Hashimoto's disease

The thyroid gland is small and rather unobtrusive, but its effects are huge. This butterfly-shaped bit of tissue on the front of the neck produces hormones that help set the metabolism of every cell in the body. When the immune system attacks the thyroid gland, the condition is called Hashimoto’s thyroiditis. This is, in fact, the most common cause of hypothyroidism in the US.

Treating Hashimoto’s Thyroiditis:

Q. I have a thyroid condition called Hashimoto’s. My TSH is usually normal but my thyroid antibodies are almost always abnormal in thyroid panel tests.

A year ago, my doctor finally prescribed Synthroid. I consistently had normal tests, but my symptoms got worse. I could not lose weight and my hair was falling out. Although I was depressed and tired, I had problems sleeping. I felt like my brain was in a fog.

Last week my doctor switched me to Armour desiccated thyroid. I am already feeling sharper and more upbeat. My co-workers have asked what’s changed because they’ve noticed the difference as well. Why isn’t Armour used more often?

A. In Hashimoto’s thyroiditis, the immune system attacks the thyroid gland. That explains why your anti-thyroid antibodies have been elevated. (Doctors look for anti-thyroglobulin antibodies, anti-thyroid peroxidase antibodies and TSH receptor antibodies.) As a result, the thyroid gland may lose its ability to produce adequate thyroid hormone.

Inadequate Thyroid Hormone Production:

Doctors usually treat an underactive thyroid gland with synthetic levothyroxine (Synthroid, Levothroid, Levoxyl). This is also called T4. The tissues of the body convert T4 to T3, the active thyroid hormone, when they need it.

Armour and other desiccated thyroid extracts (Nature-Throid, Westhroid) are derived from dried pig thyroid glands. They contain T3 as well as T4, although the ratio differs from that of human thyroids.

Some people do not convert T4 to T3 efficiently. They may feel better on a medication that supplies both hormones. With undertreatment, people may continue to suffer symptoms such as dry skin, cold sensitivity, constipation, fatigue and muscle cramps (ATA/AACE Guidelines, Endocrine Practice, Nov-Dec. 2012).

Many endocrinologists worry, however, that controlling the dose with naturally variable preparations is too difficult. They see desiccated thyroid as antiquated and point out that there are no randomized controlled trials utilizing this thyroid hormone product to treat Hashimoto’s. Other thyroid specialists have called for additional investigation of which patients may benefit from this therapy (Dayan & Panicker, Thyroid Research, Jan. 17, 2018).

You can learn more about levothyroxine and Armour and their use for thyroid problems from our Guide to Thyroid Hormones.

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  1. Lisa
    Springhill tn

    I have been on levothyroxine for probably about 7 years now and for me it’s fine but my case is also much different because I really didn’t have most of the classic symptoms of thyroid problems. My main issue was that I was just very, very fatigued and couldn’t get out of bed. I actually diagnosed myself with thyroid problems by looking back at some of my old lab results, and I then went to my Dr and had them test my thyroid, and there it was found. My levels are low, and I’ve actually been able to go down on my thyroid medicine. I take a pretty low dose. I feel pretty good now. No more fatigue or tiredness. I never had a goiter. I’ve changed my diet dramatically, and that’s helped a lot. I’ve gotten on some meds temporarily to lose weight, and so far I’ve lost a little over 30 lbs, and I have about 30 more to go. I told my Dr I want to be off the thyroid medicine eventually if my levels can go down to normal. Then why not? If I go down on my medicine again I’ll be at the smallest dose of levy, and in my opinion I could eventually go to no medicine but he doesn’t know if that’s possible. I’m hopeful. I want to try it and see. I want to stay on this path of my lifestyle/diet change and regain my health. I have some other health issues to deal with, and it’s a slow going process but so far it’s going well. I want to be drug free and be on a holistic natural path.

  2. Joan

    I had to fight for natural dessicated thyroid for years. Synthroid or generics of it wound me up and gave me terrible rashes and I was always fatigued and cold! No doctors would put me on it but I finally found a functional medicine doc who put me on natural thyroid. The difference was amazing! I have to pay out of pocket to see her but it has been worth it.

    I finally got my regular PCP to follow up with it and she prescribes it. I have my life back! People, you need to fight for this and not settle for synthetics! It has been proven to be stable over the years, which is supposedly why docs don’t prescribe it. Big pharma is winning once again!

