Unresolved Root Causes Can Keep Us Symptomatic
One reason we may not have a 100 percent response to levothyroxine is because levothyroxine does not address the underlying root causes of the condition, which can contribute to other remaining symptoms. Ive written extensively about root causes in other articles, and the importance of not just taking medications but working on our overall health through lifestyle changes and root cause medicine, so to keep this article from being a whole nother book, Ill focus on the pharmacology related issues.
If My Tsh Level Is High Should My Synthroid Dose Be Increased Or Decreased
Usually, if your TSH level is high, your Synthroid dose needs to be increased. TSH, which stands for thyroid stimulating hormone, is made when your body needs more thyroid hormones.
When you have an elevated TSH level, your dose of Synthroid may need to be increased. On the other hand, if your TSH level is low, your dose of Synthroid may need to be decreased.
During Synthroid treatment, your doctor will order blood tests to check your TSH level. And for some people, their doctor will also check the levels of their thyroid hormones, T3 and T4. Based on the results of your blood tests, your doctor will adjust your dosage of Synthroid if needed.
If you have questions about whether your dosage needs adjusted, talk with your doctor.
Taking Synthroid With Food
You should take Synthroid on an empty stomach without food. If you do eat something, and you forget to take Synthroid, call your doctor or pharmacist. Theyll recommend how long youll need to wait after eating before you take Synthroid. This length of time may depend on the type of food you ate and whether you took any other medications.
You may need to wait 4 hours to take your Synthroid after eating. This is sometimes the case so that Synthroid doesnt interact with foods or other medications in your body.
If you have questions about when to take Synthroid around meals, talk with your doctor or pharmacist.
Don’t Miss: What Doctor Do You See For Thyroid Issues
Switching Between Synthroid And Its Generic Versions
Its important to note that Synthroid and generic levothyroxine may each have different effects on your thyroid hormone levels. Because of this, its recommended by the American Thyroid Association and other organizations that you not switch between them. You should keep taking whichever medication you initially start taking.
For example, if you start taking brand-name Synthroid, you should continue to use brand-name Synthroid. If you must switch from the brand-name drug to a generic form, or vice versa, its recommended that you have a blood test 6 weeks after making the switch. This testing is done to be sure that your thyroid hormone levels stay within a normal range.
Even if you switch between different generic forms of levothyroxine that have different manufacturers, its still recommended that you have your thyroid levels tested 6 weeks later.
In some cases, brand-name Synthroid and its generic versions may come in different forms and strengths.
Be sure to talk with your doctor before switching to or from brand-name Synthroid.
Fda Warning: Not For Use To Treat Obesity Or As A Weight Loss Aid
This drug has a boxed warning . This is the most serious warning from the Food and Drug Administration . A boxed warning alerts doctors and patients about drug effects that may be dangerous.
Synthroid shouldnt be used to treat obesity or to help with weight loss. If your thyroid function is normal, Synthroid wont help you lose weight. In fact, using the drug at typical dosages in people without certain thyroid problems wont lead to weight loss. And using doses larger than those recommended by the manufacturer may cause serious side effects. These side effects can include confusion, seizures, coma, and even death.
In addition, taking Synthroid along with drugs used for weight loss may cause very serious or even life threatening side effects.
Because of these possible risks, Synthroid should only be taken as prescribed by your doctor.
Some Patients Feel T4 Medications Often Result In Inadequate Treatment
While many people do very well on T4-containing medications once they are dosed appropriately and stabilized, a 2019 review of the research found that many people taking T4 medications simply arent happy with their results, and that more than a third of patients remain inadequately treated despite levothyroxine therapy. In particular, 5-10 percent of people taking T4 replacement even if they normalize their TSH level are found to have impaired psychological well-being, anxiety, or depression.
As a pharmacist, I would ask the following questions in this situation.
Medications Interfere With Conversion Of T4 To T3
Some drugs practically put a STOP sign in front of T4 and prevent its conversion to T3 which is biologically active. Among the most common offenders:
About Dana Trentini
Dana Trentini founded Hypothyroid Mom October 2012 in memory of the unborn baby she lost to hypothyroidism. Hypothyroid Mom LLC is for informational purposes only and should not be considered a substitute for consulting your physician regarding medical advice pertaining to your health. To keep the website up and running, Hypothyroid Mom LLC includes sponsored guest posts and affiliate links including the Amazon Services LLC Associates Program and Get Healthy by Healthy Life Enterprises, Inc. These statements have not been evaluated by the Food and Drug Administration.
Also Check: How Fatal Is Thyroid Cancer
Tirosint Levothyroxine Gel Caps
Description: Tirosint is a newer thyroid medication that is a hypo-allergenic version of levothyroxine. I recently wrote an entire article focused on Tirosint. In my survey, 26 percent of respondents said they felt better taking Tirosint. Out of those that switched to Tirosint gel caps , 68 percent saw an improvement in their labs, 62 percent saw an improvement in energy levels, 32 percent an improvement in hair loss, and 50 percent saw an improvement in mood.
