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Readers' Comments
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Timed-Release T3
vs. Plain T3
February 15, 1997
The Question:
Are there advantages to using timed-release T3 instead of plain T3?
Dr.
Lowe: Many fibromyalgia patients, and clinicians who
treat fibromyalgia patients, have contacted the Fibromyalgia Research Foundation
requesting information on the advantages of timed-release T3 over plain T3. I've studied
the available scientific literature and can find no data indicating any advantage from the
use of timed-release T3. I expected this outcome of a literature search. I
did so because an
understanding of the biochemistry, molecular action, and physiology of T3 doesn't point
to an advantage in the use of timed-release T3, except in patients (such as
the elder) with extremely fragile heart conditions.
Some clinicians have reported to me that patients using timed-release T3 have a lower
incidence of cardiac arrhythmias than patients using plain T3. However, I've
performed many series of ECGs on euthyroid patients, and many on hypothyroid patients, who were
taking plain T3. Many of these patients were taking supraphysiologic dosages. Rarely have
I found arrhythmias. The few I have found were considered, upon cardiology consults, to be
associated with underlying cardiac abnormalities that were merely amplified by the T3.
Such amplification, however, isn't peculiar to plain T3. We've found similar
amplification in a small percentage of fibromyalgia patients taking T4.
In most patients who have excessive cardiac stimulation from taking plain T3, increased
heart rate without arrhythmias is the typical finding. I caution clinicians to monitor
each patient for idiosyncratic reactions to thyroid hormone, however, regardless of the form used.
Cardiac safety should be the foremost concern for patients using any form of thyroid
hormone at any dosage. It is vital that proper precautions be taken before patients with
compromised cardiac function or underlying cardiac abnormalities begin therapy with any
form of thyroid hormone. However, extensive cardiac monitoring of patients treated with
our protocol using plain T3 has resulted in no evidence that any advantage would be gained
from substituting timed-release T3 for plain T3. While I'm aware of no advantage in the
use of timed-release T3, a disadvantage is its higher cost."
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