Hashimoto's disease

Thyroid dysfunction is surprisingly common. Hashimoto’s disease, an autoimmune disorder, is frequently the cause. The usual treatment, levothyroxine, under brand names or as a generic medicine, is among the most frequently prescribed drugs in America. What do you need to know about the thyroid and its treatment?

Treating Hashimoto’s Disease with Levothyroxine:

Q. I have had Hashimoto’s disease since the late 90s. The doctor who diagnosed it said generic levothyroxine is fine as long as the pharmacy doesn’t change pharmaceutical suppliers; make sure they stick with the same one. How do you know when they change?

Lately, my hair is thinning terribly and breaking off. I also have brain fog, constipation, aching joints and insomnia.

I just had a thyroid test and my doctor said it was fine. He said maybe my pharmacy was buying from a different manufacturer. The pills smell different, but there’s no information on the bottle.

What Is Hashimoto’s Disease?

A. Hashimoto’s thyroiditis is an autoimmune condition in which the body attacks the thyroid gland. As a result, the gland loses its ability to produce adequate thyroid hormone. Women are more likely to suffer from this condition than men are. The diagnosis generally requires blood tests for TSH (thyroid stimulating hormone), T4 (levothyroxine) and antibodies against thyroid compounds such as thyroglobulin and thyroid peroxidase.

If destruction from Hashimoto’s disease results in the thyroid gland underproducing its hormones, the usual treatment is levothyroxine, also known as T4. Brand names are LevothroidLevoxyl and Synthroid.

You could take any of these forms of levothyroxine, but they are not readily interchangeable. That is why your doctor recommended sticking with the same generic manufacturer. That isn’t always listed on your pill bottle, so you will need to talk with the pharmacist to find out which generic manufacturer they were using when you were feeling well. Request that you continue to get only levothyroxine from that particular manufacturer. You may need to remind the pharmacy of your request whenever you get a refill.

How Is Your Thyroid Doing?

The symptoms you report are suggestive of inadequate thyroid hormone. Your doctor’s report that your thyroid is “fine” is not specific enough. You’ll want to get the actual results of your tests and keep track yourself. Our revised Guide to Thyroid Hormones offers more details on interpreting test results and treating hypothyroid symptoms. You may also wish to listen to our interview with Antonio Bianco, MD, PhD, of Rush University Medical Center and patient advocate Mary Shomon. It is Show 1015: Thyroid Mysteries, Controversies and the Latest Research.

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  1. ANN H

    Please tell me what is a functional medicine doctor?

    I really don’t want to change doctors, but would like to suggest something I could add to the Eltroxin. My doctor is the kind who really listens and I think the world of him.

  2. Lena Tawlks

    I have need 100 MG of levothyroid for about 10+ years. Last year it had to be decreased twice and now only 75 MG needed. For a couple of years I have eaten cashews regularly for a snack. I was surprised to read that they are very good for hypothyroidism (the people’s pharmacy) . It has apparently been good for me.


  3. Patti

    I “think” you probably know to take the thyroid medication with a glass of water and wait at least 30 min to 1 hr before drinking coffee or eating. I try to wait a hour. Years ago I didn’t know and ate a dry cereal with minerals (blocks the meds) and went right back up to what I’d been diagnosed with tsh of over 6.?

    Here’s a good site to identify the prescription you have been given: drugs.com You put in the shape of the pill, the color, the imprint i.e. mine was GG 333 which brought up all the info. Sandoz is the manufacturer. I already knew the manufacturer was supposed to be Sandoz.
    Hope this helps.

    Burlington, ON Canada

    I live in Canada and I take Eltroxin. I feel 100% better than when I was on Synthroid. Still I have an issue. Whenever I have my tests done, my FT3 is below range. The doctor never offers to add something into the mix. What could I ask for up here to help me convert better? Thank you.

  5. Jaime

    Hi Jaime, I thought you might be interested in reading this aticle in People’s Pharmacy about Hashimoto’s.

  6. Skylar
    United States

    I was on synthroid for many years and slowly became quite ill. My doctor started me on a very high dosage and had to lower it over many years from 225mcg down to 112mcg. I was having premature ventricular contractions, panic attacks, adrenaline rushes, migraines. My ankles hurt so bad it felt like I would break them when I took the stairs. My blood pressure shot up to 142/92 and I blew up to 190 pounds on my 5’3″ frame. I was 48 and felt like I was 84.
    I found a functional medicine doctor who put me on the natural desiccated WP thyroid (because it has the least amount of fillers), and for the first time in years I feel normal again. She also checked my vitamin D level, sex hormones and adrenal sufficiency. My Vitamin D was very low, my progesterone was very low and I was suffering from adrenal exhaustion. She put me on 10,000iu vitamin D3 with K2 per day and natural compounded progesterone. I also decided to try a gluten free, sugar free, dairy free, grain free, processed food free diet. I’ve lost weight and, after a year, am now at 136, down from 190. My ankles don’t hurt anymore, the pvcs, panic attacks and adrenaline rushes are gone. My blood pressure has come down to 112/78. I would never use synthroid or levothyroxine again.

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