Why Thyroid Medication Is Often Necessary | Chris Kresser

Why Thyroid Medication Is Often Necessary

by Chris Kresser

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

If you’ve been reading this blog for a while, you might be surprised by the title of this post. I’ve been critical of pharmaceutical approaches in the past, and in general, I recommend avoiding the use of medication whenever possible.

However, I have no problem with pharmaceuticals if:

  1. they work,
  2. they do more good than harm, and;
  3. there are no non-drug alternatives with the same effect.

It turns out that thyroid medication meets these criteria in cases of hypothyroidism with chronically elevated TSH. Elevated TSH indicates that the body is not producing enough thyroid hormone to meet metabolic needs. And thyroid hormone is so important to the proper function of the body that the benefits of replacing it far outweigh any potential side effects of the medication.

Remember that every cell in the body has receptor sites for thyroid hormone.

Thyroid hormones are responsible for the most basic and fundamental aspect of physiology: the basal metabolic rate. Since the basal metabolic rate affects every system of the body, low thyroid hormone causes a global decline in cellular function.

Here’s a list of things that can go wrong when thyroid hormones are low. It’s not complete, but it should give you some idea of how important the thyroid is to proper function.

  • Decreased energy production and metabolism in all cells of the body
  • Decreased bone quality and increase in fractures
  • Elevated cholesterol
  • Impaired phase II detoxification
  • Anemia
  • Decreased stomach acid production
  • Constipation, intestinal dysbiosis, malabsorption
  • Intestinal inflammation
  • Blood sugar imbalances
  • Gallstone formation
  • Vascular and arterial plaquing
  • Neurodegeneration, cognitive problems, depression
  • Weight gain
  • Hair loss
  • Dry skin
  • Cold hands and feet
  • Infertility and reproductive dysfunction
  • Weakened immune system

I could go on, but I think you get the point. If your thyroid hormones are low, you can’t be healthy. Period.

90% of people with hypothyroidism in the U.S. have Hashimoto’s disease. Hashimoto’s is an autoimmune condition that causes destruction of the thyroid gland over time. As this destruction progresses, the thyroid gland becomes less and less able to produce enough hormones to meet metabolic needs. This is reflected in an increase in thyroid-stimulating hormone (TSH).

Persistently elevated TSH is a sign that the body needs more thyroid hormone than it can produce on its own. This is one clear sign that it’s time for replacement medication.

But it isn’t the only one. Some people with TSH in the normal lab range still find that they benefit from replacement.

Note that I’m not saying everyone with hypothyroid symptoms should be on medication. In a previous post, I discussed 5 different patterns of low thyroid function that present with normal TSH levels. These include underconversion of T4 to T3, problems with thyroid binding proteins, pituitary dysfunction and thyroid receptor-site resistance. In these cases, the problem isn’t with the thyroid gland itself or its ability to produce enough hormones, but is either “upstream” (in the case of pituitary dysfunction) or “downstream” (in the case of conversion problems, binding protein issues or resistance.) For these patterns, replacement hormones are often unnecessary.

There are many in my profession (natural healthcare) that vehemently oppose the use of medication under any circumstances. I think that’s foolish. I’m more concerned about the dangers of Big Pharma than most. But that doesn’t mean we should ignore the important role drugs play in treating certain conditions.

In fact, my philosophy on healthcare can be simply stated as: whatever works best and causes the least harm. It’s not often that a drug fits the bill. But in the case of hypothyroidism with elevated TSH, I believe replacement medication is a necessary part of a larger strategy that includes balancing blood sugar, adrenals and the immune system and fixing the gut.

In the next post I’ll discuss the many different considerations when choosing a thyroid medication.


Join the conversation

  1. The “alternative” is the nutrient most people are deficient in: iodine. Though people have been taught to fear it because of badly done research.

    Anyone interested in seeing more should take a look at Abraham’s research: http://www.optimox.com/iodine-research

    He has successfully treated a lot of patients with iodine supplementation.

