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Participants in the trial had obesity or were overweight with weight-related health conditions

This calculus matters for conditions requiring strong systemic effects

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But recent research has indicated that many (especially female Hashimotos) patients do profit from a T3/T4 combination, like the normal secretion pattern from the thyroid gland and like found in dried thyroid extracts (at a ration of around 1/10th of T3 compared to T4). We assume that, in particular, those hypothyroid patients with impaired expression of Se-dependent deiodinases would respond favorably to the T3/T4 combinations, as their activation of T4 to T3 in the peripheral tissues is compromised. Schomburg then spelled out how low T3 problems could impair muscle activity and produce exercise intolerance