T3 & T4 – What You Need To Know
The body is governed by a range of hormones. Have you ever wondered why some people can eat all day and never put on weight? Why is it that you often feel tired without any reason? The answer is probably that your hormone levels are not properly tuned. If you put on weight easily and have difficulties with sleep and energy levels, then T3 and T4 may be behind your ailments.
Triiodothyronine
“Triiodothyronine” is not easy to pronounce. It is generally referred to as “T3.” A stimulus, called the thyroid-stimulating hormone, or TSH, travels from the pituitary gland to the thyroid gland, where T3 and T4 are produced in response. TSH is also known as thyrotropin. T3 controls your heart rate, your cell growth and your metabolism. Problems with T3 can cause sleeplessness and unfair weight gain. Some forms of depression are actually caused by incorrect T3 levels.
Thyroxine
Thyroxine is better known as “T4.” This is the prohormone of T3, so very low levels of T4 will automatically result in low levels of T3. A prohormone does little work by itself, but it activates the effects of the hormone it is associated with. Thus, T3 and T4 work as a team.
Balancing T3 and T4
Some health and diet advisors talk about “balancing” T3 and T4. This term causes confusion, to the general public it seems this advice tells you to strive towards the same levels of T3 and T4. However, this is not the case. In fact, “balancing” T3 and T4 means getting them in the right proportion to each other. Your T4 level should be four times your T3 level. A sedentary lifestyle, poor diet and complicating medication are major causes of T3 and T4 imbalances. Examine these aspects of your life in order to resolve your weight and energy problems.
Diet
The food you eat provides most of the raw materials your body needs to thrive. You may be aware that you have an unhealthy diet, but if you are suffering from weakness or depression caused by T3 deficiency, you probably don’t have enough energy to care. You don’t need to become the perfect cook, or remodel your kitchen in order to correct your problems. Just a few modifications to the daily food intake should help you get out of your low and find sufficient energy to start taking an interest in improving your health. Your thyroid needs iodine in order to produce T4, so start with boosting your iodine intake. Wakame, and other sea vegetables, such as dulse contain lots of iodine. If you can’t find those in your local store, get almonds, lentils and pumpkin seeds to add to your regular recipes. Prioritize wholegrain bread and rice and try to increase your seafood diet. These ingredients contain zinc iron and copper. Spinach is a great source of these vitamins, too – as are tomatoes. Anything that lists Vitamin D as an ingredient will be good for your thyroid gland.
You can improve your liver by adding mushrooms, Brazil nuts and sunflower seeds. These are great sources of selenium. You may have heard that salt is a good source of iodine. However, don’t increase your salt intake. If anything, reduce it – the sodium in salt is not good for your other organs. Avoid the following foods, which block the operation of your thyroid: soyabean, soy, millet, maize, peanuts, turnip, mustard, sweet potato, cauliflower, broccoli and Brussels sprouts.
Activities
Your thyroid-boosting diet should give you an energy boost and get you out of the doldrums. However, resist the temptation you spend that energy in the gym. You need to find outdoor activities, like cycling, walking, or sailing. Tennis and golf are good ideas, because they will give you a good reason to get out in the sun. Vitamin D will boost your T3 and T4 levels and the best source of that is the sun.
If you are the kind of person that stays at work late and accrues unused vacation days, you are probably damaging your thyroid with your job. You need to reduce the stress in your life, because that harms the production of T3 and T4. Taking the dog for a walk or tackling the garden are better uses of your time than showing your boss you can endure the office longer than everyone else in the firm. If you obsess about your job, you are doing extra damage to your thyroid gland, which is sensitive to stress. Skipping meals is also not a good idea. You can actually put on weight that way, because an uneven eating pattern will cause your body to conserve its T3 and T4 production.
Medication
Your prescription medicine may be causing your weight and energy problems. Many lithium-based medicines and estrogen boosters will impair the functions of your thyroid gland. If you are on Dilantin (phenytoin) for epilepsy, speak to your doctor about switching to a different type of treatment. Dilatin reduces the performance of your thyroid gland – so do barbiturates, such as Seconal (secobarbital sodium), beta blockers (eg. Propranolol), anti-cholesterol drugs and steroids.
Low T3 syndrome V: Should it be Treated with Thyroid Hormone?
Unfortunately, there are few studies that have examined this question specifically, and even fewer that have explored the question of whether T4 or T3 (and which type of each) would be the best choice.
As a clinician, my primary concern is always primum non nocere, or “first, do no harm.” From this perspective it’s important to recognise that the changes seen in Low T3 Syndrome may represent a restorative physiological adaptation by the body to chronic illness. In other words, T3 levels are low because the body is attempting to conserve energy and resources to better cope with the challenges it is facing.Increasing thyroid hormone levels in this situation could conceivably have adverse effects.
For example, the changes observed in the thyroid axis in acute illness are similar to those observed in fasting, which can be interpreted as an attempt to reduce energy expenditure and protein wasting. (1) Giving fasting subjects thyroid hormone results in increased catabolism (breakdown). (2)
In cases of chronic illness, however, it is less clear what effect thyroid hormone replacement has. The few studies that have been done produced mixed results. (3)
Some studies show that treatment causes harm, others show no change, and still others show an improvement. After reviewing the literature on this, I’ve come to the following tentative conclusions:
- T4 is rarely, if ever, effective in Low T3 Syndrome and may even cause harm. This is probably due to the decreased conversion of T4 to T3 that is seen in chronic illness.
- T3 replacement has been shown to be consistently beneficial only in cardiac patients who’ve recently had surgery, heart failure or a transplant.
That said, I’ve heard anecdotal reports of improvement from people who have taken replacement T3 hormone for a condition called “Wilson’s Syndrome” (which does not exist in the scientific literature or according to any mainstream medical organizations). Wilson’s Syndrome refers to low basal body temperature and other nonspecific symptoms occurring in the presence of normal thyroid hormones.
I’ll be the first to admit that “lack of evidence is not evidence against”, and as I mentioned earlier, there’s not a lot of research on the effectiveness of T4 and T3 replacement therapy in Low T3 Syndrome. It may be that as we look into this further, we’ll discover a role for thyroid hormone replacement in these conditions.
That said, I think caution is warranted. Taking T3 when you don’t need it is potentially dangerous. It can significantly upregulate the metabolic rate and lead to cardiovascular complications in some patients. And, if the changes seen in Low T3 Syndrome are a compensatory adaptation of the body in response to chronic illness, increasing T3 levels artificially may have undesirable effects.
In the majority of cases of Low T3 Syndrome, I think it’s preferable to identify the
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