How to Optimize Your Thyroid Medication to Get You Back to Feeling 100% (2023)

Do we need new drug treatments for the thyroid?

When will we see new treatments and new thyroid drugs to treat thyroid disease?

I've seen this question over and over again in one form or another over the past few years.

There are many thyroid patientssuffers nowdespite taking herthyroid medicinefaithful.

From their point of view, it makes sense that the problem is likely medication-related.

After all, shouldn't they feel better if they took their medication every day?

You would think so, but this way of thinking is actually wrong!

Would you be surprised to learn that you already have so many choices when it comes to thyroid medication?

Or that the thyroid medications we have available are100% bioidenticalfor your own hormonesthyroidproduce naturally?

And truth.

All prescription thyroid medications are exact replicas of the same hormone that your thyroid would produce if it were healthy.

This applies to Synthroid and Levothyroxine!

The problem isn't with the medications you take, but with the way you take them.

And that is the whole point of this article.

Today I want to explain what kind of changes you can make to your thyroid medication to optimize your dose and feel better.

let's jump...

4 adjustments you can make to optimize your thyroid medication

If you are diligent in taking your thyroid medication every day but still suffer from hypothyroidism, then this information is for you.

Among all the tweaks I'm about to list, there are a few combinations that will work for your body.

This also applies if ...

• You have tried other thyroid medications in the past without success
• They have only tried T3 thyroid medication and experienced negative side effects
• They have tried several different types of T4 thyroid medications to no avail

I've found that as long as you're willing to keep trying new things and adjusting your medication intake, you'll eventually find what works for you.

Yes, this may take time, and yes, it may require a doctor, but we're talking about your quality of life here.

No amount of work is more important than being able to function at an optimal level every day, experiencing better relationships in lifehaving energyenjoy life, experience anormal weight, Ternormal hair growth, etc.

Don't let your thyroid take away the best years of your life!

With that in mind, let's talk about these tweaks:

#1. Adjust the type of thyroid medication you take

When it comes to controlling thyroid symptoms, you simply won't feel better if your thyroid medications aren't optimized for your body.

For most people, this means using a combination of T4 and T3.

Unfortunately, most thyroid patients are given thyroid medications like levothyroxine or synthroid and that's it.

In other words, you're probably getting 100% T4 thyroid hormone.

But that's not how your thyroid works.

If we lined up 100 thyroid patients (or even healthy patients) we would find that each person would do better with a different T4 to T3 ratio.

One person might do well with 99% T4 and 1% T3, another might do better with 80% T4 and 20% T3, and another might do better with 50% T3 and 50% T4.

It's pretty hard to figure out where you fit on this spectrum of T4 to T3 ratio unless you play around with your dose.

Unfortunately, most doctors will never give you the chance because they stick to 100% T4 thyroid medications in the form ofLevothyroxineorSynthroid.

You can immediately see that there are many variables involved in optimizing your thyroid medication, but it doesn't stop at the T4 to T3 ratio.

In addition to the T4 to T3 ratio, some people respond better to certain types of thyroid medications.

For example, think of levothyroxine and synthroid.

Although both are technically the same thyroid drug (one is generic and the other is brand name), a person may do better with one and not with the other.

This logic applies to all brand name thyroid medications and generic thyroid medications.

Between finding your T4 and T3 ratio and finding the right type of thyroid medication, in this section alone, you have a variety of options and ways to optimize your dose.

With that in mind, let's talk more about prescription thyroid medications and further stratify them based on additional factors.

In general, we have 4 subcategories of thyroid medications:

• T4 thyroid medication only- These are medicines that only contain the thyroid hormone T4. Included in this group would be Levothyroxine, Synthroid, Unithroid, Levoxyl, Tirosint and Tirosint-sol. And each of these drugs has its own pros and cons and can be further stratified.
  • Regular T4 thyroid medication– Regular T4 thyroid only drugs are those drugs that have nothing special to offer and Levothyroxine and Synthroid would fit into this group.
  • Cleaner, more absorbable forms of T4– Among T4 thyroid drugs, some are formulated to improve absorption in the intestinal tract. Medicines that fit here includeTirosinteTirosint-So.
• T3 thyroid medication only–T3-Schilddrüsenmedikamentare drugs that only contain the thyroid hormone T3. These are the strongest thyroid medications available and are the least prescribed because most doctors are unaware of them. Among the T3 thyroid drugs we have two additional groups:
  • Immediate release T3– These are drugs that are quickly absorbed by the body.A liturgyeCitomelfall into this category.
  • T3 delayed release–T3 delayed releaseThyroid medications are compounded by a compounding pharmacy and are delayed release to prevent the release of T3 into the system (thereby reducing symptoms of thyroid hormone T3 use).
• NDT (Natural Dehydrated Thyroid)–Natural desiccated thyroidis a class of drugs derived from the thyroid gland of animals (usually pigs). They are considered natural because they are not synthetically manufactured and bioidentical because they look identical to the body's own thyroid hormone. Natural remedies for a dry thyroid contain a certain ratio of T4 and T3 plus some additional ingredients like T1, T2, calcitonin and some iodine. Drugs in this class includearmor thyroid,Thyroid NP,WP thyroid, zfight in nature.
• Combination of T4 and T3 thyroid drugs– You can get T4 and T3 thyroid drugs by combining two drugs or by combining T4 and T3 through a compound pharmacy. The ratio of T4 to T3 can be different in each case and can be adjusted to your needs.
  • Using a compound pharmacy for T4 and T3– If you use a compound pharmacy, your doctor can write a prescription for any amount of T4 and any amount of T3. Your prescription could be 55 mcg T4 and 15 mcg T3 or virtually any other ratio.
  • Using individual T4 and individual T3 to get desired dose– Alternatively, you can take two prescription thyroid medications to get T4 and T3. For example, if you were to use Levothyroxine and Cytomel, you would get T4 from Levothyroxine and T3 from Cytomel. You can adjust the dose of each drug to find what works best for you.

