Underactive Thyroid And Pregnancy
It’s important for the health of you and your baby that an underactive thyroid is treated properly before you become pregnant.
Tell a GP if you’re pregnant or trying to become pregnant and you have hypothyroidism. They may refer you to a specialist for treatment and monitoring during your pregnancy.
Page last reviewed: 10 May 2021 Next review due: 10 May 2024
Levothyroxine Alternatives: What Can I Take Instead Of Levothyroxine
Top levothyroxine alternatives | Comparison | Armour Thyroid | Cytomel | Thyrolar | Synthroid | Levoxyl | Natural alternatives | How to switch meds
Levothyroxine is a generic thyroid hormone medication used to treat an underactive thyroid . It is also approved for thyroid-stimulating hormone suppression, which aids in treating certain types of goiters and thyroid cancer. Levothyroxine can be used along with surgery and radioiodine therapy to manage thyrotropin-dependent thyroid cancer. While levothyroxine is a commonly prescribed thyroid hormone medication, some people prefer to use an alternative thyroid medication.
You may have an allergy to the ingredients in levothyroxine or you may find that levothyroxine is just not working for you. If you and your healthcare provider have decided levothyroxine is not right for you, you may be recommended a levothyroxine alternative, such as Armour Thyroid. You should not use an alternative medication without consulting your healthcare provider first.
Continue reading to learn more about levothyroxine alternatives, their possible side effects, and other important information.
Natural Desiccated Thyroid Vs Glandular Supplements
Understandably, it is easy to feel confused about the difference between thyroid glandular supplements and natural desiccated thyroid . NDT is a prescription thyroid medication that contains active thyroid hormones from pigs. Over-the-counter thyroid glandulars contain thyroid glands from animals but do not contain active thyroid hormonesâ or, at least, they shouldn’t.
Manufacturers of thyroid glandulars may accidentally include active thyroid hormones in their over-the-counter supplements. This inclusion of active thyroid hormones can be dangerous as dosing thyroid hormone should be very specific and done by a doctor.
Natural desiccated thyroid derives from the dried thyroid glands of pigs. It provides T3, T4, and other thyroid hormones found in the human thyroid. Pigs produce T4 to T3 at a 4:1 ratio, which is higher than the human proportion of 14:1.
Desiccated animal thyroid was the most common form of thyroid therapy before researchers discovered the individual active thyroid hormones. Some people still prefer to use NDT if they have used it for years or find it is more effective than T4-only medication.
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Switching From Levothyroxine To Armour Thyroid
Armour Thyroid contains desiccated thyroid with a strength measured in grains. Levothyroxine is measured in micrograms . Therefore, the dose of levothyroxine needs to be converted to an appropriate dose of Armour Thyroid. One grain of Armour Thyroid is equal to 100 mcg of levothyroxine.
The following conversions may be used when switching from levothyroxine to Armour Thyroid:
Vitamin B Is Important For Thyroid Function
Vitamin B is important for people with hypothyroidism because the B vitamins have many interactions with thyroid function and hormone regulation, Metzak says. Its best to take a nutritional supplement that includes the entire vitamin B complex, and you may need additional vitamin B12 if a blood test reveals your levels are low, she says. Good food sources of vitamin B include whole grains, legumes, nuts, milk, yogurt, meat, fish, eggs, seeds, and dark leafy greens.
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Potential Problems With Using Thyroid Glandulars
Before you run out and take a thyroid glandular supplement, there are a few things you should know.
In a 2014 study , researchers took a look at 10 thyroid support supplements 5 of which claimed to contain animal thyroid tissue and 5 of which claimed to contain only herbs.
- 9 out of the 10 supplements tested contained varying concentrations of T4 and T3 thyroid hormones.
- 4 out of the 9 supplements contained a total dose of 10mcg per serving.
- 5 products contained detectable amounts of both T4 and T3.
- 1 product contained levels of T4 and T3 hormones restricted to prescription medications .
