T3 for accelerating weight loss

Supplementation of the thyroid hormone, T3, is an underappreciated means to lose weight.

Thyroid health, in general, is extremely important for weight control, since even subtle low thyroid hormone levels can result in weight gain. The first step in achieving thyroid health is to be sure you are obtaining sufficient iodine. (See Iodine deficiency is real and Healthy people are the most iodine deficient) But, after iodine replacement has been undertaken, the next step is to consider your T3 status.

I've seen T3 ignite weight loss or boost someone out of a weight loss "plateau" many times.

Endocrinologists cringe at this notion of using T3. They claim that you will develop atrial fibrillation (an abnormal heart rhythm) and osteoporosis by doing this. I have yet to see this happen.

Adding T3 revs up metabolic rate at low doses. The idea is to push free T3 hormone levels to the upper limit of normal, but not to the hyperthyroid range. While an occasional person feels a little "hyper" like they've had a pot of coffee, most people just feel energized, clear-headed, and happier. And weight trends down much more readily.

Taking T3 by itself with no effort at weight loss generally yields only a modest weight reduction. However, T3 added to other weight reducing efforts, such as wheat elimination and exercise, accelerates the weight loss effect considerably. 5 lbs lost will likely be more like 8 to 10 lbs lost; 10 lbs lost will likely be more like 15 to 20 lbs, etc.

It's also my suspicion that more and more people are developing a selective impairment of T3, making it all the more important. I believe that you and I are being exposed to something (perchlorates, bisphenol A, perflurooctanoic acid, and others?) that may be impairing the 5'-deiodinase enzyme that converts the T4 thyroid hormone to the active T3. Relative lack of T3 leads to slowed metabolism, weight gain, and depressed mood. While avoiding or removing the toxin impairing 5'-deiodinase would be ideal, until we find out how to do this, taking T3 is a second best.

The tough part: Finding a prescriber for your T3.

Comments (57) -

  • Ellen

    4/24/2010 9:15:07 PM |

    How much would one need to take to achieve this?

  • David

    4/25/2010 3:02:18 AM |

    Mercury interferes with 5'-deiodinase and is often an under-appreciated factor.

  • Myron

    4/25/2010 3:12:56 AM |

    I live in Hawaii where I believe there exists a subtle thyroid or metabolic down regulation as an adaptive compensation for the constant warm ambient temperature.
    Cold adaption is known to enhance metabolism to keep warm.  The body seems to either be in a phase of maintaining body warmth, warming up by enhancing metabolism  [brown fat, shivering] or tending to cool down by down regulating metabolism to be more able to dissipate heat, not overheating.   This concept is supported by the extreme cold sensitivity seen when the temperature drops below 70 degrees F.

  • Jenny

    4/25/2010 1:35:40 PM |

    "The tough part: Finding a prescriber for your T3."

    My doctor refuses to do anything since my TSH level is "normal" despite the additional symptoms I've told her... says I'm being hypochondriac, yet has no problems prescribing statins and other useless and expensive drugs that I don't need..

    So, what does you do if your doc won't prescribe or even test correctly, and other local docs are not accepting any more patients, and it particularly doesn't matter who you go to anyway, as you have no insurance?

  • Valtsu

    4/25/2010 1:40:07 PM |

    Hi Dr. Davis! About iodine:

    What do you think about Ray Peat's comment? ( http://www.thyroid-info.com/articles/ray-peat.htm )

    "Mary Shomon: Do you think the majority of people with hypothyroidism get too much or too little iodine? Should people with hypothyroidism add more iodine, like kelp, seaweeds, etc.?

    Dr. Ray Peat: 30 years ago, it was found that people in the US were getting about ten times more iodine than they needed. In the mountains of Mexico and in the Andes, and in a few other remote places, iodine deficiency still exists. Kelp and other sources of excess iodine can suppress the thyroid, so they definitely shouldn't be used to treat hypothyroidism."

    Strange guy... If I understand what he's writing, he tells that all the PUFA (fish oil also) is toxic, that we shouldn't consume protein containing much tryptophan and cysteine and that high serotonin causes problems... And that fructose isn't bad.

    He keeps telling strange things but usually with very long reference lists... Strange o_O

  • susie1688

    4/25/2010 4:48:44 PM |

    Is there an OTC T3 supplement? Would the product Atomidine work?
    As Always - Thank you!

  • Tonya M

    4/25/2010 5:12:46 PM |

    Dr. Davis,

    Does kelp help boost thyroid?  I would love to find a doctor like you in my neck of the woods.

    Thanks for a great blog,
    Tonya

  • Dr. William Davis

    4/25/2010 5:50:04 PM |

    I remain undecided on what the ideal dose of iodine should be. While I am personally "experimenting" with a 12,500 microgram per day preparation, I generally suggest 500-1000 mcg per day. I suggest kelp because it provides a mixture of iodine forms.

    For T3, the dose depends on your level, sensitivity, and perhaps your level of reverse T3. I usually have people start 10-12.5 mcg per day, since this is how it comes. Alternatively, T3 can be part of an Armour or Naturethroid type preparation, now that they are back on the market.

  • Anonymous

    4/25/2010 9:59:04 PM |

    Concerning the appropriate level of T3 supplementation, my own endocrinologist, Dr. Kenneth Blanchard, has more experience with T3 than almost any other physician I'd imagine (that's one of the reasons I chose him). I'd suggest to Dr. Davis and anyone else interested to read his book if you have not already done so:

    http://www.amazon.com/What-Your-Doctor-About-Hypothyroidism/dp/0446690619/ref=sr_1_1?ie=UTF8&s=books&qid=1272227891&sr=8-1

    In his book, he suggests what most doctors using T3 would consider a very low dose: approximately 2% of the hypothyroid patient's T4 dose (by contrast, Armour Thyroid contains, I believe, more like 20% T3). Since then, he has concluded from experience with how patients feel that the optimal dose tends be even lower, approximately 1.5% of the T4 dose. But he says it does seem to vary quite a bit from person to person.

    He generally uses compounded, time-release thyroid extract (Armour), or sometimes synthetic T3, formulated to provide the desired T3 dose. He has found most people do better using the extract, presumably because of T2 and/or other compounds present.

    He has a new book coming out soon which will explain his methods in greater detail after treating thousands of hypothyroid patients with combined T4/T3 therapy.

