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Three Reasons Why Your Thyroid Medication Isn’t Working


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Reviewed by Jessica Montalvo, MD

This article is part of a special report on Thyroid Disorders. To see the other articles in this series, click here.

In the last post I explained that, for the vast majority of patients, hypothyroidism is an autoimmune disease. This isn’t just an academic distinction. It’s the reason both conventional and alternative treatments are so often ineffective.

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In this post I’m going to show you why taking replacement thyroid hormones without addressing the underlying immune imbalance is doomed to fail.

The ultimate effect of hypothyroidism, whether it’s caused by iodine deficiency or autoimmunity, is to decrease the amount of thyroid hormone available to the body. The conventional approach is to simply replace these hormones with either synthetic or bio-identical forms.

On the surface it seems like a reasonable approach. Patient doesn’t have enough hormones? Give more hormones. Simple, right?

Not so much.

Once again the conventional approach falls short because it ignores the underlying cause of the problem. It’s like taking Advil when you’ve got a pebble stuck in your shoe. It might work for a little while, and might even be necessary to dull the pain. But you’d be a lot better off if you took the pebble out of your shoe. Right?

Let’s take a closer look at why thyroid hormones often don’t work, or stop working over time. The following diagram illustrates how autoimmunity affects thyroid metabolism (please note, “HPT” stands for “hypothalamus-pituitary-thyroid axis”):


Immune dysregulation is another term for autoimmune disease. We still don’t know exactly what causes it, but most researchers agree it’s a mixture of genetic susceptibility and environmental factors such as iodine (excess), infection, pregnancy, diet and intestinal permeability.

In autoimmune disease the body attacks itself. It does this the same way it attacks foreign invaders like bacteria and viruses: with T-cells, B-cells, natural killer cells, and cytotoxic T cells. The immune response also involves proteins called cytokines, chemical messengers that pass messages between cells.

This self-attack by the immune system increases inflammation. And inflammation has a profound effect on all aspects of thyroid metabolism and physiology.

First, inflammation suppresses the HPT axis. (1) One study showed a single injection of the inflammatory cytokine TNF-alpha reduced blood levels of TSH, T3, free T4, free T3 and TRH for 5 days. (2) This shows inflammation disrupts the production and regulatory mechanisms of thyroid hormones. Thyroid medication will increase the levels of T4 (and possibly T3), but it doesn’t address the other effects of HPT axis suppression.

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Second, inflammation decreases both the number and sensitivity of thyroid hormone receptors. (3) If there aren’t enough receptors, or they aren’t sensitive enough, it doesn’t matter how much thyroid medication we take. The cells won’t be able to use it. It’s like when my grandpa used to turn down his hearing aids while he was watching the football game. It didn’t matter how much my grandma yelled at him – he couldn’t hear a word she said.

Third, inflammation decreases the conversion of T4 to T3. (4) T4 is the inactive form of thyroid hormone. The body has to convert it to the active T3 form before it can be used. Most synthetic hormone medications on the market are T4. If you give a T4 medication (like Synthroid, Levoxyl, Unithroid, etc.) to someone with inflammation, it’s not going to work because they can’t convert the T4 to T3.

Patients who don’t convert T4 to T3 well do better on bio-identical hormones like Armour, because it contains both T4 and T3 (in a 4.22:1 ratio).

Inflammation disrupts thyroid metabolism in several other ways, but I think these three examples make the point.

Now let’s review.

Inflammation causes HPT axis disruption, decreased receptor function, and decreased conversion of T4 to T3. Thyroid medication only increases the levels of thyroid hormone (usually T4) in the blood. No matter how much we take, it’s not going to restore HPT axis coordination, improve receptor function, or increase conversion of T4 to T3.

The only way to do that is to address the problem at its root by regulating the immune system and decreasing inflammation. (For more on how to address underlying inflammation, check out this episode of Revolution Health Radio with Izabella Wentz.) Unfortunately, this is rarely done in either conventional or alternative treatment of thyroid disorders.

Before I sign off, I just want to make one thing clear. I’m not saying thyroid medication isn’t necessary or useful. In fact, I think it’s an important part of treating Hashimoto’s—especially when TSH is consistently elevated and T4 and T3 are consistently low. My point is thyroid medication is only one piece of the puzzle, and it won’t be effective on its own unless the autoimmunity and inflammation are addressed.