  2. Hi, I’m 62 yrs old & not sure how long I have dealt with low-thyroid. But it was brought to my attention after my lab work up about 5 years ago. I am about 5’11” & weigh about 165 & have felt normal over all. I refused to take Levothyroxine for several years that was prescribed because I didn’t have any symtoms & after reading the side effects, mainly osteoperosis, which really scared me, mainly because I’m predisposed to have osteoperosis. But, my dr. brought it to my attention that I don’t have to have any noticeable symtoms, that it could be something internal, like my heart damage if I don’t take my medication. So, now I have been taking the prescribed meds,
    75 mcg. for several yrs. Several months ago I went in for my latest lab work & found that my thyroid is normal. Lately, I feel I’m loosing more hair than I have in the past. Now, my lab workup shows I’m pre diabetic. Is all this a pattern of side effects due to taking my thyroid meds? Because I was fearful of becoming diabetic, I cut out extra sugars plus fruit & refined carbs for the past 2 weeks. But, lately I have no energy & I feel extremely weak. I would prefer to do things natural without meds. I do my own fermented veggies, kombucha, kefir & fermented breads, like sour dough. Do you think that these are possitive things for maintaining overall health? I would appreciate you advice.

  3. I am 23 y.o, female. I had suspected: my TSH levels is 7.27 but my T3 and T4 were normal. They prescribed me 50 mg Levothyroxine for a start. But I am feeling irritation after taking this tablet daily? Can I stop the tablet?
    Thanks for listening! I appreciate your input.

    • Wow I’m taking the same meds. For years now no symptoms and feeling pretty good. Just made an appointment to get it checked out to see what going on and what are my numbers. I was also told I have to stay on the is Levothyroxine for the rest of my life. Oh my name is Angie

  4. My Thyroid went out and I could not move, I had changed my diet, eating shredded wheat, ground turkey, taking brewer yeast for B vitamins, doing everything that Drs. used to tell you when you get older. They all are full of gluten, as soon as I got off gluten I felt better. I had anxiety, depression, tired, constipation, brain fog…. I didn’t know I had celiac. If I would have ate what I wanted, I might not have had such severe symptoms. that was along time ago and I am one of the celiac that don’t heal after stopping gluten. I had hypoglycemia and eat a lot fat, the Drs. told me to eat carbs like spaghetti, that almost killed me, I went to work and would black out. I then developed chemical sensitivity, the Drs. gave me anti depressants, I didn’t sleep for 4 days. Now I have been diagnosed hypothyroid, I have had symptoms a log time and telling Drs. I am tired. I need to make sure I don’t have gluten or other foods causing it. I have taken cow thyroid and tyrosine and feel a lot better, I found Ginseng works great if your tired from adrenal fatigue. I don’t want to take synthriod and get dependent on it, I do believe that my thyroid is low, high tsh and normal t3,t4. Free t3 and t4 are unknown, they wont give me the antibody test. Said it wouldn’t matter, I would still have to take meds. I have found out something after all these years. There is a physical reason for every health condition. it is rarely ever just in your head. My B12 got low about 2 yrs. after celiac, that’s how long your liver store it, use Methylcobalamin only or your wasting your money. My C ran out and had all the low vit. C symptoms, and just lately my D ran out, aching joints and tired, Vitamin D makes most people nauseated, It made me real sick, I cant take oils and vit. D is oil solliable. If you have trouble with oils try grape seed oil. I go out in the sun shirtless 10 minutes for vit D. Any cheap vit. C works, I have a citrus allergy, so no citrus for me, vitamin C absorbic acid usually made from corn, I cant eat that either. I have leaky gut from my immune system attacking it, so all kind of food allergies. I am saying all this to give you some ideas, maybe one of these things is causing your problem. Milk protein is very similar to gluten and your body cant tell the difference. I wondered why soy bothered me, till I read the comments here. Foods have high hormones, cows last 2 yrs. then to hamburger, pesticides, GMOs, thanks Monsanto. Chickens grow twice as fast then some die on aspartame. There is chlorine in water, it is a carcinogen. Sugar is the worst thing you could eat, fat does not make you fat, sugar makes you fat and hardens your arteries and the outside lining on your disks causing disk degeneration in your back. There is a lot of fat people now days and our food is causing most of our problems. Fragrance is made from petroleum chemicals and is making people sick, all that fragrance is in your food and water, I can taste it. why does everything have to fake smell good. the air in most areas is full of trash truck masking scent. that is a chemical and its in your water.

