HYPOTHYROIDISM: T3, Versus T4 therapy

A note from May, 2022, regarding a speech by Antonio C. Bianco, MD, PhD

May 30, 2022

Thyroid expert, Dr. Antonio C. Bianco, MD, PhD, speaking at the American Association of Clinical Endocrinology (AACE) annual meeting about T3 and T4 therapy, has acknowledged that many patients (he says 10 – 20%, but as you will agree, this percentage is much larger), treated for hypothyroidism using Levothyroxine (T4, “the number-one prescribed drug in the country”), fail to experience an improvement in their symptoms.

Of course, this isn’t news to those of you who are familiar with abnormal thyroid function and particularly, those who know about Intracellular Hypothyroidism (IH), a.k.a. Euthyroid Sick Syndrome, Low T3 Syndrome, Nonthyroidal Illness, Functional Hypothyroidism, etc..

However the salient fact is that a major player in traditional medicine is willing to admit that something is wrong with medical doctors’ usual treatment for hypothyroidism. So, it seems that our doctors’ understanding of the problem is improving and that’s REALLY encouraging!

Dr. Bianco, further to his credit, has noted that combination T3 and T4 therapy doesn’t entirely solve the problem for folks with low thyroid function (as you may know, slow-release T3 is the best way to go, if the problem is intracellular hypothyroidism: if your problem is true hypothyroidism, due to Hashimoto’s disease or some other cause, T4 is obviously best).

However it seems that the medical establishment is not yet ready to embrace the idea of investigating thyroid function with TSH, free T4, free T3 and reverse T3 (+ T3/rT3 ratio) treating Intracellular Hypothyroidism with slow-release T3.

If you would like to read about Dr. Bianco’s article, please see “Debate Continues on Combination Therapy for Hypothyroidism“, by Miriam E. Tucker, dated May 20, 2022.

If you would like to read about intracellular hypothyroidism, go to “Undiagnosed Hypothyroidism”, here on SUBSTACK.

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Published by Gervais

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 85 and 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. QUALIFICATIONS: MB, BS, (UWI), 1964. LMCC 1969. FRCSC (Urology), 1974. ECFMG 1984. Florida license [inactive], ABAARM 2016. Affiliations: CSAMM, OMA, CMA, SUSO, CUA, RCP&S/C. PRACTICE TO DATE: Consultation in Functional Medicine: 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!