If thyroid medication is the fantasy magic bullet of conventional medicine, iodine is the equivalent in alternative medicine. In the next post I’m going to explain why supplemental iodine may cause more harm than good in Hashimoto’s patients.

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  1. You have to have your thyroid antibodies tested to determine whether you have Hashi’s or not.


    • Was diagnosed with graves disease 7 yrs ago. The specialist first treated my problem with iodine. First do u think that was a gd idea before evaluating my condition any further. I was treated by him for about 4 &half yrs and he would never talk to me directly only to his interns knowing i was scared and confused. I weighed a bout 113 pds during my first visits and he had me on 125mg for a yr an i rapidly gained weight then he kept me on 100 mg for about 3&half yrs my health was only gettin worst so i found another speciialist. From forst visit he made me feel better by explaining my health n better detail, then he weighed me and sd i was takin way to much levothyroxin and reduced me to 88 mg. Thats been bout 2 yrs ago now . Ive lost my job no insuraance and have been out of meds for 2 wks and i know how imp it is to have them now i feel 1000xs worse then i ever have!!!! Ne advice or explanations or concerns i need to know

    • I am just starting to research the HPT axis. Myself and my extended family have a LOT of inflammation, joint, back and hip pain. I had already cut out the gluten and refined sugar and am taking Dr. Royal Lee organic whole food supplements administered by a progressive wellness chiropractic doctor. My local wellness and organic food store advised enzymes and cherry juice extract for inflammation. I take Wobenzym N enzymes, Carlson D3 and OmegaXL and use a Homedics percussion heat massager. All of the above things have had a very significant effect on my joint pain, bloating, weight loss and sense of well being. The enzymes are special kicker. I also pray to Jesus for answers. God bless you all.

      • Debbie how is it going? How is your TPO AB? Have you had any thyroid bump disappear? I’m researching the Wobenzym.

  2. Hi Chris,
    Actually all of the ingredients you listed were already in Armour, to be precise they were since the FIRST REFORMULATION in 1996.
    However in 2008/9 they again reformulated by greatly REDUCING the dextrose & greatly INCREASING the methylcellulose.
    I wrote about it here http://forums.realthyroidhelp.com/viewtopic.php?f=2&t=14846&p
    So I’m acutely aware that for MANY it is not as effective anymore. Interestingly back in 1996 there was a similar reaction to the FIRST reformulation.
    I’m in Australia & the only Dessicated Thyroid available here is Compounded using PCCA Thyroid Extract USP. Unfortunately the Compounders ALL use methylcellulose or worse Hydromellose as fillers. I’ve had to resort to T3 only because of that & now doing very well.

  3. “Patients who don’t convert T4 to T3 well do better on bio-identical hormones like Armour, because it contains both T4 and T3 (in a 4.22:1 ratio).”
    Correction Armour is NOT bio-identical. It is natural, that is, it contains Thyroid Hormones (all of them), made naturally by the pig’s thyroid.
    The synthetics ARE bio-identical but are not natural.
    Note I am NOT saying synthetics are better certainly T4 alone is good for no-one IMHO. I tried NTH unfortunately my conversion is lousy. I do very well now on T3 only.
    Note Armour since reformulation doesn’t appear to be effective for many folks anymore.

    • Lethal,

      Regarding Armour’s reformulation, one reason some patients do worse on it now (and others do better) is that they changed the fillers. It now has calcium stearate, dextrose, microcrystalline cellulose, sodium starch glycolate, and opadry white as inactive ingredients. Many patients with Hashimoto’s have polyendocrine autoimmune disorders and react differently to the fillers in different hormone products.

  4. First, I know no better medicine to regulate Th1/Th2 imbalance than LDN (low dose naltrexone).

    Second, I think that avoiding some of the immune triggers/endocrine disruptors is almost impossible in our modern society. How one can avoid bromine, bisphenol and other hazardous compounds present in dust, devices, cloths, foams, carpet, furniture, cars, etc, etc, of almost any ambient of any city around the world?

    • Dear Sir

      Thank you so very much for reminding us of the link between Low-Dose Naltrexone and autoimmune disease. I have studies this drug extensively for my fathers’ condition. Now I would like to know of any case studies of people who have successfully been helped with LDN for their Hashimoto. Would you know of any?

      Thank you so very much in advance for your reply.