  5. My TSH level is 0.82. What does this indicate about the functioning of the pituitary gland? Should I go for any further investigation?

  6. I see no comments from men, is this a women issue mostly? I a male, my TSH is high, my Dr wants to do another test in 4 wks, if that test is high he’ll put me on Thyroid med. My problem that’s led upto doing TSH test; swollen feet, ankles, legs, thighs. I’m not sure my problem is caused by my TSH results.
    What is your opinion?

  7. I’m 36 years old male, healthy, sporty. My thyroid levels:

    TSH: 13.2
    Anti-thyroglobulin Tg (chemiluminescence): >500
    Anti-peroxidase TPO: <1300

    I was diagnosed Hashimoto last year but I feel as good as ever, have none of the symptoms they associate with Hashimoto. Went to the doctor and she told me to take medication.

    My question: Do I really need to take medication if I feel good? I was told – we are our best doctors because only we know how we feel. So if I feel nothing, why would I take medication?

    But my parents are putting a lot of pressure and I feel I may regret doing nothing. Any advice? if so really appreciate you taking 2 minutes to write me a line, thanks so much

    • Ricardo,
      I’m curious what you’ve heard from others, but I agree that “we are our best doctors because only we know what we feel,” or “physician heal thyself.” I wondered if you’ve gone off gluten or dairy? It’s possible that going off of these might normalize your numbers. Thyroid drugs are pretty powerful and do give people side effects. If you are feeling good I don’t think you should mess with a pharmaceutical. I tried levothyroxine for a short time and felt like I was going to die. I’m much older than you, 65 years and have resisted going on the pharma drugs. You might have your parents take you to a naturopath if you have some symptoms.

      • I just realized you are 36, you might just take yourself to a naturopath, though some of them are very ready to prescribe the big pharma drugs. Your testing might vary completely the next time you get testing. The testing could normalize on it’s own, I believe.

      • Hi Gail

        I tried going off gluten but it proved too hard (given my childhood eating habits). I just can’t resist bread, pasta, etc.. But my body never gave me any signs of gluten intolerance…so I went back to normal diet (I do eat always wholegrain bread/pasta though). Diary wise, I stopped drinking milk but still eat cheese and organic yogurt (in the morning with oatmeal and nuts). I did stop drinking coffee because I was hooked (all addictions are bad for health). Plus, every time I did not take coffee, I’d get a headache, so I stopped completely and now I never have headaches. That was a good example of me being the doctor. Haven’t tested for sometime now, but assume I’m good as I feel great.

        • I just don’t like to be dependant on big pharma for optimal health.I’d rather try looking and diagnose the underlying causes

          • I think that is a good suggestion. I take the tablets too and I’m not very happy with them at all.my thyroid is stable and I’m cutting them down. I eat healthy and lots of vitamin A. Healthy food is more my style than tablets hope u sucide… Gayle….

  8. HI i been taking 150mcg Levthroxin for 13yr’s now, theres time where i’ve gone without it,which i know not good! with my thyroid sometimes goes up & down but now i have it under control. I was wondering would it be ok to stop taking them and which to a thyroid supplement like a vitamin instead ???

  9. I have been taking Armour Thyroid, after a TSH of 4.8. I have been taking it for 2 months and after a few weeks, I started having terrible nausea and several loose stools a day. The Pharmacist said those are common side effect of Armour. I didn’t want to take Synthroid, and from what I hear, it can have the same effect.
    My recent TSH was .72. The doctor says it is great! I’m wondering, though, if my symptoms indicate that my dosage is too high.

    • I have been taking levothyloxie for a long while they said I jade to cut it down from 150-125 .now down to 112 they said I’m over medicated . What does this mean in my health I had cancer 2010.?

