Treatment of Hyperthyroidism
The AIM of treating Hypothyroidism is to relieve symptoms and reduce the risk of Atherosclerosis, High Cholesterol, Overweight (Excessive Body fat), Metabolic syndrome and Dementia.
The Indications (Reasons) for prescribing Thyroid medications include:
- Hypothyroidism of any type
- Low T3 levels with symptoms of Low Thyroid
- Prevention of Cardiovascular Disease / Atherosclerosis
- Lowering Cholesterol / Triglycerides / LDL
- Health & Wellness (Patients on Nature Thyroid, experience a sense of Well-being)
- Improvement of Memory
The treatment of Hypothyroidism includes Medications, Supplements and strategies that AIM to reverse Autoimmune thyroiditis.
Traditionally most Physicians including Endocrinologists prescribe Levothyroxine (Synthroid), which is a Synthetic medication.
Levothyroxine has T4 (Inactive hormone) only and no T3 (Active hormone).
T3 is the ONLY hormone that can bind to the receptors, NOT T4 or TSH.
T4 is the ONLY hormone that can cross the Blood Brain Barrier (BBB).
In addition, most patients with Hypothyroidism have decreased conversion of T4 to T3 at the Cellular level.
Therefore, an Ideal Thyroid medication should have both T4 and T3. Several Research studies have shown that combining T4 & T3 is more effective than using T4 alone.
At Ageless Integrated Medicine, we use Nature Thyroid or Armor Thyroid or WP Thyroid (Desiccated Porcine Thyroid), which has both T4 & T3.
Using this approach, we have seen Excellent results (More Energy, Loss of Fatigue, reduced Hair loss and loss of Body fat resulting in Weight loss).
Compounded T4 & T3 is used in patients who have allergies to fillers (Cornstarch or Lactose) present in Armor Thyroid or Nature Thyroid.
T3 only medications (Cytomel) or Compounded T3 can be used in addition to Nature Thyroid in patients who experience late afternoon Fatigue.
Monitoring Treatment and Blood Levels
For Ideal absorption and benefits, it is very important to take the Medication early morning on an Empty stomach along with water, wait 45 minutes to an hour, before you can drink Coffee or eat breakfast. The increase in Energy seen after taking Nature or Armor Thyroid is due to the increase in T3 levels.
At Ageless Integrated Medicine, we start the patients on lower doses and slowly increase the dose while paying close attention to the patient for possible side effects. Our AIM is to reach the Dose at which the patient feels maximum symptomatic relief (Ideal Dose) without experiencing any side effects.
Once that dose is reached, Bloodwork that includes TSH, FT4 & FT3 is repeated.
The half-life of T4 is about 5-7 days. The half-life of T3 is 1 day. Typically within 4 to 6 hours of taking Nature Thyroid or Armor Thyroid, about 50% of T3 is metabolized.
Since Free T3 levels are the best way to monitor treatment, it is important to check Blood levels between 4 to 5 hours after taking Nature or Armor Thyroid.
IDEAL THYROID HORMONE LEVELS:
- TSH 0.3-2.0 ; Ideal is 0.3
- Free T3 : 2.3 -4.3 ; Ideal is 4.3
While monitoring and adjusting the dose, it is very important to treat the Patient as a whole paying close attention to the symptoms experienced by them and how they feel, rather than rely ONLY on the Lab test values.
Supplements: Ensuring adequate intake of Protein, Magnesium, Zinc, Vitamin B12, Iodine, Vitamin B2 (Riboflavin), Vitamin C, Selenium, Vitamin A & D can promote Ideal Thyroid hormone levels.
Eliminating Triggers and restoring Intestinal Permeability: Eliminating Gluten, Dairy, Soy, Identifying and correcting Infections (H Pylori, Yersinia, Candida, SIBO) can help achieve remission (reversal) of autoimmune thyroiditis (Hashimoto’s). For more information, please see our separate page on Hashimoto’s Thyroiditis.
Side Effects of Thyroid Medications
Thyroid hormones increase the sensitivity of the Heart muscle and Blood vessels to Adrenaline and Norepinephrine (Catecholamine’s) by increasing the number of Adrenaline receptors on the Heart. Therefore, when there is an excess of Thyroid hormones in the Blood, side effects that resemble an Adrenaline surge can happen. These side effects are Dose-dependent
The possible side effects include:
- Palpitations / Tachycardia
- Insomnia (Lack of Sleep)
- Excessive Sweating
- High Blood pressure
- Worsening of existing Atrial Fibrillation
- Headaches: (Caused by High T4 levels)
Lowering the Dose, and increasing slowly will help reduce the side effects
Controversy on Osteoporosis and Low TSH
In Patients with Endogenous Hyperthyroidism (Graves’ disease, Thyrotoxicosis, Toxic Goiter) can develop Osteoporosis due to increased bone resorption (eating away of bone).
However Thyroid hormone replacement (Medications) DO NOT cause Osteoporosis even when the TSH is very low (suppressed).
Several Research studies have compared Bone Density among patients who are on Thyroid hormones to patients who are not on any Thyroid hormones and have shown that the percentage (Incidence) of Osteoporosis is the same in both groups.
If a patient who is on Thyroid Replacement (Nature Thyroid / Armor Thyroid) has a low TSH, with Ideal T4 and T3 levels and no side effects, they DO NOT have Hyperthyroidism! It just means that the Medication is working well.
If they have side effects (Palpitations, Anxiety, Tremors, Sweating), their dose needs to be lowered and titrated back up slowly.
Inadequate Response to Thyroid Medications
Most patients who are on an adequate dose of Nature Thyroid report that they feel great. However, some patients experience an inadequate response, even though they are on an adequate dose, and have Ideal blood levels of TSH, FT4 & FT3
In such patients the following should be considered:
- Ensure that the patient is taking the correct dose, Early morning on an Empty stomach and waiting 45 minutes to an hour before they eat or drink anything.
- Ensure adequate intake of Protein, Magnesium, Zinc, Vitamin B12, Iodine, Vitamin B2 (Riboflavin), Vitamin C, Selenium, Vitamin A & D.
- Consider stopping Synthetic Birth control pills (Estrogen and Progestin’s), Change Oral Estradiol to Pellets or Transdermal Creams.
- Consider reducing or changing medications like Amiodarone, Zoloft, Anti-seizure medications (Phenobarbital, Phenytoin, Carbamazepine).
- If there are changes in Weight, the dose may need to be adjusted accordingly.
- Consider elimination of Triggers (Soy, Dairy, Gluten), identify and restore Intestinal Permeability (Infections, toxins). For more information on this please read our Section on Hashimoto’s.
This website is for informational purposes only and does not offer medical advice. Some of the statements have not been evaluated by the Food and Drug Administration. The products and services discussed are not intended to diagnose, cure, or prevent any disease. All the services offered at Ageless Integrated Medicine can be prescribed by our Physician, which will include a thorough review of your Medical History, Physical Examination and possible Blood work Laboratory analysis. After such a thorough review, our Physician will determine if you are an appropriate candidate for the treatment sought based on your Individual Medical History, current health status and Laboratory results.