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MEDICAL TREATMENTS FOR HYPOTHYROIDISM AND HASHIMOTO'S THYROIDITIS

SYNTHROID OR LEVOTHYROXINE SODIUM

The basic medical treatment for hypothyroidism is the administration of replacement thyroid hormone.  Most doctors will insist on prescribing Synthroid which is a brand name for levothyroxine sodium.  This is the monosodium salt of the levo isomer of the thyroid hormone thyroxine (T4).  Therefore Synthroid or other brands of levothyroxine sodium will provide the same chemically identical hormone that our thyroid hormones make.

While there are other manufacturers of levothyroxine sodium, doctors seem to insist on prescribing Synthroid which is much more costly.  My suspicion is that the doctors are getting kickbacks, perhaps in the form of free trips (which is a form of kickback in the pharmaceutical business), for prescriptions written for Synthroid.  (Someone could look into this and report back.)

Levothyroxine sodium will work for many people with hypothyroidism and will alleviate some of the symptoms.  However, many hypothyroids will not respond well to levothyroxine sodium.

In my experience, most hypos are deficient in selenium and zinc.  These two minerals are critically important for converting the body's supply of thyroxine (T4) into triiodothyronine (T3), which is the hormone that the body uses at the cellular level.  Thyroxine is known as a "prohormone" because the body has to convert it into another hormone for use.

Therefore taking levothyroxine sodium or Synthroid is the same as taking a prohormone.  The body has to convert it into the active hormone (T3) for the effects to be felt.  If the hypothyroidism is due to a breakdown of the conversion of T4 to T3, the person will feel little benefit from taking T4 (thyroxine or Synthroid).

ARMOUR THYROID HORMONE

Another way to get thyroid hormone is to extract it from animals slaughtered for meat consumption.  The packing company Armour produces such a hormone and the hormone is also called Armour.  The advantage of Armour is that in addition to T4 it contains some T3 which has already been converted from the T4.  Also there are some references in the literature to other forms of thyroxine, such as T7 (there might be T5 and T6 also).  I don't know if these are very important, but there is the possibility that they have some minor functions, if they exist at all).

Hypos who are suffering from an inability to convert T4 to T3 (and these persons usually also have low production of T4) benefit from Armour more than from Synthroid.  More than likely Synthroid might be found just as beneficial as Armour if sufficient amounts of selenium and zinc are provided through supplementation, but it could take a period of time (days or weeks) to replenish these minerals if they are seriously depleted.

Some people might object to the use of Armour for other reasons.  There was a time when the potency of Armour varied, but it seems as though the company has corrected that problem.  Also, some people object to taking something from animals but that is just a fear and I don't see any justification for that fear.  

Overall, I think that hypos will do better taking Armour rather than Synthroid or another manufactured form of levothyroxine sodium.

HOW MUCH HORMONE?

Many people feel that since they have to take thyroid hormone then their thyroid glands must be "shot."  Doctors do their best to perseverate this myth by telling patients that their thyroid has "burned out" or will burn out.  I think this is nonsense.

As an approximation, our thyroid glands produce about 300 mcg of hormone a day.  Therefore the thyroid gland of a hypo taking 100 mcg of replacement hormone a day is producing about two thirds of the hormone that is needed.  Very, very rarely will you see a person taking over 200 mcg per day.  As you can see, most hypos thyroids are producing more than half of the thyroid hormone needed.  To me this is not "burned out."  

I am not the only person with the belief that by providing the body with the proper nutrients the thyroid will be able to produce all the thyroid hormone needed.  It's not a matter of taking a "dead" thyroid and bringing it back to life.  It's a matter of taking a thyroid that is under producing and getting it to produce more.  It's possible and people are doing it.

Some people wonder if they take less hormone than they need will that stimulate the thyroid to produce more hormone.  I tried this when I was hypo and also looked into this.  I've seen no evidence that this strategy will work.  I believe the thyroid gland is doing the best that it can and will produce more hormone when it has the raw materials to do so.

WHEN YOU THYROID RECOVERS

If you take the supplements that your thyroid gland needs to produce hormone you may experience a sudden increase in the production of thyroid hormone.  I experienced this in my recovery from hypothyroidism.

I had recently had my silver amalgam (mercury) filling replaced and was supplementing zinc and selenium along with other supplements.  One morning about an hour after breakfast when I took my Armour hormone and my nutritional supplements, I got very hot, sweaty, and shaky.  After a short period of thinking that I was really sick or dying, I reasoned that my thyroid gland may have recovered.  I stopped taking thyroid hormone and within a couple days I was feeling much better.

While thyroxine has a half life in the body of about 7 days, triiodothyronine (T3) has a half-life of about 10 hours.  This means that if your thyroid suddenly starts producing hormone or your T4 to T3 conversion suddenly increases, you could have high levels of T3 for a day or two, but these levels will soon return to normal.

There have been other members of the group who have experienced this sudden increase in thyroid production who have gone through this "hyper episode." That period can be frightening but it passes.  The best strategy is to discontinue the replacement hormone to see if it passes.  You can call your doctor to tell him or her what you've done.  You may find that your thyroid gland has completely recovered and you no longer need replacement hormone or you may find that you need to resume replacement  hormone at a lower dosage. 

If you have any questions, just post a message on the Bulletin Board.

Studies:

From Dr. Mercola's site at www.mercola.com:

NEJM Study Proves Armour Thyroid Better Than Synthroid

Patients with hypothyroidism show greater improvements in mood and brain function if they receive treatment Armour thyroid rather than Synthroid (thyroxine). Hypothyroidism, where the gland has ceased to function or been removed, is usually treated with daily doses of Synthroid. But the researchers found that substituting Armour thyroid led to improvements in mood and in neuropsychological functioning.

Not all tissues that need thyroid hormone are equally able to convert thyroxine to triiodothyronine, the active form of the hormone. But most patients with hypothyroidism (reduced thyroid function) are treated only with thyroxine. On 6 of 17 measures of mood and cognition -- a catchall term that refers to language, learning and memory -- the patients scored better after receiving Armour thyroid than after receiving Synthroid. No score was better after Synthroid than after combination treatment. The authors also detected biochemical evidence that thyroid hormone action was greater after treatment with Armour thyroid. The patients who were on Armour thyroid had significantly higher serum concentrations of sex hormone-binding globulin

The New England Journal of Medicine 1999;340:424-429, 469-470.

COMMENT: Extracts of animal thyroid tissue, first used in 1892, contained both thyroxine and triiodothyronine (Armour thyroid) and were the only available treatment for hypothyroidism for some 50 years. Because of concern about their variable potency, these extracts have been considered obsolete for some time by all but a few natural prescribers. This is a MAJOR article. I did not realize that natural therapies would penetrate this far this quickly. I am very surprised that this was published in NEJM. If one reads the editorial, you will find that it recommends that patient NOT switch from Synthroid to Armour thyroid because more research needs to be done and "the majority of patients taking Synthroid "have no complaints about their medication." If your doctor or endocrinologist refuses to give you Armour thyroid instead of Synthroid, you can use this article to show him that it is indeed better. Synthroid (thyroxine) is RARELY ever the best choice for hypothyroid patients.