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Josh Regel

Is there something besides Synthroid?

All too often I talk to patients who have been on thyroid medication for years, but still suffer with the same symptoms.  They don’t know that other medications, as well as nutritional advice for thyroid imbalance are available.  In her last blog, our staff  RN, Anita Hester, gave an overview of thyroid dysfunction (see http://regelpharmalab.com/blog/is-your-thyroid-okay/) and now will provide some helpful information for managing thyroid problems.


The first thing I suggest to my hormone patients and anyone else who comes into the pharmacy with certain complaints is to have their doctor draw a thyroid panel : TSH, T3, T4, TPO.  T4 is the most abundant thyroid hormone which is then converted into T3, affecting almost every physiological process in the body.  T4 is changed to T3 by an enzyme that is dependent on certain nutrients, especially zinc and selenium.  Nutritional deficiency and sometimes other medications can cause poor T4 to T3 conversion.  It is often important to also evaluate rT3 (reverse T3).  The body normally converts some of the T4 to T3 and the excess T4 turns to reverse T3 as a way of getting rid of it.  Too much reverse T3 is often the result of an iron problem or cortisol problem, or both.  This excess can cause the same symptoms of hypothyroidism.



Sometimes a patient has “normal” levels of TSH, T3 and T4 but they have an elevated TPO, meaning that their thyroid has developed antibodies against itself.  This can lead to a condition known as Hashimoto’s Thyroiditis.  We will take a closer look at this problem in the next blog.  Some patients have an overactive thyroid or hyperthyroidism which can cause equally frustrating symptoms.  Needless to say, any abnormal thyroid function can lead to more serious health issues if not properly addressed in time.


All hormones, including thyroid hormones, work together to make the body function properly.  If there is an imbalance with any of these then ultimately it will affect the entire relationship. That is why it is important to check all of these hormone levels and supplement with bioidentical hormones when necessary.  Excess estrogen, low DHEA, low testosterone, and low progesterone can inhibit proper thyroid function.  If the adrenal glands are suffering from fatigue, it is best to support them with nutritional supplements before beginning medication for a thyroid problem.  If not, the thyroid medication can cause further stress to the adrenals when it increases the body’s metabolism.


So back to the subject of medications and treatments…generally many practitioners only prescribe synthetic T4.  Many patients are treated successfully with these medications, but others see no relief of their symptoms because they may also need T3.  There are several T4/T3 combination medications, the most well-known being Armour Thyroid.  Some patients may only require T3 which is available with the synthetic Cytomel or in a generic Liothyronine Sodium.  Your thyroid medication can be specifically tailored to your individual needs at Regel Pharmalab if the standard drug and dosage typically offered does not relieve your symptoms.


Things that you can do to promote healthy thyroid function are:


  1. Eat a well-balanced diet, and supplement with a multivitamin or thyroid support product containing iodine, zinc, selenium and l-tyrosine. Avoid soy which can reduce T4 to T3 conversion.

  2. Reduce stress and get plenty of Vitamin C to help with adrenal health and balance cortisol. Refer to Dr. James Wilson’s book on Adrenal Fatigue to see if you may be suffering from this common problem.

  3. Be aware that oral estrogens, birth control pills, beta-blockers, lithium, and chemotherapy can interfere with thyroid function.

  4. Protect your thyroid from injury, extreme cold, and radiation.

  5. Check your hormones with a saliva test to assure that they are in balance.  Estrogen/progesterone balance affects thyroid hormones.


If you are having symptoms of thyroid dysfunction, ask your practitioner for a full thyroid panel.  A very  informative book is The Women’s Guide to Thyroid Health  by Kathryn R. Simpson.  Talk to your compounding pharmacist about other options if you feel your present medication is not giving you the symptom relief you desire.  We can also direct you to practitioners who understand that each patient’s situation is unique and should be treated as such.


What symptoms are you experiencing with your thyroid medication that you would like to correct?  Comment below.

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