005 // Medications for hypothyroid and Hashimoto’s

There are several different medications for hypothyroid and Hashimoto’s thyroiditis. If your thyroid is not working well, or if your T4 (the inactive form of thyroid) is not converting to T3 (the active form,) you need to work with your medical professional to get a medication prescription so that your cells can work as they’re designed to function.

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Are there medications you can take for hypothyroid and Hashimoto’s? Yes, there definitely are. 

Address the root causes, of course

In the last episode, I talked to you about the root causes of autoimmune issues and Hashimoto’s specifically. I mentioned that there are three things that every autoimmune condition has: a genetic component, a gut component, and a trigger. And then we talked about different things you can do to help those specific things. We’re going to get into deeper aspects of that in the future. 

Medications for hypothyroid can still be necessary

But what about medications? There are definitely medications for hypothyroid and Hashimoto’s, and that is because, if you remember, from the episode where I talked to you about your lab values, and how your thyroid works. Every single cell needs thyroid. So if your thyroid is not working, you have to have that, and those are in the form of medications. 

My stance on holistic vs western medicine

Some people have asked me, “Esther, are you just for holistic things? Are you just going to talk to me about supplements and essential oils and diet and stuff?”

No, I am not. I am a registered nurse. I know that there are absolutely fabulous things about medicine in general. I know that there are many, many helpful things, and I do not shun Western medicine just because I know that we need to look at root causes. We absolutely need to look at root causes, but we also need to be able to use the resources at our fingertips and within our pharmacies to help ourselves. I’m not going to throw out the baby with the bathwater.

Lab work informs doses for thyroid medication

What medications can you take for hypothyroid and Hashimoto’s? It’s a good question, and this is one where you need to talk to your doctor or another prescribing person–nurse practitioner, or whoever you go to. This has to be controlled by a medical professional, and they need to monitor your lab work. Because your thyroid, when it’s working well, is constantly responding to the signals from the rest of your body, from your cells.

Well, if your thyroid isn’t working it can’t respond to those signals, therefore your pharmacist and your doctor are going to have to respond to those signals for you. They’re going to have to adjust your dosing. So please work with your doctor or other health care professional to make sure that you are on the right medications.

A good relationship with your advisors is necissary

Now, of course, we absolutely need to still keep addressing root cause, because if you don’t address the mixed-up immune system that’s attacking your thyroid, it is going to keep on doing damage.

When you address all of those root causes, there have been people who have found that their thyroid is healing because it’s not under attack anymore. That is not to say that you can just stop your medications because you’re addressing the root cause. You have to be in communication with your prescribing professional. Have a good relationship. 

I consider myself the CEO of my own health care. I’m in charge. The doctor that I see, and the chiropractor that I see, they are on my team–on my board of consultants maybe you want to say, but they don’t control my healthcare. But they are vital members of my advisory,

Absolutely keep getting your blood work done. Keep taking your medications. Don’t stop them unless your doctor says, “let’s reduce your dose.” 

Thyroid medication doses can change over time

One of my friends, after she started activating her own pathways, she noticed that it was almost like she was overmedicated. Her medications had not changed, but the attack on her thyroid must have changed. Her immune system must have been able to calm down a little bit. She needed to go to her doctor and say, “Hey, I feel like I’m overmedicated; can we re-check my labs? Can we adjust my medications?”

I am not negating the fact that your body is powerful. Your body can heal.

I am also definitely not saying that it’s a sure bet. Just because you’re activating your own pathways and you’re plugging all of the holes with your micronutrients, it does not mean you can just stop your medications. 

Please hear me loud and clear. Every single cell in your body needs thyroid hormone. If your thyroid is not making T4, then it cannot convert to T3, which is the active form that every single cell needs. So you have to take medication because every single cell in your body needs that spark plug to run.

Specific medications

So let’s talk about the medications. I am very grateful for all of the people who answered my question on Facebook. I’m also always on Instagram if you want to ask me any questions. I asked, “What questions do you have about medications?” I’m going to answer all of those questions in the following segment:

T4 is the inactive form of thyroid

I talked to you that your thyroid produces T4. That’s the inactive form of thyroid. The most common medicine for hypothyroid or Hashimoto’s is levothyroxine. The brand names are Synthroid, Levoxyl, Tirosint, and Unithroid. Those are the most common ones. When I was working in the emergency department I saw people come through all the time on Levothyroxine and Synthroid. Those are the two most common forms that I saw as a nurse. 

I will say upfront that it is also the number one medication I heard patients tell me that they had to stay on the exact same brand. They could not switch around brands. Every once in a while their pharmacist would tell them that they had a different brand. “Come in, and it’s a different price. So could they please switch?” And this is a number one medication, where, if people switched brands, they would have a different response in their body. So it is very brand-specific. I don’t know why pharmacists don’t always know why. We just know it is.