Because of how quickly and consistently Tirosint is absorbed, it has also been found to be a better option for people who have certain gastrointestinal challenges , who are taking antacids/acid blockers/PPIs, or who are otherwise experiencing low stomach acid.
Dose: Tirosint gel caps are available in 12 different dosage strengths, ranging from a 13 mcg dose to a 200 mcg dose. Because this medication is more readily absorbed than other forms of levothyroxine, some people may find that they require a smaller dosage of Tirosint to keep thyroid hormones within optimal range.
Just like with all T4 medications, the effectiveness of Tirosint may be impacted if a given individual is experiencing poor T4/T3 conversion. Here are some additional things to consider:
Does Armour Cause Problems For Older People
Q. Ive read your articles on Armour Thyroid and asked my doctor to change my Synthroid prescription to Armour. He responded that he doesnt like to prescribe Armour Thyroid to patients over 65. Why do you suppose that is?
A. We dont know for sure, but we suspect some doctors worry about cardiovascular complications . Excess thyroid hormone could cause heart palpitations or arrhythmias. Although it is not clear that desiccated thyroid extract results in higher doses of T4 or T3, physicians may fear that they cant control the dose properly.
Also Check: Bioidentical Thyroid Hormone Replacement Therapy
How It Works For Tsh Suppression
TSH stimulates your thyroid to make more thyroid hormones. In addition, TSH is responsible for cell growth in your thyroid gland. This includes growth of both healthy cells and cancerous cells in the gland.
Normally, when your thyroid hormone levels are low, your body makes TSH. This signals your thyroid to make more thyroid hormones. However, if youre taking Synthroid, your thyroid hormone levels wont be low. So your body wont need to make TSH, and your TSH level will be lower than usual.
Which Is Better For Weight Loss
Is one of these medications superior to the other when it comes to weight loss?
The answer is yes!
#4. Follow me on , TikTok, and for up-to-date thyroid tips, tricks, videos, and more.
Hey There! I’m Dr. Westin Childs. Welcome to my website! This resource is dedicated to helping people with thyroid problems, hormone imbalances, and weight loss problems get the help that they need.
I am a former Doctor of Osteopathic Medicine that now focuses on producing the information you see here while also formulating some of the best supplements on the market 🙂
Want to know why I’m so passionate about these topics? Check out my own personal health story.
Read Also: How Do I Know If I Have Thyroid Cancer
What Is Hypothyroidism And How Is It Treated
Armour Thyroid and Synthroid are medications used to treat hypothyroidism.
In this condition, the thyroid gland is underactive, meaning insufficient amounts of thyroid hormones are produced.
Three main hormones are measured to determine if the thyroid is functioning properly: thyroid stimulating hormone , Thyroxine and, in certain circumstances, triiodothyronine .
Its important to remember that the thyroid gland produces mainly T4, even though the active hormone is T3. An enzyme in the body converts T4 into T3 when needed.
Currently, there is no cure for hypothyroidism and, in most cases, medication will need to be taken for life.
Synthroid For Tsh Suppression In People With A Certain Type Of Thyroid Cancer
Synthroid is approved for use in people with thyrotropin-dependent well-differentiated thyroid cancer. For this condition, Synthroid is used to suppress your levels of a hormone called thyroid stimulating hormone . When given as part of thyroid cancer treatment, Synthroid is used along with radioactive iodine treatment and surgery.
For more details on using Synthroid for this type of thyroid cancer, see the Synthroid uses section below.
Read Also: How To Regrow Hair Loss From Thyroid
Dosage Or Drug Quality Issues
You could take too much levothyroxine because you are taking the wrong dose.
- Your healthcare provider may prescribe a dosage that is too high for you.
- Your pharmacist may give you the wrong dosage or incorrect instructions for use.
It is also possible that the quality of your medication may change from one refill of your prescription to another. This is sometimes the case when your medication is produced by several different manufacturers.
If you are taking generic levothyroxine, you may receive a batch of medication that is more potent or less potent than your previous refill. Even a slight change of potency from one refill to the next can lead to over or under medication and symptoms of hyper or hypothyroidism.
Switching formulations of levothyroxinefor example, from tablet to gel caps or liquidcan also cause overmedication because your body absorbs some formulations of levothyroxine better than others.
For example, Tirosint liquid gel caps and Tirosint-SOL liquid levothyroxine are absorbed better than levothyroxine in tablet form. You might be prescribed gel-cap or liquid levothyroxine if you are allergic to dyes or fillers, but making the switch could result in overmedication.
This is why close monitoring is important. You should get your TSH level checked within six weeks of beginning thyroid hormone replacement or after changing the brand, formulation, or dose of your medication.
When To See A Healthcare Provider
Contact your healthcare provider if you’re experiencing symptoms of too much levothyroxine. They can do tests to check your thyroid levels and figure out if youre being overmedicated.
If your provider determines that you are taking too much levothyroxine, they will reassess your treatment plan. They might advise you to change your diet if it’s contributing to thyroid overmedication. Your provider might also change your medication or adjust your dose.