    By the way, I recently started experimenting with seaweed consumption and have been able to reduce my T4 dose by >30%, which is apparently highly unusual. I am now (with the help of a holistic physician) experimenting with pharmaceutical iodine supplements (Iodoral, 12.5 mg per day) to see if further progress can be made. Dr. Guy Abraham and a few other doctors who believe in high dose iodine supplementation often use even higher doses, 50 mg or more, but only with regular lab monitoring, most importantly a 24 hour urine iodine loading test.

  • rhc

    4/25/2010 10:22:26 PM |

    My organic Egg-land's Best Eggs list "iodine" 40% per egg. I was very surprised to see this since most eggs don't mention iodine. I love eggs (unfortunately have no access to free running eggs but switch among the organic ones) and easily eat 2 a day - sometimes more. Do you consider this another good and safe alternative source?

  • Heather

    4/25/2010 10:45:40 PM |

    Is there a list of docs who would be willing to prescribe T3? I think Dr. Blanchard is in my area, but from my understanding, he does not take insurance, so the cost is prohibitive.

  • Ailu

    4/26/2010 1:14:16 AM |

    My hubby is using a OTC dessicated thyroid supplement as a replacement, since his tests are in "normal" range but his body temp is very low (96) and he gains weight easily on the slightest bit of carbs.  So we decided to try it, given all we've heard.  It has really made a difference in him, he has energy when he used to be sluggish, and his weight holds steady when he takes it. Does this have the "T3" you are referring to?

  • Anonymous

    4/26/2010 2:39:24 AM |

    I started 5 micrograms synthetic T3 about a month ago.  My hypo symptoms are slightly better, but I am disappointed. I expected more improvement.

    I was experimenting with iodine drops prior to starting T3. I titrated up from 500 micrograms to 12 milligrams/day over 2 months and then ordered Iodoral. I decided not take it due to the new T3 prescription as I did not want to start 2 new therapies at once. Do you think I should start Iodoral now or wait longer?

    I recently read on STTM [http://www.stopthethyroidmadness.com/ferritin/] that ferretin levels should be greater than 50 for adequate T4 -> T3 conversion. My level was 11 (considered normal by the lab). I am considering an iron supplement for 3 months.

  • Ellen

    4/26/2010 9:22:09 AM |

    Yeah, a friend of mine saw Dr. Blanchard.. did not have much luck with him. He's too conservative.

  • Anonymous

    4/26/2010 2:22:00 PM |

    I have struggled with weight loss since my 20's
    T3 sounds great to aid in  weight loss.
    I would be interested to hear what people think about optimizing thyroid with lower insulin levels.
    since low carb diet=low insulin diet
    How about discussing Metformin for insulin control for a synergistic effect for weight loss. There is some interesting research using this med in non diabetics.

  • Anonymous

    4/26/2010 4:43:17 PM |

    People can check out the doctor finder feature upon Armour's website, if they are seeking a doctor who may prescribe T3.

    Once concern I have regarding supplementing T3 regards longevity, as animal (and some human) studies show lower T3 in the elderly = longer lifespan.

    I'm curious if Is there any longterm longevity data in people who supplement T3 vs those who don't -- excluding those with definite thyroid disease.

  • Anonymous

    4/27/2010 12:48:51 AM |

    There are many websites and forums dedicated to treating reverse T3 hypothyroid syndrome.  The treatment is T3 only.  There are legal ways to obtain T3 without a prescription and self-treat.  I am currently taking 50mcg per day, and I have seen great improvements in hypothyroid symptoms. I did, by the way, try the traditional route first and was told by different doctors that my thyroid levels were all "normal" despite increasing fatigue and low body temperatures.  Now my temperatures are up to 98.6 average and I feel SO much better.

  • Dr. William Davis

    4/27/2010 1:28:54 AM |

    Anonymous--

    Can you tell us more about how you got the T3 without a prescription?

    (Remember: This is anonymous. I'm not tracking your IP address or anything.)

  • Anonymous

    4/27/2010 2:06:51 AM |

    Dr. Davis-

    I originally found the information about how to treat T3 from two websites that were mentioned in the comments section of Dr. Eades' blog:

    www.stopthethyroidmadness.com/
    www.thyroid-rt3.com/

    There is a forum affiliated with the second website that you can find at the bottom of the page.  If you join this forum, you can find sources for T3.  There is absolutely no cost to joining the forum, and nothing is asked of you.  The moderators are just regular people who have been through the medical maze and come up with a protocol that works for them.  

    The focus of this forum is not taking T3 for weight loss, but using it to heal a damaged thyroid.  The ultimate goal for many (myself included) is to restore a normal metabolism and come off of T3.

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  • Anonymous

    4/29/2010 5:38:56 PM |

    Can 7-keto help this? I have Hashi's, am iodine sensitive - I can't take a multi-vitamin with iodine because it causes my thyroid to swell. My T3 totals are low (102, 109, etc. in a range of 76-181). I'm having an extremely difficult time losing the 22 pounds I put on since this started 2 years ago. I am on synthroid but my doctor won't prescribe any T3. I've read that 7-keto will help but not increase the T3 out of range. I'm too scared to self-treat!

  • scall0way

    5/1/2010 10:54:36 PM |

    Yeah, finding a prescriber is the hard part. I've talked to a few doctors. Every single one is *totally opposed* to any sort of treatment other than Synthroid and its clones.

  • David M Gordon

    5/5/2010 2:55:02 PM |

    I asked a research pathologist friend about your notions re T3, etc. He replies...

    "Several problems, although superficially it all makes sense.
    1. I likely am incorrect, but T3 is available only as an iv injectable (in UK, Australia). Furthermore, it is short acting, so theoretically you might need more than one injection/day.
    2. T4 (thyroxine) or T3 bind to proteins in blood (99%) and only a small amount (<1%) is the free T3, which is the biologically active hormone. The bound and the free form are in equilibrium with each other. So if you take T3 or T4, it will go and bind to proteins (ie, inactive), and only a small constant amount of free hormone is available for action.
    3. T4 converts to T3 (via deiodination), so why not take the cheaper T4?
    4. T3/T4 therapy might work for a short while, but then your body will become used to it and endogenous hormones will be secreted in lesser amounts, so that the final amount of free hormone available to you will be more or less what you secrete now. This is because of something known as "feedback inhibition", ie high levels of T3/T4 will reduce the secretion of TSH, which will reduce endogenous T3/T4 secretion.
    5. You could, of course, overpower the body's feedback inhibition loop, by taking excess amounts of hormones, but then you will stress your heart etc. There is a theory which says everyone is born with a given number of heart beats (similar to the idea that women have a given number of ova), you can use your quota pretty quickly with excess T3. Reduction of weight will occur, but at a price.
    6. There is a lot of deiodinase in the body, the only time there is not enough is when someone is sick or has liver disease, but its not a consideration for most people.

