Is this you?
You’re using Weight Watchers and exercising, tracking all of your food, now mostly just eating chicken, fruits, fish, and vegetables. You’ve been taking Levothyroxine (Synthroid) for years. Your thyroid levels are fine. Yet, you wear a Winter coat in the house and you’re still cold, and you can’t lose weight no matter what else you try?
Low thyroid function is often one of the root causes of weight gain (among other symptoms). The standard treatment for low thyroid had been “Armour Thyroid” for decades. It was made from actual animal thyroids that were dried (desiccated) and made into tablets.
Synthroid (levothyroxine, T4) came on the market in 1955 and by the mid-1970s had made a big dent in the Armour Thyroid market. Patients were switched from the real thyroid pills to levothyroxine.
In the early 1980s, our pharmacy had large bottles of desiccated thyroid on the shelves and customers regularly ordered their refills.
Synthroid patients weren’t as loyal to their prescriptions and many of them quit taking the pills. Why?
The answers were varied, but generally, they seemed to make the person feel worse.
T4 is but one of the thyroid hormones, and it isn’t the active one. It needs to be converted to T3 (Liothyronine) in the body. Those who have a diminished ability to convert T4 to T3 receive little to no benefit from taking T4 alone. When low doses of T4 have failed, prescribers are often inclined to increase the doses, which often led to more unfavorable side effects (excitability, sleep loss). Using T4 only may not be the best treatment for those with low thyroid function.
Some doctors returned to using desiccated thyroid, but then the manufacturers had difficulties with the FDA. The products were removed from the market and reformulated. Levothyroxine gained more prescribers again because it was the only available thyroid treatment, even though it still failed for many users. Compounding pharmacists obtained pure desiccated thyroid powder and filled in for the missing commercial products. Then, after a few years, even the dried thyroid powders became scarce.
Compounders can now make capsules of both thyroid hormones (T4 and T3) in specific combinations that mimic the doses in the original Armour Thyroid. Additionally, trained compounding pharmacists can prepare any reasonable combination prescribed and they are not limited to just duplicating the concentrations in Armour Thyroid (one grain, two grain, and on up). Prescribing doctors are free to tweak formulas to achieve the best results for each of their patients.
Food can trigger thyroid problems by causing inflammation. Some of the more toxic substances are sugar, artificial sweeteners, grains, alcohol, wheat (not because of gluten), and processed foods, especially processed foods deep-fried in vegetable oils. Fruit and vegetables seem like healthy foods but they provide many sugars. Some veggies aren’t veggies at all. Corn, for example, is a grain and delivers a lot of sugar.
Those who use Levothyroxine alone ought to understand that it will help the body achieve normal Thyroid Stimulating Hormone (TSH) levels, which long has been the gold standard for evaluating thyroid function. It became popular before technology allowed for the direct measurement of thyroid hormones (Levothyroxine and Liothyronine).
While TSH is still a helpful guide, it shouldn’t be depended upon alone to assess thyroid health.
Suggestions? Talk to your prescriber about using a combination thyroid medicine (T4 and T3) instead of T4 alone. That can improve the overall thyroid situation, which in itself might be associated with weight gain. Diet is important. Avoid the foods that cause inflammation. So is water and daily exercise, along with the correct thyroid prescription.
Nobody should be forced to be uncomfortable all of the time. It takes effort to find a doctor who understands thyroid function and doesn’t believe that Levothyroxine is the best answer. The search is worth it, though.
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.