    • hi my name is marion and i have hashimotosdisese i havebeen taking thyroid pills for 15 years iam on a rollercoaster i have taken levoxyl 75 that had bad side effects now iam taking tirosintand cytomel my blood work came back in range but still not feeling wellthey repeat onme i tried armour last year that worked for a while sometimes i get dizzy and brain fog if you have any advice for me i would be thankful help me please

  10. This the first time I’ve come across web page. I’ve concerns about my Levothyroxine Tablets as I feel I would be better without them. I’m on 125mg per day.

    My Thyroid function test.

    (MRE) – Satisfactory no action taken

    My, serum TSH level is 4.64 mU/L (0.27 – 4.2)
    serum free T4 is 18.7 pmol/L (12 – 22)

    Request states patient is on T4 replacement.
    Over 60 years TSH 0.27 – 4.2 mU/L
    fT4 not above 25 pmol/L.

    I’m also a diabetic, I still feel very tired, fed up and thinking of asking my doctor to take me off them, What is the point of taking them! I feel, I don’t feel better at all, I’ve put on weight as well,

  11. I need serious help from someone who understands thyroid issues. I’ve been dealing with the issue of not being able to lose weight no matter how hard I try; how healthy I eat and how active I am. and recently I’ve been noticing a lot of fat gain in a short period of time. So I got my thyroid checked and my levels are: TSH is 1.03, T4 is 9.6, T3 is 3.1. Are my levels normal? My doctor wants me to start taking levothyroxine.. do I need to? will it help my issues? any input would be extremely helpful

    • Hey, I have autoimmune thyroid disease etc, I personally wouldn’t be taking levothyroxine or upping my dose with that result as tsh is normal and this is what gp’s normally use to diagnose but I suppose may depend on whether your t4 test was total t4 or free t4. If it was total t4, then it is low, if it was free t4, then this is okayish as long as doesn’t keep going lower. I would suggest going for a second test as things such as illness can affect results sometimes. Are you feeling tired, slow, digestion issues or any other thyroid problems? If you are feeling really healthy, I would suggest looking into everything much much further before starting meds including nutrition and diet and food intolerances etc. In terms of weight loss, I find the most weight I can put on is a stone when my thyroid is low and the most I can lose when levels good is also a stone and I think that this is generally accepted as the case so wont make much difference to your weight. I have many autoimmune problems and loads of different diagnoses which all dissappeared when I gave up gluten and am on less thyroid meds now so take a little longer investigating and definately get retest :o)

      • Oh water retention is normally the reason behind any extreme weight gain for me, are you drinking enough water etc? Basically check everything else first x

  12. Hi i am 26 yrs old,my tsh was 12.5 last yr but now its 2.5 . I am still taking medicine, how long medicine will go on ??

    • I was diagnosed with hypothyroid about a year ago. I felt perfectly fine but it showed up in a routine blood test. My dr. put me on Levothyroxine and in about a week, I developed every symptom of low thyroid and felt completely miserable. Two months ago I asked her to put me on Armour and it helped with the brain fog and mental confusion but I still felt completely exhausted and slept way more than normal. She recently told me I could stop the thyroid med for 2 months since I was having a hard time accepting the diagnosis. I read a lot about coconut oil capsules and decided to try them. After a week of being on the coconut oil and not on any thyroid med, I got up today with extremely high anxiety. I was diagnosed with generalized anxiety disorder back in 1996 and have been on meds for it ever since. I called my dr.’s office and told her to go ahead and renew my thyroid med which she wanted to do but at a little higher dose. She says my T3 and T4 are fine but my TSH is 4.8. What I really want to know is will it hurt to take the thyroid med AND the coconut oil capsules?

  13. I had a horrible time with Levothyroxine .25 I felt like I drank 500 pots of coffee. I couldn’t sleep, eat, drinking a cup of coffee made it worse. I felt like my head was going to explode all day long. That happened with one pill. The next day I got up and this voice says do you really want to feel like you did yesterday? I took half 12.5 same thing just a little less and I stopped taking it. I already take Propranolol. That could be why I felt like exploding. All I know is my TSH was at 12 the last time they checked it. I refused to take the meds and it might be a little higher.
    My opinion my thyroid issue started when I was in menopause and had 50 hot flashes a day. I’ve been eating a couple of eggs a day and feel I have more energy.
    Any ideas on a medication I can get from the Dr for my thyroid that won’t make me feel so anxious? She thinks it’s my anxiety but I can tell the difference between anxiety and what that pill did.