      • Dear Mr. Kresser

        Thanks for this privilege of writing. We had inquired about Low Dose Naltrexone (not time released) but we finally did our own research on the product. We believe that everyone having Thyroid difficulties or any autoimmune disorder should research this product too since doctors will not talk to patients about it. ( One can research this and see why not.) My husband has had many relapses with his autoimmune disease and twice was bedridden for over two months. He has recently started taking LDN and his symptoms have practically all disappeared. Many people have had similar success!!!

        We hope that this post can help others with similar problems.

  5. Btw, sorry for calling you Eric. Don’t know where that came from. A mental derangement perhaps :-). OK, I’m curious about what you are going to say about the triggers. VBR

  6. Eric, I did not study this subject, but my first reacting would be that “dampening” (reducing) the immune system is not a good idea. How would you like to do this and what would be the other effects of this. I would suggest that people try to find and avoid the things that are causing the auto-immune reactions. Illiminating foods like grains (http://bit.ly/ckgK4E), soy (http://bit.ly/ablHkW), dairy and (perhaps) eggs would be a good start. Are you going to continue on this subject?

    • Hans,

      Removing potential immune triggers is important. I will discuss this further. But often that’s not enough. Most autoimmune patients have a Th1/Th2 imbalance that must be addressed. This is what I mean by dampening the immune system. “selectively dampening” or “regulating” would have been more accurate terms.

      • Hello, I’m wondering if you can help me. I have been feeling very sick for quite some time. My thyroid levels were 9.5 TSH I believe they said at one point it was 14. When I first became ill I lost about 60 pounds and was very underweight. Now I have gained 115 lbs in a short time. I have tried Levo, Synthroid, and Armour, and I believe something else. Right now I am on Armour. But when I dyed my hair I had a severe allergic reaction which caused me to see urgent care. The doctor prescribed Prednisone and after a day or so I was feeling healthy like I did years ago before I became ill. However, 2 days after the course of pills, I began to become ill again. Now the doctor has prescribed two courses of Methylprednisolone but in the instructions it states that prolonged use of this drug is not recommended. When the Prednisone ended I began to have severe dizziness but not like vertigo, more like I was drunk. Last night I missed the last pill and this morning had the drunk feeling again until about an hour after taking the Methylprednisolone.

        What I’m saying I guess is that the inflammation on my face does seem to coincide with my overall health. It is very severe when I feel the worse, and almost gone completely when I am on the Prednisone and feeling better.

        However, now it seems like my body is getting used to the Prednisone or the Methylpredisolone is not as strong, because I am beginning to return to feeling as I did before I ever began taking it.

        The doctor said that I do not have an autoimmune disorder and that the dizziness they believe is caused by soft tissue on a CT Scan which they believe is a cholosteatoma. I am seeing the ENT doctor in a few days but I’m just curious, what are some options if when the Methylprednisolone prescription ends in a week? Or should that treat this inflammation completely? Along with the inflammation I get this flushing feeling like I’m getting a fever but it never goes above 100.4. It’s usually about 99.4

        Also, last week, after the Prednisone ended I threw up for about four hours, every 20 minutes or so.

        I am on Meclizine 12.5 mg at bedtime only, Armour thyroid, 30MG in the morning, and 15 mg at bedtime, AMOX-CLAV 875 MG as before I threw up the doctor thought I had an ear infection that was causing the dizziness.and Methylprednisolone 4 MGdospak 21’s, which I am to refill on Thursday if I’m not feeling better.

        • Sorry I just realized that I didn’t clearly ask a question…..my question is what direction of care should I seek if the ENT doctor says it’s nothing and I still feel sick after finishing the Methylprednisolone?

          Should I see an endocrinologist or should I just see my regular internal medicine doctor and try to adjust my thyroid medicine?

          Or, is there another type of doctor who could address this inflammation on my face?

          I should mention that I have had a lot of other health issues over the last few years. I had a non-cancerous growth in my mouth that covered two teeth. I also had severe leg cramping and parasthesias (sp) I was diagnosed with anemia, and scurvy (?) I also had a tooth break off randomly while chewing gum half of it just fell out, and have before this never had mouth issues even with cavities in general. I did also test positive for MCV antibodies but they never said anything about it because the test for an active infection was negative.

          Also I have the feeling of a lump in the right side of my throat near my neck bone. It comes and goes and sometimes feels like pins and needles. Is this just my thyroid? They also removed four other small cysts from my throat and uvula. They thought I had an STD but it came back negative for an STD or cancer. They said, it’s not anything.

          I have a lot of lumps on my neck, lymph nodes swollen I think.

