{"id":7962,"date":"2016-12-26T09:41:06","date_gmt":"2016-12-26T15:41:06","guid":{"rendered":"https:\/\/wholehealthchicago.com\/?p=7962"},"modified":"2022-06-08T20:55:20","modified_gmt":"2022-06-09T01:55:20","slug":"thyroid-medication-isnt-working","status":"publish","type":"post","link":"https:\/\/wholehealthchicago.com\/blog\/2016\/12\/26\/thyroid-medication-isnt-working","title":{"rendered":"When Your Thyroid Medication Isn\u2019t Working"},"content":{"rendered":"\n

Let\u2019s start with two thyroid facts: <\/strong><\/p>\n\n\n\n

The diagnosis of hypothyroidism (low levels of thyroid hormone) is missed by most physicians.<\/u> Patients arrive with obvious symptoms of hypothyroidism<\/a> every doctor learned in medical school, among them sensitivity to cold, weight gain, dry skin, fatigue, and constipation. The doctor listens, sometimes attentively, and then orders a TSH (thyroid stimulating hormone) blood test. TSH does not come from the thyroid itself, but rather from the pituitary, a Wizard of Oz sort of gland that controls your thyroid from behind its curtain.<\/p>\n\n\n\n

Understand that a high TSH test result indicates low thyroid function. Think of your pituitary churning out the hormone in an attempt to stimulate your thyroid. If your TSH is within normal range (currently 1.0 to 5.0), you\u2019re told that low thyroid is not a problem and 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

What your doctor should be measuring are your actual thyroid hormones, T3 and T4, and testing you for the common thyroid autoimmune disease called Hashimoto\u2019s thyroiditis<\/a>. She also should know that many endocrinologists now believe any TSH test result above 2.5 should be treated as an indicator of low thyroid. Probably 20% to 30% of adults drag around with their TSH higher than 2.5.<\/p>\n\n\n\n

On the opposite end, patients themselves over diagnose hypothyroidism.<\/u> If you go online and start reading websites devoted to the thyroid gland and underactive thyroid, someone somewhere has attributed every possible discomfort the human body can experience to low thyroid.<\/p>\n\n\n\n

Take being overweight as an example. Let\u2019s face it: a single daily thyroid tablet for weight loss would be a whole lot easier than eating healthfully and boarding your elliptical. It\u2019s human nature to pray that the villain of your middle-age spread is an underactive thyroid rather than an overactive fork.<\/p>\n\n\n\n

Early days<\/strong><\/h3>\n\n\n\n

The first physician to point out that hypothyroidism was likely being badly underdiagnosed by doctors was Broda Otto Barnes, MD<\/a>, a Rush Medical College-trained physician and professor at the University of Illinois College of Medicine. Noting the consistently low body temperatures of low-thyroid patients, he standardized a basal body temperature self-test you can find here<\/a>. Barnes drew the line at 97.8 (recently changed to 97.6) and felt that any temperature lower than that in a person who also had symptoms of low thyroid merited a trial of thyroid hormone treatment.<\/p>\n\n\n\n

The Barnes self-test never caught on with a majority of physicians, mainly because TSH was discovered at about the same time and seemed more scientific. These days, an increasing number of you bring your basal temperatures to your doctors as evidence of self-diagnosed hypothyroid status. It\u2019s likely your doctor hasn\u2019t a clue about Barnes and his work, but to reassure you your doc may actually order a TSH test. If it comes back normal (below 5.0), you\u2019ll hear \u201cYour thyroid\u2019s fine,\u201d but in your heart you know better.<\/p>\n\n\n\n

With perseverance, you\u2019ll eventually locate a physician to write a thyroid prescription based on your symptoms and basal temperatures.<\/p>\n\n\n\n

Ineffective thyroid replacement: what next?<\/strong><\/h3>\n\n\n\n

But what happens when you take the prescribed thyroid replacement and nothing happens? Your hopes are dashed. You\u2019re still cold, tired, and, worse than anything, you haven\u2019t lost an ounce. What went wrong? Don\u2019t give up! There are several avenues for consideration:<\/p>\n\n\n\n