    • Yes, I had horrible reflux when my thyroid went out…but have never seen low stomach acid under a thryoid symptom before (this post is the first). My doctors have always treated this with acid blockers (which would do the opposite of what is needed if low thyroid actually suppresses acid). I just started having terrible reflux again…and just had my blood work done. I think that my levels might be crazy again. Although doctors have advised acid blockers, I think I will try using pepsin instead.

    • Hi i am taking Levothyroxine been two months. This med is very well tolerable. I have no problem what so ever.My thyroid Tsh was 4.97 and i feel tired all the time, but since i am taking this med i am feeling very well.

      • I also take thyroid and sometimes u get tired of taking it sometimes it works and sometimes if I don’t take it I feel like I can’t do anything I just want to lay around and b lazy all day long

  14. My recent blood results I believe showed poor thyroid results: serum TSH level: 4.15 mlU/L
    Serum free T4 level: 13.14 pmol/L
    Serum free triiodothyronine level: 4.2pmol/L

    My doctor said my levels are fine but I’m not so sure. Are these OK or should I be on medication. I am 10 weeks pregnant.

    3 years ago in an earlier pregnancy my TSH was 1.5.
    I have a feeling this recent increase in TSH may be due to a chronic infection/ inflammation with CRP 12.
    I would appreciate advice if I should go back to my doctor for medication or buy some natural thyroid supplement to help my body out.

  15. I have half thyroid. The other half was removed because of goiter. Have been on nature thyroid for a year. Started to have anxiety and panic attacks, inside tremors, heart palpitations, weird thoughts, hot flashes, so about months ago I took myself to half a grain to eventually nothing. Finally found a dr that told me I was over medicated and possible allergic to dissicated thyroid. He said it would take 4to6 weeks fored to be out of system. I still have se symptoms but I am able to sleep better. Has anyone had this problem and what would you suggest?

    • Take a beta blocker if synthroid or the generic give you anxiety (elevated pulse or blood pressure). A beta blocker would control those symptoms until your body gets use to the artificial t4.

  16. I just found out I have hashimotos. I went in for a TSH level a week ago and it was 3.6, so my doctor tested me for antibodies and TSH again. My TSH a week later was 2.5 so she doesn’t want to put me on medicine. I’m trying to get pregnant with no luck and I’m wondering if it would be helpful to be on medication while I’m trying to get pregnant. I think my TSH might have been highly the week before because I was pregnant and now this week I’m not (I’m 3 days late but pregnancy test is negative). I’m just not getting clear answers from anyone and I’m concerned about my test results.

  17. i no longer have a thyroid, radioacive iodine,i have b een on synthroide for almost 30 years. should i have the amount adjusted if im not feeling right. i never have had changes to the amont i take. is there alternatives to synthroid, i htink im allergic to it now

  18. i have taken synthroid for about 9 months and gained 20 pounds. so i switched to 90mg (i think it is 1.5 gr) and have stopped gaining but i can’t loose the weight. i eat and exercise the same as i did before i started synthroid. my tsh was 2.06 when i started this and the tsh is now .20 and the t3 level is 4.0 on armour. whats going on, i thought i was supposed to loose weight on this treatment. i do feel better in a lot of ways otherwise. have a great day keith

  19. My TSH result was 9.8 after I had a BUPA health assessment last September. Advised to test 3 months later (NHS) and now shows TSH 6.3 BUT tested positive for antibodies. Doctor says don’t need medication. i have requested another test in 6 months (she wanted to wait a year!). I am 64 year old female. Don’t have any extreme symptoms just usual aches and pains of old age!