What does this information mean for you?

Let's use an example to really support this success.

Imagine you take 100mcg of levothyroxine and you don't feel well, although you take your thyroid medication conscientiously.

Knowing you're not feeling well is a good place to start, but you have many options from here:

• First, you can simply try switching to another, more absorbable form of T4 thyroid medication such as Tirosint or Tirosint-Sol. This change may be enough to help you feel a lot better on your own.
• Second, you might consider adding T3 to your medication in the form of Liothyronine or Cytomel. If you were to do that, you would be taking a combination of T4 and T3 in multiple doses. You can start slowly by adding 5 micrograms of T3 to your 100 microgram dose of levothyroxine.
• Third, if other options fail, you can try switching to Armor Thyroid (a type of natural desiccated thyroid) to see if that helps.

This is just the beginning in terms of the options available to you, but I hope it opens your eyes to the possibilities.

If your doctor isn't actively working with you to find out what works best for your body, you might want to get a second opinion!

You can usethis resourceto help you find more doctors.

#two. Adjust how you take your thyroid medication

The next adjustment you can make to your thyroid medication is to adjust the way you take it.

Most thyroid sufferers assume that when they are given thyroid medication, they simply take it orally with some water, swallow the pill or capsule, and call it quits.

It turns out there are other ways to take your thyroid meds!

Here are 3 different methods you can use to get thyroid medication into your body:

• Oral– This is how most thyroid patients take their thyroid medication. You swallow the capsule whole and wait for it to be absorbed into the bloodstream via the intestinal tract.
• Sublingual– Another method you can use to get thyroid medication into your body is to allow time for it to be absorbed under the tongue. This method is known as sublingual absorption. This doesn't work for all types of thyroid medication and absorption isn't consistent from person to person, but it's definitely another option. You can learn more about taking your medication sublingually (including how to do it)Here.
• by injection– Finally, some thyroid medications can be takenper injection. This route of taking thyroid medication allows bypassing the gut, which is the site of many absorption problems. This route is not used very often and is usually used as a last resort, but can still be considered in rare cases.

Doing something as simple as mixing your thyroid medication and letting it absorb under your tongue might be all it takes to see a significant improvement in your symptoms.

#3. Adjust the time of day you take your thyroid medication

You may also consider adjusting the time of day you take your thyroid medication.

You've probably been told to take your thyroid medication first thing in the morning, first thing in the morning, and without food.

So familiar?

If you're like most thyroid sufferers, chances are you followed the directions and have been taking your meds ever since.

It probably won't come as a surprise when I say this, thoughThis is not the only time of daythat you can take your medicine and it is not necessarily the best time of the day to take it.

Let's talk about some additional patterns and times of day that you can take your thyroid medication that may help your thyroid medication work more effectively:

• Take your thyroid medication in the morning- You're probably doing that right now. Ostandard advice(1)is to take your thyroid medication as soon as possible, away from food, drink, coffee, supplements, etc. If this isn't working for you, try some of the other options listed below.
• Take your thyroid medication at night- If you only take your thyroid medication once a day, it's probably better to take it in the evening than in the morning. This is backed up by some clinical studies showing that thyroid patients who take their medication at night seehigher levels of free thyroid hormone(2)compared to those who take it in the morning. Taking your thyroid medication in the evening may be best, as the intestinal tract is naturally slower in the evening than in the morning. You may think that taking your thyroid meds at night is interfering with your sleep, but that doesn't seem to be the case for most thyroid sufferers! Yes, it can happen, but it's actually quite uncommon.
• Split up your dose and take it several times throughout the day– The next strategy to consider would be to take your full dose of thyroid medication and spread it out throughout the day. Why do you want to try this? Because it better mimics the way a healthy thyroid works! In a healthy person, the thyroid produces thyroid hormone continuously throughout the day. Thyroid sufferers who take thyroid medication orally are receiving a massive dose that should last them throughout the day. Multiple dosing or splitting the dose allows for more sustained thyroid hormone levels throughout the day, which may affect how you feel.
  • Multiple dosing throughout the day- Multiple dosing is often used with thyroid medications that contain only T3, such as Cytomel and Liothyronine, as these can cause symptoms if taken all at once. But you can use this strategy with any type of thyroid medication, including levothyroxine. If you wish to do this, simply take your full dose of thyroid medication and divide it into halves, thirds or quarters and take your medication at intervals throughout the day. Every 12 hours if using halves, every 8 hours if using thirds, and every 6 hours if using quarters.
• Alternating total daily doses of your thyroid medications- Some patients are so sensitive to small changes in their thyroid medications that it can be difficult to determine exactly how much they need. Additionally, measuring some thyroid medications, such as levothyroxine, requires a blunt instrument rather than a fine scalpel. They are limited in their dosing options, meaning it's difficult to find a dose when your body wants something in between the standard doses. If you fall into this category, changing total daily doses might make more sense. Here's how it works: Imagine you're taking 100mcg of levothyroxine a day, but that's not enough. If you increase your dose to 112 mcg of levothyroxine, you will find that it is too much. To get a dose between these levels, you can alternate days of taking 100 mcg of levothyroxine and 112 mcg of levothyroxine throughout the week. This works out to an average total daily dose of about 106 mcg of levothyroxine if you take it every other day. You can also alternate taking higher doses every third day, taking higher doses only on weekends, and so on. The possibilities are endless! It's just a matter of finding what works for you.

