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Home > Anti-aging Research > Triiodothyronine [T3]

Liothyronine/Cytomel®/Triiodothyronine [T3]

Where to purchase (check with your doctor first):

T3 at International Anti-aging Systems

CME:

Triiodothyronine Augmentation For the Treatment of Depression in Substance Misusers Unresponsive to Tricyclic Antidepressants - HKMJ 2001;7:299-302 - "we believed this treatment strategy should be used more often in local practice"

News & Research:

Persistence of Mortality Risk in Patients With Acute Cardiac Diseases and Mild Thyroid Dysfunction - Am J Med Sci. 2011 Aug 26 - "A total of 1026 patients (mean age: 67.7 years) were divided into 4 groups: (1) euthyroid (EU, n = 579); (2) subclinical-like hypothyroidism (SLHYPO, n = 68); (3) subclinical-like hyperthyroidism (SLHYPER, n = 23) and (4) low-triiodothyronine syndrome (LowT3, n = 356). Follow-up started from the day of thyroid hormone evaluation (mean follow-up: 30 months). The events considered were cardiac and overall deaths ... Survival rate for cardiac death was lower in SLHYPO and in LT3 than in EU (log rank test; χ = 33.6; P < 0.001). Survival rate for overall death was lower in SLHYPO, SLHYPER and LowT3 than in EU (48.3; P < 0.001). After adjustment for several risk factors, the hazard ratio for cardiac death was higher in SLHYPO (3.65; P = 0.004) in LowT3 (1.88; P = 0.032) and in SLHYPER (4.73; P = 0.047). Hazard ratio for overall death was higher in SLHYPO (2.30; P = 0.009), in LowT3 (1.63; P = 0.017) and in SLHYPER than in EU (3.71; P = 0.004). Hazards for SLHYPO, SLHYPER and LowT3 with respect to EU were proportional over the follow-up period ... In patients with acute cardiac disease, a mildly altered thyroid status was associated with increased risk of mortality that remains constant during all the follow-up" - See T3 at International Anti-aging Systems.
Antipsychotics Significantly Decrease Free Thyroid Hormone Concentrations - Doctor's Guide, 9/4/08 - "In patients who receive antipsychotic medication, levels of free thyroxine and free triiodothyronine show significant decreases that may affect thyroid hormone functional activity in some tissues, such as the liver"
Best Thyroid Treatment? - Dr. Weil, 8/29/08
Looking For The Fountain Of Youth? Cut Your Calories, Research Suggests - Science Daily, 7/3/08 - "While scientists do not know how calorie restriction affects the aging process in rodents, one popular hypothesis is that it slows aging by decreasing a thyroid hormone, triiodothyronine (T3), which then slows metabolism and tissue aging" - All the studies I've read seem to support the opposite:
- Longer-lived Rodents Have Lower Levels Of Thyroid Hormone - Science Daily, 10/12/06 - "T4 levels varied significantly between all of the groups, with the shorter-lived groups having higher levels of T4 than longer-lived groups ... However, because T3, levels did not differ significantly among all the groups, further research in this area using larger sample sizes (numbers of rodents in each group) is needed"
- ACUTE EFFECTS OF TRIIODOTHYRONINE REPLACEMENT THERAPY IN PATIENTS WITH CHRONIC HEART FAILURE AND LOW-T3 SYNDROME: A RANDOMIZED, PLACEBO-CONTROLLED STUDY - J Clin Endocrinol Metab. 2008 Jan 2 - "Low-triiodothyronine (T3) syndrome is a predictor of poor outcome in patients with cardiac dysfunction ... dilated cardiomyopathy (DC) ... In DC patients, short-term synthetic L-T3 replacement therapy significantly improved neuroendocrine profile and ventricular performance"
- Low triiodothyronine: a strong predictor of outcome in acute stroke patients - Eur J Clin Invest. 2007 Aug;37(8):651-7 - "The 1-year mortality was 27.34% for low T3 and 19.37% for normal T3 cases (P = 0.006). A smaller percentage of patients with low T3 values were independent at 1 year compared to those with normal T3 values [54.2% vs. 68.7%, chi(2) = 12.09, P < 0.001, odds ratio (OR) = 0.53"
- Natural killer activity and thyroid hormone levels in young and elderly persons - Gerontology 2001 Sep-Oct;47(5):282-8 - "Decreased serum concentrations of total T(3) may contribute to low NK activity in the 'almost healthy' subgroup of the elderly"
- Does low tri-iodothyronine independently predict mortality in elderly hospitalised patients? - Int J Clin Pract 2001 Jul-Aug;55(6):409-10 - "Our study shows an association of low serum T3 with patient mortality in elderly hospitalised patients"
T3 Supplementation Raises Patients' Response to Sertraline - Clinical Psychiatry News, 11/06 - "The sertraline-T3 cohort also was much more likely (odds ratio 2.69) to go into remission by the sixth week of treatment. At that point, 58.5% (31/53) of the T3-augmented patients but only 38% (19/50) of the placebo group was in remission"
Longer-lived Rodents Have Lower Levels Of Thyroid Hormone - Science Daily, 10/12/06 - "T4 levels varied significantly between all of the groups, with the shorter-lived groups having higher levels of T4 than longer-lived groups ... However, because T3, levels did not differ significantly among all the groups, further research in this area using larger sample sizes (numbers of rodents in each group) is needed"
Thyroid Supplementation Enhances Antidepressant Response - Medscape, 9/21/06 - "Remission occurred in 31 patients (58.5%) receiving T3 compared with 19 patients (38%) in the placebo group" - See T3 at International Anti-aging Systems but check with your doctor first.
T3 Therapy Not Yet Ready for Psychiatric Use - Clinical Psychiatry News, 2/05 - "Today, many patients with complaints of chronic malaise or fatigue approach their physician seeking T3 therapy, but the fact is that none of the handful of well-designed randomized controlled trials done since then has been able to confirm the initial report of superior outcomes ... There is reason for concern that supraphysiologic doses of T3 in this setting could interfere with protein and fat metabolism and interact synergistically with catecholamines to increase myocardial oxygen demand, with resultant increased arrhythmia, MI, heart failure, and death"
