January is Thyroid Awareness Month, making it a good time to highlight the importance and variety of medication that can help treat thyroid disorders.

Why Thyroid Disorders Can Require Medication

Whether you suffer from an underactive thyroid (hypothyroidism), an overactive thyroid (hyperthyroidism), it is essentially a hormone imbalance where your thyroid hormone levels are not optimal, causing a variety of symptoms.

Learn about the symptoms of hypothyroidism, hyperthyroidism, and more here

Determining If You Need Thyroid Medication

When testing thyroid function, many doctors only test the levels of Thyroid-Stimulating Hormone (TSH). Although TSH is considered the “gold standard” test by many endocrinologists, there is no consensus on the appropriate reference range for this test. Some endocrinologists consider any number within the reference range (it’s around .40 to 4.0 mlU/L at many US labs) “normal,” and others feel that TSH must be as high as 10 mlU/L.

Moreover, this “gold standard” test does not consider the levels of Free T4 and Free T3 — the actual circulating thyroid hormones, nor the antibodies that detect autoimmune thyroid disease (such as Hashimoto’s thyroiditis). As a result, you may have sub-normal levels of T4 and T3 (meaning bodily systems are not receiving enough thyroid hormone), and/or antibodies that show that your thyroid gland is in self-destruct mode, yet if your TSH is within the reference range, the endocrinologist may say it’s “normal.”

It is also uncommon for endocrinologists to screen for a patient’s levels of Reverse T3 (RT3). As the mirror image of T3, RT3 is responsible for keeping active thyroid hormone levels balanced and is important for overall thyroid function. Thus, in order to receive an accurate picture of your thyroid health, it is best to have a full panel screening of your thyroid hormones.

Once a full thyroid panel is conducted, an experienced endocrinologist can determine if thyroid medication is right for you.

Types of Thyroid Medication

Despite popular belief, there is no one effective standard treatment for thyroid disease. In fact, one of the most important things to understand as both a practitioner and as a patient is that each case is different and every body has individualized needs.

Synthetic T4

Levothyroxine, Synthroid, and Levoxyl are some of the most common medications prescribed for hypothyroidism. Such synthetic forms of T4 are administered in an attempt to balance the patient’s thyroid hormone levels based on the expectation that the body will begin to convert T4 into T3 effectively. However, if T4 remains unconverted or is over-converted into Reverse T3, symptoms of thyroid dysfunction will continue.

Moreover, multiple studies have shown that T4-only formulations are not effective in resolving symptoms and thyroid function. More specifically, a 1995 study published in the Journal of Clinical Investigation found that reaching optimal levels of TSH and T4 with only T4 formulations did not result in T3 tissue levels that were in normal range. This caused the pituitary to exhibit proper T4 and TSH levels, but nearly all other bodily tissues were deficient. Additionally, some patients in this study (those who converted T4 to RT3) even experienced a worsening of their symptoms with the use of T4 medications. As a result, T3 may be a more effective treatment for some patients.

T3 Formulations

T3 formulations such as Cytomel are currently prescribed less than the above described T4 medications but can be quite effective for certain individuals. Specifically, patients suffering from RT3 issues and suboptimal thyroid function can experience significant improvement from T3 formulations (even if they present with normal levels of T4 and TSH). This is because an appropriate supply of T3 can actually reduce the need for additional T4. In regards to Cytomel (liothyronine sodium), it is a synthetic formulation of thyroid hormones and can be more efficient in improving thyroid function than Levothyroxine and other T4 medications because the T3 provided by Cytomel does not need to be converted and can quickly influence metabolic function throughout the body.

Natural Desiccated Thyroid

As its name implies, Natural Desiccated Thyroid (NDT) drugs are a prescription hormone treatment derived from natural sources, which are typically animals. In fact, in the United States, NDT is exclusively formulated from pigs (the dried thyroid gland of the pig specifically).

There are multiple brands of NDT including Nature-throid, Thyroid WP, Armour, and Acella.

Unfortunately, few doctors utilize this promising and effective treatment method in the United States. Because NDT closely resembles human thyroid hormones, it is easier for the body to process. This medication is also highly customizable allowing for unique formulations of T4, T3, T2, T1 and other thyroid hormones and nutrients to be easily incorporated into the same treatment. It is also important to note that NDT is regulated by the FDA and undergoes a rigorous quality assurance testing.

Compounded Medications

Compound medications can combine T4 and T3 formulations, eliminating the potential of including thyroid-inhibiting substances such as lactose and gluten, which are common in many medications. Compounded medications are alsp customizable in regards to the levels of T3 and T4. As a result, patients can receive the specific quantities of hormones needed for their unique situation. It is worth noting that patients who have not done well using T4-only formulations or NDT frequently benefit from a specified compound treatment.

Final Thought

Balancing your thyroid hormones with medication can be a difficult and frustrating journey. If you have been struggling with receiving the proper thyroid medication and are not getting the help you need, contact a member of Holtorf Medical Group today.

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