Low Thyroid: Taking Levothyroxine, But Still Don’t Feel Right?
One of the most common chronic maladies affecting people is low thyroid function. Symptoms which bring patients to a doctor may include unexplained weight gain, fatigue, loss of hair and lateral eyebrows, brain fog, feeling cold when others are warm, cold hands and feet, and menstrual irregularities.
These symptoms are caused by lack of the active form of the thyroid hormone, T3. Invariably, as a part of the diagnostic work-up, the doctor will order a thyroid stimulating hormone or TSH test. TSH is a brain hormone that stimulates the thyroid gland to make more or less of the inactive form of the thyroid hormone thyroxine or T4. The thyroid gland makes T4 and it goes into circulation in the body converting into the active form of the thyroid hormone T3 in tissues requiring an increase of metabolic rate.
If the TSH is high, the demand by the brain is for more production of thyroxine; if the TSH is low, the request is for less production of thyroxine (confusing, I know). This is a general relationship that has no specific correlation with the signs and symptoms of low thyroid function. Remember, it is T3 (not T4) that is responsible for how a patient feels.
Unfortunately, the medication most commonly prescribed for thyroid patients is synthetic levothyroxine¹ which very poorly converts to T3; yet is a $2.6 billion a year business in the U.S.²
The TSH has a very definite, very specific relationship to the dose of synthetic levothyroxine.
The problem, however, is that most doctors have presumed, without any scientific evidence, that the TSH has an exact relationship to the suffering perceived by the patient.
The patient may notice some improvement of symptoms as the dose of levothyroxine is raised, allowing some conversion to T3. However, the doctor may be more focused on the TSH levels than the patient symptoms, and if the patient tells the doctor that symptoms are improved with a higher dose, but the resultant TSH level is below the range listed on the lab report, the doctor may dutifully lower the dose to the amazement of the patient.
The relationship between the dose of synthetic levothyroxine and the TSH test allows the appearance of a rational mechanism for the diagnosis and treatment of low thyroid function. The reality is that there is no specific blood test for measuring hypothyroidism. The best way to determine adequacy of treatment is by how the patient responds to thyroid supplementation.
I have found that patients taking Thyroid USP, a regulated product made from real pig thyroid glands, will immediately notice an improvement in symptoms. Pig thyroid glandular composition is very similar to that of the human, except containing more T3. The United States Pharmacopeia (USP) establishes written and physical standards for medicines and dietary supplement products³ which are used by regulatory agencies and manufacturers to help ensure the products strength, quality, purity, and consistency.⁴
If you suffer from low thyroid and standard medical treatment has not been successful, know that additional options are available.
David M. Odom, MD practices bio-identical hormone replacement therapy and weight loss medicine at Longevity Therapeutics in La Quinta. (760) 698.8400. www.dr-odom.com
References: 1) Levothyroxine is the generic name for brands such as Synthroid, Levoxyl, and others; 2) https://www.prnewswire.com/news-releases/amneal-announces-10-year-licensing-and-supply-agreement-with-jerome-stevens-pharmaceuticals-inc-for-levothyroxine-300699199.html; 3) https://www.usp.org/reference-standards; 4) https://en.wikipedia.org/wiki/United_States_Pharmacopeia