- All of the herb-based supplements tested positive for T3.
- 2 of the 5 herb supplements tested positive for T4 between 17 and 91mcg per serving.
For perspective, most of these doses are not that high.
For instance, a dose of 5mcg of T3 would be considered a baby dose of Cytomel or liothyronine.
A dose of 25mcg of T4 would also be considered a very low dose of levothyroxine or Synthroid.
The primary issue is those thyroid patients taking these supplements would have no idea that they were taking active thyroid hormones!
In addition, because these ingredients are not being tested for, there is most likely wild variability in T4 and T3 concentrations between lots.
In other words, the same supplement might have some T4 and T3 this time but zero the next time.
Whether the manufacturers leave in the hormone intentionally or not is not known but the point is that many of them may have it.
Vitamin D Improves Tsh Levels
Research has shown a strong association with vitamin D deficiency and people with hypothyroidism, Metzak says. In a study published in the November 2013 issue of the International Journal of Health Sciences, researchers looked at the vitamin D levels of 30 people with hypothyroidism and 30 who didn’t have the condition and found that the vitamin D levels were significantly lower in those with hypothyroidism. A study published in 2018 in the Indian Journal of Endocrinology and Metabolism found that vitamin D supplements improved TSH levels in subjects with hypothyroidism as well as thyroid antibodies in people with autoimmune thyroiditis. You can get vitamin D from fortified milk, yogurt, and orange juice. Food are often not adequate, however, Kellman says. He recommends supplements for those who are vitamin D deficient. Your doctor can let you know if thats necessary, and which dosage is best for you.
As with any chronic condition, a healthy diet can go a long way with hypothyroidism. Eat an anti-inflammatory diet full of lots of fruits and vegetables and unprocessed foods, and limit sugar, Londergan says.
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They Can Contain Iodine
We need only 150 mcg of iodine per day in our diet, according to the Institute of Medicine. That tiny amount of iodine enables the thyroid to manufacture just the right amount of the thyroid hormone thyroxine, Lipman says.
But ingesting excess iodine can cause health problems. It is particularly worrisome for people with thyroid nodulesbumps on the thyroid glands that can be very small and often go unnoticed. If you have a nodular thyroidand chances are that 50 percent of us will develop one or more nodules by the time were 60even a slight excess of iodine can cause your thyroid to go into overdrive and produce excess thyroxine, Lipman says. An overactive thyroid can cause sudden weight loss, a rapid or irregular heartbeat, sweating, and nervousness or irritability.
Conversely, studies also show that too much iodine can cause the thyroid to slow down or even stop producing hormones in certain peoplethe opposite effect of what many people hope these supplements will do for them. That can result in weight gain and fatigue, and can increase your risk of cardiovascular disease, Lipman says.
Yet many supplements contain more than 150 mcg of iodine. For example, both Enzymatic Therapys Metabolic Advantage and Whole Foods Thyroid Complete contain 200 mcg per two-capsule serving. Follow the recommendation on the labels and swallow two capsules three times a day and youve ingested 600 mcg of iodineenough to cause health problems in certain people if taken long term.
Common Thyroid Supplement Myths That Need To Be Debunked
Myth #1. Thyroid supplements contain thyroid hormones.
One of the more frustrating myths stated about thyroid supplements is that they contain thyroid hormones.
And while this myth has some truth to it, its not a common occurrence and its something that is actually illegal in the United States.
This concern stems from a study that was done years ago which tested very low-quality supplements from big box stores that showed some of these supplements do contain small amounts of thyroid hormones.
But this study was done years ago and it was done on low-quality supplements that were not third-party tested or manufactured in GMP compliant facilities.
It simply isnt fair to take an isolated study and claim that all thyroid supplements are harmful just because there are a few bad supplement companies out there.
I should also point out that it is illegal to include active thyroid hormones such as T3 and T4 into thyroid supplement formulations.
So anyone caught doing this would be in big trouble with the FDA.
