Which Is The Best Thyroid Drug For Hypothyroidism?

Which is the best thyroid drug for hypothyroidism

The biggest human temptation is to settle for too little.

-Thomas Merton

Many Hypothyroid Mom readers ask which thyroid drug is best. My answer is always the same, “I wish there was one thyroid drug that worked for all of us but the reality is that we each react differently to the different medications. We must work closely with our doctor to investigate which treatment is ideal for us and what dosage is optimal.” The key is that you must know all the treatment options to ensure your doctor is exploring the options to find what’s right for you. If you are being treated with thyroid hormone replacement medication but you still don’t feel well, insist on further exploration. If you are still not feeling well, get a second opinion, a third opinion, even ten medical opinions until you find a doctor that explores the options to find what’s right for YOU.

Don’t settle.

Thyroid Drug Options

T4 Drugs

Author of the book Living Well with Hypothyroidism: What Your Doctor Doesn’t Tell You…That You Need to Know Mary Shomon included the following information at About.com Thyroid Disease.

Levothyroxine is the generic name for the synthetic form of thyroxine, a thyroid hormone replacement drug. This drug contains the synthetic form of one thyroid hormone, T4. Levothyroxine is the most commonly prescribed thyroid hormone replacement drug.

Brand names in the U.S: Synthroid, Levothroid, Levoxyl, Unithroid

Brand names in Canada: Synthroid, Eltroxin, and PMS-Levothyroxine

Brand names outside U.S.: Euthyrox, Thyroxine, Berlthyrox, Droxine, Eferox, Elthyrone, Eltroxin, Eutirox, Letrox, Levaxin, Levotirox, Levothyrox, Levotiroxina, Oroxine, T4KP, Thevier, Throxinique, Thyradin, Thyradin S, Thyrax, Thyrax Duotab, Thyrex, Thyro-4, Thyrosit, Thyroxin, Thyroxin-Natrium, Tiroidine

Mary also included an article on a thyroid medication called Tirosint. The levothyroxine in Tirosint is in a liquid form inside a capsule.

T3 Drugs

There are synthetic T3 drugs like Cytomel. Through a compounding pharmacy, there are also prescription compounded T3 drugs including time-released T3.

Natural Desiccated Thyroid

Brands include Forest Lab’s Armour, and Nature-throid and Westhroid by RLC Labs. There is a generic version of NDT made by Acella Pharmaceuticals. Canada’s desiccated thyroid made by Erfa is called Thyroid. There are also compounding pharmacies worldwide that produce compounded versions using the raw natural desiccated thyroid powder.

Find The Right Thyroid Treatment For YOU

We are each unique with individual sensitivities. Our bodies will NOT all react the same to these different medications. The dosages that are ideal for each of us will also vary. Our uniqueness is what makes finding the right thyroid treatment tricky.

Thyroid hormone replacement drugs are powerful, so powerful they can kill you if not taken properly. This is why it is critical to be under careful medical supervision when on these drugs, especially careful when starting a new brand or increasing dosage level. Call your doctor immediately if you experience adverse reactions.

1. Sensitivities to the fillers used in the medications

Author of the book Your Personal Paleo Code: The 3-Step Plan to Lose Weight, Reverse Disease, and Stay Fit and Healthy for Life Chris Kresser at Medicine For The 21st Century wrote a great post 3 Steps To Choosing The Right Thyroid Hormone:

Many popular thyroid medications contain common allergens such as cornstarch, lactose and even gluten. As I explained in a previous post, most hypothyroid patients have sensitivities to gluten, and many of them also react to corn and dairy (which contains lactose).

Synthroid, which is one of the most popular medications prescribed for hypothyroidism, has both cornstarch and lactose as a filler.

Even the natural porcine products like Armour suffer from issues with fillers. In 2008, the manufacturers of Armour reformulated the product, reducing the amount of dextrose & increasing the amount of methylcellulose in the filler. This may explain the explosion of reports by patients on internet forums and in doctor’s offices that the new form of Armour was either “miraculous” or “horrible”. Those that had sensitivities to dextrose were reacting less to the new form, and experiencing better results, while those that had sensitivities to methylcellulose were reacting more, and experiencing worse results.

Thyroid Pharmacist Dr. Izabella Wentz, author of the book Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause wrote this information on her Thyroid Lifestyle Facebook page:

Compounded T4/T3 products offer another alternative. These medications also offer the advantage of being made without fillers such as lactose or gluten, which are present in some thyroid medications and can be problematic for thyroid patients.

However compounded T4/T3 products need to be prepared by a specially trained compounding pharmacist. These compounds are usually much more expensive and may need to be refrigerated to preserve activity.

Thyroid compounds are usually prepared in the same physiological ratio that is found in Armour®, however, physicians can elect to change the amount of T3/T4, as the compounding pharmacists are literally making the medications from scratch. This can be a huge advantage for those patients that did not feel well on conventional treatments or natural desiccated treatments.

