Functional hypothyroidism

Just when you thought that family doctors would never learn about prescribing T3:

Jacqueline Jonklaas, Professor in the endocrinology division at Georgetown University, has submitted a paper entitled “Evidence-Based Use of Levothyroxine/Liothyronine Combinations in TreatingHypothyroidism”

Below are excerpts from a (2nd March, 2021) report in Medscape Medical News:

“Numerous trials have been conducted on short-acting liothyronine (LT3) in combination with the standard therapy of levothyroxine (LT4). However, the experts agreed that shortcomings in the existing studies and mounting unanswered questions need to be addressed, Jacqueline Jonklaas, MD, PhD, told Medscape Medical News“……………

“Patient-reported outcomes were acknowledged as essential in the full picture of understanding treatment efficacy, and the experts agreed that an emphasis on those outcomes will be important in any future trials of combination therapy.”

“Among the key topics agreed upon is the need to evaluate a sustained-release T3 preparation. Such a preparation could overcome concern of the dissipation of circulating T3 that occurs with oral tablet formulations, which fail to achieve the relatively stable levels seen in normal individuals, Jonklaas noted.”

“There was unanimous agreement that when and if a sustained-release T3 preparation became available and had undergone preliminary testing, new trials with such a preparation were definitely warranted,” she said. Preliminary testing of a new product that potentially provides sustained release of T3 has recently started.


THIS MEANS that doctors have finally begun to listen what patients have been saying for the past many years: the accepted treatment of hypothyroidism using Ltroxin and Synthroid doesn’t work and the time has come to prescribe T3, or a combination of T3 and T4, instead.

So in a couple of years, the use of slow-release T3 will be accepted, the misery of millions who have been treated with T4 alone will come to an end and “the system” will authorise prescription of slow-release T3 as a “covered” medication.

I am a Toronto-trained Urologist. I practiced in downtown Toronto, from 1977 to 1997, when I went to Saudi Arabia as chief of Urology at the Armed Forces (teaching) hospital in Tabuk. Returning to Toronto in Y2000, I switched to family practice. In 2007, began to prescribe Hormone Restoration Therapy and in 2012, I became a member of the American Academy of Antiaging Medicine [A4M]. I successfully wrote the A4M's written examination in December, 2013 and In May, 2016 I passed the oral examination, for accreditation as a BHRT consultant. In 2014 I began BHRT practice in Collingwood, Ontario and in January, 2017, joined the Stone Tree Naturopathic Clinic. Now I am 82 and have retired, but it seems wasteful to jettison my learning and experience: the medical establishment knows nothing of BHRT / Functonal medicine and I feel obliged to offer my knowledge in the interest of those who are willing to think outside the box. MY QUALIFICATIONS: MB, BS, (from UWI), 1964. LMCC 1969. FRCSC (Urology), 1974. ECFMG 1984. Florida license 1998 [inactive], ABAARM Certification [A4M], 2016. I am a Member of CSAMM [the Canadian Society for Aging and Metabolic Medicine], the OMA&CMA, SUSO, CUA, RCP&S/C. PRACTICE TO DATE: Consultation in Functional Medicine, including assessment of Chronic Fatigue Syndrome, Fibromyalgia, Andropause, Menopause, Teenage and Postpartum Depression/Panic Attacks, Thyroid Hormone malfunction, Infertility, Sexual Dysfunction and “the Undiagnosable”. ALL ARE WELCOME to read, comment or question!