In almost thirty years of practice, I have noticed a pattern with patients who come to me with hypothyroidism (low thyroid) and state they do not feel well on their standard thyroid replacement. Since I am completing a doctoral dissertation on hypothyroidism, I have read plenty of studies demonstrating that this is a problem in the general hypothyroidism population.

The Standard Does Not Work For Everyone

The standard thyroid replacement in medicine is levothyroxine, the thyroid hormone known as T4. It is offered under different brand names, such as Synthroid, Levoxyl, and others. There can be a few reasons why people feel their hypothyroid symptoms (fatigue, slow metabolism, brain fog, dry skin, mood imbalance, etc.) are not improving on levothyroxine therapy. These reasons include:

1. Wrong dose
2. Levothyroxine is not bioidentical but is synthetic, and cell receptors do not receive it properly
3. There are other reasons behind hypothyroidism for their symptoms
4. The patient is not converting levothyroxine (T4) to the more biologically active thyroid hormone known as T3

The Titan T3 

Blood tests can measure the levels of total T3 and free T3. Most doctors do not test T3 levels, although this hormone is critical as the dominant player in cellular metabolism. To optimize T3 levels, one can improve gut function where the microbiome is involved in thyroid metabolism, supply nutrients such as selenium and iodine (such as our Thyroid Wellness), which are required to make T3, or use medications that contain both T4 and T3 so the patient is guaranteed to get the active T3.

North American Doctors Can Prescribe T4 and T4 Combinations

A survey of American Thyroid Association members asked about thyroid prescribing options. Of the 389 survey respondents, 363 were physicians who prescribed therapy for hypothyroidism. A total of 86% were endocrinologists, and 64% were from North America. Respondents were given 14 scenarios describing patients with hypothyroidism and were asked to choose among six therapeutic options. The survey results indicated that physicians are willing to prescribe combination therapy with T3 under certain circumstances, especially North American doctors.  This trend opposes the American Thyroid Association’s guidelines but not those of British and Italian societies.

Conclusion

If you are on thyroid replacement and still have hypothyroid symptoms, then work with a doctor who can optimize your T3 levels.

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