  3. M-A
    Williamsburg, VA

    I started out on Nature-thoid, at $5 per month with my insurance and was fine for several years. But when one of my test numbers went up very slightly last May, my GP doubled the minuscule dosage I was on, and just like that I developed an incredibly itchy scalp that later appeared also on my waistline, the nape of my neck, and the small of my back. So we switched to Levothyroxine which had no change, and then to Synthroid, which is $35 per month. And yes, the itchy rash hardly subsided. I have wracked my brain as to whether there is something else that’s an allergen, but eliminating many things never reduces the itch by much. Now I’m looking into the possibility of it being a “stress rash”. It would make sense, as my husband is deployed and he left last July. But I wonder if anyone else ever experienced a hive-like rash as a result of hypothyroid medication?

  4. Beverly

    Thank you to everyone for your experiences with getting diagnosed and treated properly for thyroid problems with Armour and natural thyroid preparations. This has been very enlightening. I had one lobe of my thyroid removed a few years ago because it was so large it was obstructing my trachea. You could see it across the room, not kidding! The same thing started happening to the other side some months later, the burning pain and pin prick shocks. I stopped eating wheat and it has totally subsided. I will be talking to my doctor about having more tests and getting treated if needed. Thank you again for all your stories.

  5. Sue

    Doctors and Pharmacists put the fear of God in you that you should never change. and if you do you may self destruct and your body will go into cyberspace and circle in an orbit with Elon Musk’s convertible.

  6. Diane
    Upstate NY

    I do really well on Armour thyroid and have been taking it for 15 years. Recently our insurance company decided that everyone who is hypothyroid should take Synthroid. Now Armour thyroid is no longer a “preferred drug”. This has caused my 90 day cost of Armour to go from $20 to $90. Protest letters to my insurance company have not had any impact. Big Pharma taking in lots of money and trying to put Armour out of business. I hope they don’t succeed !

  7. Deborah

    I have Hashimoto’s Thyroiditis and my doctor is not treating it! My thyroid tests are normal, but the thyroid antibody test is always positive. Why are they not treating???

  8. Wanda M

    I was diagnosed with Hypothyroidism in my 20s. I took levothyroxine for years. in 2015, I asked my endocrinologist to let me try Armour Thyroid. A few weeks later, I started retaining fluids and gained 12 lbs in a week! My ankles and legs were horrible. I went to several doctors trying to find out what was wrong with me. I started thinking about anything that was new in my diet etc…and remember the Armor Thyroid. I had researched it for side effects and could find no adverse side effects. So I typed in, “Can you take Armour Thyroid if you’re allergic to pork?”

    Immediately, it came up, “If you are allergic to pork, do not take Armour Thyroid.” But that is the only way I could find it was by being specific. I immediately quit taking it and the swelling and fluid retention went away. I had always known that pork made me swell so rarely ever ate it, but it just didn’t dawn on me that Armour Thyroid was port derived.

    Just thought I’d throw that in there in case anyone else has a pork allergy. I don’t take anything for my thyroid now and seem to be doing okay. I did gain a few lbs.

  9. Jan

    It is amazing how most doctors resist using Armour Thyroid. I took synthroid or levothyroxine for years. After having cancer, I actually gained weight and had all the old symptoms of a thyroid condition. I asked for Armour. It was given to me but none of my doctors had a favorable opinion of it. One laughed at me when I said it was better for me. Another said it was an antiquated treatment. None of them cared that I felt better. That is how the endocrinologist treated me. IN GP doctors’ offices, they didn’t know how to administer the drug and kept trying to cut the dosage. I had one PA who all but accused me of taking it to lose weight even though the endocrinologist she worked under was fine with it. In short, doctors have gotten so use to the convenience of considering only the TSH and using the one type of drug for all thyroid conditions, most don’t even know how to use Armour Thyroid and those like it. It has really been disappointing to me to experience the closed-mindedness of doctors about thyroid replacement therapy.

  10. Marla

    I had suffered with thyroid problems for years. Doctors would give me synthyroid but I didn’t see any changes. Finally I went to a doctor who specializes in functional medicine. She switched me to Armour Thyroid and within days saw immediate improvement. Unfortunately, my insurance company doesn’t include Armour Thyroid in their formulary, so every year we need to send a special request to get their approval and, as the other person said, the price has increased dramatically.

    • Jessica

      Marla, I’m in the Dallas area, too. Can you recommend your functional medicine doctor to me? Thank you! chirky at g mail dot com

    • Elle

      I went for my refill on naturethroid and the pharmacy had a limited supply and thought that it may no longer be available. A wait and see situation.