  1. Your dose isn\u2019t high enough<\/u>. 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 the results of a full thyroid panel (TSH, T3, T4). Some patients feel best being a scoatch<\/em> under hyperthyroid (a scoatch is slightly less than a smidgen), but going around in a self-induced overactive thyroid state (called factitious hyperthyroidism) is simply unhealthy.<\/li>
  2. The thyroid replacement product isn\u2019t right for you<\/u>. Conventional physicians have been brainwashed to prescribe Synthroid\/Levoxyl, a synthetic T4 that replaced Armour\u2019s dried (desiccated) pig (porcine) thyroid in the 1960s (older Chicagoans still remember Armour as a meat-packing company). T4 triggers cells outside the thyroid to make T3, the active form of the hormone. Some people have better T4-to-T3 conversion systems than others. The original Armour thyroid was a blend of T4 and T3 and very similar to human thyroid. Several years ago, Armour was acquired by a Big Pharma company that changed the manufacturing process and bollixed it up.<\/li><\/ol>\n\n\n\n

    The name of the best natural thyroid is easy to remember: Nature-Throid<\/a>. Other excellent thyroids are WP Thyroid<\/a> and ERFA<\/a>. If your doctor adamantly refuses your request for NatureThroid, consider Liotrix<\/a>, a blend of synthetic T4 and T3 in the same ratios as NatureThroid. Or find a different doctor.<\/p>\n\n\n\n

    1. You may have an issue with T4 altogether and may need pure T3 (liothyronine, Cytomel) added to your T4 as a separate prescription<\/u>. Since T3 is much more potent than T4, your initial dose will likely be quite small, on the order of 5 mcg (mcg stands for micrograms, one millionth of a gram or one thousandth of a 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 potentially dangerous heart arrhythmias.<\/li>
    2. You may be taking Cytomel (T3), but feel an afternoon crash<\/u>. 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 micrograms three times daily. There are also capsules of slow-release T3 available, but you\u2019d need to get these from a compounding pharmacist. It can be expensive and is rarely covered by insurance.<\/li>
    3. You may have forgotten about your adrenal glands<\/u>. Your thyroid and adrenals are both pituitary-controlled, stress-responding glands. When you\u2019re under chronic stress, both can become fatigued. If you start treating for low 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 hormone replacement. If you still feel thyroid symptoms and your lab tests are good, have your doctor order an adrenal test,<\/a> which measures salivary cortisol throughout a single day.<\/li>
    4. You may have overlooked selenium<\/u>. It\u2019s only recently been shown that diets low in selenium can induce hypothyroidism<\/a>. You needn\u2019t add another supplement for this. Just eat some selenium-rich foods\u2014they\u2019re all quite tasty. This first list is for meat and fish eaters, the second for vegetarians<\/a> (pescetarians, please scan both).<\/li>
    5. Familiarize yourself with Janie Bowthorpe\u2019s website Stop The Thyroid Madness<\/a><\/u>. The more I read her, the more I\u2019m convinced she knows more about thyroid than 99% of physicians practicing in the US.<\/li>
    6. Don\u2019t increase your thyroid dose without professional supervision<\/u>. I\u2019m well aware of Denis Wilson, MD\u2019s, work and his \u201cWilson\u2019s Temperature Syndrome,\u201d which is essentially Broda Otto Barnes revisited along with time-release Cytomel in place of desiccated porcine thyroid<\/a>. But Cytomel is simply too powerful for you to play with on your own.<\/li>
    7. Remember that fatigue is one of the most common problems people bring to their primary care physicians<\/u>. There are dozens of causes of fatigue. If your pursuit of hypothyroidism doesn\u2019t pan out, don\u2019t give up. Keep researching, at our WHC blog<\/a> and elsewhere.<\/li><\/ol>\n\n\n\n

      Be well,
      David Edelberg, MD<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

