Hypothyroidism
Lesson 5: Treatment Options
Synthetic Medications
The most common treatment for hypothyroidism would have to be thyroid hormone replacement. Thyroid replacement therapies provide the body with the thyroid hormones it needs to function properly. They “replace” what the thyroid can or will not make by itself.
Although natural, or desiccated, thyroid hormone replacement options were more common in the past, in recent years, synthetic, or laboratory-created, hormones are prescribed more often for the hypothyroid in the 21st century. (In the next section, we will discuss these natural hormones in greater detail.)
T4 supplementation is more commonly prescribed than T3. The reasoning, which you may or may not agree with, argues that since T3 is usually formed via T4 to T3 conversion, if the body has enough T4, then it will, by association have enough T3.
(Remember: T4 to T3 conversion is the process by which one iodine molecule is removed from T4 to make T3. It is also known as mono-deiodination.)
Currently, research seems to suggest that the hypothyroid do not generally have a problem converting T4 into T3. However, if you are on T4 supplementation, your TSH is in the 0.5 to 2.5 range, and you still have strong hypothyroid symptoms, you may be one of the growing numbers who would benefit from T3 supplementation in conjunction with your synthetic T4.
Okay, now that we know a little bit about what hormone replacement therapy does, I want to tell you about the common synthetic medications. If you are hypothyroid, chances are you know about some of this, or will at some point during the course of your treatment.
Levothyroxine (synthetic T4) is the drug of choice for many physicians. The majority of hypothyroid patients take it. It has been in existence since the 1950s. In the US, it is usually prescribed under the brand name of Synthroid.
Other names for this drug include:
These drugs replace the level of T4 needed in the body; however, they have different fillers which may cause certain sensitivities in some individuals. It often takes a bit of shuffling around to see which brand name works best.
There are also generics available for T4. They are not recommended in many instances because the stability and potency of synthetic T4 may become compromised further. It may be a good idea to ask your doctor, if she prescribes you a synthetic T4 to make it clear that the pharmacy should not substitute your brand name prescription with a cheaper, generic, one; at least, not until the generics catch up in quality.
Although T4 is usually the only medication prescribed to treat hypothyroidism (at least initially), T3 may be used in conjunction with it. The thyroid does make two hormones. It is not unreasonable to suspect that T3 can help alleviate some of the more stubborn hypothyroid symptoms. It is also believed to help antidepressants enter the bloodstream more rapidly.
Synthetic T3 is known as Liothyronine. The brand name for it is Cytomel, in the US. In France, it’s Cynomel and, in the UK, it’s known as Tertroxin. Since T3 has a shorter life span in the body, a person who takes T3 may have to take it more than once a day. (T4 is almost always taken once a day, but we’ll discuss ‘pill etiquette’ in more depth later on in this lesson!)
Although T4 is still the most common hormone replacement alone, there is a growing group of people who take a synthetic T3/T4 combination. They do this, in part, because it can be difficult to juggle T3 and T4 dosages separately. Perhaps, they just work better ‘naturally’.
Regardless, there is a T3/T4 combination drug out there. The brand name is Thyrolar; its pharmaceutical (drug) name is Liotrix. It is not widely used or known at this point. Your doctor may not even be aware of it.
Thyrolar has the proper T4/T3 ratio of 4:1. However, it can be problematic for those with cardiovascular problems, including hypertension. For more information on this product, contact Forest Pharmaceuticals Professional Affairs Department at 1-800-678-1605, ext. 7301 or online at: http://www.thyrolar.com/.
I would also like to reiterate that mention of any thyroid medication does not imply an endorsement or recommendation of any sort. I am not a doctor or medical professional. I hope that this information causes you to think about what treatments are available, what they do and what you think would work best for you, in conjunction with your physician or specialist’s recommendations.
Education is a huge part of empowerment. We are ready to move onto the next section: natural hormones.
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