The People's Perspective on Medicine

Show 1096: What You Need to Know About Treating Thyroid Disease

Treating thyroid disease can be more complicated than it may seem. An endocrinologist and a patient explain what you need to know.
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What You Need to Know About Treating Thyroid Disease

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An estimated 20 million Americans have trouble with their thyroid glands. Doctors have become accustomed to making the diagnosis of hypothyroidism based on a single blood test. Often they prescribe just one medication for treating thyroid disease. But does that work equally well for everyone?

Genetic Variations That Make a Difference:

New research shows that some people have a gene variant that makes their bodies less efficient at converting the circulating hormone levothyroxine (T4) into the active hormone triiodothyronine (T3). As a result, the usual treatment may not be completely effective at helping them overcome their symptoms. Find out what else they might need for treating thyroid disease.

Taking Your Medicine:

When and how you take your thyroid medicine can affect how well it works. Did you know that coffee can interfere with the absorption of levothyroxine? Soy products may also pose problems. Find out the best ways for thyroid patients to work with their doctors in treating thyroid disease.

This Week’s Guests:

Dr. Antonio Bianco

Antonio Bianco, MD, PhD, is the Charles Arthur Weaver Professor of Cancer Research in the Department of Internal Medicine. He is the president of Rush University Medical Group and vice dean for clinical affairs in Rush Medical College. Dr. Bianco’s research focuses on understanding the deiodinase enzymes D1, D2 and D3 and their effect on thyroid hormone action. He was co-author of a Seminar paper on hypothyroidism published in The Lancet, March 20, 2017. Here are some links explaining his research:

You can listen to Dr. Bianco’s extended interview:

Mary Shomon

Patient advocate and author Mary Shomon transformed her 1995 thyroid diagnosis into a mission to educate and empower others struggling with thyroid and hormonal conditions. She is a nationally-known patient advocate and activist, and founder of She is the author of New York Times bestseller The Thyroid Diet Revolution: Manage Your Metabolism for Lasting Weight Loss and a number of other books on thyroid disease, hormone health, and weight loss. Her most recent book, written with Dana Trentini, is Your Healthy Pregnancy with Thyroid Disease.

Mary is a leading force on hormonal and thyroid health in social media, with her hundreds of thousands of community members at: Thyroid Support/Facebook, with Mary Shomon Thyroid Diet/Facebook, with Mary Shomon Twitter: @thyroidmary

The photo is of Mary Shomon.

You can listen to Mary Shomon’s extended interview:

Listen to the Podcast:

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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If you have prescription drug insurance or Medicare Part D, you can request that your pharmacist send your prescribing doctor a “prior authorization request” or exception request for Armour thyroid. Armour is not a preferred brand medication, but most insurance companies have a process called Prior Authorization request to check if the “published” price can be lowered. There also are prescription cards (BestRX or similar) usually in doctors’ offices that can be checked at the pharmacy for a lower “cash” price for an individual’s prescription.

I am not doctor,but I think hypothyroid should not be treated drastically,,there is always risk of osteoporosis , as long as it is under 10 , instead doctor should ask patient to loose weight if over , exercise more and eat properly to feel better.

I was prescribed synthroid after menapause , without searching cause. Due to menapause estrogen dominant so it increase tsh , it has been 20 years now, I want to know can I ever quit taking synthroid or once I take my thyroid now depend on it. So I have to take till I die.

What is the opinion of you two at the people’s pharmacy??

I was taking the synthetic Synthroid for years and thankfully Armour Thyroid came back on the market and I immediately switched to Armour and experienced an increased feeling of wellness. Thanks, Armour!!

Big pharma is the most profitable sector of the US economy. THis is on the backs of all us, especially those on Medicare. How can we stop this criminal behavior?

You must contact your congress people over and over and over again. Once is not enough. Call them, meet with them, write them. Then do it again and again. People have to start stepping up and speaking out. The pharmaceutical industry tortures animals and keeps people from life saving treatments by jacking up prices of drugs (even generics that have been on the market for decades) to unbelievable levels. This is not acceptable and we must speak out and continue to speak out until someone listens. The insurance industry is no better, either. BTW, 2018 will be probably the most important election of my lifetime. VOTE, VOTE, VOTE!!

Beeclee 10/03.2017

I developed red blotches all over my body over a period of 3 years after being switched to generic synthroid. This did not happen on Synthroid. I am now taking Armour and feel much better. Blotches are beginning to fade. I did not make the connection until my dermatologist did a biopsy.

Why talk of any single medicine? All synthetic formulations are ‘foreign’ to our body and are only accepted with much reluctance. Our medical system should focus more on natural medications.