      Let\u2019s start with two thyroid facts:  The diagnosis of hypothyroidism (low levels of thyroid hormone) is missed by most physicians. Patients arrive with obvious symptoms of hypothyroidism every doctor learned in medical school, among them sensitivity to cold, weight gain, dry skin, fatigue, and constipation. The doctor listens, sometimes attentively, and then orders a TSH […]<\/p>\n","protected":false},"author":2087,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[28,2,139,209,3,2315,2314,246,48,27],"tags":[173,179,1108,1492,427,1208,429],"class_list":["post-7962","post","type-post","status-publish","format-standard","hentry","category-alternative-therapies","category-blog","category-cardiovascular-health","category-fibromyalgia-chronic-fatigue","category-knowledge-base","category-most-comments","category-most-view","category-thyroid-adrenal-sex-hormone-issues","category-w","category-weight-issues","tag-adrenal","tag-adrenal-fatigue","tag-armour-thyroid","tag-cardiovascular-disease","tag-hormone-balancing","tag-hormone-replacement-therapies","tag-thyroid"],"yoast_head":"\r\nWhen Your Thyroid Medication Isn\u2019t Working<\/title>\r\n<meta name=\"description\" content=\"Patients arrive with obvious symptoms of hypothyroidism every doctor learned in medical school, among them sensitivity to cold, weight gain, dry skin, fatigue, and constipation.\" \/>\r\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\r\n<link rel=\"canonical\" href=\"https:\/\/wholehealthchicago.com\/blog\/2016\/12\/26\/thyroid-medication-isnt-working\" \/>\r\n<meta property=\"og:locale\" content=\"en_US\" \/>\r\n<meta property=\"og:type\" content=\"article\" \/>\r\n<meta property=\"og:title\" content=\"When Your Thyroid Medication Isn\u2019t Working\" \/>\r\n<meta property=\"og:description\" content=\"Patients arrive with obvious symptoms of hypothyroidism every doctor learned in medical school, among them sensitivity to cold, weight gain, dry skin, fatigue, and constipation.\" \/>\r\n<meta property=\"og:url\" content=\"https:\/\/wholehealthchicago.com\/blog\/2016\/12\/26\/thyroid-medication-isnt-working\" \/>\r\n<meta property=\"og:site_name\" content=\"WholeHealth Chicago\" \/>\r\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/wholehealthchicago\" \/>\r\n<meta property=\"article:published_time\" content=\"2016-12-26T15:41:06+00:00\" \/>\r\n<meta property=\"article:modified_time\" content=\"2022-06-09T01:55:20+00:00\" \/>\r\n<meta name=\"author\" content=\"wholehealthchicago\" \/>\r\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\r\n<meta name=\"twitter:creator\" content=\"@wholehealthchi\" \/>\r\n<meta name=\"twitter:site\" content=\"@wholehealthchi\" \/>\r\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"wholehealthchicago\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutes\" \/>\r\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/wholehealthchicago.com\/blog\/2016\/12\/26\/thyroid-medication-isnt-working\",\"url\":\"https:\/\/wholehealthchicago.com\/blog\/2016\/12\/26\/thyroid-medication-isnt-working\",\"name\":\"When Your Thyroid Medication Isn\u2019t Working\",\"isPartOf\":{\"@id\":\"https:\/\/wholehealthchicago.com\/blog\/#website\"},\"datePublished\":\"2016-12-26T15:41:06+00:00\",\"dateModified\":\"2022-06-09T01:55:20+00:00\",\"author\":{\"@id\":\"https:\/\/wholehealthchicago.com\/blog\/#\/schema\/person\/8f28cef347f94e6801d2bdd38b9cea19\"},\"description\":\"Patients arrive with obvious symptoms of hypothyroidism every doctor learned in medical school, among them sensitivity to cold, weight gain, dry skin, fatigue, and constipation.\",\"breadcrumb\":{\"@id\":\"https:\/\/wholehealthchicago.com\/blog\/2016\/12\/26\/thyroid-medication-isnt-working#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/wholehealthchicago.com\/blog\/2016\/12\/26\/thyroid-medication-isnt-working\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/wholehealthchicago.com\/blog\/2016\/12\/26\/thyroid-medication-isnt-working#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/wholehealthchicago.com\/blog\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"When Your Thyroid Medication Isn\u2019t Working\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/wholehealthchicago.com\/blog\/#website\",\"url\":\"https:\/\/wholehealthchicago.com\/blog\/\",\"name\":\"WholeHealth Chicago\",\"description\":\"WholeHealth Chicago is the Midwest's oldest and most respected center for integrative care, successfully blending the latest advances in conventional medicine with a wide range of clinically proven alternative therapies.\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/wholehealthchicago.com\/blog\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/wholehealthchicago.com\/blog\/#\/schema\/person\/8f28cef347f94e6801d2bdd38b9cea19\",\"name\":\"wholehealthchicago\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/wholehealthchicago.com\/blog\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/b63bce17acaeb51f185933c60fa6fa86c347679a70b79ec51e5b772e271a469f?