    So yes, it might prove difficult to find a prescriber..."

    As always, I appreciate your blog and its included insights. Thank you!

  • Dr. William Davis

    5/5/2010 3:14:37 PM |

    Hi, David--

    I think your research pathologist friend should probably stick to researching pathology.

    I take oral T3 as liothyronine, since it was temporarily out of supply as Armour or Naturethroid.

    Perhaps he is relying on a textbook copyrighted 1984.

  • David M Gordon

    5/5/2010 5:26:38 PM |

    Thank you, Dr Davis

    Over the course of a few weeks recently, I read all your posts on this site. You offer a heck of a lot of excellent information. I appreciate that you repeat many topics; e.g., niacin, its attendant flush, and how to deal with it.

    I also appreciate that you are on the leading, but not bleeding, edge on health topics. An example: my doctor  bemoaned the sorry state of my D3 level and I was befuddled: "But I ingest 1500IU/day!" She suggested an endocrinologist... and THEN I read your post re tablet D3 vs gel capsule. I corrected my error immediately, and now I cannot wait to re-test my D3 level.

    Which brings me to my question. After reading all your posts, I find that you do not collate all your recommendations into one post or FAQ. Such an item would be helpful for all your readers. Which specific lab tests should I, or any reader, request?

    And returning to this post, I assume no doctor will prescribe T3 -- without first testing your thyroid levels. Whether high, low, or perfect, what is the appropriate dosage of T3 to achieve the results you indicate?

    Thank you!

  • jpatti

    5/7/2010 6:40:10 AM |

    Anonymous is correct that http://www.thyroid-rt3.com/ is a very good resource.  There is a Yahoo! group associated with that web site for rT3 problems specifically and an associated group for adrenal issues.  

    I have an rT3 problem.  I've done very well on 100 mcg T3 per day and no T4 at all.  This was after getting cortisol sorted out and it took several months to titrate to my current dose.  

    By temperature, bp and pulse, this is an appropriate dose for me.  And yes, I have lost weight on it, without really trying - as when disabled, weight loss is pretty low on the list of priorities.  I lost 17 lbs the first two months, and have no idea since then as I don't have a scale.  

    It's not FOR weight loss.  It certainly helps weight loss, as trying to lose when low on T3 is an uphill battle.  But I don't think it's appropriate to say it's FOR weight loss.  T3 is for treating hypothyroidism... and IMNSHO, no other use is appropriate.

    That being said, I have a much looser definition of hypothyroidism than most doctors.  Most people feel best and achieve normal temperatures with FT3 near or just over the top of the range if on both T3 and T4 as with natural thyroid; those on T3 only tend to do best at quite a bit over the FT3 range (you need more T3 when T4 is totally suppressed as when treating rT3).  

    Where Anonymous is a bit off is the legality of self-treatment.  It's a fuzzy area.

    Self-treatment can be done, as it's legal to import 3 months of medications from an international pharmacy for personal use.  Some of these pharmacies do not require a script, and no one from customs shows up at your house to doublecheck your prescription.  

    But I think it's overstating a bit to say it's entirely legal.  It seems the assumption is you're importing stuff you have a script for; that this isn't enforced and self-treatment is possible doesn't mean it's entirely legal.

    However, it's certainly not near insurmountable if you don't have a good doctor and don't mind bending the law a bit.

    The NTH Yahoo! groups are very good sources of advice for those interested in self-treating.  

    But it is not about just ordering some meds, I seriously doubt a moderator on any of the groups would tell you where to get even an aspirin without asking you for your labwork first.  

    Hormones are serious stuff and while correcting imbalances is definitely necessary to health,  it's not something you do just to drop a few pounds more easily.

  • P. Hentermine

    5/26/2010 5:24:36 PM |

    How about discussing Met forming for insulin control for a synergistic effect for weight loss. There is some interesting research using this med in non diabetics.

  • Anonymous

    6/1/2010 6:50:05 AM |

    That T3 is so easy to get a hold of. Ive been taking it w/o a prescription for years for weight loss. Ive gone up to as much as 125mcg a day for 6 weeks of T3 for weight loss, you loose alot of muscle going that high too. I have foud that ramping off very slowly also allows your normal thyroid level to recover faster too. Always remember to "pyrmid" when using this stuff. It allows your body to adapt to it w/o shock and come off easily with no thyroid damage aswell. You wouldnt wanna be using this stuff for life now would you!

    Here a little example of how i used it during the 6 weeks for weight loss-

    25/25/25/25/25/50/50/50/50/50/75/75/75/75/75/100/100/100/100/100/75/75/75/75/75/50/50/50/50/50/37.5/37.5/37.5/37.5/37.5/25/25/25/25/25/12.5/12.5/

    Each margin represents a day. The tabs are dosed at 25mcg each.

    Dr. drugs are so easy to get a hold of now a days, a child could order meth over the internet if he knew how. Why do all you "Dr's" fail to realize that? The internet can teach you anything.

    Here are a list of sites in which you can order T3. YES with out a prescription, T4 too even if you wanted too..

    www.musle-man.com
    www.rxhealthdrugs.com
    www.spiropenttabs.com
    and alot more..

    And here are a list of forum boards filled with experienced body builders and trainers who can tell you how to successfully and safely use these hormones and steroids to achieve your goals.

    www.elitefitness.com
    www.anabolicminds.com
    www.bodybuilding.com
    and a whole lot more.
    -just be sure to go to the sites, type in T3, or anything you wish to know, into the search bar, and you'll have all kinds of threads filled with information, pop up.

    Hope i taught you guys all something usefull.

    -Dr.knowitall. =)

  • P. Hentermine

    6/7/2010 7:03:45 PM |

    I will manage my thyroid hormone as it is responsible for weight gain and I want to reduce my weight very soon.

  • Anonymous

    6/11/2010 10:36:19 PM |

    www.iron-dragon.com has t3 also, very reliable.  not too sure on the other site posted here.

  • Anonymous

    6/14/2010 3:34:08 AM |

    Nice tnx for the info...

