The most widely prescribed drug in most states in America is Levothyroxine, also known as Synthroid. More than 120 million prescriptions for Levothyroxine are given by doctors every year in the United States.
This medication is commonly prescribed to seniors, as hypothyroidism is more common in the aged. However, as I have pointed out before, Levothyroxine is often not the best way to treat hypothyroidism for those who need thyroid replacement. A very recent study published in the Annals of Internal Medicine studied the effect of Levothyroxine compared to placebo in 683 people aged 65 years or older, whose testing showed subclinical hypothyroidism (elevated TSH but normal T4).
The researchers found that Levothyroxine did not improve hypothyroid symptoms or fatigue compared to those taking a placebo.
One of the reasons that the synthetic thyroid replacement is not all that helpful is that it does not contain the most active thyroid hormone T3, also known as triiodothyronine. The primary function of Levothyroxine, which is T4, is to be converted by the liver and kidneys into the more active Free T3, which drives energy production in cells. As people age, the metabolism abilities of the liver and kidney decrease, so T4 to T3 conversion decreases. As well, seniors may be prone to deficiencies in nutrients that are required for thyroid hormone production, such as selenium, iron, and iodine. Of course, your typical doctor does not address the nutritional requirements for thyroid production.
Integrative doctors such as myself prefer desiccated thyroid extract (DTE), or compounded bioidentical (same as what your body produces) T4 and T3 combination. The American Thyroid Association and American Association of Clinical Endocrinologists do not tell doctors NOT to prescribe DTE or compounded T4/T3 combination. However, they also do not advocate using these helpful thyroid replacements. Interestingly, the American Thyroid Association removed a statement stating the T4/T3 combination should not be used. An online survey by WebMD found that that DTE was perceived by patients to work better than Levothyroxine. A previously published study had found the same results; people felt better on DTE!
If you are on synthetic thyroid replacement such as Levothyroxine (Synthroid), then seek an integrative doctor knowledgeable in bioidentical thyroid replacement to switch forms and be monitored. My experience is that most patients feel better on the bioidentical thyroid. Also, make sure you are getting the nutrients you need for proper thyroid production.
Dr. Mark Stengler NMD, MS, is a bestselling author in private practice in Encinitas, California, at the Stengler Center for Integrative Medicine. His newsletter, Dr. Stengler’s Health Breakthroughs, is available at www.markstengler.com and his product line at www.drstengler.com
Goetz, T. (2018). The Most Popular Drugs in America, State by State. Retrieved 3 June 2020, from https://www.goodrx.com/blog/the-most-popular-drugs-in-america-by-state/#:~:text=Levothyroxine%2C%20also%20known%20as%20the,in%20the%20US%20every%20year.Hoang T, et al.
Dessicated Thyroid Extract Compared With Levothyroxine in the treatment of Hypothyroidism: A Randomize, Double-Blind, Crossover Study. The Journal Of Clinical Endocrinology And Metabolism. 2013 May;98(5):1982-90.)
Tucker, M. (2020). Patients Say Desiccated Thyroid Better Than Standard Therapy. Medscape. Retrieved 3 June 2020, from https://www.medscape.com/viewarticle/928573#vp_1.[/vc_column_text]
