Some individuals are walking around with low levels of thyroid hormone (hypothyroidism). They’re surviving with fatigue, sensitivity to cold, constipation, dry skin, weight gain, hoarseness, weakness, high cholesterol, muscle aches, tenderness, stiffness, pain, swelling of joints, thinning hair, depression, impaired memory, and more.
They know they aren’t healthy, but the standard methods for measuring low thyroid activity tell their doctors just the opposite. The TSH test (Thyroid-Stimulating Hormone) evaluates thyroid function by measuring how much TSH is in the blood. Elevated TSH is suggestive of underactive thyroid and lower levels point to normal, or overactive thyroid activity.
In decades past, the standard treatment for low thyroid was a prescription for desiccated porcine (pig) thyroid (Trade Name: Armour Thyroid, Naturthroid,). More recently, the go to prescription for low thyroid is Levothyroxine (Trade Name Synthroid, aka T4).
Daily doses of T4 will cause TSH levels to decline into the normal range, suggesting to today’s health practitioners that the problem is fixed. Many patients will disagree. They still have the symptoms of low thyroid – and might even feel worse on the new prescription for Levothyroxine (T4).
What good is it to know you have normal TSH values if you still feel bad? What does it mean, to feel bad? As per modern medical wisdom about low thyroid, patients: “Ought to learn to live with the symptoms.” Is that truly the best answer? Heck, No.
A better approach might be to work with a health provider who can help find and correct the underlying causes of low thyroid by prescribing a treatment plan that focuses on hormone replacement. Find a prescriber whose basic approach to a health problem such as low thyroid is to discover the root causes and fix them. Osteopathic doctors approach health this way.
In recent years, there have been repeated problems obtaining quality natural glands that meet regulatory guidelines. How would someone treat low thyroid when the traditional desiccated thyroid products aren‘t available? An alternative to porcine thyroid extract would be two different bioidentical thyroid hormones. T4 (levothyroxine or Synthroid) and T3 (liothyronine or Cytomel) can be prescribed one to three times daily – as two prescriptions and as a single compounded capsule.
How will a doctor know what dose of bioidentical thyroid hormones the patient needs? It can be tricky and might take a little time to find, and a good compounding pharmacist can help. If the doctor already has been prescribing desiccated thyroid, the beginning amounts of T3 and T4 are known. For example, the one-grain thyroid pill delivers 9 mcg of T3 and 38 mcg of T4. The compounding pharmacist can follow the doctor’s prescription with those values or adjust either/both of those two ingredients to meet the patient’s needs.
If the patient has not been using desiccated thyroid, bioidentical thyroid is still an option. Beginning with a low dose (equivalent to a quarter grain of the natural thyroid product, for example (2.25 mcg T3 and 9.5 mcg T4)) and adjusting up every 30 to 60 days, until there are improvements in symptoms and the patient is satisfied.
Prescribers may want to start with T3 and T4 doses comparable to the common thyroid extract products. The beauty of a compounded preparation is that there is no need to always adhere to the average ratios in natural desiccated thyroid products. The doctor can prescribe more T3 or less T4 with each refill. The pharmacist knows how to compound the perfect formula.
Both T3 (Liothyronine) and T4 (Levothyroxine) are available to the compounding pharmacist as pure bio-identical hormone products, meaning they are identical in every way to the active thyroid hormones naturally made in the human body.
Any traditional medicines that have worked ought to be regularly evaluated in light unexpected problems, or new knowledge. There was a time when dried thyroid glands were the best option because that’s all we had. Today, medicine can do a better job, if we allow it.
Larry Frieders is a pharmacist in Aurora who had a book published, The Undruggist: Book One, A Tale of Modern Apothecary and Wellness. He can be reached at thecompounder.com/ask-larry or www.facebook.com/thecompounder.