago as the 1700s, treatments included ‘natural’ thyroid products, harvested from the thyroids of animals – and as the only possible treatment. Patients had no choice! They could take the medication and feel slightly better, or not take and continue to feel ill. 

As time passed, and scientists could use microscopes to investigate the inner workings of the body. Artificial thyroid hormones were made entirely synthetically, and these could be tailored to each patient to arrive at the right dose for the body in question. This led to a more modern treatment, with patients being offered artificial T4 and occasionally artificial T3 too. But the mechanism by which the body converts T4 into T3 was not known of until fairly recently, medically speaking. 

Once this was discovered, doctors found it far more prudent (not to mention cost effective) to switch to levothyroxine monotherapy. 

What is Levothyroxine Monotherapy? 

Levothyroxine is artificial T4: the hormone produced plentifully by the body when the thyroid is working properly. This is now ‘the norm’ when it comes to treatments for hypothyroid issues. After your diagnosis, you and your doctor will work together to get your dosage just right. 

This can be a tricky process as T4 is a strong hormone and is only required in relatively minute, but very precise doses, to give you the best quality of life. One reason that T3 is not routinely prescribed alongside the T4 is because often while the thyroid’s production of T4 is affected, it does not lose its ability to convert this into T3 – which means that your precisely measured dose of T4 is converted into T3 as the body needs it, so adding a dose of artificial T3 alongside this can mean that you end up with an excess of T3 in your system – which is not ideal and can lead to symptoms akin to that of hyperthyroidism until the T3 levels drop back to normal! 

Artificial T3 is called liothyronine (appearing also as brand names Cytomel and Triostat, amongst others – you can find out more about T3 tablets at International Pharmacy on this link). 

So… Does Anyone Need Combination Therapy? 

Yes, is the short answer here. While most people do very well on levothyroxine monotherapy. Some people do lack the ability to convert enough T3 from their medication, due to the illness they have. In other cases, medical professionals have found that while the T4 monotherapy is sufficient to keep the patient alive and ticking over. They still feel unwell and cannot live their lives as fully as they 

would like. In some of these cases, experiments with carefully tailored combination treatments have seen vast improvements in these patients’ energy levels. And general joie de vivre. Women on Combination Therapy for their thyroid issues may have to revert to levothyroxine monotherapy while they are pregnant. To ensure the growing embryo does not lack for T3 – T3 does not cross into the fetus. And if the mother is on a combination therapy, too little T4 could cross over, leaving the embryo with some developmental ills. Always consult your medical professional about any changes to your thyroid medication, before you try them!

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