Posted on May 4, 2015 It is hypothyroidism at the cellular level, meaning you still have symptoms such as, fatigue, joint pain, depression, weight gain, constipation, hair loss, ovarian cysts, heavy painful periods and infertility, even though you are taking thyroid medication and your TSH is normal . There are two reasons this can occur. First, some doctors believe that providing only enough thyroid hormone to get a patient to mid to high-normal TSH levels is sufficient. Second, the current standard treatment levothyroxine (synthetic T4) (brand names include Synthroid, Levoxyl, Levothyroid, Eltroxin, Euthyrox) may not be enough for the majority of people to actually feel well, because the body also needs a small amount of the hormoneT3 in addition to the levothyroxine. Some just do not feel well on a levothyroxine/T4 only drug, like Synthroid. There are those that feel far better taking T3 only, like Thyrolar, Cytomel or compounded timed release T3. Others have had success adding T3 with their levothyroxine. Finally others have success just using Armour, or Nature-throid, the natural thyroid hormone replacement of T3 & T4. Surprisingly, it’s still considered controversial to use T3 for people with hypothyroidism by the less innovative or accepting members of the medical world, despite research that clearly demonstrates the need for T3 in many thyroid patients. In February 11, 1999, the New England Journal of Medicine published a groundbreaking research report that says that many patients feel better on a combination of T4 and T3, verses just T4 alone. Many people have a normal or even LOW-normal TSH level, yet still suffer continuing hypothyroidism symptoms. In these cases, the addition of T3 helped relieve depression, brain fog, fatigue, and other symptoms. This information about T3 is quite revolutionary and has major implications for people who don’t feel well on their current thyroid therapies.