          I also fractured my spine and had some issues with walking about 6 months after that but they seem to have resolved. However, I hit my head at the same time but never mentioned it to the doctor as it didn’t hurt. These dizzy spells or drunk feelings did begin before I dyed my hair so I’m wondering what is the most likely cause of these? The ear build up? The hitting it on a metal car rim then the pavement? The thyroid?

          My question is what can I do after I finish the Methylprednisone? What type of doctor would be good for me to see? I have just been avoiding the doctors for a very long time because I got so tired of it. The thyroid medicine made me feel worse but these episodes are very strange. I don’t drink more than once or twice a year or so but it’s been feeling like I had four drinks or so……and like I said, that started before I was on any medication at all.

          But when I had such a bad allergic reaction to the hair dye and told the doctor about the drunk feeling they put my on the Prednisone and that really seemed to help all my other symptoms too. I’m assuming the Methylprednisone is similar but what can I do when it ends next week? I can barely do anything when I feel that drunk feeling I get without it.

  7. What do you think of treatment with Cytomel? It’s T3 only. My concern is that I might need some other thyroid fractions (T4, perhaps T2/T1) as might be found in Armour. Thoughts? 

    • Kathy,

      I’m sorry, there’s really no way I can answer that question without doing a full exam and lab work.

      • am also suffering thats kind of broblem .iahv thyoride glan my gland become expand day by day and looking very bad but in my test my tsh t1 t2 t3 all the test are normal no deficiency of iodine plz tell me wt i do can i became healthy again iam very dissapoint from life due to this disese operation is not the solotion of this problem plz tell me the way or any good doctor or any website through this my problm solved plz help me and guide me regards milli

  8. I’m personally interested in this series, and hope that you will also be addressing your take on how to ” dampen the immune system and decrease inflammation.”

  9. It’s entirely possible the doctor didn’t tell you, because it wouldn’t have altered the course of treatment.

    Your husband can have his TSH receptor antibodies tested.  This is sometimes called a TSI test, or a TRAb test.  If these antibodies are elevated, it’s likely he has Graves’.  TPO & TG antibodies are also often elevated, as they are in Hashimoto’s.

  10. Thanks, Chris.  Not sure or not if he had Graves disease. Would the doctor have tested and mentioned that? Is there anyway to test that now?

  11. Hi Chris-
    My husband had hyperthyroidism, which has treated by irradiation. Now he has hypothyroidism and takes Synthroid. Since he thyroid was deliberately damaged, and it isn’t an autoimmune problem, is synthroid his only choice?

    • Since your husband can’t produce thyroid hormone on his own, replacement is his only choice. That said, are you certain he didn’t have Graves’ disease? Graves’ is the autoimmune form of hyperthyroidism. If he had that before, he likely still has it now and it would be important for him to address the autoimmunity.

      • Hello,

        I have been on medication since 2007 for Graves’s disease and I don’t want to go under surgery nor to take radioactive iodine. I know that it’s an autoimune disease and probably will never recover but I did twice and keep falling back in the sickness. You are speaking of adressing the autoimunity and inflamation, and I woud like to know what you would advice for Graves’ case in particular? I have seen various doctors and none helped with the sideeffects, they are only willing to regulate the hormone levels…
        Thank you so much in advance for your help.

  12. Thanks!  I look forward to your next post 🙂
    In reading some more on cortisol and the birth control pill, it seems common place that cortisol is high on oral contraceptives.  Even my lab requisition says it will only test cortisol if patient is confirmed to not be on oral contraceptives.  Could this be a partial link to why so many women suffer from hashi’s?
    Also, to whomever was saying iodine is not an issue…I work as a Nuclear Medicine Technologist and we test the thyroid gland function by giving the patient a very very small dose of radioactive iodine.  We can then measure, with a radiation detector, how much is in the patient’s thyroid and how much is still circulating in their body.  If the patient consumes even seafood (which relatively speaking is low in iodine content) in the 3 weeks prior to their test, it skews the results a lot!  They actually look like their thyroid is hypofunctioning because their thyroid is so full of iodine (for lack of a more medical description) that it won’t take up the radioactive iodine we give them.  So essentially by having them on a no iodine diet 3 weeks prior to the test we can then get a snapshot in time of their thyroid function.
    Just FYI

