Low Thyroid, Hypothyroidism And Natural Hypothyroid Therapies:  Should we treat with Cytomel or Armour Thyroid Even When Thyroid Blood Tests are Normal?

Mainstream Thyroid Treatments

Most “mainstream” physicians believe that one should not treat with thyroid hormone unless standard thyroid hormone blood tests are abnormal. They usually prescribe the T4 form of thyroid hormone, rejecting any role for the T3 forms of thyroid, Cytomel and Armour Thyroid.

Natural Hypothyroid Therapies

Many holistic, integrative and complementary alternative medicine physicians believe that many people are effectively hypothyroid because they are unable to make the main active thyroid hormone, which is not T4 but the form found in Cytomel and Armour thyroid, that is, T3.

This low T3 form of hypothyroid, they assert, does not show up on blood tests, because it occurs inside our cells, not outside in the blood stream.

Rationale For T3 Natural Hypothyroid Therapies: Cytomel or Armour Thryoid

The standard thyroid hormone medicine, T4, that most doctors prescribe, is not the active form of thyroid hormone. The thyroid makes mostly T4, and secretes this into the blood. Then our cells take up T4, but before the cells can put T4 to work, cells must convert T4 to a natural hypothyroid hormone, known as T3. Synthroid and Levothyroid, the most often prescribed thyroid hormones, contain only T4. Cytomel is 100% T3. Armour Thryoid (pork-derived) is about 60% T4 and 40% T3.

If the cell has a decreased ability to convertT4 (Synthroid) into T3 (Cytomel), cellular metabolism could be too low i.e. hypothyroid for lack of T3-- despite the standard blood thyroid hormone tests being normal. If the cells have trouble converting T4 to T3 then natural hypothyroid therapies have to supply the needed T3, most often by treating with Cytomel or Armour Thyroid.

Ironically, almost all mainstream experts agree that difficulties converting T4(Synthroid) to T3(Cytomel) can occur. However, most mainstream thyroid specialists believe that only a few individuals suffer from low T3 intracellular hypothyroid.

In contrast, most alternative medicine thyroid doctors believe that T3 deficiency within the cells is actually a common problem. Hence, their emphasis on natural hypothyroid therapies such as natural Armour Thyroid, or the synthetic T3 medicine, Cytomel.

Rationale for Natural Hypothyroid Therapies Using Cytomel and Armour Thyroid

We do not yet have enough first rate studies of natural thyroid therapies, but, recent research shows that there are quite a few settings in which T4 to T3 blockage may occur. For example:

The enzyme that converts T 4 thyroid hormone into T3 requires the mineral Selenium. If selenium nutrition is sub-par, the cell cannot produce as much T3. Zinc, Vitamin A, and Vitamin D may also be needed.

Hypothyroid diets: Certain otherwise healthful foods, in large amounts, can block the production of both T3 and T4.

Severe physical illness can also block the formation of T3. These conditions may include such common conditions as fibromyalgia and chronic fatigue syndrome.

The stress-hormone cortisol (cortisone) can block T3. Both physical and emotional distress often makes cortisol rise. This is especially so among persons with anxiety and depression.

In recent years leading mainstream psychiatrists have accepted that thyroid hormone therapy for people with depression, can improve mood–even among people whose standard thyroid blood tests are normal. T3 forms, Armour thyroid and Cytomel, were used in most studies, although Synthroid or Levothyroid also may work.

Dr. CB Nemeroff, from the Department of Psychiatry of the Emory University of Medicine endorsed the use of natural hypothyroid therapies as an adjunctive treatment for depression:
Augmentation of tricyclic antidepressant or selective serotonin reuptake inhibitor therapy with thyroid hormone (T3)... has been shown to be effective in open and controlled trials.(Nemeroff CB. Augmentation strategies in patients with refractory depression Depress Anxiety 1996-97;4(4):169-81).