Are You On The Right Type Of Thyroid Medication?

thyroid medication

Thyroid replacement therapy is often the necessary step to restore low thyroid function in people with hypothyroidism and Hashimoto’s disease. While thyroid drugs are not intended to correct underlying causes of thyroid dysfunction, using the right type of thyroid medication is critical for improving hypothyroid symptoms and getting back to normal.

If you are taking the wrong type of thyroid medication there should be no surprise that your hypothyroid and Hashimoto’s symptoms are not improving.

Your thyroid gland produces T4 and T3 thyroid hormones. Depending on the type, the thyroid replacement therapy provides you with one or both missing hormones.

4 Types Of Thyroid Drugs Available Today

1.T4-Only Drugs

T4-only medications such as Synthroid, Levothyroxine, Levoxyl, etc. are the most commonly prescribed thyroid drugs used today in conventional medicine.

However, they don’t produce good results for the following groups of thyroid patients:

  • People who lost their thyroid completely or partially due to thyroidectomy
  • People who have an impaired thyroid function due to a complete or partial thyroid destruction as a result of an autoimmune attack on their thyroid in Hashimoto’s disease.
  • Patients who are not able to convert the inactive prohormone T4 into the active T3 form by liver- and kidney-produced 5’-deiodase.
  • People who are sensitive to fillers and binders in particular thyroid drug brands.

Unfortunately, the longer you have hypothyroidism, especially if it is untreated or undertreated, the higher the risk to develop liver dysfunction which impairs your ability to convert T4 medication efficiently.

This creates a major problem and is a very common reason why you still could experience hypothyroid and Hashimoto’s symptoms even if taking T4-only thyroid drugs.

Despite T4-only thyroid drugs being a standard care for low thyroid, there are other thyroid drugs that can be used instead or as a complimentary therapy.

thyroid treatment

2. Natural Desiccated Thyroid (NDT).

Desiccated thyroid is a natural medication that can have a porcine or bovine source and is derived directly from the thyroid glands of pigs or cattle respectively. It has been used for over 100 years well before synthetic T4-only drugs were created in the lab and came to market.

Since your thyroid gland produces both T3 and T4 hormones, the idea of relying on T4-only medication is quite unnatural from a physiological perspective because even suppressive doses of T4 drugs cannot fully compensate for missing T3 produced by the thyroid gland itself.

In addition, some people have a T4 to T3 under-conversion in peripheral tissues and their cells are left starving for T3.

These are two major reasons why many patients who didn’t respond well to T4-only drugs feel better on desiccated thyroid.

However, there are also some people who don’t feel well on natural desiccated thyroid and can even develop negative responses to it because of the following reasons:

  • Some Hashimoto’s patients can produce thyroid antibodies to desiccated thyroid medication since it is a natural compound.
  • Desiccated thyroid drugs come in a fixed T4 to T3 proportion which is 4:3 and can be too high for some people because the naturally produced ratio with the thyroid gland is about 14:1.

However, natural desiccated thyroid is considered safe. Today different brands such as Armour thyroid, ERFA, Naturethroid, Westhroid and others are available but seldom prescribed by conventional medicine doctors and many thyroid patients don’t even know that this alternative to T4-only thyroid drug exists.

3. T3-only thyroid drugs.

T3 comes in a tablet form as a liothyronine sodium which is a synthetic form of natural T3 called triiodothyronine. Common brand names are Liothyronine or Tertroxin in the UK and Cytomel in the USA.

While many thyroid patients can benefit from using T3-only drugs alone or in a combination with T4-only thyroid drugs, many doctors are not comfortable prescribing it and some countries don’t allow it.

The reason is that T3 is an active and fast acting thyroid hormone and when supplied externally your body has a limited ability to handle it when it is taken in excess. To get maximum benefits and avoid negative responses it is very important to use T3 drugs correctly.

T3 medication, including natural desiccated thyroid, should be used with caution, especially when a person has underlying heart condition, anxiety and is prone to thyrotoxicosis and Hashitoxicosis.

4. Compounded Thyroid Drugs.

Both T3 and T4 drugs can be specially formulated or customized in a compounding pharmacy. They can be made as separate compounds or in combination with each other and encapsulated in gelatin capsules with dye-free and vegetarian options.