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/b63bce17acaeb51f185933c60fa6fa86c347679a70b79ec51e5b772e271a469f?s=96&d=mm&r=g\",\"caption\":\"wholehealthchicago\"},\"url\":\"https:\/\/wholehealthchicago.com\/blog\/author\/wholehealthchicago\"}]}<\/script>\r\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"When Your Thyroid Medication Isn\u2019t Working","description":"Patients arrive with obvious symptoms of hypothyroidism every doctor learned in medical school, among them sensitivity to cold, weight gain, dry skin, fatigue, and constipation.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/wholehealthchicago.com\/blog\/2016\/12\/26\/thyroid-medication-isnt-working","og_locale":"en_US","og_type":"article","og_title":"When Your Thyroid Medication Isn\u2019t Working","og_description":"Patients arrive with obvious symptoms of hypothyroidism every doctor learned in medical school, among them sensitivity to cold, weight gain, dry skin, fatigue, and constipation.","og_url":"https:\/\/wholehealthchicago.com\/blog\/2016\/12\/26\/thyroid-medication-isnt-working","og_site_name":"WholeHealth Chicago","article_publisher":"https:\/\/www.facebook.com\/wholehealthchicago","article_published_time":"2016-12-26T15:41:06+00:00","article_modified_time":"2022-06-09T01:55:20+00:00","author":"wholehealthchicago","twitter_card":"summary_large_image","twitter_creator":"@wholehealthchi","twitter_site":"@wholehealthchi","twitter_misc":{"Written by":"wholehealthchicago","Est. reading time":"6 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/wholehealthchicago.com\/blog\/2016\/12\/26\/thyroid-medication-isnt-working","url":"https:\/\/wholehealthchicago.com\/blog\/2016\/12\/26\/thyroid-medication-isnt-working","name":"When Your Thyroid Medication Isn\u2019t Working","isPartOf":{"@id":"https:\/\/wholehealthchicago.com\/blog\/#website"},"datePublished":"2016-12-26T15:41:06+00:00","dateModified":"2022-06-09T01:55:20+00:00","author":{"@id":"https:\/\/wholehealthchicago.com\/blog\/#\/schema\/person\/8f28cef347f94e6801d2bdd38b9cea19"},"description":"Patients arrive with obvious symptoms of hypothyroidism every doctor learned in medical school, among them sensitivity to cold, weight gain, dry skin, fatigue, and constipation.","breadcrumb":{"@id":"https:\/\/wholehealthchicago.com\/blog\/2016\/12\/26\/thyroid-medication-isnt-working#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/wholehealthchicago.com\/blog\/2016\/12\/26\/thyroid-medication-isnt-working"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/wholehealthchicago.com\/blog\/2016\/12\/26\/thyroid-medication-isnt-working#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/wholehealthchicago.com\/blog"},{"@type":"ListItem","position":2,"name":"When Your Thyroid Medication Isn\u2019t Working"}]},{"@type":"WebSite","@id":"https:\/\/wholehealthchicago.com\/blog\/#website","url":"https:\/\/wholehealthchicago.com\/blog\/","name":"WholeHealth Chicago","description":"WholeHealth Chicago is the Midwest's oldest and most respected center for integrative care, successfully blending the latest advances in conventional medicine with a wide range of clinically proven alternative therapies.","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/wholehealthchicago.com\/blog\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/wholehealthchicago.com\/blog\/#\/schema\/person\/8f28cef347f94e6801d2bdd38b9cea19","name":"wholehealthchicago","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/wholehealthchicago.com\/blog\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/b63bce17acaeb51f185933c60fa6fa86c347679a70b79ec51e5b772e271a469f?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/b63bce17acaeb51f185933c60fa6fa86c347679a70b79ec51e5b772e271a469f?s=96&d=mm&r=g","caption":"wholehealthchicago"},"url":"https:\/\/wholehealthchicago.com\/blog\/author\/wholehealthchicago"}]}},"_links":{"self":[{"href":"https:\/\/wholehealthchicago.com\/blog\/wp-json\/wp\/v2\/posts\/7962","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wholehealthchicago.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wholehealthchicago.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wholehealthchicago.com\/blog\/wp-json\/wp\/v2\/users\/2087"}],"replies":[{"embeddable":true,"href":"https:\/\/wholehealthchicago.com\/blog\/wp-json\/wp\/v2\/comments?post=7962"}],"version-history":[{"count":5,"href":"https:\/\/wholehealthchicago.com\/blog\/wp-json\/wp\/v2\/posts\/7962\/revisions"}],"predecessor-version":[{"id":30284,"href":"https:\/\/wholehealthchicago.com\/blog\/wp-json\/wp\/v2\/posts\/7962\/revisions\/30284"}],"wp:attachment":[{"href":"https:\/\/wholehealthchicago.com\/blog\/wp-json\/wp\/v2\/media?parent=7962"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wholehealthchicago.com\/blog\/wp-json\/wp\/v2\/categories?post=7962"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wholehealthchicago.com\/blog\/wp-json\/wp\/v2\/tags?post=7962"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}