Reply to Doctor Who States that T3 is Dangerous--Fibromyalgia, Hypothyroidism, Thyroid Hormone Resistance - DrLowe.com, 12/8/03
Combinination Levothyroxine/Liothyronine Shows No Obvious Benefit Over Levothyroxine Alone in Patients With Primary Hypothyroidism - Doctor's Guide, 12/11/03
Combination Therapy No Better Than T4 Alone for Primary Hypothyroidism - Medscape, 12/9/03
Thyroxine Plus 3,5,3'-triiodothyronine Treatment for Depressed Patients with Hypothyroidism Does Not Improve Patient-Assessed Well-Being - Doctor's Guide, 10/30/03
Thyroid Hormone T3 Doesn't Boost Effectiveness of SSRIs - Clinical Psychiatry News, 10/03
Adding T3 to Paroxetine Adds No Benefit in Depressed Patients - Doctor's Guide, 4/28/03
Algorithm-Based Treatment Shows High Lack Of Response To Selective Serotonin Reuptake Inhibitors - Doctor's Guide, 4/17/03 - "When the clinicians added T3, they found it was effective among 10 out of 16 women patients (62.5%), but was not effective in any of the 9 male patients who received it. Although values were within the normal range, patients who responded to T3 had higher serum thyroid-stimulating hormone levels than those who did not ... The effect of T3 may be related to thyroid function even within the normal range"
Options for Treatment-Resistant Depression - Psychiatric Times, 7/02 - "Use of T3 may interfere with thyroid metabolism if taken chronically, so its use should generally be limited to two or three weeks. Doses of T3 between 25 mcg/day to 50 mcg/day are more effective than T4"
Bipolar Patients Sensitive to Thyroid Function Variations - Doctor's Guide, 1/8/02 - "They studied 65 patients in the depressed phase of bipolar I disorder to test the hypothesis that patients with lower thyroid function, even within the normal range, might have a poorer response to treatment initially ... Outcomes were relatively poor unless patients had FTI [free thyroxine index] values above the median and TSH values below the median"
Does thyroid supplementation accelerate tricyclic antidepressant response? A review and meta-analysis of the literature - Am J Psychiatry 2001 Oct;158(10):1617-22 - "This meta-analysis supports the efficacy of T(3) in accelerating clinical response to tricyclic antidepressants in patients with nonrefractory depression"
Sustained Release T3 / Time Release T3 - WilsonSyndrome.com - "When Dr. Wilson first started treating Wilson's Thyroid Syndrome, Cytomel (instant release) was all he used. When he had about 300 patients at a time on Cytomel, he would get about 6-8 beeper pages over the weekend from patients having complaints and 2-3 of those calls would be about some pretty worrisome side effects. When Dr. Wilson conceived of and started using T3 mixed with a sustained release agent (see WTS history) he would go 6 months without a page"
Synthroid / Armour Thyroid - WilsonSyndrome.com - "Some patients and physicians hear about the need for T3 and think they can gain the benefits of T3 by using Armour instead of Synthroid because it contains T3. But Armour thyroid doesn't contain just T3. It contains a lot of T4 as well! T4 is the very hormone we're trying to reduce in WTS in order to deplete RT3 levels"
Thyroid Hormones Accelerate Depressive Response to Drug Therapy - Doctor's Guide, 10/30/01 - "Five of the six studies found T3 to be significantly more effective than placebo in accelerating clinical response ... Investigators say they found that the average effect was highly significant"
The acute effect of calcium carbonate on the intestinal absorption of levothyroxine - Thyroid 2001 Oct;11(10):967-71 - "When 1,000 microg of levothyroxine alone was given to subjects, the maximum average total T4 absorption was 837 microg (83.7% of the dose ingested) at 120 minutes. When levothyroxine was coadministered with 2.0 g of calcium (as calcium carbonate), the maximum average T4 absorption decreased to 579 microg (57.9% of the dose ingested) at 240 minutes"
Use OF T3 Thyroid Hormone to Treat Depression - DrMirkin.com, 5/19/01 - "some people become depressed when they take just T4 and their depression can be cured when they take both thyroid hormones, T3 and T4"
Replacing T4 With Triiodothyronine Improves Cognition And Mood In Hypothyroidism - Doctor's Guide, 7/5/00 - "Substituting T3 for a portion of T4 changed the concentrations of thyroid hormones and thyroid-stimulating hormone (TSH) as well as improving cognition and mood"
T3---fibromyalgia, hypothyroidism, thyroid hormone resistance - drlowe.com
Wilson's Thyroid Syndrome - "Conversion of T4 to T3 can also be impaired by glucocorticoids" - Maybe that is the mechanism by which cortisol causes depression, and if so, could T3 then cure the depression? - Ben
Adding Natural Hormone Boosts Brain Function In Hypothyroidism - Doctor's Guide, 2/11/99 - "We found there wasn't much difference between the two treatments in terms of metabolic effects or effects on various peripheral organs," Prange said. "There were big differences, however, in the mental state of the patients. If these findings hold up, they will be very important."
Depression Management - ContinuingEducation.com, exp. 12/31/02 - See table six, recommends 5 - 50 mcg T3, 100 mcg (.1 mg) T4
Liothyronine Sodium - RxList.com - "Twenty-five mcg of liothyronine [T3] is equivalent to approximately 1 gram of desiccated thyroid or thyroglobulin and 0.1 mg of L-thyroxine [T4]" - I don't know if that is correct concerning 1 gram of desiccated thyroid. That would mean that it would take 17 of the normal 60 mg desiccated thyroid capsules to equal 25 mcg T3 and 100 mcg T4 (1000/60 = 17). I would think that that amount would be lethal. Maybe it should have been grains instead of grams. Any feedback would be appreciated. - Ben