  13. This series is amazing thank you!!!  I was diagnosed with Hashimoto’s a year ago from an antibody blood test even though my TSH was normal I was put on Synthroid.  I also suffer from Chronic Idiopathic Urticaria and take Reactine daily to control the hives.
    I am very curious about your next segment as I would love some tips on addessing the autoimmune part of this as I clearly am suffering from two autoimmune diseases, all which came on after the birth of my second daughter.
    I would love to know what you think about high cortisol levels and its effect on thyroid hormones, more specifically the conversion of T4 to T3 and/or antibodies that could be faciliated by high cortisol?  I can remember being 18 years old and put on the birth control pill and having all the symptoms of hypothyroidism after about a year on the pill, but all my labs came back normal (aka my TSH was normal) except my cortisol was very very high.  Dr said this was normal on the birth control pill.  About 6 months after that at a clinic a different dr said my thyroid felt firm and to get it checked out.  I was 19 and stupid and did not.  Since then I have steadily had increasing problems with weight gain, acne, fatigue, allergies, and now hashimoto’s and hives.  Seems connected in my mind but I would love your thoughts…when you have time of course 🙂

    • Sarah,

      Birth control pills increase thyroid binding proteins, which in turn decreases the levels of free thyroid hormone (the active forms) available to the body. This won’t turn up on a test unless free hormones are measured, which they rarely are. That explains why you had hypothyroid symptoms on the pill, but had normal test results. Cortisol is a hormone that is elevated during an active stress response. Stress is inflammatory. Inflammation reduces T4 to T3 conversion, dysregulates the HPT axis, and decreases receptor function.

      So yeah, it’s all related.

      In a later post I’ll be talking more explicitly about problems that cause hypothyroid symptoms that won’t show up on normal lab tests. I’ve just mentioned one (increase in thyroid binding proteins), but I’ll go into more detail on that and talk about a few more.

      • Hey everyone I absolutely love love this site I was diagnosed with hypothyroidism about 3 months ago and put on levatroxinen for it and found out I have a autoimmune deisese but my body’s not agreeing with the med I don’t feel any different at all I’m 34 and feel like the walking dead but to get to the ? Has anyone else ever had any issues with the med affecting your heart?My heart rate goes from 79-80 to 110 just out of the blue and also I
        Feel like my hearts just stopping and I catch myself waking up in a gasp for air or I can be sitting around and do the same and I know it’s the thyroid med because I quit taking it over a week Ago and I am not having any of the heart related issues.Still tired and can’t rest hurt all over and my hairs falling out not counting the weight gain and I told my doctor and she did my labs and I’m still waiting in test.anyone else had or having those problems?
        Thanks .

        • Yes, arythmia of the heart (rapid beating out of the blue) is a side effect of thyroid medicine.

        • I had ur problem I don’t convert T4 to T3 got Hashimotos . On T3 only every 8 hrs got my life back.

          • Khoa Sunshine, can you please elaborate on your comment? I have Hashi’s SERIOUS inflammation and my doctor keeps lowing my Armour because my heart rate is 110 (has been since I was put on Thyroid meds) but now I can’t even leave my house, anxiety, fatigue, feel like my body was hit by a truck..everyday….Can you please direct me to information on t3 only? I am very interested since I have ZERO quality of life. Thank you so much for your time.

            • Most of my knowledge did come from Chris Kresser .I didn’t even know I was sick until I gave up smoking and put on 5kilo in 5 weeks ,a bit quick I thought.Went for blood test . Antibodies over 1000 tsh,t3,t4 all off the ricter. In other words .Patholgy couldn’t read them. Doctor rang personally and said come in now. He gave me a script for t4 and said have a blood test in a month. Well I wasn’t sick but in 2 weeks I was like a cripple and the pain so severe I couldn’t sleep and I was so depressed with panic attacks . never new what they were either. Had to get some,one to drive me to Dr.He was in shock I was not the same thin bright bubbley person he met. I talked about a thing called RT3 he new nothing of it, so I gave him a copy of Chrisses RT3 site. .I went off the T4 for 8 days and he tested me for arthritis and lymes desease. I went back 8 days later running jumping and laughing. And his results were negative. So he said I could try T3 but I had to get a medi bracelet as I don’t have a thyroid any more hashimotos killed it. I was then stabilized on T3 in less than a month as it is instant in the body but must be taken every 8 hrs or when u feel ur heart flutter. My tsh is 0 my T4 is 0 and my T3 is just above the high range which is 6.2 the perfect T3 reading. Ps I did attempt Thyroid extract as well but this cause an immune attack on my body because the desease thought that the bio,identical was a fresh new thyroid. . This was almost as bad as RT3. I love my life on T3. Thank you for ur knowledge Chris.

