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Thoughts on Thyroid

Updated: Jan 20

About 12 million Americans have an underactive thyroid gland. The condition is called hypothyroidism. Conventional treatment with the synthetic thyroid hormone levothyroxine works very well for most of these patients.

However, for about one in seven of these individuals, levothyroxine (T4) just isn’t enough. In certain cases, the person may benefit from adding a second thyroid hormone called liothyronine (T3).

But before you assume that lack of T3 is the problem, it is a good idea to keep the following in mind:

Information on Taking Thyroid Medication Once you start taking thyroid medication, wait at least a month or two before deciding if the pills are working or not. It is unreasonable to expect your symptoms to disappear instantly. Keep in mind that you may have to see your doctor several times to check your blood levels and based on the results adjust your levothyroxine dose to get it just right. Taking levothyroxine too soon before or after a meal or snack may reduce absorption to 64%, according to the American Thyroid Association (ATA). So, remember to take it on an empty stomach 30–60 minutes before breakfast, or three or more hours after dinner. Take it with a glass of water. Do not take antacids or supplements containing calcium or iron four hours before or after taking your levothyroxine. Iron and calcium can interfere with the absorption of T4. Do not switch from a brand name to generic thyroid hormone, or vice-versa even if the dose is the same. The US Food and Drug Administration (FDA) requires that all levothyroxine preparations deliver 95-105% of the potency on the label. Even tiny variations could make a difference. Where to Store the Medicine Keep your medicines in a cool, dry, dark place, like in a cabinet or on a shelf in a closet and not in your bathroom. Excess heat, light, and moisture can make thyroid medications less effective.

Important Points to Note Don’t get tempted to take a supplement that claims to “support” thyroid health without checking with your doctor. Some of these supplements may contain thyroid hormones not listed on the label. Adding them to your medication may cause an overdose. Some supplements, including types containing a seaweed called kelp, may contain very high levels of iodine. Adding T3 to your T4 may help some, but not all people with hypothyroidism. T3 is the body’s active form of the thyroid hormone. Most people convert levothyroxine (T4) to sufficient T3. Check with your doctor if your hypothyroidism symptoms persist despite normal TSH levels. S/he may want you to try adding triiodothyronine (T3) to your levothyroxine therapy. It could work, but research suggests it doesn’t help everyone.

  • An estimated 20 million Americans have some form of thyroid disease.

  • Up to 60 percent of those with thyroid disease are unaware of their condition.

  • Women are five to eight times more likely than men to have thyroid problems.

  • One woman in eight will develop a thyroid disorder during her lifetime.

  • Most thyroid cancers respond to treatment, although a small percentage can be very aggressive.

  • The causes of thyroid problems are largely unknown.

  • Undiagnosed thyroid disease may put patients at risk for certain serious conditions, such as cardiovascular diseases, osteoporosis and infertility.

  • Pregnant women with undiagnosed or inadequately treated hypothyroidism have an increased risk of miscarriage, preterm delivery, and severe developmental problems in their children.

  • Most thyroid diseases are life-long conditions that can be managed with medical attention.

To see Dr. Green's recommendation on thyroid supplements, please click here:

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