The People's Perspective on Medicine

Thyroid hormones


Thyroid hormones come in a variety of formulations and brand names.

Natural products made of dried thyroid glands from beef and pork are sold as Armour Thyroid, Thyroid Strong and Thyroid USP.

They are generally quite inexpensive, but dosage levels may vary. That is why endocrinologists usually prescribe synthetic products such as Synthroid or Levothroid.

When people develop a sluggish thyroid gland they often feel tired and weak. They may become constipated, sensitive to cold or anemic. They may also suffer with dry skin and hair, thick brittle fingernails and have shortness of breath when they exercise. Some people report clumsiness, weight gain, or puffy eyes.

Thyroid problems are diagnosed with blood tests. The best is one that measures thyroid stimulating hormone, or TSH. This test also helps determine the proper dose of thyroid hormone for treatment.

Side Effects and Interactions of Thyroid Medication

Side effects of thyroid replacement therapy are rare if the dose is appropriate.

Specialists recommend beginning treatment with a low dose and gradually increasing it until symptoms of underactive thyroid disappear and the TSH blood test is normal. This may initially require blood tests every four to six weeks and good communication with the doctor.

Too much thyroid hormone can lead to complications such as osteoporosis and heart disease. Signs of overdose include insomnia, heart palpitations, jitteriness, rapid heart beat, increased sweating, higher blood pressure, changes in appetite, and reduced menstrual flow.

Other adverse reactions of excessive thyroid levels include tremor, headache, diarrhea, and weight loss. Report any such symptoms to your physician promptly.

A number of medications may interact with thyroid hormone or alter the tests that detect thyroid problems. People taking estrogen, asthma medicines, decongestants (including those found in over-the-counter cold or flu remedies), antidepressants, certain cholesterol lowering drugs, blood thinners such as Coumadin or heart medicine like digoxin should check with a physician or pharmacist.

In theory, the herb guggul might counteract thyroid-suppressing drugs or increase the effect of thyroid hormones. Monitoring thyroid function is prudent. Licorice may alter the required dose of levothyroxine because of its impact on the thyroid gland.

Never stop taking thyroid hormone without first checking with your health care provider.

Special Precautions

Too much thyroid hormone can make a person more susceptible to osteoporosis or weakened bones. You may wish to discuss with your doctor whether you need tests to monitor bone density.

Thyroid replacement is usually needed for the rest of one’s life, and stopping the medicine suddenly could precipitate symptoms of inactive thyroid.

Don’t discontinue any thyroid hormone without your doctor’s supervision. It is usually best to stick with one formulation rather than switching from one brand to another frequently.

Taking Thyroid Hormones

The usual recommendation is to take thyroid hormone before breakfast. Although this hormone is probably best taken on an empty stomach, it is more important to take it at the same time every day to maintain a constant level in your body.

Do not take this medication with iron pills, as they can interfere with proper absorption.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I don’t know where to start. I am about to have a total removal of my thyroid and it looks like the hormone replacement therapy is an experiment. Since both t3 and t4 are involved, it appears that synthroid only replaces t4 hormones. What is Amour? It seems that it works better for a lot of writers here. I am concern about this hormone replacement therapy. please help.

Teresa, a majority of people do all right and many do very well on T4 alone. You might be one of them!

If not, you can ask your doctor about a treatment that would include T3 as well. See our Guide to Thyroid Hormones for more information.

I have been off and on thyroid medication for years. I experience dizziness, shortness of breath, chest pain one half hour to three hours after taking the meds. The doctors tell me it is not the thyroid medication. Finally, my general practitioner gave me Armour. I have been on it less than a week, but I am hoping it will give me better results.

I would do the Gerson therapy and get off all of that stuff. You’re so toxic you’re not going to ever feel well with all those drugs in your system.