Abstracts:

Familial Longevity Is Associated with Decreased Thyroid Function - J Clin Endocrinol Metab. 2010 Aug 25 - "We found that a lower family mortality history score (less mortality) of the parents of nonagenarian siblings was associated with higher serum TSH levels (P = 0.005) and lower free T4 levels (P = 0.002) as well as lower free T3 levels (P = 0.034) in the nonagenarian siblings"
T3 affects expression of collagen I and collagen cross-linking in bone cell cultures - Biochem Biophys Res Commun. 2010 Aug 10 - "T3 increased mRNA expressions of procollagen-lysine-1,2-oxoglutarate 5-dioxygenase 2 (Plod2) and of lysyloxidase (Lox), both genes involved in post-translational modification of collagen. Moreover, it stimulated mRNA expression of BMP-1, the processing enzyme of the lysyloxidase-precursor and of procollagen. An increase in the collagen cross-link-ratio Pyr/deDHLNL indicates, that T3 modulated cross-link maturation in the MC3T3-E1 culture system. These results demonstrate that T3 directly regulates collagen synthesis and collagen cross-linking by up-regulating gene expression of the specific cross-link related enzymes, and underlines the importance of a well-balanced concentration of thyroid hormones for maintenance of bone quality"
The pharmacodynamic equivalence of levothyroxine and liothyronine: a randomized, double blind, cross-over study in thyroidectomized patients - Clin Endocrinol (Oxf). 2010 May;72(5):709-15 - "This is the first study addressing the equivalency between L-T3 and L-T4 therapy measured by baseline and TRH-stimulated TSH. The therapeutic substitution of L-T3 for L-T4 was achieved at approximately 1:3 ratio"
The pharmacodynamic equivalence of levothyroxine and liothyronine. A randomized, double blind, cross-over study in thyroidectomized patients - Clin Endocrinol (Oxf). 2009 Sep 10 - "The therapeutic substitution of L-T3 for L-T4 was achieved at approximately 1:3 ratio"
Increased reverse T3 is associated with shorter survival in independently-living elderly. The Alsanut study - Eur J Endocrinol. 2008 Nov 10 - "rT3 was the only thyroid hormone associated with shorter survival"
Higher Serum Free Thyroxine Levels Are Associated with Coronary Artery Disease - Endocr J. 2008 May 23 - "The relative risk (RR) for CAD in highest tertile of FT(4 )showed increased risk compared with the lowest tertile (RR 1.98; 95% CI 0.98-3.99, p<0.001). Our study showed that FT(4 )levels were associated with the presence and the severity of CAD. Also, this study suggests that elevated serum FT(4 )levels even within normal range could be a risk factor for CAD" - That might be an argument for going with T4 on say even days and T3 on odd days.
ACUTE EFFECTS OF TRIIODOTHYRONINE REPLACEMENT THERAPY IN PATIENTS WITH CHRONIC HEART FAILURE AND LOW-T3 SYNDROME: A RANDOMIZED, PLACEBO-CONTROLLED STUDY - J Clin Endocrinol Metab. 2008 Jan 2 - "Low-triiodothyronine (T3) syndrome is a predictor of poor outcome in patients with cardiac dysfunction ... dilated cardiomyopathy (DC) ... In DC patients, short-term synthetic L-T3 replacement therapy significantly improved neuroendocrine profile and ventricular performance"
Low triiodothyronine: a strong predictor of outcome in acute stroke patients - Eur J Clin Invest. 2007 Aug;37(8):651-7 - "The 1-year mortality was 27.34% for low T3 and 19.37% for normal T3 cases (P = 0.006). A smaller percentage of patients with low T3 values were independent at 1 year compared to those with normal T3 values [54.2% vs. 68.7%, chi(2) = 12.09, P < 0.001, odds ratio (OR) = 0.53"