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  • Anonymous

    7/24/2010 6:52:33 AM |

    I have been taking T3 for over two yrs and there is no weight loss benefits. I was on 120mcg per day and I started to develop heart palpitations and my face looked swollen. I don't think any one should be taking T3 for weight loss because it can also make you Extra hungry when taken with other meds.

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  • Helena

    12/2/2010 11:50:33 PM |

    I'm a little lost... I have been walking around thinking that I have a bad thyroid with me gaining so much weight (15-20 lbs in the last 15 months)and I have a morning temp of around 96.6 F; and then today I get my test results back:

    TSH 0.32
    T4 FREE 1.4
    (Levels that point for 'Subclinical Hyperthyroididm")
    Do I stop taking Kelp supplement?
    I was taking between 150-450 mcg per day for about 1 year.

    Also found that my A1c was at 5.7% (slightly high)

    B12 borderline low

    HDL 46 (low)
    LDL 139 (high)
    TriG 226 (high)

    And on top of that my Vitamin D has dropped from 78 last year to 40!!!

    What the heck happened? Could this be related to taking synthetic hormones (birth control pill) for 11 years? (Stopped 14 months ago) Or is it just me hitting the big 30??!

    Help!

  • Anonymous

    12/11/2010 2:58:02 PM |

    www.alldaychemist.com. No I'm not an employee/owner, but a customer. This is where I get my T3, T4, and that glaucoma medicine that makes your lashes grow.

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  • Anonymous

    1/27/2011 4:50:50 PM |

    T3 or any form of Thyroid medicine just for weight loss is highly dangerous. I have been doing this for over a year, starting with T4 and now mixing the two (worried about RT3). Unfortunately I am suffering severe side effects, angina, breathlessness, atrial fibrillation arrhythmia and many other things, i am too scared to come off them but I have and am doing my body alot of damage, which could be fatal (I should never had started). My advise is to only take the hormones via a doctor and only if you suffer from hypo.  

    Anon

  • Anonymous

    2/5/2011 6:13:58 AM |

    I have taken both Clen, Anavar and T-3. I have seen moderate results with clen, extreme muscle mass gain with anavar, and the most leaning out and weight loss with the t-3. My only concern was that it took 4-5 months taking t-3 to lose 15 pounds and I was taking what I thought was the maximum. How can I lose 20 lbs of fat in 2-3 months and still maintain muscle? Should I switch to anavar from clen when I notice muscle loss?

  • Anonymous

    2/5/2011 6:30:15 AM |

    Last post above by a 31 year old female that works out, eats right and wants to go from about 20% body fat down to 10% by April/May. I use to be a fitness model and have been off t-3 now for about a year, but still cycle clen. I hear alldaychemist is a good site.

  • robrob

    2/5/2011 7:02:24 PM |

    I was under the impression that t4 gets converted to t3 what at the liver or cellular level? if your insulin resistant (or suffering from what some term the famine feast cycle from a history of reduced caloire diets or poor quality diets) you not converting to t3 or are t3 resistant you can be leptin resistance and insulin resistant you can be thyroid resistant to.


    I would think one would need to get at the root of the problem, rather than treat the symptom, it could be caused by some chronic nutritional deficiency, regardless of cause, as long as your on the famine feast cycle (look it up) you will not lose weight permanently. nor cure metabolic syndrome or low thyroid that has no known cause.

    there is a strong genetic compeonent I think some call it the thrifty gene, I call it the survival instinct myself which encompases more than just energy in and out.it encompases all metabolism, reactions to enviromental changes mental and physical adaptations and what not.

    and I wouldn't be surprised if the real culprit for hypo or hyper thyroid for those not suffering a weight problem or metabolic synrdome is due to malnuturtion as well like vita d, cal, vita k, a, magnesium and other minerals defiencies.

    these control the immune system dont they? maybe the genetic component is that your unable to absorb them as well and need to over compensate via taking in excess via foods.

    but then I wonder about how nutritious our food really is. sure maybe the toxic enviroment may play a role like increasing the nutrient needs of the body in order to detoxify them. but I don't believe they directly cause a problem. everyone has these toxins in ther bodies in usa, but not everyone suffers health problems from it.

    could be their genetic and nutritional status that determines that. but the only thing I know who takes t3 are those who suffer wilsons syndrome, stress induced reduction tha doesn't resolve itself after the stressor has past.

    and then they only take it for a short time to get the body back into balance not as a weight loss tool.

  • Anonymous

    2/9/2011 1:27:55 AM |

    Can you use T3 for weight loss w/o losing muscle?  I have a prescription for 10 mcg a day that I haven't been taking, so I can start ramping up a bit.

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  • Michelle

    7/7/2011 3:40:06 PM |

    I am on t-3/t-4 therapy for hypothyroidsim.   T-3 was added a month ago and although I feel better than I have in the past 3 years, I have had NO WEIGHTLOSS!!!  I am an active female and eat well, I bike 15 miles daily.  Confused as to why I am not seeing any results....

  • Robert

    10/2/2011 12:32:59 AM |

    I was just diagnosed with hypothyroidism. My TSH was 5.4. Which is high on both the old and new scale. I weigh 384 lbs., do not sleep well, have swollen legs, and am sluggish and tired. I can loose weight when I eat right and exercise. My blood pressure and sugar are normal. I am also going for a sleep test for sleep apnea next week. Also just for info I had a ct scan just before my blood test and they did give me the contrast, (iodine). My doctor put me on t4,  25mcg per day. (levo) At the beginning of the year I started a diet and lost 50lbs in about 6 months. Then kinda got off the wagon and gained all my weight back. I was in the hospital a couple years ago and the doctors told me my sodium & potasium was really really low. Also I have access to cynomel. I am afraid to start the t4. And have some questions:
    1. Is 5.4 that high for TSH? 2. What could have caused this to be so high? From everything I read it looks to me like 5.4 is very high. Why then would my doctor only put me on 25mcg? Everything I read says most people are on 75 to 125 mcg per day and their TSH is much lower than mine. 3. Should I ask my doctor to prescribe t3 also? If he will not should I start my own that I have access to? If so I would start very low dose say around 12.5 mcg along with my 25mcg of t4. 4. Could the ct scan caused my TSH to be high? Could having low sodium and potasium cause my TSH to be high? 5. Should I have another test done? Also have my t3 & t4 levels checked this time? He did not do those test the first time. I am afraid because I cannot gain any more weight! I am maxed out! My body cannot take any more. And just five pounds would be really bad. I do not want to take the t4 alone if there is any chance that I might gain additional weight. 6. One more question, is there anyway I can get my thyroid back to normal with out taking a bunch of medication? Like eating right, exercising, loosing weight. Or is the high TSH causing the weight gain? Because my diet is terrible.