By law, thyroid supplements can NOT contain active thyroid hormones because they would no longer be considered thyroid supplements at that point, they would instead be classified as thyroid medications that require FDA approval.
Do not fall for the lie that ALL thyroid supplements contain active thyroid hormones because its simply not true.
Myth #2. Thyroid supplements contain iodine.
Thats pretty much the only response I have to this statement.
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Desiccated Porcine Thyroid Medication
Desiccated animal thyroid extract was an early way to treat hypothyroidism.
This is a powder for medical use. It is also a combination of T3 and T4 hormones.
Common brands of this NDT include:
- Acella NP Thyroid
This type of levothyroxine alternative contains a higher concentration of the T3 to T4 ratio. Therefore, taking too much can lead to excessive thyroid hormone production.
Tips For When You Start Taking Ndt
When you’re starting or taking NDT, here are a few guidelines to keep in mind:
- Take your NDT in the morning with a glass of water, ideally on an empty stomach, at least 30 to 60 minutes before eating breakfast.
- Wait at least an hour after taking your NDT before drinking coffee or milk, because both beverages can negatively affect absorption.
- NDT absorption can also be affected by antacids that include calcium, aluminum hydroxide, magnesium, iron and calcium supplements, multivitamins containing iron or calcium, and beverages like calcium-fortified juices. Take NDT four hours before or after these medications, supplements, or drinks.
Also, keep in mind that because the T3 in NDT peaks rapidly in the bloodstream, some patients enjoy the best results with a split or divided dosage, taking some NDT in the morning and the rest in the afternoon or evening.
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When To Take Levothyroxine:
Although it is often recommended that levothyroxine be taken on an empty stomach about 30 to 60 minutes before breakfast, and, as noted above, at least 60 minutes before drinking coffee, some people find it difficult to consistently take this medication in the morning. Interestingly, some studies have shown that taking levothyroxine in the evening can be just as effective in controlling hypothyroidism as taking it in the morning, and in some cases, may even improve absorption 2020 Mello, Front Med 2022), although people who wish to try this should still consult with their physician before making this change. The American Thyroid Association’s guidelines state that levothyroxine can be taken at bedtime as an alternative to taking it in the morning, and that doing this can achieve optimal, consistent absorption.
Although some people have raised concerns that taking levothyroxine at night could cause or worsen insomnia, this does not appear to be reported as a side effect in clinical trials in which the drug is taken at night. In addition, insomnia associated with use of levothyroxine taken in the morning occurs primarily when taken at a higher dose than needed . It’s also worth noting that hypothyroidism itself has been linked to difficulty sleeping in some research, possibly due to symptoms such as muscle pain and cold intolerance interfering with sleep, and other clinical symptoms, such fatigue, often improve with treatment.
What Is Natural Desiccated Thyroid
NDT â also referred to as desiccated thyroid extract or “porcine thyroid” â is a thyroid hormone replacement medication in continuous use since the early 1900s. It was the first treatment for hypothyroidism and the only available treatment for the first half of the twentieth century.
Levothyroxine is a synthetic version of just one thyroid hormone â thyroxine . NDT â a natural drug made from the dried thyroid glands of pigs â includes not only T4 but the active thyroid hormone, T3.
There are four brands of natural desiccated thyroid currently available in the United States by prescription, including:
- ArmourÂ® Thyroid, manufactured by AbbVie
- Nature-ThroidÂ®, manufactured by RLC Labs
- WP ThyroidÂ®, manufactured by RLC Labs
- NP ThyroidÂ®, manufactured by Acella
The FDA also designates NP ThyroidÂ® as a “generic” equivalent to ArmourÂ® Thyroid.
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Thyroid Hormone Production Support Vs Thyroid Function Support
You should understand that there is a difference between supporting your thyroid and supporting thyroid function.
Most thyroid support supplements focus on helping your thyroid gland PRODUCE more thyroid hormone.
They do this by including ingredients that you can consider the building blocks of thyroid hormone.