  20. I have normal thyroid readings but the Dr said I have thyroid, However he did not prescribed any medication. Please advise

  21. My tsh is 0.01 and have a swelling on face and puffy hands weight going up what should I do I am replacing my medicine I am taking low dose but my face is puffy what cause

  22. I’m wondering if anyone has felt horrible on the thyroid mediciation? Im only 24, (found out when I was about 14 I was hypo) I’ve had some endos tell me I was born with hypothyroid, but not until this week did a new endo tell me I actually have hasimotos… he said my anti bodies broke the chart they were so high…I’ve had tsh levels over 100 in the past and most recently they’re about 27…I have no symptoms that I feel though,i actually feel fine.. but my endo says I HAVE to take the synthroid, even though it makes me feel awful..ive tried it over and over again and each time.. I get extremeee anxiety, I get body tremours, heart palps.. I mean this is every time I go on the medicine with all different doses…I feel far worse on it to the point I feel the need to stop taking it . and its so discouraging because I want normal levels. I DONT eat a healthy diet, im thin, but I eat way too much pizza haha.. does anyone have ANY recommendations for me.. Im getting my script filled today to try this once again but im already nervous about it

    • Every one! celiac and gluten cause hashimotos, try stop eating gluten and you will know. There is gluten in most foods Americans eat, try chicken and frozen veggies, use sea salt, drink water. Also high thyroid has some of the same symptoms as low, especially being tired. I use desiccated cow thyroid if needed, try tyrosine and iodine, ginseng will boost your adrenals if your tired and don’t know why, celiac will deplete your vitamins, b12, c, and D mine was low

  23. Chris, are there any cases where people were able to heal their Hashimotos and regenerate their thyroid by permanently rebalancing, healing the gut, and changing their lives? The thought that I am permanently going to have to take medication because my thyroid is toast no matter what is very depressing :-/

    • I agree with you Dave, and would love to know this myself. I have tried the Vitality Herbs and Clay supplements approach…they speak much about the thyroid and healing, not sure if you are familiar with them. Just something I came across. But this forum is much more robust and realistic, since folks actually post what works for them and what the symptoms are…
      Anyhow, just stuff I was looking at and wanted to share, since I also, do not want to have to take the meds.

  24. Hi, what if the problem is from the pituatary instead of the thyroid? what treatment is there for regulating the pituitary to function well?

  25. Hi Chris it is a very old post but I have found it now, so I am trying my luck.
    My TSH lowered from 13 to 7.6 within a month and without medications. My t4 remained at low point within the range- 11 and t3 in the middle – 4.9 as far as I can remember. I have a few worrying symptoms such as low body temperature, ibs, fatigue and occasional brain fog, with worsening memory. I do not want to take thyroid medications because I think that my low Sex hormone binding globulin leave me with an excessive amount of estrogens which affect thyroxine binding globuline. What’s the best method of correcting excessive estrogen in this situation? I came of birth control pill and that’s when the thyroid problems started.

  26. Hello Chris,
    Do you have any evidence of being able to control hypothyrodism without medication ie with a mixture of homeopathy, acupuncture and diet and supplements, stress management etc. I have just been diagnosed with high tsh, normal T3 and lowT4.
    I eat a very healthy virtually paleo diet but have had huge amounts of stress over the years and suffer from adrenal fatigue. I am also in Menopause and have a lot of joint pain.
    I would really like to try and tackle it naturally before I go down the medication route. I am just about functioning at present but have quite a few symptoms.
    I would really appreciate your opinion on this.

