Why do we replace T4 and not T3?

T3 and T4 are not equal in strength; T3 is the more active hormone of the two. While T3 is stronger, taking synthetic T4 hormone has been considered the standard treatment for hypothyroidism. The reason for this is because most of the T3 in our bodies actually used to be T4.


Why is most medication T4 replacement and not the more active form of T3?

Thyroxine (T4) is a prohormone, and our body converts T4 to T3, the active form of thyroid hormone. T3 is not used as a replacement medication because current LT3 drug formulations are associated with a short half-life in our bloodstream, estimated at five to six hours for T3 compared to five to six days for T4.

Why is T3 not used to diagnose hypothyroidism?

However, healthcare providers don't typically rely on T3 tests to diagnose hypothyroidism because it's usually the last of the thyroid function tests to come back abnormal. In addition, some people can have severe hypothyroidism with a high TSH level and a low free T4 level but have a normal T3 level.


Which is more effective T3 or T4?

Using the average SD50 for the two T3 regimens (37 mug/day), the calculated relative potency indicates that oral T3 is 3.3 times as potent as oral T4, a value in reasonable agreement with the value previously estimated with a calorigenic end-point.

Do you need T3 after thyroidectomy?

Jonklaas et al. showed that normal T3 levels can be achieved with traditional L-T4 therapy alone in patients who had undergone near-total or total thyroidectomy, which suggests that T3 administration is not necessary to maintain serum T3 values at their endogenous pre-thyroidectomy levels.


What Is Thyroid Conversion: Inactive T4 to Active T3 Pathway?



Can you take T3 only for hypothyroidism?

Dr. Friedman also thinks it is unphysiological to have a very low T4 level, which is what happens if someone is only taking T3. Because the thyroid converts T4 to T3 and not the other way around, a person with severe hypothyroidism and only on a T3 replacement will have a very low T4 level.

How do you know if T4 is not converted to T3?

If your T3 production is low or, if you are having issues with converting T4 to T3, you may feel tired, depressed, constipated, and experience other symptoms such as feeling puffy, gaining weight, have dry skin, and experience hair loss.

Why T4 test is preferred over T3?

Because T4 is converted into another thyroid hormone called T3 (triiodothyronine), free T4 is the more important hormone to measure. Any changes show up in T4 first. T3 and T4 help to control how your body stores and uses energy to do its work (metabolism).


What is the difference between T3 and T4?

They're often collectively referred to as “thyroid hormone” because T4 is largely inactive, meaning it doesn't impact your cells, whereas T3 is active. Once your thyroid releases T4, certain organs in your body transform it into T3 so that it can impact your cells and your metabolism.

Why is T3 more important?

Triiodothyronine (T3) is a thyroid hormone. It plays an important role in the body's control of metabolism (the many processes that control the rate of activity in cells and tissues).

Is TSH more important than T3 and T4?

However, TSH is always the best first test because it is more reliable than plasma T3/T4 levels, which tend to fluctuate. In primary hypothyroidism, TSH levels are elevated due to the loss of negative inhibition on the anterior pituitary. In contrast, in primary hyperthyroidism, TSH levels go down.


What is the difference between T3 and levothyroxine?

T3 is more potent that T4, which means that one mg of T3 has a greater effect on the body than one mg of T4. Levothyroxine (Synthroid) is a synthetic version of T4, and liothyronine (Cytomel) is a synthetic version of T3.

What are the limitations of total T3?

Keep in mind that this test has some limitations, which are that: T3 is largely bound to blood proteins (99.7%) Only unbound T3 is active. Measuring total T3 (both bound and unbound) may give misleading information if the binding proteins are increased or decreased.

Is T3 Uptake obsolete?

T3 Uptake Testing: T3 uptake testing is obsolete. This assay measures available thyroid hormone binding sites and to determine hormone levels.


Does levothyroxine replace T3 or T4?

Synthroid (levothyroxine) is a man-made version of T4, and Cytomel (liothyronine) is a man-made version of T3. Both medications can replace thyroid hormones when your levels are low.

Why is T4 converted to T3?

T4 is converted into T3, the active form of thyroid hormone, by two enzymes called deiodinases. People with hypothyroidism are treated with a synthetic T4 hormone, which the enzymes convert to T3. This treatment is usually effective, but some people continue to have symptoms even after treatment.

Do you need both T3 and T4?

Some healthcare providers recommend taking T3 (triiodothyronine) in addition to T4 for the treatment of hypothyroidism (that is, two separate pills). 1 Liothyronine, known by the brand name Cytomel and Triostat, is the synthetic form of T3.


What is the main function of T3 and T4?

The thyroid gland releases triiodothyronine (T3) and thyroxine (T4). These hormones play an important role in regulation of your weight, energy levels, internal temperature, skin, hair, nail growth, metabolism and is an important part of the endocrine system.

Which is more important ft3 or FT4?

Free T4 is the most important hormone to play the thyroid function, and his abnormalities are often directly related to hyperthyroidism or hypothyroidism.

What is the best thyroid replacement hormone?

Thyroid hormone is usually given in pill form and is often used to treat an underactive thyroid that is secreting little or no thyroid hormones. The most commonly prescribed thyroid hormone replacement is pure synthetic thyroxine (T4).


Does T4 have more iodine than T3?

Both have two iodine atoms on their tyrosine (inner) ring. They differ in that T4 has two iodine atoms on its phenyl (outer) ring, whereas T3 has only one. The compound formed if an iodine atom is removed from the inner ring of T4 is 3,3',5'-triiodothyronine (reverse T3 [rT3]), which has no biological activity.

How do I know if I need T3 replacement?

Signs and symptoms you need T3

The signs and symptoms can include fatigue, weight gain, depression, concentration and memory problems, hair loss, joint and muscle aches, dry skin, constipation, infertility, elevated cholesterol, erratic menstrual periods, and other signs of slow-downs in your key bodily functions.

Do some people have trouble converting T4 to T3?

An inability to properly convert T4 to T3 is common among thyroid patients and can even result in a fluctuating TSH, or a TSH that is 'in range' and a low Free T3.


Why reverse T3 is not important?

Nonthyroidal Illness

People with hypothyroidism may have a low rT3, while people who are critically ill can have a high rT3. However, these changes do not always occur, so most critical care experts do not rely on rT3 to help distinguish thyroid disease from other causes of major illness.

Does T3 suppress appetite?

T3 directly stimulates food intake at the level of the hypothalamus. In rodent models, peripheral and central hypothalamic administration of T3 increases food intake [9–11].