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Optimal Metabolism and its association with large reductions in chronic diseases


Senior Member
Trends in Medicine Trends Med, 2017 Volume 18: 1-5

The definition of Optimal Metabolism and its association with large reductions in chronic diseases

Donald T Levine* Associate, Nyack Hospital and Goodsamaritan Hospital, Rockland County NY, USA

Published: January 18, 2018


This study describes for the first time a definition of Optimal Metabolism from the standpoint of cellular function.
Very simply, cells require an optimal amount of T3, the main thyroid hormone for ideal performance. This paper describes specifically how to optimize a patient’s metabolism and the results.

Optimal Metabolism is measureable and specifically defined by the FT3 (free T3) in the upper 20% of the normal range, the TT3/RT3 ratio (total T3/reverse T3) between 10-15, and the FT4 > 0.6.

Being in the Optimal Range predictably coincides with substantial reductions in chronic diseases including Subclinical Hypothyroidism and other low T3 states. Being in the Optimal Range results in improved health spans and increased productivity. Substantial reductions in cost of health care also result because repetitive expensive hospitalizations, ER visits, ineffectual repetitive medical workups, and ineffective treatments are eliminated
Optimal Metabolism can improve public health at much lower cost.

(T3) liothyronine and (T4) levothyroxine were given in gradually increasing dosages until the Optimal Range was reached and maintained.


The Immune system API was 63%. API for Neurology was 80%. API for Dermatology was 70%. Gastroenterology/Constipation - API of 74%. Overweight - patients lost 7 lbs. average. *Decreased Medications - Allergy 34%; Prednisone and Psychotropics 4% each. Side effects: Heart Palpitation - 16%, Heat Intolerance - 5%, Muscle Cramping - 4%. Conclusions and relevence Optimizing Metabolism is safe resulting in large multiple systemic improvements. Decreased disability, increased productivity, and increased human health spans result.

Recurrent suppressive or more interventional therapies, hospitalizations, and medical costs can all be greatly reduced. This study is not double-blinded, placebo-controlled, and cannot prove causality. However, because of the large number of controlled trials and the magnitude and breadth of the improvements, those studies should be undertaken. Physicians could and should consider this readily available therapy perhaps beginning with their most difficult and refractory cases. Low metabolism is extremely common. The most common cause is aging [4]. Metabolism will also slow in response to trauma, illness, inflammation or starvation as the body tries to preserve protein by causing RT3 to increase and FT3 to decrease [1,5,8]. RT3 makes the conversion of T4 to T3 less efficient [2] causing further slowing of metabolism. At some trigger point systemic dysfunction occurs. Low metabolism is not generally recognized by doctors or patients as an underlying cause of chronic medical conditions.

This is because:

1) Optimal Metabolism from the viewpoint of cellular function is not a current concept so,
2) Accurate blood testing reflecting the metabolic status at the cellular level is not ordered.
3) Symptoms of low metabolism are not considered during consultation when chronic illnesses are presented. Even if reported they are not linked because
4) Current evaluation and treatments are concerned only with T4 and TSH levels which do not accurately reflect cellular function which is predominantly controlled by T3 (four times stronger than T4). So, conversely; if cellular metabolism were raised to an optimum level, its function should improve and those resultant pathologic states resolve.

This would happen when:

1) cells have an Optimal exposure to FT3 stimulation (upper 20% of normal range)
2) The normal ratio of TT3/RT3 is established (10:1); reflecting the total stimulatory and inhibitory cellular environments.
3) Keeping the T4 levels in the low normal or just below the low normal range to preserve normal T4 metabolism. TSH is considered the least important variable since it plays no direct role in the conversion of T4 to T3 or RT3 – the metabolic on-off switch. TSH only controls the manufacture and release of T4 and a little T3 from the thyroid gland. The main metabolic switch is located within the cell membranes where there are no TSH receptors. Accurate measurements are necessary to obtain average FT3 levels. To account for T3’s 6hr half-life the T3 dosages are halved, given twice a day, with repeat blood testing 6hrs after the last dose after allowing 3weeks for equilibration. Current metabolic elevation goals treating with T4 (levothyroxine) often results in RT3 elevation and may not elevate FT3. Current treatment goals seek to keep the T4 level below the high normal and the TSH from being too suppressed which can be associated with hyperthyroidism (contributing to osteoporosis) and thus causes physicians to undertreat even with T4. The existing protocol does not address the cellular environment or cellular functional requirements. It places too much emphasis on pituitary gland’s TSH levels. Cellular low metabolism can occur with high, normal, or low TSH levels. “Subclinical Hypothyroid
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Senior Member
This article from Dr Levine is worth a read.
His concept of Optimizing Metabolism is basically on raising the fT3/rT3 ratio above 10 I think, but he commonly adapt his protocol to each patient;
he seems to have good results on many chronical conditions, allergies include.

3 cases are reported on page 4, it's easy to read.