              • To koa sunshine:

                I’m happy that T3 is working out for you – some of our doctors won’t prescribe it for us. (I assume you’re talking about Cytomel, and not the timed release T3?)

                — Generic Cytomel, under the name “Cynomel” can, however, be purchased online without a prescription. unfortunately, the smallest cynomel tablet is 25 mcg, which makes it a tad more difficult to cut into smaller doses – “Cytomel” starts at a 5 mcg tablet—

                How can we judge what amount of T3 we should be taking, i.e., should we be checking blood pressures, temps, pulses, symptoms, or all of the above in order to take the amount that might work for us.

                Also, would you mind letting us know how many microgramsyou are taking every 8 hours, how long you’ve been taking it, and what your starting dosage was?

                Sorry for all the questions, but I’m convinced that questions like this, regarding dosages, are the missing link when sufferers are trying to find answers that our doctors simply cannot give us.

                We may all be different (as I’m constantly reminded), but we do have two very important things in common – we are all human beings, and we are all suffering.

          • I have a underactive thyroid as well. Been on levothyroxinefor over a year now.staryed with 25mg.now 50mg. And then 75mg. But im still tired . I feel like ive been run over by a truck everyday allday. I just want my life back. Im so tired of being tired. My doctor just increase the amount, but it doesnt change things. Im so sick ofbeing tired until imerisable. Please help me…anyone I stay in bed allday stuggle to just cook, never finish cleanign up nothing. Im 57yrs old

          • I have a underactive thyroid as well. Been on levothyroxinefor over a year now.staryed with 25mg.now 50mg. And then 75mg. But im still tired . I feel like ive been run over by a truck everyday allday. I just want my life back. Im so tired of being tired. My doctor just increase the amount, but it doesnt change things. Im so sick ofbeing tired until imerisable. Please help me…anyone I stay in bed allday stuggle to just cook, never finish cleanign up nothing. Im 57yrs old.

        • Yes i had that med=levatroxinen and had thesame problems with hart rate + panick attcks that lasted for 8 hours cus’ of this Med now i take Sintro’ i am still Not as good as i used to be But i have taken my helth into my hands leaving the doctors ONLY to writ up prescripshens and for blood tests
          I have/ had Graves , had to have radioactive iodine to remove thyroid , wish some one will talke about ppl , like me , who do Not have a thyroid any more ( hint hint )

          • Read my post I have found everything I need just by going to Chris Kressers site . Listen to ur body and find it on this site . My life is great now and it was a nightmare. . Don’t give up . Get out of ur own head and see the light its there .Good luck .

          • I also have suffered from Graves’ disease and had radioactive iodine treatment 15 years ago. Recently had a baby n my thyroid levels changed drastically throughout the pregnancy. For me I have to just accept that I cannot do what I “should” be doing. I have to trust that God has a plan for me. I have to be merciful to myself and not beat myself up for being lazy. The guilt of having days where I have to force myself to get out of bed where I actually have to wonder if I can handle my daughter alone. It’s the guilt trip I give myself that wounds me the most. Bad week here sorry 🙂 but I’m on levothyroxine 112mcg cytomel 5 mcg celexa 40 mcg because the depression finally got to me when I noticed it affected my daughter and not just my husband and I. I’m also taking 37.5 mcg of phentermine to lose the baby weight. On the phentermine I was able to lose 20 lbs in 6 months. But people with a thyroid would lose twice that amount. The only drawback is that when I stop taking it I gain the weight back very quickly. I will say that Prozac made me gain weight, celexa makes me severely hypo very quickly, I’m able to lose 3-5 lbs a month eating oatmeal, slim fast, lean cuisines n saltines n chicken noodle soup. I hate for people to see me when I’m hypo, so I hibernate, lay in bed, cry a lot, only want to eat peanut mnms n gummy worms. I get full of paranoia, hate and rage when I’m hyper also severe diarrhea, my hair falls out and I fear the graves will come back and I will have big eyes again. So now I’m 33 and I have an awesome daughter and husband who love me and I don’t know who I am. Am I just an angry/grumpy person? Was I ever sweet or kind? Or am I a sad victim? Was I ever happy? Did my horrible personality make me Ill? Or did my illness give me this horrible personality? I’m hypo currently and on day 3 of med increase n still worn out after a 10 hour shift of work putting on my happy face n now can’t even play with my daughter. She must think I hate her. Anyway, thanks for letting me vent and maybe this info will help someone.