Not sure what people mean by “natural.” Thyroid meds that contain thyroid hormone from porcine sources are not “natural” to humans and cause great suffering for animals. I prefer to take a synthetic hormone so as not to cause any more suffering. I take T3 and T4 and feel ok, though not terrific. Stress has something to do with that so I am working on it. I am intensely disturbed about the pharmaceutical industry making profits off of the backs of animals and people who are desperate to find some quality of life. I will say that for me, it is worth still feeling a bit tired as opposed to torturing animals. BTW, I felt the best on Levoxyl but insurance reimbursed the pharmacy BELOW COST and they lost money with every Levoxyl RX. The biggest problems I see are the pharmaceutical and insurance industries have our congress people in their pockets. As long as people are apathetic, do not vote, do not contact their congress people, humans and animals will continue to suffer. We must have more humane choices for our treatment.

Some oxymoron practices in mainstream medical autoimmune hypothyroid practices:

TSH is an indirect measure of the active hormone T3. If TSH indicates enough T3 but measures of T3 show it is low, US endocrinologists treat the TSH not the T3.

There is research showing sleep shift change as in international travel or shift work change cause TSH to spike in normal thyroid people. Their thyroid compensates by producing more T4 and T3. Autoimmune hypothyroid are on a fixed dose of medicine. If I tell an endocrinologist that I take my regular dose of levothyroxine every 12 hours instead of every 24 hours for a couple of days it helps me recover from jet lag. Otherwise it takes me 2 weeks to get over jet lag. Endocrinologists have a fit when I tell them what I do. Then I show them my lab results.

If you forget to take your daily dose of levothyroxine you are told to skip that pill and wait for the next. Research has shown that taking your weekly dose of levothyroxine is OK with no harm done.

Levothyroxine has a long half-life and endocrinologists wait 60 – 90 days to check the effectiveness of a change. The same effect can be mimicked in a week or two by taking a double dose one day if you are increasing the dose, and skipping one day if you are decreasing your dose. Do the math for steady state based on the half-life.

I think 2 things that can be responsible for a poor response to T4 treatment and which were not discussed on the program are a low T3/rT3 and low cortisol. After my response to T4 only was not good, I found the T3/rT3 (functional T3/reverse or poorly functioning T3) to be 15. I think that is marginal but would like to know more.

Then I tried T3 only (Cynomel, a high quality much cheaper than Cytomel) QID but it did not help much. Then experimenting with raising and suppressing cortisol, I found that hydrocortisone supplementation did the job. Then hydrocortisone became unavailable without a prescription and I have not done so well. It is probably not feasible to find a doctor willing to prescribe hydrocortisone without going through a lot of money and trial and error, so now I use a mix of T4 early morning and T3 BID but am not very happy.

It was very interesting to hear the role of the thyroid in the development of fetal nervous system. Has anyone thought about trying massive thyroid for a Zika-exposed pregnant mother to counteract the effects of the virus on the baby’s brain?

Not enough is known about thyroid issues. Endocrinologists don’t approve of the drug I prefer to use which is Armour Thyroid. It works better for me and actually, I have less depression and less hair loss. I had one tell me last year that it was an antiquated treatment and although he didn’t push it, wanted to give me levothyroxine again. Few Endocrinologist listen to the patient. I had one to laugh at me when I told her that I also prefered it because it seemed more natural than the synthetics. Everything is better for me since I began taking Armour Thyroid. I have no idea why doctors won’t recognize it as being better for the patient. On synthroid, I often felt like a walking zombie with no enthusiasm for life. It worked in the beginning but stopped working eventually. That is all I can say.

Our bodies are really different; I first took Armour Thyroid but it caused major palpitations; then I was put on the generic Synthroid — that did absolutely nothing for me; I was switched to Synthroid and it works for me.

Using Tirosint and feeling better.

I was taking the generic levothyroxine for many years and I was still tired. Then I started losing my hair and although I was heavy and did not eat a lot I was gaining weight.

About a year ago my primary Dr. for over 20 years, said he would like to try me on Armour thyroid. A Natural thyroid that came from pigs. He would have tried it sooner but the price was too high and he knew I couldn’t afford it.

I started taking it and in about 2 weeks I was feeling more lively. I wanted to do things again. When I went back to him 3 months later I had lost about 10 lbs. In the past year I have lost 60 lbs, I am feeling good and my hair is growing back. It’s like a miracle drug. Very inexpensive now that the FDA has finished analyzing it or whatever they do that makes the price go up. When they take a drug off the market and then put it back on the market it is considered a new drug. Even though it had been on the market many,many years.

I feel they are doing the public a big disservice when they do this. My friend could not take the synthetic and had a seizure from one manufacturer of the synthetic and a very bad illness from another. She could not do without the Armour and paid $400 a month until her Dr made the manufacturer understand that she had to take Armour and the synthetic made her very ill. When is Big PHARMA GOING TO STOP THIS.

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