Things like tyrosine and iodine fall into this category.
Your thyroid gland does need these ingredients to produce thyroid hormone which is why they are included in thyroid support supplements.
But if you dont have a thyroid then these specific ingredients are meaningless to you!
Your thyroid gland is no longer in your body which means it can no longer produce thyroid hormone.
And you are getting all of your thyroid hormones directly from medication that does not require these ingredients.
So remember this distinction
You dont need thyroid support supplements that help produce thyroid hormones.
Instead, you need thyroid support supplements that help support thyroid conversion and help your medication do its job.
And this is exactly what we are going to be talking about.
Natural Vs Synthetic Treatments
There are both natural and synthetic options to balance the thyroid. We typically recommend natural thyroid supplements as part of an integrative approach to health, rather than starting with prescription medications.
The term synthetic thyroid treatments typically refers to levothyroxine synthesized T4 that looks and acts like the T4 made in your thyroid gland. To avoid confusion, know that levothyroxine is a thyroid medication, though some incorrectly call it a synthetic thyroid supplement.
What is the difference between natural and synthetic thyroid treatments? Synthetic thyroid treatments are man-made and must be prescribed by a doctor. Natural supplements are found in nature and may be taken without the advice of a physician .
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Bacopa Monnieri For Hypothyroidism
Bacopa monnieri, also called brahmi, is another traditional Ayurvedic herb used to treat low thyroid. Animal studies have found that Bacopa increased thyroid hormone production by as much as 41 percent when taken daily. In this study, mice were given a 200 mg dose of the herb. Bacopa is often used in combination with other herbs. For some people, Bacopa may cause side effects including nausea and diarrhea. T-Balance Plus, our exclusive formula for low thyroid support contains Bacopa, Coleus, along with other beneficial nutrients.
Natural Alternatives To Levothyroxine
The natural alternative to levothyroxine is a natural desiccated thyroid extract from animal sources. Armour Thyroid contains a natural form of thyroid hormone that comes directly from the thyroid gland of pigs. Certain vitamins and supplements are natural options that may help manage hypothyroidism. A healthy lifestyle that includes the right diet can also help support the thyroid gland and healthy thyroid hormone levels.
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Coleus Forskohlii For Hypothyroidism
Coleus forskohlii is a plant native to India used in traditional Ayurvedic medicine to treat various diseases including underactive thyroid. Studies about the herb are encouraging. In the body, Coleus forskohlii acts as an adaptogen by encouraging production of T4 and T3 thyroid hormones when levels are too low. Coleus forskohlii also helps to increase basal metabolism, helping the body to burn more calories by increasing lipolysis. This is a significant benefit for women experiencing low thyroid weight gain.
Naturopathic doctors generally recommend between 100-200mg a day of Coleus forskohlii when low thyroid symptoms appear. Coleus forskohlii is often used in combination with other helpful herbs and vitamins/minerals.
How To Use Thyroid Glandulars
Ready to try thyroid glandulars? Heres what you need to know:
To get the most benefit, I recommend using between 150 and 600mg of Thyroid gland powder.
The thyroid glandular ingredient may be called something slightly different on the back of your supplement but look for something that contains those words.
Heres an example of what it might look like:
In this picture, you can see that each serving contains 150mg of thyroid gland powder.
It even outlines the source of the glandulars which is from New Zealand or Argentina.
Youll want to start out with 150-200mg of thyroid gland powder and see how you do over the course of a couple of weeks.
When you start, pay close attention to how you are feeling, especially your thyroid symptoms.
If you are feeling improvement but not quite getting to where you want to be then you can slowly increase your dose by 150-200mg increments every few weeks up to a total dose of 600mg.
On the other hand, if you find that you are on the sensitive side then dont be afraid to stay at lower doses.
If youd like to get started on a thyroid glandular support supplement then look at one like this which meets all of the safety criteria listed above, comes from the right source, and comes in intervals that are easy for adjusting your dose as necessary.
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