  14. I’ve been reading your blog with interest, being uninsured and only able to access my naturopath when I can pay out of pocket. What you report makes me think I’m generally on the right path towards keeping healthy and healing myself as I get older. Here’s my question.
    Will you be talking about the tests to determine the need for iodine? My naturopath suggested I take one and I was put on iodine after that.
    I wonder about all the immune system problems I’ve developed as I’ve moved through my 40’s: Allergies, mild asthma, tinea versicolor, mild eczema, thyroid problems, the list keeps growing.
    I still feel energetic and mostly fine but I can’t help but get stressed out trying to figure out how to keep healthy. What should one do if it seems that their immune system is out of balance? Thyroid is just part of it. A very important part according to this article. Thanks

    • Claire,

      I wish there was an easy answer to your question. Unfortunately, autoimmune disease is complex and each case must be considered individually. That said, I’ll be providing some general steps to regulate the immune system and reduce inflammation that are applicable to everyone. Stay tuned.

      • Hello ,
        I have hashimoto’s. I used to take T3-T4 for my thyroid and while on it, I felt terrible. I felt I have anxiety and insomnia, irritability and depression. so I went to a nutritionist which helped me to get rid or candida, and told me to stop all medications and vitamins. so , I stopped everything, then after 2 months, I started to feel terrible. my anxiety, irritability and insomnia came back. I did some thyroid tests and and TSH is 218.00, T4free is 0.37, T3 total is 53, total T4 is 2.4. so as you see all my tests are not so good. So I went back to my regular doctor and I told him to give me armour thyroid. So he did, but now I can’t even tolerate 1/4 of the armour pill. I started having shaking, nauseous, panic, irritable feeling. My adrenals are a little elevated, I thought it would be my adrenals, but now reading your blog, it makes me think that maybe I’m feeling these reactions because I might have to much inflammation. do you think if I lower my inflammation, I can start to tolerate the thyroid medication? It would be great if you could help me, I am desperate and don’t know what to do anymore. I can’t tolerate thyroid medication, but I feel irritable without it too. so any advice would really help me. thanks

        • My concern is that we all call it inflammation, when Lyme disease is attacking so many. You all need to be put on antibiotics, but, the insurance companies are trying to cover all of this up. Inflammation needs to be detected to see what bacteria is causing this. Especially people that have been sick for a while.

        • I too have been diagnosed with hashimoto thyroiditis and my tsh is 12. My t3 and t4 are within range. In spite of having plenty of energy the Dr. tried me on levothyroxine at the very lowest dose. For three wks I thought my racing mind was going to explode and I did not make the correlation that it was the med. After one wk. off the levothyroxine I felt myself. I have nodules on both side of my thyroid under one centimeter. They say I have thyroiditis but I feel fine. I don’t understand?

  15. Jesse,

    There’s a difference between suppressing the immune system across the board with steroids and dampening the parts of it that need dampening.  And there are many ways to reduce inflammation that don’t involve immunosuppressive drugs.

    • So, if I my conversion rate is over 200% (I have hashimoto’s) and I’ve been taking Levoxyl for 4.5 months. I cut out gluten and sugar….they why are my T4 #’s taking forever to come up? Started at .8, just now got to 1.0. I am feeling a little better, but not losing any weight and I am meticulous about eating.

      • I feel ya cut out soda sugar fake sugar then keep gaining…I get blood test… On my doctor appointment paper it read patient very upset about weight. You try hard and gain. I’ve always been chubby now I’m 301 never been that big. I’m real upset

    • When I was 17 I was diagnosed with the Graves Disease and treated with radioactive iodine. I am now 33 and been taking synthroid and levothyraxine for over 20 years my weight is almost impossible to lose and suffer with irregular periods what do you suggest I do? Thanks

      • I have been on Synthroid since ’99. I felt like a zombie. I finally found a doctor that would prescribe me naturethroid which is generic for Armour. My numbers after three adjustments are perfect and I finally feel normal again. Naturethroid has T3 also and seems to be just what I needed. I would suggest anyone on Synthroid to try the natural replacement.

        • Hi Shel,

          My GP suggested that I see the specialist. He won’t prescribe me any more medication until I see the specialist. Says my numbers are up and down. I’ve been on Thyroid meds for about 18 yrs and this is the first time that I’ve been told my numbers are out of whack.

