T4-Only vs T4 + T3 Thyroid Therapy
Levothyroxine alone is the modern default. A subset of candidates with persistent symptoms despite normalized TSH benefit from T4 + T3 combination therapy. Selection is provider-reviewed against free T3, reverse T3, and symptom profile.
T4 monotherapy is the provider-reviewed first-line for hypothyroidism.
T4 + T3 combination is appropriate when symptoms persist despite normalized TSH and free T3 is low-normal.
Educational. Final pathway selection is provider-reviewed via synchronous video consultation against your biomarkers, history, and goals.
Frequently asked
What is a poor T4→T3 converter?
Candidates with DIO2 polymorphisms or systemic illness may underconvert T4 to active T3.
Is desiccated thyroid the same?
Desiccated thyroid is a T4+T3 formulation with fixed ratio; not equivalent to titrated combo therapy.
Take the optimization assessment.
The adaptive assessment maps your symptoms, history, and goals to candidate pathways — and routes you into provider review.
Begin assessment