{"id":30591,"date":"2022-11-28T06:44:41","date_gmt":"2022-11-28T12:44:41","guid":{"rendered":"https:\/\/wholehealthchicago.com\/blog\/?p=30591"},"modified":"2022-11-28T11:46:14","modified_gmt":"2022-11-28T17:46:14","slug":"when-your-thyroid-medication-isnt-working-2","status":"publish","type":"post","link":"https:\/\/wholehealthchicago.com\/blog\/2022\/11\/28\/when-your-thyroid-medication-isnt-working-2","title":{"rendered":"When Your Thyroid Medication Isn\u2019t Working"},"content":{"rendered":"\n

Two thyroid facts worth knowing:<\/p>\n\n\n\n

    \n
  1. The diagnosis of mild (also called \u201csubclinical\u201d) hypothyroidism (low levels of thyroid hormone) is overlooked by many physicians.<\/li>\n\n\n\n
  2. When you actually are diagnosed with hypothyroidism, you might be prescribed the medicine that won\u2019t work best for you.<\/li>\n<\/ol>\n\n\n\n

    You\u2019ve shown up for your usual ten minute, quick glance billed to your insurer as an in-depth primary care office visit. You\u2019re allowed to talk about one problem only, and so you present the symptoms of hypothyroidism every doctor and nurse practitioner should be able to recite in their sleep. She listens, sometimes attentively, and orders the insurance approved blood test, a TSH (T<\/strong>hyroid S<\/strong>timulating H<\/strong>ormone).<\/p>\n\n\n\n

    Be aware this is not<\/strong> measuring anything produced by your thyroid but rather a second hormone from a different gland a few inches away, the pituitary gland. It\u2019s an indirect measurement, sort of like determining how fast your car is moving by looking at your fuel gauge rather than at the speedometer.<\/p>\n\n\n\n

    Does the TSH give you an accurate picture of your thyroid status? Sometimes, sometimes not. But if the lab reports your TSH as between 1.0 and 5.0, you\u2019re told your thyroid is \u2018normal\u2019, and that, as they say, is that. Oh, by the way, a high TSH means your pituitary is encouraging your thyroid to make more hormone. High TSH = under-active thyroid (get it?).<\/p>\n\n\n\n

    So, if your TSH is between 1.0 and 5.0, you\u2019re sent on your (less than) merry way, tired, cold, sluggish and depressed, thinking \u201cI thought it was my thyroid\u201d.<\/p>\n\n\n\n

    Well, it still can be your thyroid. You need more in depth testing. So it\u2019s time to be a pro-active patient!<\/p>\n\n\n\n

    Just like you watch your speedometer, and not your fuel gauge, if you want to avoid a speeding ticket, your doctor should be measuring your actual hormones (T3 and T4) and testing you for the common thyroid autoimmune disease called Hashimoto\u2019s thyroiditis. She also should know that a lot of endocrinologists now believe any TSH above 2.5 should be treated as hypothyroid. Probably 20%-30% of adults drag around with their TSH above 2.5.<\/p>\n\n\n\n

    You do need to be realistic and not blame everything on your thyroid. <\/strong><\/h3>\n\n\n\n

    You may be surprised to learn that eating too much, or eating unhealthful foods, or being chronically inactive can also put weight on, poundage not curable by taking thyroid medication. And as for \u2018tiredness\u2019, it shouldn\u2019t surprise you that \u2018fatigue\u2019 is one of the top complaints physicians hear from patients. Thyroid issues are responsible for some fatigue issues but certainly just a small percent.<\/p>\n\n\n\n

    If you suspect underactive thyroid (hypothyroid) is responsible for some of your symptoms, you can do a quick screening test on yourself invented by Broda Barnes, M.D., <\/strong>a Rush Medical College trained physician and professor at U. of IL College of Medicine. We use it often here at WholeHealth Chicago to initiate thyroid treatment<\/a>. Low body temperatures (below 97.6) frequently accompany hypothyroidism. Barnes standardized the measurement and gave \u201ccold\u201d patients a trial of thyroid hormone treatment which was usually successful. However, the TSH test was invented at about this time and seemed more \u2018scientific\u2019.<\/p>\n\n\n\n

    But uh-oh! What happens when you\u2019re taking the prescribed thyroid replacement and nothing happens. <\/strong>That\u2019s right. Your hopes\u2026dashed; you\u2019re still cold, tired and worse than anything, you haven\u2019t lost an ounce. What went wrong?<\/p>\n\n\n\n

    Don\u2019t give up! Any of several possibilities:<\/h3>\n\n\n\n
      \n
    1. Your dose isn\u2019t high enough. A definite possibility, but don\u2019t increase it on your own. Dose adjustment is not DIY healthcare. Let your doctor adjust your dose by listening to your symptoms and tracking results of a full thyroid panel (TSH, T3, T4). Some patients feel best being a scoatch below hyperthyroidism (a scoatch is slightly less than a smidgen), but going around in a self induced hyperthyroid state (called \u2018factitious hyperthyroidism\u2019) is simply unhealthy.<\/li>\n\n\n\n
    2. The thyroid product isn\u2019t right for you. Conventional physicians have been brainwashed to prescribe Synthroid, a\/k\/a Levoxyl, a synthetic T4 which replaced dried (\u2018desiccated\u2019) pig (\u2018porcine\u2019) thyroid in the 1960\u2019s (Armour <which older Chicagoans remember as the meat packing plant>). Why \u2018pig\u2019? Because the pig\u2019s thyroid blend of T4 and T3 is actually closest to the human thyroid. The current brands of pig thyroid (called \u2018porcine\u2019) covered by insurance are Armour and NPThyroid.<\/li>\n\n\n\n
    3. Alternatively, your doctor might add pure T3 (liothyronine, Cytomel) to your T4 as a separate prescription. Since T3 is much more potent than T4, your initial dose will like be quite small, on the order of 5 mcg (mcg stands for micrograms, one millionth<\/strong> of a gram, one thousandth of a <\/strong>milligram). If you\u2019re prescribed Cytomel, never ever self-treat (\u201cOh, I\u2019m feeling so fat today, I\u2019ll just take a few extra Cytomel\u201d). Yikes! Too much Cytomel can trigger very unpleasant side effects and possibly dangerous heart arrhythmias.<\/li>\n\n\n\n
    4. If you are using Cytomel (T3) you might feel an afternoon crash. This is because T3 has a short half life and disappears quickly from the body. You might feel better if you spread your dose throughout the day, e.g., 5 mcg three times a day. There are also capsules of slow release T3 available but you\u2019d need to get this from a compounding pharmacist. It is expensive and rarely covered by insurance.<\/li>\n\n\n\n
    5. Don\u2019t neglect your adrenal glands. <\/strong>Your thyroid and adrenals are both pituitary controlled, stress responding glands and when under chronic stress, both can get fatigued. If you start treating your thyroid, your increasing metabolism may place an extra burden on your adrenals. Symptoms of adrenal fatigue can mimic hypothyroidism. Take an adrenal support formula<\/a> when starting thyroid. If you still feel thyroid symptoms, and your lab tests are good, have your doctor order an adrenal test measuring salivary cortisol<\/a> taken throughout a single day.<\/li>\n<\/ol>\n\n\n\n