I was compelled to respond to your report, relating to having low thyroid function and staying off meds. The ultimate result of continuous hypothyroidism could be very adverse. Low thyroid means low or dysfunctional metabolism. That may have many adverse effects felt or non-felt. So it is prudent to check it out and receive treatment.
The treatment may have side effects of lower risks, but sustained hypo-thyroidism will produce a “silent killer” artery sclerosis which may lead to blood circulation cut off to vital organs.
See a competent endocrinologist

Being on Synthroid, the brand, for 30 yrs., moved & new doc put me on the generic. Didn’t think anything of it, but 4-5 yrs later had weird sensation in my lymphnodes for about 4-5 moths – long story short: dentist, doctor, (antibiotic) otolarengologist(sp?) MRI, sonogram, and finally an endocrinologist who told me ONLY the brand, medically necessary. Problem immediately disappeared. Total cost? $20,000.00 Having been on synthroid for so long, I never even suspected that had anything to do with it. Evidently my regular doctor didn’t have a clue. And they wonder why health care costs so much!
Great write-up in our local paper – congratulations! I didn’t know you were on the radio and that is how I found this website. I always rushed to your column in the paper each week. I have found there is nothing like others experiences to contemplate. You are performing a valuable service.

I had a TT for papillary cancer 4/2009 with radioiodine ablation in 8/2009. I was on Synthroid until 4/2013. I knew that I should be feeling better than I was but since my lab tests were making my endo happy, I let it ride. Until that is, I couldn’t anymore. I was miserable. I went to the web site and learned a lot about treating hypothyroidism with desiccated natural thyroid meds like Armour, Naturethroid, Westhroid, Westhroid-P, Acella, the Canadian Erfa, etc.
Armour reformulated their med in 2009 and for many people it isn’t working the way it once did. Westhroid-P is now just WP thyroid. It has only 2 fillers as compared with the others. Some folks are having issues with the fillers in the NDTs. Finding a doc, especially an endo (the accountants of the medical profession – it’s all about the numbers) who will treat a person by the symptoms and not just numbers is worth their weight in gold. The Stopthethyroidmadness site has a list of “good docs” recommended by patients as those who will listen and are willing to explore other options beside just T4 only therapy. Feeling good is our right as patients.

If you were taking Armour Thyroid and doing well, I would ask your doctor to go back on it. I see this posting has been a few year. I like to hear how you are doing. I was taking Synthroid first for a few year. This Jan and Feb of 2013 was bad, do the Doctor switched me to Armour Thyroid. It has been two weeks, and have been told it takes about a month.

I have fought my doctors for 40 years to keep giving my prescription that works well for me taking Armour Thyroid. As the theory is that synthetics are better. Well supposedly, synthetics provide T4, but not T3 and your body is supposed to make up for the lack of it. Does everyone’s body do this?!!!
Well, the answer is “It is supposed to!” as answered by one of Orlando, FL’s supposed finest endocrinologists and a payment of $300 for one 10-minute visit with a refusal for me to continue on Armour Brand. Arthritic pains, sleepless nights, bowel problems, anxiety issues, weight gain, doesn’t matter to the FDA Cartel that runs our country to keep its citizens running back to the doctors for the issues that ensue from their prescription “guesstimates.”

I lived in Orlando but found an excellent doctor in Brandon, FL. She prescribes Armour. Her name is Dr. Erika Bradshaw.

I’m on Armour Thyroid 160. My Dr. did not want to give it to me, said they stopped making it. I found it. Most of my thyroid has been removed and I love Armour. But I’m now taking Boniva and want to know if this is what I should take with Armour. If it is OK to take which med. do I take first? Or how would I deal with this? Thanks for your help. Marcris

I went to a Long Beach Endocrinologist who charged me $150 eight years ago to simply say she hated it when patients researched their health online and that Synthroid was the way to go and that I was imagining my problems. I should have walked out without paying – she didn’t even write a script. The pharmacist at Target on Bellflower Blvd., on the other hand, was well aware of the feedback loop I was having where my thyroid shut down production even more with Synthroid and Leveloxolin while my body did not metabolize it at all. I was half dead, fat, mentally incapacitated. Armour worked immediately. However, in December of 2015, I inexplicably gained 10 pounds in 17 days – quite a trick even if you were trying, which I wasn’t. I’ve read that there is a formula change and I know that is true because eight years ago my pills stunk like the natural dried pig thyroid that they are, while now they are hard and without a smell. I’ve had difficulty ever since and I’m looking for the reason.
Please write in if you know!
K. Cann