          I’m about to get an appt. with the Thyroid specialist. I haven’t been on any medication for about 5 weeks now. Is Naturethroid over the counter or a prescription drug?

          For 18 yrs, I’ve been tired – that has never changed. Hate it. Can’t even keep my eyes open on a Saturday night to watch a late movie. 🙂

          • Hi Shel, Naturethroid is a prescription medication. It is not compounded but you can get it with a prescription.

      • I have hypothyroidism. I had to have half my thyroid removed due to a nodule. Typically a fine needle biospy would have detected cancer, but in my case, rare cells were found and I had to have surgery. After surgery and taking levothyroxine, I went on a low carb diet. Cutting out all starchy foods like potatoes, pasta, corn, and breads, along with ni sweets of any kind was hard to do, but pure self-discipline got me through it. It was the only diet that worked for me. I lost 60 lbs in just under a year. However, I know that all people won’t have the same results as I did, and all people can’t just do a low carb diet, as some other possible conditions along with a thyroid disorder might prevent that particular diet from working. Always consult with your physician before starting a new diet to be sure the diet is safe for you. Good luck with your weight loss.

    • What are those ways that I can fight inflammation, Chris; I really need to know. I am SO sick. I’ve been battling hypothyroidism for over ten years, and each year I’ve gone further downhill. Today I’m to the point where I can barely function. My legs and arms are so painful, weak and shaky, they are almost useless; consequently, all I am able to do is sit here on this wing chair watching TV, nodding off every hour or so, and periodically shuffling to the kitchen for food. This is not living and i don’t want to do it anymore. (My Blood tests over this ten-year period have consistently shown extremely high c-reactive protein, and no doctor has been able to tell me why.)

      • so sorry you are not feeling well and I understand. Do you have a good integrative dr in your area to go to because they can help you with your c-reative protein being high. Do you have a heart dr as well he/she may be able to help you but for me, it is finding a good integrative dr in your area who can run other tests to see what is going on and help you more than the standard western medicine dr. Good luck and hope you feel better soon.

      • I cannot stress enough to encourage everyone on levothyroxin to ask for brand name synthroid. I HAVE lived with this issue for 30 years and anytime a pharmacy slips up and gives me generic…my symptoms worsen…it has been so bad that it caused me to have high blood pressure, high blood sugar, and now…fatty liver!
        When I take brand name synthroid…my symptoms lessen and some times I have periods when the symptoms go away! I love those days!

  16. I’m confused. In the last post you said that depressing the immune system was worse than the disease it would be treating:
    “But in the case of Hashimoto’s, the consequences – i.e. side effects and complications – of using immunosuppressive drugs are believed to outweigh the potential benefits. (Thanks to conventional medicine for a relative moment of sanity here.)”
    But in this article, you say it is unfortunate that this treatment is rarely done.
    Which is it? Am I misunderstanding something?

    • My other doctor was like that i finally got a really good endocrinologist and it is taking time and it is tough as it is sometimes a bit too high or too low. Stress has major effect on us even when we don’t feel it is. He says stress does not
      affect the thyroid my other gp disagrees. Welll, you may want to see if you get a referral to a good endocrinologist . I have only being tested for t4 t3 and free t4 also for autoimmune diseases . It is a roller coaster ride . I wish you the best let me know what happens. Sheryl

      • Yes john i don’t make a doctor lol! Tommorrow i am seeing my family doctor taking all vitamins everything i am taking to see what could be the culprit of making my thyroid off every 3 months. I no longer drink coffee around it and take it before i go to bed cut off all eating 3 hours before . I am hoping this works. I am not taking iodine in the vitamins. omega 3 , iron free multi , vitamin d 3,000 mg daily, and cranberry tablets.


  17. Great series Chris.  Just a quick question regarding iodine (and I appreciate you are busy atm so no hurry).  While I can appreciate that simply throwing large doses of iodine at the thyroid problem may be an issue (people need to realise that often having too much of something can cause exactly the same sorts of issues as not having enough – iron is the classical example), what are your throughts for those who live in known iodine-deficient areas.  I am based in New Zealand and most of our soils are very low in iodine and iodine supplementation has recently been strongly recommended for all women planning a pregnancy in New Zealand and along the eastern seaboard of Australia for this very reason.  Thanks of ryour preciosu time in advance.

    • Jamie,have you sorted your thyriod problem,and would you recommend going off thyriod medication and trying thyriod support