Treatment for thyroid not working: some options
Are you currently taking conventional thyroid medication, but still have symptoms of an underactive thyroid? You may feel like your treatment for thyroid is not working.
If you have medically proven Hashimoto’s Hypothyroidism and take prescribed Thyroxine (T4) such as Oroxine or Eutroxsig, but still suffer some of your original hypothyroid symptoms such as:
- fatigue
- brain fog
- hair loss or thinning
- heavy or irregular periods
- dry skin
- fluid retention
- constipation
- weight gain
- depression
- cold peripheries
- memory impairment
- muscle aches
- irregular heart beat
- high cholesterol
There may be an alternative that alleviates these symptoms.
Integrative and functional medicine doctors can prescribe Natural Desiccated Thyroid (NDT) for patients with proven hypothyroidism who do not feel better when taking thyroxine (T4) alone.
What is Natural Desiccated Thyroid extract (NDT)?
Thyroid extract of porcine origin has been used successfully since 1884. Thyroid extract contains the same hormones that your own thyroid would produce-T4, T3, T2, T1, calcitonin and other enzymes, and that is why some people find that natural thyroid extract works better than synthetic thyroxine (T4) alone. NDT meets the stringent guidelines of the US Pharmacopoeia and is approved by the FDA.
One grain of thyroid extract (65 mg) contains 38mcg levothyroxine (T4) and 9mcg liothyronine (T3). The dosage of NDT is adjusted according to your symptoms and blood test results. It is supplied on prescription by holistic doctors such as myself from compounding pharmacies and is not sold by conventional pharmacies.
Who Is Likely To Feel Better with NDT?
People most likely to feel better with NDT have blood tests showing levels of T4 that are in the middle or upper part of the range, but the level of T3 is in the lower part of the normal range. This means that your body is having trouble converting T4 to T3. Common reasons for this include stress, poor adrenal function with either low or high cortisol, iron deficiency, gut dysfunction and toxic metals such as mercury blocking enzyme pathways. The main image for this blog post is an example of someone with healthy levels of T4, but low levels of T3:
T3 Is More Active Than T4
T3 is much more biologically active than T4, so a relative lack of T3 can make a big difference to your wellbeing. Although the thyroid gland produces more T4 (80 percent) compared with T3 (20 percent), T3 binds nine times more strongly to thyroid hormone receptors than T4.
Divided Dosages
Desiccated Thyroid extract is often taken twice a day. The first dose is taken on waking and a second dose is taken in the afternoon, usually at around 3 pm. The major reason is that the T3 component has a short half-life and most of it is metabolised within six hours. It therefore needs to be taken twice daily to achieve consistent blood levels. The afternoon dose helps prevent an afternoon energy slump.
It is important to understand that you need to gradually increase your dosage of natural desiccated thyroid hormone (NDT) until you reach a therapeutic level. Thyroxine (T4) needs time to build up in your system so and it may take up to 6 weeks to reach a steady level. Your body also needs time to adjust to the increased levels of T3.
Avoid taking iron, oestrogen and calcium supplements at the same time as NDT, since both bind the thyroid hormones to some degree.
Your NDT Take Home Message
Some people with medically proven hypothyroidism who are taking Thyroxine (T4) find that their hypothyroid symptoms are not getting better. They ay feel their treatment for thyroid is not working.
Natural Desiccated Thyroid extract (NDT) has been helpful for many people with persisting symptoms, especially where blood tests show relatively low levels of T3.
Treatment is monitored in two ways. One is with blood tests where the aim is for T3 to be in the upper part of the range and T4 to be in the middle of the range. Perhaps the most important way to know that the treatment is working is how you feel and the disappearance or reduction of your original hypothyroid symptoms.
Related: The subclinical hypothyroidism controversy
Related: Do thyroid symptoms equal thyroid disease?
Dr Peter Holsman is a qualified Medical Practitioner, Naturopath and Professional Speaker based in Melbourne. An expert in his field with over 30 years of experience, his area of expertise is holistic, integrative and functional medicine to help treat people with fatigue related illnesses including digestive problems, anxiety, stress, depression, chronic fatigue syndrome, menopause, thyroid and adrenal hormone concerns.