Synthetic thyroid meds did NOT work for me & one day I realized I should feel better NOT worse on my meds – couldn’t sleep, angry, NO energy, hair falling out, gaining even more weight, etc. The first dose upon switching to Armour & later Naturethroid I felt like someone woke me up! Hair quit falling out, started sleeping again, had energy to get UP, lost some weight & feel GREAT! NEVER will I switch back to a synthetic thyroid med -they have NO T3 & if your body could convert T4 to T3 you wouldn’t need a thyroid med at all, would you?! It took me a LONG time to find a doctor that would switch me to natural thyroid meds but it was WELL WORTH THE EFFORT & COMMITMENT TO FEEL BETTER! Time for patients to stand up for their right to choose something that WORKS!

I was on 90mg of Armour for years, my Dr and I decided to change to see if I felt any different so I went on naturoid from may till last month. My Dr sent me to a Dr specializing in weight loss because I could never lose any. In July he doubled my naturethroid, I was fine for a while but then they thought I should go back on Armour because it has a broader coverage.
For the past three weeks I’ve been so dizzy all day long, I’ve reduced my Armour to 1 60 mg no difference. The Dr said it might take a while to get out of my system, but I think its been long enough, I’m tempted to go back on naturthroid to see if it makes any difference. Or could it be my hormones? Please help!

I have HyperThyroidism and Taking Tapazole 5mg and first my endo doctor told me that my blood tests were off the charts and I would have to decide on surgery or Iodine Treatment, two months after endo doctor told me that, told me that they do not do surgery just for that but, the blood work tells that I need to stay on Tapazole for the rest of my living live on earth- My concern (not endo Doctor) that the Medication that I am due to take for the Rest of my life-Damages my Liver-
Would Armour Thyroid help me ? Good Luck to all with Health Problems.

I have had a problem with getting doctors to prescribe the drug Armour, which has been around for 100 years. I had half my Thyroid removed due to cold nodule. I went to 8 different endocrinologists in one year. They all quoted a study that said that synthroid was better because of quality control and the subjects in the study reported no significant difference. The study they quoted had only 33 people… I don’t know about you but from my science days, 33 is not scientifically valid to draw a conclusion. I had one doctor who I never even saw say I was depressed (I saw his physician assistant). He would give me antidepressants and Synthroid. but not Armour.
When I was on Synthroid I gained 10 pounds in one year and felt horrible. I have been on Armour for a year and have lost a few pounds and feel so much better. (Found a physician assistant who would switch me)
I believe it has to do with both T3 and T4. Some women/men need it some and some don’t. Why make us suffer?
Even after 37 states had a class action suit against Knoll because of their marketing approaches that suggested that the Synthroid brand was better – – claims that were disproven by the company’s own research, doctors still believe this myth. Why? Because Synthroid is one of the top five selling drugs in the U.S., and is a consistently profitable drug for its manufacturer. The drug has always been heavily marketed by an army of pharmaceutical sales representatives, and its manufacturer, currently Abbott Labs, provides patient literature, and sponsors endocrinology meetings, med school lectures, and funds various thyroid-related medical organizations and patient organizations.
The American Thyroid Association and American Academy of Clinical Endocrinologists, and many individual physicians all have a history of receiving substantial funding from Synthroid’s manufacturer. If you want to get ahead in endocrinology, get grant money, advance in one of the professional or patient thyroid groups, or get your golf outing partially paid for, you had better have a good “relationship” with Synthroid, its maker, and its representatives.
We need to fight this type of patient abuse.