    • HI Heather, and Chris and other posters on this forum-
      Wow, I started reading this — and have not been able to tear myself away from the computer. It is like I found a revolution. I have been stumbling over the last few years, and now months with gut issues, bouts of rashes (eczema)– but I have had that since a child, and now constipation and a polyp removed, and most recently irregular periods, a cyst on my ovary (it disappeared 6 weeks later), and waking up every single night. I had my labs done, (I finally went to an integrative doctor) and she told me I may have thyroid issues. I could not make much sense of what she told me about T3, and T4. TSH, etc…My numbers were TSH 2.13 on a scale of 0.450-4.500, UI/mL, and the T3 at 12.3 ng/dL on a scale of 9.2 – 24.1, and then T4, 0.97 ng/dL on a scale of 0.82 -1.77.
      And I do know my glucose is high, because even with fasting, I as at 91 on a 65-99 scale.
      So my TSH seems normal but my T3 is low?
      All this stuff was overwhelming. And reading the posts here, I am getting the hang of it, but still is overwhelming. It’s like you need to heal your gut, to heal your thyroid, but you need to heal your thyroid to heal your gut.. AAAHHHHH. And I have been reading for years and trying to adapt my diet with things like the Maker’s Diet and the Body Ecology Diet.
      Anyhow here try any of those? I am not gluten free completely (but I don’t eat breads ans such). I never made the association with gluten, and I did not have the poop test done, but maybe I should. But all things point to me avoiding gluten full time.
      I stopped with the dairy, and only do almond milk, or raw goat milk kefir.
      Anyhow, having read all this and seen my symptoms I seem to have the thyroid issues.

      And as Heather said above, can I use homeopathy and not take hormone replacements to regulate my thyroid and gut into balance?
      And also why Paleo? The reason I ask, is that I still need/want the fiber since that has greatly alleviated my constipation. What can help with my sleeplessness? I am taking magnesium now.

      And it seems there are so many systems working together and all at once in our bodies, that it is hard to regulate one, and not affect others, and get the exact right combination (diet, meds, homeopathy etc..).
      I started taking Vitality Herbs and Clay as my only form of supplement. Based on the premise that our bodies produce whatever they need, we just need to detox, and get them into balance. The body will produce what it needs, and there is no one single drug or answer that can fix the complexity of what our bodies are.
      Amazing how we are created as human beings, with all our hormones and systems, and how we are designed to have all these things work to keep us functioning.
      I am very happy to see folks on this post who have found relief and hope.
      Best to all, and I will continue my quest for wellness. Thanks so much for this great website and its knowledge.

  27. Thank you for this article, it really IS spot on. I had Graves’ and it was treated in the 80’s with PTU. That was un-fun. I have been on a rollercoaster since. TSH as high as 120, now it’s 12 thank goodness. But still not good enough. What a frustrating disease this is.

  28. to answer about thyroid meds and high antibodies I would be a perfect example. I’ve had antibodies over 13,000 and at last check they were 7640 but thyroid meds have never worked for me and i’ve tried different types. I have addressed underlying conditions and gone gluten free having worked with a dr. trained by Dr. Kharazian and since doing so i’m off thyroid meds completely and my thyroid labs are just fine. I use coconut oil in place of them which has taken care of any lingering hypothyroid symptoms. On my thyroid group we have a few members who’ve also been able to go off meds or greatly reduce their dose since going gluten free and doing the protocol and I see a few more positive results from others going gluten free every few days.

    • I have antibodies at 286, all my other numbers for my thyroid are great. Doctor put me on 45mg of Armour Thyroid meds. I don’t see any change in how I feel/look etc. She now only takes the TSH test…I took the test through an online med company and paid for it myself. Why doesn’t she take this same test (antibodies)? Should I ask and see if I can stop taking my meds? I thought it might help with my asthma. Is Glueten free that helpful?

  29. I have spent a LOT of time on thyroid boards during the past two years. During that time I have seen many people come and go. Many will turn up desperately hoping that if their sex hormones optimise, their adrenals heal or they go off gluten, they will be ‘cured’. Experience has shown me however that this just does not happen. Optimising sex hormones often means people need less thyroid and going off gluten really makes a MASSIVE difference (I never got properly well until I went off gluten) but it is the rare person whose thyroid starts to function properly after they have taken these steps. Instead, they waste years trying to ‘heal’ and ‘cure’ themselves, when they could have had proper thyroid function restored instead.
    I think eliminating gluten would PREVENT hypothyroidism. I also think optimising adrenal and sex hormone status could also play a preventative role. However, experience with people who have gotten well has shown me that once the antibodies get high enough and the frees low enough; the thyroid will rarely come back online. Even if it does, should a person really have to waste years of their life being miserable and waiting for it to do so?