In a similar way compounding pharmacies can also make a compounded desiccated porcine thyroid capsules using a lactose-free powder and contain a fixed ratio of T3 to T4 hormones.

Here are some of the biggest benefits of using a compounded pharmacy:

  • Strength and ratio of T4 and T3 can be adjusted to your personal needs outside of the commercially available options.
  • If you show negative reactions to some inactive ingredients, binders or fillers such as lactose, corn and gluten they can be replaced with better suitable options.
  • Thyroid medication can be formulated with a sustained release (SR) mechanism of action that mimics natural secretion of thyroid hormones by the thyroid gland when hormones are released continuously throughout the day.
  • This is especially helpful for people who are sensitive to adding T3 and have to take Cytomel or Liothyronine in smaller doses to achieve more consistency.
  • Compounded T3 is usually much more affordable than, for example Cytomel, however T4-only compounded drugs are substantially more expensive than Synthroid.

Should You Switch?

As you see, there are currently 4 types of thyroid drugs that can be used to treat hypothyroidism and compromised thyroid function in Hashimoto’s disease. If the standard treatment with T4-only drugs doesn’t work for you, don’t get discouraged. It doesn’t mean that you don’t have any alternatives.

Conventional thyroid treatment guidelines state that T4-only drugs are the best and only treatment option for hypothyroidism and that there are no benefits from using a combined T4 plus T3 hormone replacement therapy.

What you need to be aware of is that most of these claims are based on research studies funded by pharmaceutical companies interested in promoting their own products and not conducting an independent research.

Indeed, there are studies that confirmed benefits of using natural desiccated thyroid and a combined T4 plus T3 hormone replacement therapy over T4-only drugs. It is scientifically proven that symptoms improvement under desiccated thyroid treatment cannot be attributed simply to a placebo effect.

Unfortunately, most conventional doctors are not aware of these findings and continue to follow official guidelines that recommend T4-only thyroid treatment.

finding good thyroid doctor

Often changing to a different type or brand of thyroid medication can produce life-changing results. Many thyroid patients see their hypothyroid and Hashimoto’s symptoms improve significantly after they switch from a T4-only medication to a properly balanced combination of T4 and T3 thyroid drugs.

If your doctor is not open to the idea of looking for better treatment options and prescribing natural desiccated thyroid or T3 medication then it could be the time to find a new doctor or look for a natural medicine practitioner such as a naturopath, integrative, functional or holistic medicine practitioner who are aware of other thyroid drugs and are willing to prescribe it.

What If You Cannot Tolerate Thyroid Medication?

However, there are still some other imbalances that you need to know about and get checked for as well, when people get negative reactions even on a combination T4 and T3 therapy.

If you cannot tolerate T4-only or a T4 plus T3 thyroid hormone replacement very well when you clearly need it then there should be a good reason and explanation why it is happening to you.

There is a possibility that the problem is not the medication but actually you.

There are 5 imbalances that prevent your medication from working well:

1.Thyroid Autoimmunity

Up to 90% of hypothyroidism in the industrialized countries is due to autoimmune thyroid disease called Hashimoto’s thyroiditis. Conventional medicine continues to treat hypothyroidism without taking into consideration the autoimmune component of Hashimoto’s.

As a result, any type of thyroid medication may not fully work because it does not address the cause of the Hashimoto’s disease which is an overreaction of the immune system and not the thyroid hormone deficiency.

With time many Hashimoto’s patients do not see much difference compared to being on T4-only medication, using natural desiccated thyroid or a combined T4 plus T3 therapy because the autoimmune attack and destruction of the thyroid gland remain in progress and put them at the additional risk to develop another autoimmune disease with another set of symptoms.

The truth is that it is impossible to stop the autoimmune attack on the thyroid with thyroid medication alone without re-balancing immune system.

2. Low cortisol levels.

Up to 80% of people with autoimmune Hashimoto’s disease have both adrenal and a thyroid dysfunction at the same time. Unfortunately, adrenal problems are missed most of the time because symptoms of hypothyroidism, Hashimoto’s and low adrenal function are overlapping and conventional doctors seldom even test for adrenal imbalances.

