Tiratricol® (liothyronine sodium)
Tiratricol (3, 5, 3-triodothyroacetic acid) is a popular 'nutritional supplement' among bodybuilders and weightlifters, many of whom believe that the compound increases metabolism, spurs fat burning, upgrades body composition, and helps produce a 'cut' look. Such beliefs are not completely illogical, since tiratricol is a close chemical relative of triiodothyronine, a key hormone produced by the thyroid gland which in fact does boost metabolic rate. Tiratricol is widely available at health-food stores, is sold over the internet, and is particularly popular in Europe. It is marketed under the brand names Triax, Tri-Cuts, and Tricana.
Unfortunately, a new report ('A Report of Hypothyroidism Induced by an Over-the-Counter Fat Loss Supplement (Tiratricol)', International Journal of Sport Nutrition and Exercise Metabolism, Vol. 13(1), pp. 112-116, 2003) indicates that regular tiratricol ingestion may be associated with some serious, negative, health consequences. The report documents the cases of two physically fit adults, a 39-year-old male athlete and a 40-year-old female weightlifter, who used tiratricol supplements and ultimately developed hypothyroidism (extreme inactivity of their thyroid glands). The male took 3000 to 4000 mcg of tiratricol per day for about one month and developed extreme fatigue, loss of appetite, sweats, chills, lethargy, and an inability to conduct his usual workouts.
The female ingested 6000 mcg of tiratricol per day for 56 days while training four to five times a week and consuming a low-fat diet which was sufficient in protein and moderate in complex carbohydrate as part of an effort to lose weight and improve body composition. She was completely healthy prior to embarking on the tiratricol programme (and her thyroid function was totally normal) but developed decreased appetite and severe lethargy and began to gain weight, in spite of her relatively stringent diet and strenuous exercise programme.
When the two athletes consulted with doctors to determine the cause of their symptoms, blood tests revealed that their levels of thyroid-stimulating hormone were incredibly low less than .01 mU/litre (normal is .4 to 5.5 mU/litre). Thyroid-stimulating hormone is a key compound which 'gears up' the thyroid gland, causing it to release increased amounts of thyroid hormones, which ultimately heighten metabolism. When thyroid-stimulating-hormone levels are extremely low, the thyroid gland becomes relatively inactive, and weight gain and extreme fatigue are common consequences.
What happened next?
When the two athletes discontinued their tiratricol supplementation, it took five months for thyroid function to return to normal in the male athlete (!) and about 40 days for the female's thyroid action to come up to par. The new report, published by researchers at the Texas Health and Wellness Clinic in Houston, Texas, indicates that such adverse effects of tiratricol supplementation are all too common. Apparently, because of its close chemical similarity to triiodothyronine, tiratricol is a very potent inhibitor of thyroid-stimulating hormone. In the normal person, high levels of triiodothyronine would tend to decrease activity of the thyroid gland by inhibiting thyroid-stimulating hormone (as part of a 'negative-feedback' mechanism); otherwise, the thyroid gland might over-produce thyroid hormones such as triiodothyronine.
When an athlete supplements with tiratricol, he/she does not have high levels of triiodothyronine, but the very similar tiratricol 'pinch-hits' for triiodothyronine and shuts the thyroid gland down. Making matters worse, although tiratricol is chemically similar to triiodothyronine, it does not have the latter's positive effects on metabolism, and its suppression of thyroid-stimulating hormone leads to decreased oxygen consumption, lowered heat production, and a reduced metabolic rate. As if that were not enough, tiratricol can actually increase laboratory readings (taken from blood tests) for triiodothyronine because it is cross-reactive with the triiodothyronine antibody. This can cause some doctors to believe that a patient has an overactive ('toxic') thyroid, even though in fact the thyroid has been shut down by tiratricol; improper therapeutic modalities may be employed as a result.
The bottom line?
Tiratricol is not a metabolic accelerator nor a fat-loss aid. Rather, it is a potent drug which is capable of inducing severe thyroid abnormalities in athletes who use it. There is a tremendous amount of hype surrounding tiratricol, with ads for the compound suggesting that the product burns incredible amounts of fat and produces dramatic improvements in muscle definition. However, the reality is that tiratricol supplementation should be avoided by all athletes.
In addition, these tiratricol problems serve as a reminder that when an athlete consults his/her doctor about a health problem, he/she should always mention and completely and accurately describe their supplement use (of course, doctors should make every effort to elicit such information, too). Had the two athletes in this study not mentioned their tiratricol consumption, their doctors would probably have misdiagnosed their problems and may have come to believe that the subjects were suffering from fundamental thyroid problems, rather than experiencing a reaction to a dangerous supplement.
Unfortunately, research suggests that about 70% of individuals fail to completely report their supplement use during medical office visits or during pre-surgery screenings ('Herbal Medications: Current Trends in Anesthesiology Practice A Hospital Survey', Journal of Clinical Anesthesiology, Vol. 12, pp. 468-471, 2000). The dangers of this failure to communicate are obvious, especially since many supplements contain compounds which act as potent drugs which may interact in a negative way with drugs prescribed by health professionals.
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