I am a pretty healthy, fairly active person. I eat better than 95% of Americans but I do eat more soy products than many. I did have fatigue and weight gain but no other symptoms about three years ago. I also was going through early menopause.
My nurse practitioner checked my TSH and free T-4 levels and said that I had too high level of TSH. She put me on levothyroxine, 50mg a day. I resisted this recommendation at first because I am a natural health person and certainly do not like the idea of being on a drug for the rest of my life! But after a few months, I started the medication. I really didn’t notice much change. My levels were taken after 2 months and they were good according to her. I didn’t really feel any different.
About 9 months later I learned about the benefits of taking at least 1000 units of Vitamin D 3 every day. After a short time on this, this is when I really felt like my energy level increased dramatically. Enough so that I thought I could go back to school and start prerequisites for nursing school which is quite a rigorous program!
But, the problem is that I have had all kinds of annoying health problems since starting the levothyroxine. After just a few months on it, I developed recurring episcleritis, inflammation in my right eye. I have to use Tobradex or Tobramycin every time it happens. This is a steroid and antibiotic eye drop. I had to treat myself at least 12 times with this since it started. This past summer I developed a rash under my breasts and something like athlete’s foot with itchiness and peeling on my left foot. To me all of these symptoms seem to be an inflammatory response. Of course, my nurse practitioner says this is not related to levothyroxine or the the eye drops. Now she gave me an antifungal cream for my foot and rash. So now I use three drugs which I just hate.
I have to use the eye drops because when my eye gets inflamed. I still have to do all my studying. I am very frustrated and feel like I am on this cascade of drugs and drug reactions and I just want to stop them all including the levothyroxine. I know even Terry & Joe G. will say no to do this. I feel like my CNP is not listening to me. I don’t believe her telling me that these weird symptoms are not related to all of these drugs or possible fillers in the generic drug.
I would like to try dessicated Thyroid but now this is difficult to get and I know my CNP would not write a prescription for it. I am low income and on state insurance and in an HMO, so it is not very easy to get another opinion (or prescription).
I know that this is another no-no, but I cut my levothyroxine dose in half on my own and had my yearly thyroid levels checked and they were fine. I did this for nine weeks before the blood test and before I saw my CNP for my yearly check up. I didn’t tell her that I did this because I know what she would say. I did bring up my concerns with her but she said what I thought that she would say.
At this point I just want to stop the levothyroxine because I never had severe symptoms of hypothyroidism in the first place! I may do this because it is my body! I won’t stay off of the levothyroxine if bad things happen but until I find a doctor who will prescribe Armour Thyroid or something similar, I am sick of this domino effects of drugs and side effects! I also have cut back on eating soy products and may cut back further in case that caused my supposed hypothyroidism in the first place.
I guess I just wanted to tell my story here. I love People’s Pharmacy radio show and all of the resources they bring to the general public. I also appreciate the balanced view they Joe & Terry G. bring about medical issues. They actually listen to people who, for instance, have muscle aches from taking statins when I know that many of these person’s doctors don’t listen to them! Keep up the good work, People’s Pharmacy!

In 2007 my doctor did a blood test which showed a low thyroid. He sent me to a specialist who had me swallow a substance that shows what the thyroid looks like. Prior to that, I had filled out a questionnaire wherein I replied no to every question related to a system of low thyroid. I felt fine all these years. It didn’t occur to me to question why I had been sent to a specialist if I didn’t have any of the symptoms. Since then I have been on Levothyroxin and am up to 75 mcg.
I was also on the non-generic form of Synthroid at the beginning. I have not felt good since 2007, my muscle use has decreased, my doctor insists it has to be something else and now wants to raise me to 100 mcg because the blood work still shows a low thyroid. I have read Dr. Rubin’s findings where he feels some people have a low thyroid, no symptoms, so let things alone. Is there anyone out there who might have had a similar experience?

Can you take Allegra D at the same time you take Armour??? Both are required on an empty stomach???

6-7 yrs ago I had some blood work done that came back saying I needed to be on some Thyroid meds, Synthroid was prescribed and off I went to my local pharmacist thinking this is a one shot deal, well my pharmacist told me once I start these I am a lifer which I wanted nothing to do with (I was exhibiting no symptoms).

About a yr later I was talking with a health care type person and they said you need to be careful because you could be doing damage to your body and not be aware of it (still not exhibiting any symptoms) so of course I head to a different doc who confirms my need for some thyroid meds.