    Thank you.















    9

  • Dr. William Davis

    10/2/2011 2:37:56 PM |

    Hi, Robert--

    Iodine is the only way to restore thyroid function; since you got iodine-containing x-ray dye recently, it seems unlikely that iodine deficiency is at the root of it.

    My personal view is that very few people should take T4 without T3--people feel better, are happier, lose weight much more effectively. The problem: the endocrinology and primary care community will fight you tooth and nail. This may sound cynical, but I attribute this to the fact that much thyroid "education" comes from the sexy sales rep who was hawking Synthroid.

    Your T4 dose is low because it is wise to start gradually, else you can get hyperthyroid symptoms. Your TSH, by the way, is indeed in the hypothyroid range, sufficient to account for substantial health problems, including weight gain and heart disease.

  • Eliu

    10/30/2011 10:53:31 PM |

    Jenny i have found an offshore supplier from turkey of T3 (Tri-lodothyronine)  & T4 (thyroxine) i personally have bought T3 & T4 and it is Amazing, the medication manufacturer is Bitiron which are notorious for quality, Bitiron combines both T3 & T4 into one 62.5mcg (Microgram) pill, yielding 50mcg of T4 and 12.5mcg of T3, each box of 100 pill are $22, i have personally bought it and recieved within 10 days and shipping is free, they deliver through USPS and accept paypal payments for a more secure peace of mind, they also sell T3 alone, T4 is generally much weaker than T3 so usually people wont consider it for weigh loss, but what many dont know is that T4 serves as a shuttle for T3...A Normal male will intake 50mcg of T3 up to 100mcg of T3 anymore can cause hyperthyroidism which isnt healthy, i estimate a female should never excede 50mcg of T3, so taking 2 daily will yield 100mcg of T4 and 25mcg of T3 which i believe is a healthy dose for a female, when you take this medication you should always do a pyramid cycle this is where you start off with half a tab, after a week increase to one tab, after 2 weeks increase to 1.5 tabs and after 2 weeks increase to 2 tabs, and keep it steady at that rate for a while then down to 1.5 tabs for 2 weeks and 1 tab for 2 weeks then half a tab for 1 week, i suggest yout take Iodine and L-Tyrosine (Amino Acid) pill after you are finished to help the body naturally produce natural Thyroid hormones once again, NEVER stop taking the pill in the middle of the regiment and NEVER skip a dose.. please do further research to learn more about Thyroid hormone control and its weight loss benefits before doing any regiment.
    (this is the website to get the T3 & T4) http://www.anabolix.eu/
    or Contact the supplier directly at this email:
    anabolicsteroid@hotmail.com
    Please tell them Eliu Quesada Reffered you to their service, good luck and best wishes in your weight loss journey

  • James

    11/9/2011 7:26:16 PM |

    T3 is an excellent supplement for weight loss.  I have used this in a prescription capacity and had great results.  Some sites sell this as a "research chemical".  I have a blog that discusses research chemicals however we do not sell them.  

    Great article on T3 for weight loss.  You are actually the first result on Google for that term.  That is how I found you...

    Thanks

  • Lisa

    12/15/2011 1:23:26 AM |

    Dr Davis,
    1)  My thyroid was radiated twice due to Graves disease 15 years ago.  Since my thyroid is no longer functioning, would there be any benefit to taking iodine along with my synthroid and T3?  
    And
    2) With the Graves disease, I developed thyroid eye disease, pretibia myxedema and Acropachy. Will taking T3 effect or aggravate those conditions?

    Thank you,
    Lisa

  • Wendy

    12/25/2011 9:27:50 PM |

    Dr. Davis, I envy your patients!  I'm a post meno-hell 56 year old female who, until five years ago, has always been thin; underweight according to all height-weight charts.  Over the last 4-5 years I've gone from 110 lbs. to nearly 150!  I've always been able to cut back on intake and weight would fall off; now a normal for me day's intake is a chicken breast or fish fillet/day and a cup of hot chocolate at bedtime (skim milk).  Sure, I realize that as we age we tend to gain weight but this is way over the top and unhealthy.  I've also been suffering from virtually all hypo symptoms except no difficulty conceiving and problem periods (for obvious reasons).  I've been unemployed for years and have no health insurance so obtaining medical care is virtually impossible.  Around 2 years ago I went to a low cost clinic; they said my thyroid numbers were within normal ranges but didn't give me the numbers.  They did send my cholesterol number, OVER 300, with instructions about diet and exercise.  Not exactly news, duh.  When the lbs. really began coming I began walking/jogging 2-3 miles/day, zero weight loss.  I'm sick of freezing feet!  I was stumped about why the corners of my eyebrows have disappeared until I began researching hypo.  I've been on nearly antidepressant known to man.  I finally located a free clinic last spring.  The first Dr. I saw ordered lab work and said if it wasn't definitive he would refer me to an endo.  Drs. at the clinic rotate once/year.  When I returned I saw a different Dr.  He insisted my lab work was normal but, to shut me up, he put me on 25 mcg. of Levo.  After 3 days I felt great but it wore off within two weeks.  I returned to the clinic, the next Dr. said I'm definitely hypo and increased my dosage to 50 mcg.  He wanted to titer me up to 125.  Awesome... I thought.  No change, I was still symptomatic.  After a couple months I increased it to 75.  Despite my raging symptoms the next Dr. decreased it because my TSH was very low.  He's a resident and will be a regular at the clinic until he's finished with his residency.  And, on each visit my weight has steadily increased.  The next time I went in, my most recent visit, my weight had increased at an alarming rate.  He told me to run 6 miles/day.  When I was his age I did run, I had young knees!  I'm sick of the blame the patient game.  At the rate I'm gaining weight this woman, who has always been the skinny one, is going to weigh 200 lbs.  UNACCEPTABLE.  Clearly I'm the only person concerned about my health.  I've scrimped and saved money when possible and ordered some T3 online last week.  I'd rather die than be yet another morbidly obese American at risk for Type II diabetes.  I'm sick of freezing year round.  As I type my feet are so cold they're almost numb.  I'm scheduled to return to the clinic in a few weeks.  They never give me my numbers but this time I'll DEMAND them.  I didn't learn until November that my lab work from April did, indeed, indicate that I'm hypo.  Most patients at the clinic are poor, unsophisticated, uneducated people who don't challenge the Drs.  I'm poor too but I'm a well-informed law school graduate with top-notch research skills.  Yes, lawyers lose jobs too, age discrimination is pervasive.  I don't anticipate having begun taking my self-prescribed cytomel before my upcoming appointment.  Hope springs eternal that if I do benefit from it I will eventually be able to convince one of the rotating, overall apathetic, Drs. to prescribe it.  Ordering online will quickly become financially prohibitive if it really does help.  A little cooperation from the medical professionals sure would be helpful.

