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OBjeCTive Currently, the position of the American Thyroid Association is that hypothyroidism causes symptoms of metabolic slowing due to inadequate production of thyroid hor- mone by the thyroid gland; it is diagnosed by a lab result of a high thyroid stimulat- ing hormone (TSH) level. While hypothyroidism is considered a chronic, incurable condition, the symptoms typically can be controlled by ingestion of thyroxine (T4) for life. Due to this conclusion, medical providers overall adhere to the assump- tion that people with normal TSH levels can not have thyroid-hormone-responsive symptoms; likewise, thyroid-hormone-responsive symptoms should not be treated with triiodothyronine T3 and are not reversible. Our objective was to examine if treatment with sustained-release (SR-T3), in patients with normal TSH values and low body temperatures, reduced symptoms consistent with low metabolic rate—and if improvement in symptoms remained even after discontinuation of the T3 treat- ment regimen. inTeRvenTiOnS We report the results of 11 euthyroid outpatients with low body temperatures who took oral SR-T3 every 12 hours according to a cyclic dosing schedule designed to titrate low body temperatures to normal. The SR-T3 they took was formulated with the aim of delivering the T3 gradually over 12 hours. ReSulTS All of the patients in this study responded with an elevation in oral temperatures and improvement in five symptoms measured following the T3 treatment regimen. COnCluSiOn Patients exhibiting hypometabolism with normal TSH levels may experience a re- versal of symptoms with normalization of low body temperatures on administration of a sustained-release T3 regimen such that their symptoms remain improved after the regimen has been discontinued.

Reversing Hypometabolic Symptoms by Normalizing Low Body Temperatures with Sustained-release T3 in Patients with Euthyroid TSH Levels