The numbers are astounding. Every month more than 22 million Americans take the
drug Synthroid®, a synthetic thyroid hormone replacement.1 This makes it the most
widely prescribed drug in America. Sadly, most of those on this unnatural form of the
hormone are totally unaware that better natural alternatives exist.
Levothyroxine—brand names Synthroid®, Levoxyl® and Tirosint®—is the go-to thyroid
prescription for virtually all conventional doctors, including the hormone specialists
known as endocrinologists.
Years ago, I had a patient in her late fifties whose internist had put her on one of these
brand name drugs. I’ll call her Linda, not her real name of course. Despite taking the
drug as prescribed, Linda still suffered from a number of low thyroid symptoms
including fatigue, poor memory and a slow metabolism. She brought me her most
recent blood thyroid tests showing her thyroid hormone levels were suboptimal,
particularly her Free T3 level.
“Linda simply didn’t feel quite right…”
Free T3 is by far the most dominant thyroid hormone in the body in terms of supporting
metabolism and energy production in our cells. So, like many people on levothyroxine,
although her blood work didn’t show a serious thyroid imbalance and she was able to
get through her daily activities, Linda simply didn’t feel quite right.
My plan was to switch her to a bio-identical thyroid hormone and see if she responded
like the majority of my other patients who made the switch. Sure enough, Linda was
noticeably better: her energy level improved, she lost some weight, and several other
troubling symptoms improved. And when I repeated her blood thyroid levels there was
an improvement in her numbers, especially in the Free T3.
About a month later I received a call from Linda’s internist. It was clear he wasn’t
happy about me switching Linda’s thyroid medication to a bio-identical. He told me he
had “overseen her healthcare for years” and made it clear that he felt I was interfering
with his relationship with her.
With Linda’s chart notes and lab work in front of me I calmly pointed out the facts of
her case. She felt significantly better after the switch in medications, and when you
compare her lab work from before the change to after her thyroid levels had improved.
After a few moments of silence, he sputtered that the bio-identical thyroid meds such
as Armour® and Naturethroid® didn’t contain standardized amounts of thyroid
hormones.
Bio-identical thyroid meds are FDA approved
“Not true,” I explained, “they‘re both standardized and FDA approved.” (Not that the
FDA’s approval of drugs means much to me, of course). I then pointed out that actually
it was the Synthroid® he had prescribed to Linda that had a history of manufacturing
problems that concerned the FDA about it being “reliably potent and stable.”2
And that was, essentially, where our conversation ended. But at least he didn’t slam
the phone down in my ear, so perhaps he learned something.
You’re probably wondering why the vast majority of doctors continue to prescribe
synthetic levothyroxine when better bio-identical choices are available. The simple
answer is ignorance. Doctors are only human and they prescribe what’s familiar and
most comfortable for them. Unfortunately, what’s most familiar to them comes with a
big bias.
Hypothyroidism: It’s complicated
When it comes to thyroid issues the phrase “it’s complicated” is a perfect fit. The truth
is there’s no single cause of thyroid problems so there’s no one-size-fits-all treatment
either. And when it comes to hypothyroidism you’ve got to pinpoint the cause (or
causes) to figure out the cure.
Causes for this common condition can include nutrient deficiencies (such as selenium
and iodine), immune system imbalances (autoimmunity), exposure to toxins (such as
mercury, pesticides, fluoride and bromine) and hormone imbalances. I’ll explore each
of these concerns in more depth in future issues of Health Revelations. And be sure to
look for a revealing article on iodine in an upcoming issue.
Big Pharma based “education” leads to biased treatments
Doctors receive their education first from medical school and then from continuing
education seminars. Major drug companies pour megabucks into these institutions,
and then they continue to sponsor training events and seminars for the rest of these
doctor’s careers.
Naturally this affects the type of information they’re provided with. There’s a clear bias
towards synthetic drug treatments and, let’s face it, it will be a cold day in Hades
before Big Pharma provides these docs a balanced picture with information on nonsynthetic
thyroid replacement options as well. (As a matter of fact, by the time you’re
done reading this article you’ll likely have a far better understanding of thyroid
prescription options than the majority of practicing doctors!)
As a result, if you’re a conventional medicine doctor and your patient has low thyroid
(hypothyroid) levels you automatically prescribe levothyroxine (usually Synthroid???? or
Levoxyl????). If you’re unable to get the patient’s thyroid levels balanced, or if she is
having problems, then you refer her to an endocrinologist for more specialized care.