  • Wendy

    12/25/2011 9:44:30 PM |

    I forgot.  I've suffered from constipation since entering my 20's.  Bad pins and needles in hands and legs; arthritis since my 20's that has become much worse over the years.  Insomnia, physicians have been throwing antidepressants at me for decades.  I've been told I have a "low normal" body temp since I was a kid.  My mom was diagnosed with hypo last year at age 82 after developing an enormous goiter.  Her Dr. said she's probably been hypo for decades even though it never showed up in her labs.  The list of why I need proper treatment soon is infinite.

  • Belinda

    1/7/2012 9:06:00 AM |

    Wendy, I read your post and I saw myself because I share both your symptoms and your experience. I gained 50 pounds in one year and cannot get it off, although people remark that I don't eat much and they don't understand why I am 184 lbs. I am fatigued all the time, I have difficulty losing weight, I have difficulty concentrating, and yes, I have cold feet (I have to wear socks to bed in the SUMMER). I have been trying to get multiple doctors to recognize that there is something wrong with my thyroid since 2007. I have been tested so often I feel like a pin cushion, and they always tell me my numbers are normal. I ordered copies of all my lab results and I can see that the numbers are going up, and I can feel that my symptoms are getting worse. I am a biochemistry student who would like to go to medical school eventually, and I cannot afford to keep listening to doctors tell me that the problem is not my thyroid when I know that it is. I was laid off from my job and spent a large chunk of my savings on an endocrinologist who insisted that my symptoms were due to a sensitivity to wheat, although I had been tested for 100 different allergens and the results all came back negative! I could not afford to continue paying him to not give me what I asked him for, which was a 1 month trial on thyroid medication. So I did it myself. I researched online, ordered T3, and gave myself a pyramid dosing schedule. I made sure I was aware of the side effects so that I would be able to recognize when to lower my dose. About a week or two after I started T3, I felt like my old self again. I had energy, I was losing weight, and I could concentrate. When I stopped taking the T3, all of my sympoms came back and I immediately put the weight I lost back on.I have been to 3 doctors since I completed my self-administered T3 trial, and I have specifically told them that the medication made me feel better, but they told me that it was because it would make anyone feel better because, as my last doctor told me, "it's like speed." However, my own research has indicated that if you are taking a dose that is unhealthy for your body, it tends to give you headaches and heart palpitations. So obviously my body responded favorably to the T3 since I did not experience those side effects. You should go to the website that the anonymous poster listed called thyroid-RT3.com to see how to pyramid dose and you should try it and see if you feel better. Then you can go back to those doctors and tell them that the T3 made you feel better and you would like to try that. Hopefully, you will get farther than I have. I am going back on T3 on my own. I would have liked to have it monitored by a medical professional but I refuse to live the rest of my life feeling like this. Right now I'm just trying to decide how long to cycle on the T3 and how long to cycle off without making my thyroid worse.

  • tess

    4/29/2013 7:44:49 PM |

    Lisa, this is way too late but....

    what a lot of nutritionists don't seem to realize is that the whole body uses iodine, not just thyroid tissue!  it is the opinion of many TRUE specialists that the RDA is way too low, also.  so unless you're a seaweed fanatic, supplementing iodine is probably a good thing -- but make sure you balance it with selenium -- the two work as a team, and people who have had problems with iodine are frequently selenium-deficient.

    good luck!

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Large new clinical study launched to study. . .niacin


Oxford University has issued a press release announcing plans for a new clinical trial to raise HDL cholesterol and reduce heart attack risk. 20,000 participants will be enrolled in this substantial effort. The agent? Niacin.

How is that new? Well, this time niacin comes with a new spin.

Dr. Jane Armitage, formerly with the Heart Protection Study that showed that simvastatin (Zocor) reduced heart attack risk regardless of starting LDL, is lead investigator. She hopes to prove that niacin raises HDL cholesterol and thereby reduces heart attack risk. But, this time, niacin will be combined with an inhibitor of prostaglandins that blocks the notorious "flushing" effect of niacin.

The majority of Track Your Plaque participants hoping to control or reverse coronary plaque take niacin. Recall that niacin (vitamin B3)is an extremely effect agent that raises HDL, dramatically reduces small LDL, shifts HDL particles into the effective large fraction, reduces triglycerides and triglyceride-containing particles like IDL and VLDL. Several studies have shown that niacin dramatically reduces heart attack. The HATS Study showed that niacin combined with Zocor yielded an 85-90% reduction in heart attack risk and achieved regression of coronary plaque in many participants.

In our experience, approximately 1 in 20 people will really struggle using niacin. Flushes for these occasional people will be difficult or even intolerable. Should Dr. Armitage's study demonstrate that this new combination agent does provide advantages in minimizing the hot flush effect, that will be a boon for the occasional Track Your Plaque participant who finds conventional niacin intolerable.

But you already have access to niacin, an agent with an impressive track record even without this new study. And you have a reasonably effective prostaglandin inhibitor, as well: aspirin. Good old aspirin is very useful, particularly in the first few months of your niacin initiation to blunt the flush.

Although this study is likely to further popularize niacin and allow its broader use, it's also a method for the drug companies to profit from an agent they know works but is cheap and available.

You don't have to wait. You already have niacin and aspirin available to you.

The dark side of CT heart scans

"I just got a heart scan!" declared Eric to his doctor. He handed the report to him.

"Oh my. Your score is 154." The doctor paused, then looked at Eric with a serious look on his face. "If we're going to understand whether or not you're in danger, you'll need a heart catheterization."


I've seen this happen countless times. How can I say this diplomatically? THIS IS WRONG!! In my view, it's absolutely criminal for this to happen. Physician ignorance, profiteering, whatever--it is wrong.

