T3/T4 Side Effects - From A Doctor
Good read
Potential Side Effects
If someone has blockages in the arteries that feed the heart and is on the verge of a heart attack, taking thyroid hormone can trigger a heart attack or angina, just like exercise could. Thyroid treatment can trigger heart palpitations as well. These are usually benign, but atrial fibrillation is possible. Because of this concern, and because using T3 or treating for hypothyroidism with a normal blood test is still controversial, I often recommend that patients at significant risks of angina--people who smoke, have high blood pressure, are over forty-five years old, have cholesterol levels over 260, and a family history of heart attacks in individuals under sixty-five years old--have an exercise treadmill test done before treatment, even if they can't complete the test.
To put the risk in perspective, in the many hundreds (and perhaps thousands) of patients that I have put on thyroid, I don't remember any having a heart attack or dangerous problems from taking it. In the long run, I suspect thyroid treatment is more likely to decrease one's risk of heart disease by lowering cholesterol.
The other main concern is that excess thyroid hormone can cause osteoporosis (bone thinning). In my research, I have seen no studies showing any increase in osteoporosis in pre-menopausal women if one keeps the Free T4 thyroid blood levels in the normal range. I do not consider TSH to be a reliable monitor of thyroid levels in CFIDS/ FMS because of hypothalamic dysfunction. We don't know for sure if keeping the T3 level above normal in FMS patients with thyroid resistance worsens the osteoporosis already commonly seen in CFIDS/ FMS, but this has not been a problem. If you need to keep T3 or T4 above the upper limit of normal, you should consider a DEXA (osteoporosis) scan each six to twelve months. If this is showing osteoporosis, lower the thyroid dose. If this is not possible, consider other osteoporosis prevention measures.
Below is the section from the preprinted treatment protocol we use with our patients. The full treatment protocol with over 150 treatments listed by category can be seen at www.endfatigue.com. Click on the "treatment protocol" link (on the far left, bottom button). If you would like a free copy of the file with the complete treatment protocol and the patient questionnaire, which you are welcome to use in your practice (both of which will save you an incredible amount of time), feel free to e-mail me at: [email protected]