“There’s almost no context in which I would speak of “an appropriate dose of T4,” since thyroxin is so effective as an anti-thyroid substance. It’s appropriate if you are also taking T3, or if you want to shrink your thyroid. Thyroid will dependably correct your pregnenolone production, if you have enough cholesterol, vitamin A, and protein. The cholesterol will be consumed to make pregnenolone and progesterone and bile acids. If cholesterol is below 160, fruit sugar helps to raise it. The protein is needed to detoxify estrogen, unsaturated oils, etc, and to maintain the T3. Protein deficiency gives anti-thyroid signals, and T4 will be used to make reverse T3 to inhibit T3’s effects. About 3 mcg of T3 especially if it’s taken with milk or gelatine-rich salty soup is effective for stopping the nocturnal alarm reaction.” -Ray Peat, PhD