Treatment
Adding the active T3 hormone to standard T4 can resolve symptoms that levothyroxine alone leaves behind — with the precision of adjustable, separate doses.
Overview
Standard hypothyroid treatment is levothyroxine — synthetic T4 — which your body is meant to convert into active T3. Combination therapy adds a small, separate dose of synthetic T3 (liothyronine) to that T4. Because the doses are separate, they can be tuned independently, giving precise control over your active hormone level.
Who It Helps
Like desiccated thyroid, combination therapy targets the patient who remains symptomatic on T4 despite a normal TSH — often a poor T4-to-T3 converter. The difference is precision: with separate synthetic T3 and T4, we can fine-tune each based on your Free T3 and Free T4, rather than the fixed ratio in NDT.
Safety & Monitoring
T3 acts quickly and is potent, so combination therapy demands conservative dosing and good monitoring. We check Free T3 alongside TSH and Free T4, watch for over-treatment, and adjust gradually. It may not be appropriate for some patients, particularly those with certain heart conditions — your clinician will individualize the plan to your symptoms and labs.
Common Questions
Clinical references: American Thyroid Association · Endocrine Society
Keep Exploring
If you've normalized your TSH but not how you feel, adding T3 may be the answer. Book a consultation and we'll review whether combination therapy fits your labs and goals.
Available across California via telehealth · in-person in Chatsworth & Santa Barbara.