  11. Gma

    I was on Synthroid or generics for 40 years. Was depressed, had memory issues, was overweight, losing my hair, and more. Four years ago I found a functional medicine doc who put me on natural thyroid (not Armour ), and it changed my life. At that time, I tested positive for Hashimotos, and it is not easy to overcome but I now have reached the point that my Hashi’s is conquered! My lab results all look good. The only negative thing that I have found is that “most” docs (including endocrinologists) – those not familiar with functional or integrative medicine – simply refuse to understand that the TSH test result is suppressed (as it should be) when taking a natural desiccated thyroid product and freak out over the very low test reading; and they tend to blame anything and everything else on it! I wish they would get educated but unfortunately they think they know everything and don’t want to learn about it. Very sad situation.

  12. Sylvia

    Generic thyroid medication does not work well for me. I have to have my doctor write “dispense as written” on my prescription for brand name Levoxyl. If not, I get generic levothyroxine.

  13. Cindy

    Was recently told I had ‘no thyroid’ and now currently, with a new doc, was told it was too high while on lowest dose of synthroid (the generic one) and to double my dose. I then had a rash/hives reaction and stopped taking it. When the doc suggested I take tinacin(?) I found before taking it that it had the same rash warnings on the insert (believe me, it wasn’t easy to get the insert info without purchasing it!). I am now on nothing and desperate to find a doctor that cares. My nurse sister suggested asking this second doc for Armour. Should I do this? Before the first doc, my symptoms were horrible, I looked like the Michelin Man, gained 35 lbs in 2 months, blurred vision, cramps all over, I couldn’t even walk with so many reactions to my body! I never want to go through this again. Cannot find a doc to tell me what caused all my issues then. Too bad there is no way to respond/reply to these “thoughts.” Please advise if you can.

    • Beverly

      Yes, ask the second doc. If s/he says no, go to another one until you find someone who will take your concerns seriously. It’s important to do this soon. You shouldn’t have to suffer.

  14. Karen

    After years of not feeling right, I was diagnosed with Hashimoto’s (only after going to a doc who took a LOT more labs than just T3, T4). I was put on Armour and started to feel much better. Then I moved, and my new doctor insisted that I switch to Synthroid. I got worse and worse, and the doctor wouldn’t listen to me. One day I left her office and just sobbed in my car in the parking lot as she told me I was “fine”. I was falling asleep taking my boys to school. I was not fine!

    I finally found an integrative MD in Chicago who ran a lot of labs and then explained to me that my body has trouble converting T4 to T3. For the first six weeks, I went off the Synthroid and took nothing else. I also went gluten free. I felt MUCH better. He then put me on Armour and other supplements and homeopathic meds to help my adrenals. It took about a year, but I gradually felt better and better until I had more energy than I had ever remembered having as an adult. The company who made Armour was sold a few years ag, and the new company increased the price by about 300%. I asked my pharmacist if there were other options, and my doc gave me a prescription for natural thyroid medicine, which is 1/3 of the price of Armour and works just as well, or better.

    If you feel that you have symptoms of hypothyroid and your doctor isn’t listening, find an integrative MD. Also, if your doc won’t prescribe natural thyroid replacement, find another doctor! I actually got WORSE on Synthroid.

  15. Nancyj95@optonline.net
    Mineola, NY

    I, too take Armour Thyroid and have taken it consistently since I was diagnosed with that and Lupus at the same time about 20 years ago. I have to pay lots more for it because it is not in my insurance’s formulary. I had to be put on synthroid a couple of years ago when the Armour was unavailable. The difference in the way I felt was unreal! I had a miserable year until it was available again. I gladly pay the difference, so I can not just survive, but enjoy my life.

  16. Karen

    I was finally diagnosed with Hashimotos Disease in 2013 after suffering most of my life with symptoms that most doctors have ignored. I take Naturethroid-pretty much the same as Armour, and it has changed my life. My hair stopped falling out. I can think. I lost 100 pounds. I am no longer cold or suicidal. If anyone forced me onto synthetic thyroid, I would be furious.

  17. GENIEB
    N. C.

    I have taken thyroid for 60 years….I take Armour Thyroid because I break out in hives when I take the synthetic (man made). Armour was a generic brand at one time and very inexpensive $10.00 a month (60 MLGC 2 a Day) now it is $50.00 a month and is no longer labeled generic by my insurance. Hope this helps.

  18. April
    New York

    I had my thyroid removed because of large tumors. I was given levothyroxine. I spent 4 months sitting on the couch thinking that if this was what my life was like from now on, I would prefer to be dead. I had never had thoughts like that before in my 59 years of life. My doctor said my numbers were fine. I told him my thoughts. He then prescribed Armour Thyroid. Three days later I felt like my normal self. I know what doctors think. I hear it from other people on synthroid, and how their doctors refuse to prescribe it, but they really need to have to go through the feeling to understand its not just about numbers.

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