This means that the majority of thyroid patients are treated for hypothyroidism alone. It can have more consequences than persistent hypothyroid symptoms and the adrenal function gets worse over time.

In addition, an adequate amount of cortisol is required for the activation of thyroid receptors and helping T3 get into the cells. This is why a lot of patients with low cortisol levels usually continue to suffer from hypothyroid-like symptoms that don’t respond well (if at all) to any type of thyroid drugs and can actually lead to adrenal burnout.

If you read the patient’s instruction to any thyroid medication you find out that an uncorrected adrenal insufficiency or low cortisol is a contradiction to taking any type of thyroid drugs and will find a warning like this:

Thyroid hormone increases metabolic clearance of glucocorticoids. Initiation of thyroid hormone therapy prior to initiating glucocorticoid therapy may precipitate an acute adrenal crisis in patients with adrenal insufficiency. Treat patients with adrenal insufficiency with replacement glucocorticoids prior to initiating treatment with thyroid drugs.

The bottom line is that you cannot compensate for your adrenal imbalance and low cortisol levels by taking thyroid medication and have to correct adrenal insufficiency first before starting any type of thyroid drugs.

Another important point is that if low adrenals were the cause of secondary hypothyroidism, properly addressing adrenal dysfunction will correct low thyroid completely (or at least partially) and can make thyroid medication unnecessary.

3. High adrenaline and other stress hormones.

When you become hypothyroid your body tries to compensate for missing thyroid hormones by over-activating your stress response. As a result, you start to produce high levels of stress hormones cortisol and adrenaline.

Thyroid medication and especially T3 thyroid drugs tend to make you much more sensitive to the effects of adrenaline. You may feel like you are not able to tolerate thyroid drugs and experience anxiety, increased heart rate, heart palpitations and other effects of stress when taking any type of T3.

The good news is that there are many stress factors that you can control, make yourself more resistant to stress and minimize its effects. For example, you can use specific foods to help suppress your stress response and improve how your body uses thyroid hormones.

Doing so will not only improve your tolerance of T3 thyroid drugs but also start using thyroid hormones far more efficiently that will follow by less hypothyroid symptoms.

4. Iron deficiency.

If your ferritin levels are low it doesn’t mean that you should start simply take iron supplements until your levels get into a normal range. This will most likely never happen because the situation is more complicated.

In fact, low ferritin and iron deficiency anemia are a common sign of hypothyroidism. If you are on thyroid medication but your ferritin levels remain low it is most likely the sign that this type of drug doesn’t work well for you.  It means that you are experiencing thyroid hormone resistance when your cells are not getting and/or not using properly thyroid hormones your thyroid medication provides.

5. Broken thyroid hormone pathway.

However, more often than many thyroid patients realize the problem is how thyroid medication is actually used by your body and whether thyroid hormones reach their target cells.

Finding the right type of thyroid medication is just a first and necessary step in the complicated process of restoring your natural thyroid cycle and making it work efficiently.

If at any point of their lifecycle thyroid hormones become blocked and don’t reach your cells or your cells cannot fully metabolize them, it will ultimately result in hypothyroidism on a cellular level.

This means that if your thyroid hormone pathway becomes blocked you will always remain hypothyroid and fail to restore your health doesn’t matter how high your dose of thyroid medication is and whether you have normal or even optimal thyroid levels based on your blood test results.

Fixing problems with immune system, high adrenaline, broken thyroid hormone pathway, iron deficiency and low cortisol can make a huge difference in efficiency of your thyroid treatment and your quality of life. Learn about hypothyroidism treatment that helps you to overcome all these issues and see for yourself how big of a difference it can make.

P.S. Many people use this eye-opening information as a starting point to experience truly life-changing thyroid treatment results.

Hypothyroidism Exercise

About Marina Gutner, PhD

Marina Gutner, PhD, researcher, medical writer, thyroid blogger and founder of Outsmart Disease who writes about life-changing treatments for hypothyroidism, Hashimoto's thyroiditis and autoimmune disease and how to balance hormones in women