  30. I don’t agree with that statement, because I don’t believe that everyone with high antibodies needs to be on replacement.  Antibodies fluctuate throughout the course of disease and aren’t necessarily indicative of the autoimmune attack.  Antibodies simply mark a tissue for destruction themselves; they don’t do the destroying.  Nor do I necessarily believe replacement is necessary for people with low FT3 or FT4.  It’s possible they may have elevated TBG secondary to estrogen dominance.  In that case, correcting the estrogen dominance may be sufficient to reverse the symptoms without replacement.

  31. I’m getting very checky here, but how about:
    “It turns out that thyroid medication meets these criteria in cases of hypothyroidism with chronically elevated TSH, low free thyroid hormone levels or high antibodies. These markers indicate that the body is not producing enough thyroid hormone to meet metabolic needs. And thyroid hormone is so important to the proper function of the body that the benefits of replacing it far outweigh any potential side effects of the medication”.

  32. I changed this paragraph:

    Persistently elevated TSH is a sign that the body needs more thyroid hormone than it can produce on its own. This is one clear sign that it’s time for replacement medication. But it isn’t the only one. Some people with TSH in the normal lab range still find that they benefit from replacement.

  33. I see what you’re saying now.  Perhaps I should have been more clear.  I didn’t mean to imply that high TSH is the only time meds may be helpful.  Just that it’s a clear indicator that they’re necessary.  I’m aware that many people with TSH in the normal lab range will benefit from thyroid meds.

  34. I know you have because I read all these great articles. Which is mainly why I am confused by your high TSH = thyroid meds stance. I have always had a ‘normal’ TSH, yet my antibodies were through the roof. I balance my blood sugar, am gluten free and low carb, and treat my adrenals. Yet I still am sick as a dog without my thyroid medicine. So, I really don’t get the emphasis on TSH in this post. It is a dangerous lab, which leaves people very ill for decades, as it takes so long to rise if the thyroid is not functioning correctly.

  35. Thanks so much for this series on thyroid issues.  Your blog is one that I regularly follow as I try to learn all I can about allergies, asthma, and autoimmune disease.  I just started a Paleo diet about 2 months ago, and while I feel great, I still need to be on medication for all three problems.  In fact, I’ve been on Synthroid for 20 years, Allegra for about 4 years (just seasonally), and Advair for 8 months.  While I’m very hopeful that someday I will be able to get off the allergy and asthma medications, I wonder whether it’s even possible to do without Synthroid.  Do you have any experience with this?  How long does it take for the body to heal?

    • As I said in the article, it may never be possible (or desirable) to stop taking Synthroid – presuming it’s the right medication for you. To answer that question, you need to know what the underlying mechanism is. There’s no “one-size fits all” approach to thyroid medication, as I’ll explain in the next post. But if you have chronically high TSH without medication, and/or Hashimoto’s, it’s likely that you’ll always need replacement.

  36. I’ve just recently been diagnosed as hypothyroid and very likely with Hashimoto’s (I tested positive for antibodies). My TSH was not very elevated – always hung around in the middle of the range but on a couple of tests went to the higher end of the range. Unfortunately I live in British Columbia where the range is very wide for TSH – .3 to 5.5. I finally found out about testing for Free T3 and Free T4 and that’s when the FT3 came back very slightly below the range. My FT4 is nothing to write home about either. I’ve since found out that TSH fluctuations are par for the course with Hashi’s, so it’s possible that I’ve had a TSH out of range in the past but just didn’t luck out enough to get tested that day.
    I will tell everyone I know who is having symptoms of hypo to get all three (plus antibodies) tested and to not give up until they do. I’ve been very likely dealing with this since I was 12 and I got unexplained hives on my legs for 2 years and developed pompholyx on my hands, which persists seasonally to this day. Hives are often a sign that Hashi’s is developing. I’m 38 now and have suffered fatigue and weight gain, infertility and a bunch of other issues my whole adult life. I’m super happy to finally have a diagnosis but I know it’s just the beginning of things now. Thanks for your site, I’ve learned a ton since I stumbled across it!

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