There's very few reasons why someone who has no symptoms should go directly to the cath lab for a procedure. (A rare exception might be an exceptional quantity of plaque in the left mainstem artery, e.g., >100. This is highly unusual.)

Even a nuclear stress test (e.g., thallium) at this level of scoring is only 10-15% likely to be abnormal. That means 85-90% likelihood of being normal. There's rare reasons to perform a heart catheterization in a person with no symptoms and an entirely normal stress test. The vast majority of people like Eric do not need a heart catheterization to discern risk.

If Eric's doctor had been up-to-date on the published literature on the prognostic value of heart scans, he could have advised Eric what the risks were--without a catheterization. Many doctors simply don't want to be bothered. Or, they opt for the more profitable method--a hospital procedure.

Always discuss your heart scan with your doctor--but be armed with information in case your doctor is uninformed or unscrupulous. Unfortunately, that's not uncommon. The Track Your Plaque program is your advocate, a source for unbiased information.

The dirty little secret about aneurysms

Jake had an abdominal aneurysm identified--by accident.

While getting a CT scan of his abdomen for unexplained abdominal pain, a 4.4 cm aneurysm was discovered. Jake's abdominal pain eventually passed without explanation, but he was left with this aneurysm.

Jake's primary care doctor referred him to a surgeon. "It's too small to require surgery right now. Wait a few years and it'll probably get bigger. When it gets to around 5.5 cm, that'll be the time to operate. Let's schedule an abdominal ultrasound or CT scan every 6 months."

Jake then got himself a heart scan. His high score of 879 then led him to my office. Lipoprotein testing, a stress test, correction of his lipoprotein patterns, changes in lifestyle followed. One year later, Jake's heart scan score was unchanged.

How about his abdominal aneurysm? 4.2 cm--a modest quantity of regression. When Jake's surgeon learned of the change, he just shrugged. "Okay, we'll just watch it from here."

Shockingly, the conversation surrounding aneurysms is just like the one Jake received: Let's just watch it grow until you need surgery.

If you've every seen anyone have abdominal aneurysm surgery, you know it is an awful, painful, barbaric process with high risk for major complications like kidney failure and loss of the legs. Waiting for an aneurysm to grow is a lousy solution. Surgeons point out that, although surgery is imperfect, it's better than the alternative: rupture, which is catastrophic with a 50% chance of dying.

But what about stopping the growth of the aneurysm? Or even reversing, or shrinking, it?

Surgeons say it can't be done. Yet we've done it--many times. And it's not that difficult.

The steps to take are very similar to that in the Track Your Plaque program for coronary plaque regression, with a few different strategies. Suppression of inflammation, for instance, plays a more important role and blood pressure must be abolutely normal, even during exercise.

More to come on this important topic in the future, including an upcoming Special Report on the www.cureality.com membership website.

Heart scan scores dropping like stones!!

I saw two instances of dramatic coronary plaque regression today.

John, a 53-years old mechanical lift operator, dropped his heart scan score from 479 to 323--a 32% regression of coronary plaque volume!

Eric, a 50-year consulting engineer, dropped his heart scan score from 668 to 580--a 13% reduction.

Both men did nothing special beyond the principles advocated in the Track Your Plaque program. Recall that, without preventive efforts, your heart scan score is expected to increase by 30% per year. Both men are well on their way to freedom from risk of coronary "events".

Two less people to feed the revenue-hungry hospital procedure system! We need many more like them.

Pre-diabetes: An explanation for explosive coronary plaque growth

Art's first CT heart scan in March, 2006 yielded a concerning score of 1336. He felt fine--no chest discomfort, no breathlessness, etc.

Art agreed to take the statin cholesterol drug his primary care doctor prescribed. He also agreed to take the fish oil, niacin, and some of the nutritional supplements that we advised. But Art just couldn't bring himself to make the commitment to lose weight.

At the start of his program, Art--at 5 ft. 8 inches--was 40 lbs overweight (212 lb). This was important since his blood sugar wavered in the pre-diabetic range, going as high as 130 mg. (The American Diabetes Assn. defines diabetes as a blood glucose of 126 mg or greater.)

One year later, Art's lipid and lipoprotein values were corrected to perfection. But he still weighed in at a hefty 209 lbs--essentially no change. His blood sugar likewise hovered in the 120's.

I felt Art need to be prodded, so I asked him to undergo another heart scan. His score: 1935--a 600 point increase, or 45%!

Only now has Art begun to comprehend to power of diabetes and pre-diabetes to fan the flames of plaque growth. Recent published data, in fact, show that the majority of recently diagnosed diabetics already have well-established coronary artery disease.

Don't let this happen to you. Do not dismiss diabetic patterns as they will catch up to you. If Art can lose the 30-40 lbs in the abdominal weight that is creating the diabetic pattern, he will likely succeed in stopping plaque growth. Otherwise, it's just a matter of time before his heart attack, stent, or bypass.

Who cares if you're pre-diabetic?

Marta is a smart lady. She's worked in hospital laboratories for the last 23 years and knows many of the ins and outs of lab tests and their implications.

After years of being told that her cholesterol was acceptable, she needed to undergo urgent bypass surgery after experiencing severe breathlessness that proved to be a small warning heart attack at age 57. But this made Marta skeptical of relying on cholesterol to identify heart disease risk.

I met Marta two years after her bypass surgery when she was seeking better answers. And, indeed, she proved to have several concealed sources of heart disease: small LDL particles, Lipoprotein(a), intermediate-density lipoprotein (IDL--a very important abnormality that means she is unable to clear dietary fats from her blood), among others. But she was also mildly diabetic with a blood sugar of 131 mg (normal < or = 100 mg). This had not been previously recognized.

As I'm a cardiologist and our program focuses on reversal and control of coronary plaque, I asked Marta to return to her primary care doctor to continue the conversation about diabetes. She was a bit frightened but followed through.

"Well, you're not urinating excessively. And your long-term measure of blood sugar, hemoglobin A1C, is still normal. I wouldn't worry about it. We'll just watch it."

I guess I should know better. What the poor primary care doctor doesn't know is that pre-diabetes and mild diabetes are potent risks for heart disease. In fact, some of the most explosive rates of plaque growth occur when these patterns are present. It's well established that risk for heart attack in a diabetic is the same as that of someone who's already suffered a prior heart attack--very high risk, in other words.

Marta's primary care doctor's advice would be like inquiring about cancer and the doctor says "Let's just wait until it's metastatic--then we'll start to worry." Of course, this is insane.