Levothyroxine or Synthroid is T4. That’s what your thyroid would create, would make, if it was functioning well. In your body, the T4 then will switch to T3, and that’s the form that your cells can use.

T3 is the active form of thyroid

If that switch is not happening well, if you’re, if you’re taking your thyroid medication, your T4, but it’s not converting to T3 in your body, then you also need to have a T3 as part of your medication regime.

Now the problem with T3 is, that it gives you more energy and it speeds up your metabolism because that’s what your thyroid does. Back, I think it was in the ’80s, maybe the ’70s, I’m not quite sure when it was, but people were using T3 as a diet medication. They were using it off-label, and then they were getting sick because they were inducing this hyperthyroid state. 

Your thyroid is very, very specifically regulated in your body. You can’t just take extra because you want to boost your metabolism, or you want to lose weight. That’s not safe. And so when people were doing that, then T3 itself got a bad rap because people were getting sick. They were getting sick because they were not using it correctly, but as a result, T3 itself got a bad rap, and not all doctors prescribe T3 just because of that stigma, and because they didn’t go back and say, “Hey, wait a minute. Why is this stigma there?”

If the doctor goes back and looks at it, they will realize that your T4 from your thyroid needs to convert to T3. If that’s not happening, then you also need medical medication for your T3. 

Now again. I am a nurse. I am not your doctor. I’m not a doctor. I am not a pharmacist. I am not prescribing. I am telling you how things work in your body. Talk to your doctor or your prescribing person to get your specific plan.

T3 of the different brands and forms. They’re a bit longer to say: Triiodothyroinine. That’s a really long word. I don’t know if I’m saying it correctly, and some brand names are Liothyronine, Cytomel, and Triostat.

When to take your medications for hypothyroid

Some of the questions I got Where can I take this at night? Can I take T3 at night? 

You can take your T4 any time of the day. It just has to stay the same time every single day. Your T4 (Levothyroxine or Synthroid) takes a while to build up in the body. Its half-life, or how long it’s active in your body, is very long, but you have to take it at the same time every day. Most people will take their T4 in the morning, because you’re supposed to take it on an empty stomach, and that’s when you have an empty stomach.

The T3 you also need to take at the same time every day, and that one you do need to take in the morning or during the day. Because T3 again, is the active form of thyroid. It’s the form that every cell uses, and so to have that energy to have your cells working, to have your metabolism going during the day when you want it to be going, you need to take your T3 during the day. 

T3 is very short acting. Some people, again work with your pharmacist and your doctor, but some people need to take T3 multiple times a day. Figure out what works for you, but T3 you do not want to take at night.

Combo T4-T3 medications

Then there’s the combination T4 + T3. The most common form of this is Armour. It also goes by NDT, or natural desiccated thyroid. It’s also called pig or porcine thyroid extract. I am really grateful for the people who have gone before us and have figured this out because your body needs T4 and T3. If your thyroid gland isn’t doing it, and if the T4 isn’t converting to T3, I am so grateful that we have a medication that we can take to help us out.

Again, you do need to take this at the same time every day, and because it has T4 in it, it is supposed to be taken on an empty stomach.

Take your thyroid medications on an empty stomach

Now let me talk a little bit more about that empty stomach issue. You take it with water. You cannot take your T4 with coffee. I know a lot of people will drink their coffee right away in the morning with their medications, and they’ll still have an empty stomach. However, the coffee and the caffeine in the coffee interfere with absorption. Other things that interfere with absorption are things that contain calcium iron, some amino acids called tyrosine, and some other medications.

Take your medication in the morning on an empty stomach with a large glass of water. Most people can wait about ten to thirty minutes and then eat breakfast. So if you keep a big glass of water on your bedside stand, which I recommend anyway, because it’s great to start your day with a big glass of water. Keep that on the bedside stand with your medication, and then, first thing in the morning you can take that medication, drink a big glass of water, and proceed with getting dressed and brushing your teeth and doing all of your toiletry stuff, and by that time, hopefully, you can eat your breakfast without a problem.

Hashimoto’s and thyroid disease are common. Share this post.

That answers all of the questions that I received.

If this is helpful for you. Please share this podcast. We know that hypothyroidism is very, very common in women, especially women in middle age and older. And, of those people who have thyroid problems, about 90% are caused by Hashimoto’s, or the immune system going haywire. So I guarantee you have some friends who might not have told you, “Hey, I have Hashimoto’s, or hey? I have thyroid problems,” but they are struggling So please share this podcast so the word can get out so that women can find the help that they need, and move forward on a path to health with Hashimoto’s.

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