What if the patient improves at first, but then stops feeling as well even though the temperature is holding?

If the T3 therapy improves a patient’s symptoms at all, it is because it has increased the patient’s body temperature patterns. That is a very good sign because it suggests that the patient’s symptoms are at least to some extent temperature-mediated. During T3 therapy, it is not uncommon for a patient’s temperature to drop back down again (due to compensation, see p85), or for it to become unsteady (c24), and therefore for the patient’s symptoms to return. When a person first starts the T3 therapy, it is easier to keep the T3 level steady because one is building on a steady endogenous foundation of T3. For this reason, the beginning of a cycle often provides the best opportunity to see if the symptoms are temperature-mediated and T3-responsive. At that point of the cycle, if the temperature can be raised close to normal, it has a better chance of being steady also. And a temperature that is sufficiently normal and steady is what is required for clinical improvement. Of course, as a cycle wears on, and as the doses of T3 increase, the chances of “muddying the water” (making the T3 level unsteady) also increase. If the T3 therapy improves a patient’s symptoms to any degree, it is likely that the symptoms are to some extent temperature-mediated. At that point it becomes less of a question as to whether the T3 therapy is on the right track. The question becomes, “Can the T3 therapy be adjusted in such a way (e.g., with increased compliance, T4 test dose, cycling the patient on and off therapy) that the patient’s temperature and symptoms improve and remain improved (c28).