2. A gentle start to dosing

My doctor increased my thyroid drug dosage gradually in an incremental fashion until she found the dose that was optimal for me. She adjusted my dosages by regularly monitoring my Free T4, Free T3, Reverse T3 and thyroid antibodies and most importantly by listening to my symptoms. I contrast that with the stories I hear from readers of their adverse reactions to their doctor’s  prescription for sudden large dosage increases and medication brand switches at high doses. T3 drugs such as Cytomel and natural desiccated thyroid have active T3 in them which for some people can be stimulating for the heart and cause heart palpitations. It is critical to have a gentle start.

In the book Thyroid Power: Ten Steps to Total Health, Richard Shames and Karilee Halo Shames wrote:

Some people do not want to take the time to start with a mild dose, adjusting to their medication gradually. However, we have found that the slow, step-by-step method of reaching your optimal dose is more easily tolerated by the body than the “sock it to me” approach so characteristic of our fast-paced culture.

3. The need for T3 treatment

In mainstream medicine, T4 drugs like Synthroid are the gold standard for treatment of hypothyroidism. While these drugs work for some, for many of us these drugs fail to relieve our symptoms. Our bodies need to convert the T4 in these drugs to the active useable thyroid hormone T3. However for many hypothyroidism sufferers, our bodies don’t convert the T4 to T3 and we are left suffering symptoms. If you are on T4 only drugs and you are still not feeling well, speak with your doctor about testing your Free T3 levels to determine if you would benefit from T3 medication.

Many of us report feeling our best on natural desiccated thyroid. However others report not reacting well to NDTs and responding better to synthetic T4 and T3 drugs. Even with natural desiccated thyroid, many of us feel great on one brand but terrible on another. Again we are each unique and it’s about finding what works best for you.

4. Finding your optimal thyroid levels

Many hypothyroidism sufferers are not feeling well despite treatment because their lab results are in the “normal” range but not at the optimal level for them.

Mary Shomon included this great article at About.com Thyroid Disease.

Help, I’m Hypothyroid and I Still Don’t Feel Well

More innovative doctors are beginning to believe that a TSH of around 1 -2 —in the low end of the normal range — is optimal for most people to feel well and avoid having hypothyroid or hyperthyroid symptoms. Similarly, some practitioners feel that optimal hypothyroidism treatment includes Free T4 in the top half of the normal range, and Free T3 in the top 25th percentile of the normal range.

If you are being treated with thyroid hormone replacement medication but you still don’t feel well, insist on further exploration. If you are still not feeling well, get a second opinion, a third opinion, even ten medical opinions until you find a doctor that explores the options to find what’s right for YOU – 30 online resources to find a good thyroid doctor.

Don’t settle.

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About Dana Trentini

Who knew that little butterfly-shaped thyroid gland at the base of my neck could affect my life so completely? I founded Hypothyroid Mom in memory of the unborn baby I lost to hypothyroidism. Winner of two 2014 WEGO Health Activist Awards: Health Activist Hero & Best In Show Twitter. *Hypothyroid Mom includes Affiliate links. Connect with me on Google+

Comments

  1. Hello. I am going to take a chance that my email will not be sold or other wise used inappropriately. I have many health issues, the most major of which is being stuck in a V.A. world of pharmaceutical drug pushing.
    I am a Type 1 IDDM male, and have been since 1983 when being a missile launch crew member caused my pancreas to shut down. I will forgo the nightmarish treatments, or lack thereof or any semblance of what I read as normal health care. For instance, since 1983, I have only been allowed to see two endocrinologists.
    One of the many health issues I face now is that of a thyroid that teeters, causing in my opinion, uncontrolled weight gains, creating such an ugly and awful feeling of my entire body daily, as well as the psychological issues of depression and such.
    I have been on synthroid for the past 10 years or so that have been slightly increased as of late. However, in reading just this article now, I am learning there are many other issues and possible medicinal assistances available. Yes, I have educated myself throughout the years about all the complications surrounding this death sentence I received when my pancreas shut-down, but put way too much faith in V.A. primary care physicians.

    I say this because the V.A., in my opinion, does not go to extra lengths to assist patience and only do what was taught in medical school as a standard of treatment, “catch-all” medicine as I call it.

    I am not a cookie and do not live on a cookie sheet. I am not a number to get past in order to fill some completion sheet. I am tired of feeling like I am dead already and just plodding through life waiting for a dirt nap.

    I do not each much at all these days, and weigh about 232 lbs. A month ago I had lost 35 lbs and began to feel really good, but then for no apparent reason, all the weight is now coming back and no response from my doctor.

    I am unable to eat since according to other doctors, I have a gastro type issue that does not allow for me to digest healthier food at all. My doctor a year ago put me on polyethylene glycol, which according to the literature and Internet is not supposed to be taken more than a few weeks. This has been an on-going issue since I suffer from chronic constipation, bloating, and very uncomfortable heaviness.

    My new doctor told his nurse to call me and inform me I need to drink more water. I already drink over 5 quarts daily. This was his only recommendation and sent me a new prescription for the glycol.

    If you cannot help me, please do not send anything in my email. I do not wish to have ads, joining, or anything as such. I just want and ask for assistance or advice, which I will not ever hold you or other for being responsible for. My treatment these days is more about just what I can do, and asking for help outside of the only treatment I have. I just won’t go back into a V.A. medical facility for any reason.

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