When you think about how you take your thyroid medication, you're usually trying to mimic how the healthy thyroid works in nature.

Despite your doctor's best efforts, taking a massive dose of thyroid medication by mouth to replace a complicated system like the thyroid will never achieve healthy thyroid function.

But that shouldn't stop us from trying!

Taking multiple doses throughout the day will get you closer to thathealthy thyroid functions(3).

Until we develop a continuous pump of low-dose thyroid drugs injected into your blood when needed, we'll never be as good as the thyroid.

But we can get close, and multi-dosing can help us get there.

The amazing thing about multi-dosing your medication is that you don't have to convince your doctor.

For the most part, your doctor shouldn't care if you take the same amount of thyroid medication just at different intervals throughout the day.

It's much easier to give multiple doses of your current thyroid medication than trying to convince your doctor to use a medication you're unfamiliar with.

For this reason, multiple dosing should be high on your list of things to try when working with a doctor who isn't keen on new thyroid medications.

The biggest downside to multiple dosing is that it can get messy very quickly and if you don't do it right you can suffer from decreased absorption.

Remember:

If you are taking multiple doses of your thyroid medication, you must still avoid taking smaller doses with food, drink, supplements, etc.

If you feel like you can't do this, or if you think you're more likely to miss doses because of the new schedule, it's probably not a good idea to try.

#4. Adjust your dose of thyroid medication

Finally, we have the dose of thyroid medication you are taking.

This is what most people focus their attention on, and with good reason.

If your thyroid medication dose isn't optimized, it doesn't matter what other changes you make! You just won't feel any better.

As important as it is, it's difficult to give specific advice because the dose of thyroid medication each person needs varies widely.

Because of this, we need to keep the information here general.

The first thing to know is that most thyroid sufferers are not receiving enough thyroid medication.

In other words, they are underdosed.

This means that for most of you reading this, the odds are high that this is the caseYou need to take more thyroid medication(not less).

That said, there are still some people who areTaking too many thyroid medicationsand their dose should be reduced.

To make things even more confusing, what needs to happen with your dose can change many times over a lifetime.

Your thyroid medication needscan changebased on many factors including age, comorbid conditions, recent illness or infection, how much stress you are experiencing, how much sleep you are getting, hormone levels and more.

Even if you find a dose that works for you now, there is no guarantee it will continue to do so for years to come.

Because of this, you must always be on the lookout for thyroid symptoms and lab tests.

You can use a combination of these two things to control your dose.

Never use just one without the other!

This is the strategy most clinicians use (dosing based on TSH alone) and is why so many thyroid patients remain underdosed.

The second thing to remember is that you can't tell if a dose is working for you or not unless you give it enough time.

Changes in thyroid medications take at least 6 weeks to take effect in the body.

For this reason, you must be patient with changes!

You won't know for sure if a dose change will work unless you give it 6 solid weeks.

Changes before that lead to inconsistent and/or confusing results.

packaging

Trust me when I say this, I know being a thyroid patient can be tough.

Just because it's hard to be in your shoes doesn't mean there's nothing you can do to make yourself feel better!

One of those things should be taking the time and energy you need to optimize your thyroid medication.

With the 4 categories listed above, you should have literally hundreds of options and different ways to tweak and tweak your thyroid meds.

By making changes to your thyroid medications, you'll find a combination that just works.

I can say that I did exactly that when I saw patients.

And it's this strategy that has helped me get thyroid patients back to (or close to) 100%.

Now I want to hear from you:

Do you feel like your thyroid medication is being optimized?

If not, are you considering any changes or adjustments?

Did you know you can make all of these changes to how you take your thyroid medication?

Have you tried any of these tweaks yet? Did they work for you?

Leave your questions or comments below!