When a patient consults with an endocrinologist the treatment almost always involves
a trial of different doses of levothyroxine until blood levels are considered “normal.”
And if your tests look normal but you don’t feel much better, too bad, you must have
something else wrong with you.
Get good numbers and feel GREAT!
There IS a better way. And it’s to not treat patients like they are their lab test numbers.
Instead of making treatment only about the numbers also make it about how the
patient feels. I tell my patients I want their thyroid numbers to look good AND for them
to feel great. And that’s why I choose to use bio-identical thyroid hormones.
Significant symptom improvement with DTEs
Desiccated thyroid extracts (DTE) are a group of bio-identical thyroid medications
derived from purified porcine (pig) thyroid tissue. The levels of T3 and T4—the two
most active thyroid hormones in the body—are standardized in DTEs. They also
contain trace amounts of iodine and the calcium-regulating hormone calcitonin, as well
as two other thyroid hormones, T1 and T2. Not as much is known about T1 and T2, but
they do play roles in the human body.
Armour, Nature-Throid and WP Thyroid are the three commonly available brand name
DTEs. I usually prescribe Nature-Throid to my own patients. Nature-Throid is
hypoallergenic and doesn’t contain any dyes. (Armour thyroid contains some corn
starch and titanium dioxide which aren’t major allergens, but for a small percent of
users may cause sensitivity problems.) Nature-Throid is also less expensive and is
available in more doses that Armour and WP Thyroid. And neither Nature-Throid nor
WP Thyroid has any history of being recalled by the FDA for inconsistent hormone
content, while Armour has.
An impressive study comparing DTEs to synthetic levothyroxine was published in The
Journal of Clinical Endocrinology and Metabolism in 2013.3 The randomized, double
blind, crossover study involved 70 people ages 18 to 65 that had hypothyroidism and
had been on a stable dose of levothyroxine for at least 6 months (two of the
participants had been on DTE). They were given either DTE or levothyroxine for 16
weeks and then switched to the other thyroid medication for 16 weeks without
knowing what medication they were taking.
Laboratory testing and symptom profiles were done at the end of the treatment period.
At the end of the study 48.6 percent of the participants preferred DTE, 18.6 percent
preferred levothyroxine, and 32.9 percent had no preference.
The volunteers in the group that preferred DTE lost an average of four pounds, and
their subjective symptoms were significantly better. This makes sense since they also
had measurably higher levels of T3, the most active of the thyroid hormones for
metabolism.
If your doctor is hesitating about switching you to DTE refer them to this textbook
study. Note that DTE is measured in a different unit called grains. One grain contains
38 micrograms of T4 and 9 micrograms of T3.
Say no synthetics—switch to bio-identicals instead
Once a patient has converted over to DTE I normally retest their thyroid levels within
four weeks to make sure the dose is correct. Sometimes adjustments need to be
made. If the levels are good the patient can be tested every four to six months.
If you are currently on a synthetic thyroid hormone prescription your local holistic
doctor can help you convert your prescription to either DTE or compounded thyroid as
well. If for any reason you don’t respond as well as you, and your doctor, are hoping
after the switch he can tweak the formula by choosing the exact microgram of T4
and/or T3. The modified prescription will then be filled through a compounding
pharmacy that will prepare the formula to the exact specifications prescribed by your
doctor. This provides a very precise tailored treatment, but the downside is it’s more
expensive. The ability to personalize your prescription is something you CAN’T get with
the Big Pharma versions of this drug.
Remember, no matter if you’ve been dealing with thyroid problems for years, or you’re
newly diagnosed, effective, safe bio-identical thyroid hormones could be the solution
you’re looking for.
Article Citations:
1. Brooks, M. Top 10 Most Prescribed, Top Selling Drugs. WebMD.com. Accessed March 27, 2014 at
www.webmd.com/news/20140805/top-10-drugs
2. Conlon, M. Abbot Must Prove Synthroid’s Safety and Efficacy To FDA. Accessed March 27, 2015 at
http://drugtopics.modernmedicine.com/drug-topics/content/abbott-must-prove-synthroids-safety-and-efficacyfda?
page=full
3. Hoang T, et al. Desiccated 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.
Adapted from Dr. Stengler's Health Revelations Newsletter with permission.