Don’t Miss: Does Thyroid Cancer Have Stages
What To Do In Case Of Overdose
If you think youve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away. Dont try to treat the overdose yourself.
Synthroid And Birth Control
In most cases, youll continue to take Synthroid during pregnancy if you were using the drug before becoming pregnant.
However, if youre sexually active and you or your partner can become pregnant, its still important to talk with your doctor about your birth control needs. Theyll recommend whether you need to use birth control while youre taking Synthroid.
Its important to note that Synthroid may interact with certain birth control drugs. For more information about birth control drugs that may interact with Synthroid, see the Synthroid interactions section above.
Recommended Reading: Image Of Thyroid Eye Disease
How Does Synthroid Relate To T3 And T4
Synthroid is a man-made form of the natural thyroid hormone called T4. But your thyroid actually makes two main hormones: T3 and T4.
If your body doesnt make enough thyroid hormones, your doctor may prescribe Synthroid for you. In this case, Synthroid is used to replace your natural T4. Then, your body uses T4 to make T3.
Taking Synthroid can help bring your thyroid hormones to healthy levels. And the drug helps to regulate your metabolism . Your metabolism affects everything from your digestion to your bodys growth and repair to even your temperature.
Potency And Ingredient Inconsistency With Generic T4 Versions
While generic availability is a positive thing because it reduces the cost of most medications, with medications that have a narrow therapeutic index, like thyroid hormones, generic versions open up the door for inconsistent thyroid hormone levels with every refill.
This is because the dosages and fillers may vary ever so slightly between each manufacturer. Different pharmacies may dispense different manufacturers, and even the same pharmacy may switch between manufacturers from month to month. For patients taking generic thyroid hormones, its important to note the name of the manufacturer as well as request that their refills be filled with that particular manufacturers version of levothyroxine. While most pharmacists and physicians actually recommend keeping on T4 hormones made by the same manufacturers , this doesnt always happen in the real world.
Generic prescriptions suffer from a potential potency and ingredient inconsistency issue as a result of having multiple manufacturers providing the drug to the same pharmacy. The U.S. Food and Drug Administration requires the potency of all thyroid hormone medications to fall within a range of 95 to 105 percent, but different manufacturers can pick what potency within that range they will provide. Different makers also include different fillers.
How to Overcome:
Don’t Miss: Signs You Have Thyroid Cancer
Synthroid Levoxyl Unithroid Tirosint Or Other Brand Names
Levothyroxine is available under different brand names, including Synthroid, Levoxyl, Unithroid, and Tirosint. The brand-name versions of levothyroxine are FDA approved to treat hypothyroidism and provide TSH suppression for euthyroid goiters, thyroid cancer, and other thyroid problems. These brand-name medications contain the same ingredients as generic levothyroxine, and they are levothyroxine alternatives that are safe and effective when taken as prescribed. Tirosint differs from other brand names of levothyroxine in that it comes as a liquid gel capsule with no color additives or fillers.
Natural Alternatives To Synthroid
You may wonder if there are natural treatment options for certain thyroid problems that Synthroid is used to treat. Its important to note that there are no proven natural alternatives to Synthroid. If your doctor prescribes Synthroid for you, you shouldnt substitute a natural alternative without first discussing it with your doctor.
But if you want to explore natural options, we describe below some approaches that may or may not help to improve your thyroid health:
- Gluten-free diet. Sometimes thyroid function may be affected by factors you can control, such as your diet and nutrition intake. In one
- symptoms of your thyroid condition. However, there currently arent any studies that show that vitamin D is an effective treatment for thyroid disorders.
If you have questions about using natural treatment options for a thyroid condition, talk with your doctor. They can recommend a treatment plan thats right for you.
You may wonder how Synthroid compares with other medications that are prescribed for similar uses. Here we look at how Synthroid and levothyroxine are alike and different.
Recommended Reading: Side Effects Of Thyroid Meds
Better Evaluation More Data Needed
Pessah-Pollack pointed out that the study data don’t address whether patients’ initially prescribed levothyroxine doses were optimal, and noted that sometimes changes are needed, such as during pregnancy, following weight gain, or if the patient is taking other certain medications.
“It’s unclear from patient-reported symptoms whether or not they actually had an evaluation of their thyroid levels to ensure that their dose of thyroid hormone was correct before switching over to T4/T3 replacement…There are many factors that need to be taken into account before we decide that the medication itself isn’t working.”
What’s sorely needed, she said, are “well-designed, blinded studies that look at this controversy.”
“Here, we don’t know why patients are feeling better…We need to do additional work including validated symptom questionnaires and comparing thyroid levels of patients who are on Armour thyroid with those on levothyroxine monotherapy.”
Toloza agrees: “It is not possible to say that DTE is working better for the user due to the limitations and the nature of the data used in our study.”
“However, our findings are in-line with previously published research, which has shown that a subset of patients may prefer DTE to levothyroxine and have higher satisfaction with this treatment. Nevertheless, the reason behind this is still not well understood,” and it should be further investigated.
Medicina. Published online April 3, 2020. Abstract
Send comments and news tips to .