Free triiodothyronine and thyroid stimulating hormone are directly associated with waist circumference, independently of insulin resistance, metabolic parameters and blood pressure in overweight and obese women - Clin Endocrinol (Oxf). 2007 Jun 4
A Comparison of Lithium and T3 Augmentation Following Two Failed Medication Treatments for Depression: A STAR*D Report - Am J Psychiatry. 2006 Sep;163(9):1519-30 - "After a mean of 9.6 weeks (SD=5.2) of treatment, remission rates were 15.9% with lithium augmentation and 24.7% with T(3) augmentation"
T3 augmentation of SSRI resistant depression - J Affect Disord. 2006 Apr;91(2-3):211-5 - "The women took a mean daily dose of 40.6 mug of T3 for a mean duration of 3.75 weeks, while the men were on a mean daily dose of 43.8 mug of T3 for 3.5 weeks. T3 augmentation was associated with a statistically significant drop (p<.003) in the mean HAMD at end of the three weeks compared to baseline scores"
Critical appraisal: Combined T3 and T4 replacement therapy is not better than replacement with T4 alone - Rev Med Chil. 2005 Sep;133(9):1116-9
Natural killer activity and thyroid hormone levels in young and elderly persons - Gerontology 2001 Sep-Oct;47(5):282-8 - "Decreased serum concentrations of total T(3) may contribute to low NK activity in the 'almost healthy' subgroup of the elderly"
Effect of triiodothyronine on mitochondrial energy coupling in human skeletal muscle - J Clin Invest 2001 Sep;108(5):733-7 - "these data suggest that T(3) promotes increased thermogenesis in part by promoting mitochondrial energy uncoupling in skeletal muscle"
Topical triiodothyronine stimulates epidermal proliferation, dermal thickening, and hair growth in mice and rats - Thyroid 2001 Aug;11(8):717-24 - "hair length that was 1,180% longer ... 85% more hairs per millimeter ... topically applied thyroid hormone has dramatic effects on both skin and hair growth. These observations offer a new strategy for developing thyroid hormone and its analogues for treating disorders of skin and hair growth"
Does low tri-iodothyronine independently predict mortality in elderly hospitalised patients? - Int J Clin Pract 2001 Jul-Aug;55(6):409-10 - "Our study shows an association of low serum T3 with patient mortality in elderly hospitalised patients"
Thyroid Hormone Replacement Therapy - Horm Res 2001 Jan;56 Suppl S1:74-81 - "Desiccated thyroid contains both thyroxine (T(4)) and triiodothyronine (T(3)); serum T(3) frequently rises to supranormal values in the absorption phase, associated with palpitations. Liothyronine (T(3)) has the same drawback and requires twice-daily administration in view of its short half-life ... TSH values of </=0.1 mU/l carry a risk of development of atrial fibrillation and are associated with bone loss although not with a higher fracture rate. It is thus advisable not to allow TSH to fall below - arbitrarily - 0.2 mU/l ... recent animal experiments indicate that only the combination of T(4) and T(3) replacement, and not T(4) alone, ensures euthyroidism [normal thyroid status] in all tissues of thyroidectomized rats ... It could well be that a slow-release preparation containing both T(4) and T(3) might improve the quality of life, compared with T(4) replacement alone, in some hypothyroid patients"
Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism - N Engl J Med. 1999 Feb 11;340(6):469-70 - "among 15 visual-analogue scales used to indicate mood and physical status, the results for 10 were significantly better after treatment with thyroxine [t4] plus triiodothyronine [t3]"