I started on a low dose of Synthroid (with no symptoms) and have worked my way up to alternating doses of 150 mcg and 137 mcg and of course with no noticeable difference other then the blood work says I am fine.

My only issue is that I think it effects my core temp some how, when I start to exert a little bit of energy, dancing, work (not overly strenuous) I start to sweat, and I mean sweat from my head, back and chest mostly, the amount of sweat compared to the energy output doesn’t line up.
Has anyone else had this kind of thing? Age 56

I was put on generic synthroid and my hair started to fall out about 6 weeks after I started it. My doctor told me my hair loss could not be from the synthroiod!! Yet I have spoken to several women who claim to have had the same experience. Why won’t doctors listen to their patients????

I am on Synthroid 0.75 mcg but it makes me irritable, depressed, angry and unable to enjoy life….I want to switch to something else but my doctor won’t listen….what to do? Where do you find a endocrinologist that will listen to your symptoms?

Armour thyroid dosage DOES not vary—it was around for decades —it is my thyroid replacement drug of choice as if I must take a medication for the rest of my life —let it be natural.

How about a medicine that does the exact same thing, is natural and is not made with pork? I keep kosher and am very strict about my diet.

did you find anything kosher?

To all who are taking synthetic thyroid hormone and still not feeling well, and either aren’t able to get a doctor to prescribe Armour or don’t want to take Armour, ask your doctor to supplement your Levoxyl or Synthroid (T4 replacements) with Cytomel (T3 replacement). I am amazed at how many doctors do not include this in treatment of hypothyroidism. My endocrinologist changed my life when he added cytomel to my treatment.
My thinking got clearer, my memory is sharper, my depression is gone, and I don’t crash in the afternoon anymore. He calls Cytomel brain food. And best of all my regular doctor has gone to conferences about just this so when my endo retires, my regular doctor is ready to take over. Not all doctors use cytomel, even the major medical university I live near does not teach the use of Cytomel.
Find a doctor who will use it if yours won’t. And experiment taking some in the morning and some in the afternoon. It doesn’t need to be used all at once.
If you are still having symptoms then make sure your TSH is near 1.0. Some doctors medicate just until you are in the range. Those lab ranges are just that…ranges. A doctor ought not to care so much about the number as much as the symptoms. My hair falls out at 1.6 and I can’t break a sweat at the gym. Yet 1.6 is a fantastic score if you are looking at ranges. Get me to 1.0 and my hair stays in and every workout is worthwhile.
Be persistent until you feel great!

Armour thyroid is the best thing that has ever been prescribed to me, as well! The aversion that some MD’s have to Armour makes me angry. I went to an Endo who absolutely refused to give me Armour, even though I had severe reactions to the synthetics. I finally found a doc who WANTED to give me Armour and it’s been wonderful. No more depression, unbearable fatigue, or feeling like my life sucks. I would NEVER go back to the synthetics. They were horrible!!!

Armour thyroid is the best thing that has ever been prescribed to me. After almost 2 years of trial and error with synthetic thyroid hormones, a new to me but “old school” physician prescribed this to me and it was the best medicine I have ever taken. He told me it would take about 2 weeks to feel the effects and don’t you know that at right about 2 weeks I felt like a new person! Unfortunately, that physician has retired and my new MD hates the thought of giving me Armour, but I have insisted on it and he reluctantly refills the Rx. Don’t give it up! If it works for you, keep with it. I know it works for me!

When I was diagnosed with underactive thyroid, I was prescribed Synthroid. This did not seem to work well for me, so I switched to Armour Thyroid, which other than the smell was working well for me.
I had moved and although my new doctor kept me on Armour, she thought it best if I went with the Synthroid as it was easier to control.
I do not feel as well. I am always cold, dry hair and skin. I am also taking Allegra, Nexium, Lovaza, Zoloft, Zocor, Boniva and Metoprolol. Most are the Generic Brand. I also take Citracal, Vitamin D, Centrum Silver and Ester C. I occasionally have a dizzy spell and unsteady on my feet.
Should I go back to Armour?
What are the interactions between all these meds and vitamins? Thank you for your response.

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