Pre-diabetes and mild diabetes should not be ignored or just "watched". Even though the blood sugar itself may not be high enough to endanger you, the hidden patterns underlying your body's unresponsiveness to insulin creates a torrent of hidden coronary risk.

For better answers, Track Your Plaque members can read "Shutting Off Metabolic Syndrome" at http://www.cureality.com/library/fl_dp001metabolic.asp on the www.cureality.com website. ("Metabolic syndrome" is the name commonly given to the constellation of abnormalities associated with pre-diabetes and diabetes.)

Don't get smug!

It may sound silly, but after someone succeeds in stopping their heart scan score from increasing or reduces their score, I warn them to not get smug. Let me explain.

I'll tell you about Jack. I met Jack a few years ago after he had a heart scan at age 39. His score: 1441! A score this high at his age obviously puts him in the 99th percentile. Also recall that a score >1000 carries a 25% annual risk for heart attack.

This captured Jack's attention. At the start, his lipoproteins were disastrous with numerous abnormal patterns. Jack committed to the program. After one year, his lipoproteins were around 80-90% corrected towards perfection. He'd lost 27 lbs, was exercising six days a week, and felt great.

Jack's repeat score one year later: 1107--over a 300 point drop! A huge success. He was ecstatic.

Unfortunately, work and life in general distracted him. Jack allowed himself to drift back to old habits, indulging in fast food 2 or 3 times a week, slacking on exercise such that it became sporadic, half-hearted efforts, and regained 15 lbs. He even failed to show up for appointments and we lost contact for two years.

One day, Jack simply decided to see where he stood, so he got himself another heart scan. The score: 2473--over a doubling from his reduced score.

The message: Long-term consistency is key, even after you've achieved control over your score. Stick with your program--and don't get smug!

Holidays are dangerous!

If you're on holiday from work today, make sure you're not on holiday from your health, too.

Too often, people come back to the office telling me that the holidays simply got out of hand--cookouts, picnics, family gatherings, etc.--and they simply couldn't avoid overeating, overdrinking, sitting around--and gaining 3-5 lbs in a weekend. (Our record is 10 lbs in a weekend!)

I don't want to harp on this issue and ruin your holiday, but I can't stress how important it is that you don't allow this to happen to you. Weight gained in a brief space of time has exceptionally destructive effects. Ever see the movie "Super Size Me"? It's an entertaining and well-done yet graphic portrayal of the damaging effects of rapid weight gain.

Enjoy your time off. Relax, enjoy your family and friends--but continue to pay attention to choosing the right foods, don't overeat, take time out to do something (or several things) physical. It'll pay off hugely in the long run.

More on carotid plaque...

Although not a perfect test, carotid ultrasound is an exceptionally easy and accessible test. Using high-frequency sound, clear images are available for most people.

I say it's not perfect because the way it's done in 2006 makes it a non-quantitative test. It is a qualitative test. In other words, you may find out that there's a 30% blockage ("stenosis"), at the far end of the common carotid artery on the right side. Unfortunately, this gives you an isolated measure of diameter of the plaque compared to the artery. What it does not tell you is what the volume of the entire plaque is. That's a far more accurate measure (and one that is incorporated into your heart scan score, by the way).

Nonetheless, carotid ultrasound is easy, very safe, and available in most hospitals and many clinics. One difficulty: most insurance companies will not allow you to go through a carotid ultrasound scan as a "screening" procedure, i.e., a test just to see if you have a carotid plaque. They will generally pay if you're having symptoms of a stroke or "mini-stroke" (transient ischemic attack, or "TIA"), have an abnormal sound in your carotid ultrasound detected by your doctor (a carotid "bruit"), or some other unusual indications. Sometimes, a resourceful physician will muster up a diagnosis based on something in your history (e.g., left arm numbness, a common and often benign complaint that can also signal stroke).

Another option are the mobile scanners or some hospital services that offer carotid screening, usually for a very modest price. Drawback: Sporadic availability, difficulty in obtaining serial scans, and imprecise reporting since it's viewed as a screening test. But it's better than nothing.

My hope is that, as screening services using safe imaging techniques like ultrasound propagate and increase in direct availability to the public, you'll be able to circumvent the obstacles imposed by your insurance company and even, sometimes, your doctor. But try your doctor first.

Carotid plaque can be shrunk

Rose, a 64-year old woman, just had a 70% carotid blockage identified by a screening ultrasound. When the result was given to her doctor, he prescribed Lipitor and told Rose that an ultrasound would be required every year. She would need carotid surgery, an "endarterectomy", if the blockage worsened.

"Can't I reduce the amount of blockage I have?" asked Rose.

"No. Once you've got it, it doesn't get any better."


Is this true? Once you've got carotid plaque, you can only expect it to get worse and it can't be reduced?

This is absolutely not true. In fact, compared to coronary plaque, carotid plaque is easier to reduce!

Of course, the Track Your Plaque program is designed to help you control or reduce coronary plaque. But, in our experience, people who have both coronary and carotid plaque will show far greater and faster reduction of carotid plaque. Dramatic reductions are sometimes seen. I've personally seen 50-70% blockages reduced to <30% on many occasions.

The requirements to achieve reduction of carotid plaque are very similar to the approach we use to reduce coronary plaque. One difference is that hypertension may play a more important role with carotid plaque and needs to be reduced confidently to the normal range before carotid plaque is controlled.

I find it shocking that the attitude like the one provided by this physician continue to prevail. Unlike coronary plaque, which has a relatively small body of scientific literature documenting how it can be reduced, carotid plaque actually enjoys a substantial clinical literature. Part of the reason is that the carotids are more easily imaged using ultrasound. (Heart structures can be seen with ultrasound, but not the coronary arteries.)

Numerous agents have been shown to contribute to reduction of carotid plaque: statin drugs, niacin, fish oil, the anti-diabetic "TZD" drugs (Actos, Avandia), several anti-hypertensive drugs, vitamin E, pomegranate juice, and several others.

It outrages me to hear stories like this. Rose is not the only one.

Don't accept the flip dismissals or the over-enthusiastic referral for carotid procedures. Insist on a conversation about plaque regression.


Note: Although I am a vigorous advocate of atherosclerotic plaque regression, this does not mean that if you have a severe (70% blockage or greater), or if there are symptoms from your carotid disease, that you should engage in a program of reversal. You must always take the advice of your doctor if your safety is in question.