An Endocrinologist peeks through, RAI disaster, and why synthetic T4 is only a mirror image

The clueless Cuckoo’s Nest of Endocrinology just goes on and on, according to repeated negative comments by thyroid patients in groups after they have visited with an Endocrinologist. i.e. you will be put on T4-only and dosed by the TSH, then told you are just fine and only need an antidepressant or statin or BP med.

But in a recent issue of the Clinical Thyroidology For Patients (A Publication of the American Thyroid Association), Volume 5, Issue, 5, 2012, there comes the question: Should patients with no functional thyroid gland be treated with both thyroxine (T4) and triiodothyronine (T3)?

Of course, the question is like asking “Should those starving be given food? ” The article starts out stupid, stating (in bold):

  1. “…the absence of T3 production by the thyroid can be overcome by maintaining higher circulating T4 levels, resulting in normal circulating levels of T3. This is why T4 in the form of levothyroxine is the main treatment for hypothyroid patients”. Patients all too well know how ludicrous this is.
  2. “Recent studies have generally found that there is no clinical advantage in adding T3 to the usual T4 replacement regimen.” What about this study which reveals that there can be inadequacy of peripheral deiodination of T4 to T3 in some, or this study which found no support for the hypothesis that people with symptoms of hypothyroidism but thyroid function tests within the reference range benefit from treatment with 100 µg thyroxine daily, or this study which found that triiodothyronine added to thyroxine improved mood and neuropsychological function, and more.

But then comes the little peek from the door by the MD author after mentioning the 2011 study titled “Levothyroxine monotherapy cannot guarantee euthyroidism in all athyreotic patients.” The concluding paragraph has this in it:

The present study identifies a subgroup of hypothyroid patients, namely those whose thyroid was surgically removed who do not have normal FT4 and F3 levels despite normal TSH levels on T4 alone. What is not shown by this study is whether or not combination therapy (T4 plus T3) is beneficial in these patients. Further studies are needed to sort this out.

Further studies are needed?? They are already out there! Besides, if 99% of Endocrinologists would use the proverbial toothpick to open up the eyelids of their minds, they just might notice all the continuing hypothyroid symptoms their patients have while on T4-only meds whether STUDIES prove anything or not. WAKE UP!!


Scientists have always been able to synthetically duplicate substances by creating the same mix of molecules, aka a synthetic copy of the original compound. That’s what levothyroxine (l-Thyroxine) is a man-made copy of T4 (Thyroxine). Synthroid is an example. But it’s a mix of the left handed nature-made combination of molecules, aka L-(Laevorotary), along with the synthetic, man-made right handed version, aka D-(Dextrorotary), i.e. the latter is a mirror-image, not a direct image, according to this article.

The author feels it doesn’t act like a hormone. So though your blood will show you have an increased level of levothyroxine, it’s not the same as having an increased level of the natural t4. And of course, we as thyroid patients also know that the body is NOT meant to live on a storage hormone alone, even if it was pure. We also need direct T3 added to that T4. Even natural desiccated thyroid provides direct T3. So with natural desiccated thyroid, we get T4, T3, T2, T1 and calcitonin.


Read thyroid patient Robyn Thompson’s story on why she so regrets doing RAI (Radioactive Iodine), and how her Graves TSI antibodies are now worse than ever before, here:


I loved what thyroid patient Joy McHargue said to someone on the STTM Facebook group when asked what to do about high stress. Her answer: Pray, salt, magnesium, rest, adaptogens of your choice, Vitamin C, talk about the stress to a calming person, take time away from the stress doing something fun regularly, epsom salt baths, fresh air?


I added info about the T3 Circadian Method for Adrenal fatigue, refined information throughout, and cleaned up misspellings. You can order the book at the bottom of any page on STTM, or via the tiny photo.


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3 Responses to “An Endocrinologist peeks through, RAI disaster, and why synthetic T4 is only a mirror image”

  1. Honora

    Read this and then googled “synthroid isomer” and this is what I got.
    Levothyroxin (L-thyroxin) is a synthetic hormone of thyroid gland; left-rotating isomer of thyroxine (T4);
    I guess that L in l-3,3′,5,5-tetraiodothyronine sodium stands for Levo i.e. left rotating isomer. The French link to the mixed isomer forms pertains to a Merck product.

  2. Tony

    I wonder if it would be possible to make a natural T4? It might help balance the amount of T4 and T3 so you can get the exact amounts you need.

  3. Andy

    Great post with some great links to really useful studies.


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