I must start out by stressing that this book is wondeful for anyone suffering from hypothyroidism, regardless of whether they want or need to try t3 only therapy. I personally use t4/t3 treatment, yet still found much useful information in this book, particularly on t3 dosing, and how t3 interacts with cortisol.
The book does a great job of explaining how thyroid hormones work, both t4 and t3, and what may have gone wrong when t4 only (or t4/t3 therapy) fails to return a person to optimal health. To date, I've not yet seen a book that has truly addressed this.
Unfortunately, most thyroid books fail to explain exactly how thyroid hormones work in your body and, more importantly, why the particular form of thyroid hormone you are taking may not be working for you as hoped. Worse, most thyroid books seem to be premised on the view that everyone will recover on t4 therapy or t4/t3 therapy, which is just not true. Paul manages to fully explain everything a hypothyroid patient needs to know, especially those that fail to truly recover on t4 only therapy, yet this book is very easy to read and comprehend.
Perhaps even more importantly, this book is very detailed in dosing -- in other words, how to make t3 work for you. This was actually the main attraction of this book for me. Although the dosing is for t3 only users, I think many of the principles can be applied to t4/t3 therapy. I have never seen any thyroid book that gave much detail on how to find your correct dose of meds. Patients need to have access to this kind of information. It would be nice to think we could rely on our doctors for this information, but as Paul's experiences make clear, most patients need to rely on themsleves -- and then find a doctor who is willing to be open-minded and listen. Doctors know so little about t3 (as the author aptly points out) that finding one to prescribe it for you certainly doesn't guarantee that he or she will be able to tell you how to use in a manner that restores your health. Patients need help with how to determine a correct dosage, and this book definitely fills the bill on that account.
I also found the concept of dosing t3 in a manner to achieve normal cortisol levels very significant and fascinating. I agree that the adrenals may not be able to work properly if they do not have the proper thyroid hormone, or enough of the proper thyroid hormones at the right times. I dislike the use of the term "adrenal fatigue" as it implies the adrenals are somehow "exhausted," not simply that they are working improperly due to lack of proper thyroid hormone. However, I didn't find this to detract from the book at all as the author makes it quite clear that those suffering with true Adrenal Insufficiency or Addison's will not recover adrenal function with his methods. I do worry the use of this term will discredit the book with doctors, but perhaps they can overlook this as well.
I don't agree with everything in this book, but I don't expect one person to know everything. I also emphasize that what I think to be errors are insignficant to the big pciture and do not detract from all the wonderul information contained in the book, information that is backed up by science and citations as well as personal experience.
I do feel a need to point out the errors, though. One thing that caught my eye is the assertion that t4 medication has not had to meet FDA regulation. It's true that t4 medications were grandfathered in for a long time, perhaps at the time the author wrote his statements, however, they have since been forced to undergo FDA regulations some time ago due to concerns over product consistency.
I also think the author's experiences with such greatly fluctuating TSH results while on t3 only therpay is not due to being on t3 or the timing of labs, but is more likely due to having a very bad case of Hashi's. In my experience, and those of others I know, a suppressed TSH does not jump up over range simply because of what time of day you are getting your labs done. TSH generally remains significantly suppressesed on t3 therpay (or even t4/t3 therapy)until you stop taking your medication. I personally would be converned about such fluctuating TSH results while on suppressive doses of meds and would consider looking into methods to lower the autoimmune attack, such as going gluten free, which is known to lower Hashi attacks.
I also don't think that a ft4 of .3 while on t3 only means the thyroid gland has necessarily undergone more destruction due to Hashi's. I don't have hahi's and yet my ft4 fell to .2 to .4 depending on how much t3 I took. I understand why the author came to these conclusions, even though I don't agree with them.
But again, I want to make clear that these minor statement or conclusions that I personally believe to be erroneous do not take away from this book at all or it ability to greatly help many people. I highly recommend this book to anyone with hypothyroidism and certainly everyone who has found t4 to leave them less than fully recovered. I applaud the author for taking the time to share his experiences and research and hope it will further continued research and use of t3 as a treatment for hypothyroid patients worldwide.