Why hypothyroid type symptoms may not completely resolve with medication

Synthroid, otherwise knows as it’s generic name Levothyroxine, is commonly given when people have underactive thyroid (hypothyroid), or Hashimoto’s, an autoimmune hypothyroid (antibodies disrupting thyroid function). It replaces T4, a hormone produced by our thyroid gland in the inactive version, where then predominantly the liver, to a lesser extent the gut, and remainder of the body converts it to the active form, T3. T4’s half life is about 5-7 days, taking longer to break down, versus T3’s half life of about 1 day- thyroid is metabolism, so given a short-term dose can ramp up our whole system (aka T3), hence why we’re commonly given T4. However, if we’re stressed, the body converts T4 to a hormone called reverse T3 (rT3), which is also inactive.

In hypothyroid the TSH is usually elevated because it’s not making enough T4 or T3 (made as a very small amount) so the feedback mechanism tells the body to work harder, so TSH increases. T4 or T3 doesn’t necessarily have to be low to receive Synthroid, or Cytomel (T3 replica), respectively, yet this one-size-fits-all approach usually hits a plateau to varying degrees with people as they find that Synthroid doesn’t work anymore like it used to, and/or their numbers look normal but they still don’t feel good- or their numbers are all over the place and they really don’t feel good. Yet if it’s solely working to fix the mechanism.. why is it common to feel that there’s more going on..?

Maybe you feel some of your symptoms are coming back, like fatigue, low libido, hair thinning, anxiety- perhaps the dose was changed, or the numbers look perfect and you get this sinking feeling that you’re missing something. The answer is yes- because our body is so much more complex than we even understand and that one mechanism that makes thyroid hormone is only a part of what’s going on. Remember that rT3 scenario? Well imbalanced hormones such as high estrogen (very common in men and women) can raise a binding globulin that ties up active thyroid hormone.

Doing a deep dive into the origins of stress, that can include, poor relationships, poor nutrition choices, sedentary lifestyle, not sleeping well, or outstanding health concerns, to name a few. Blood sugar issues (very common too), whether they show up on your blood work in an elevated glucose or Hemoglobin A1c, or constant cravings for carbohydrates and sugar (another indication), can further impact thyroid hormone because insulin resistance is a source of stress and also contributor to obesity- worsened by an underactive thyroid, so it’s this feedback cycle that’s like a chicken or egg scenario. And our adrenals, those two glands that sit on top of our kidney- responsible for our stress response, hormone balance, and electrolytes- if that cortisol curve is out of wack, it’s stress. So can’t treat the thyroid without addressing adrenals.

If you feel that Synthroid is still working, I still encourage you to look at all aspects of health as mentioned above because these concerns did not just happen overnight, so there were processes in play that got us here. We change the processes, we may change the outcome.

  • Consider T4/T3 medications like Armour, WP thyroid, or Nature-throid: Sometimes people report doing better on this than Synthroid (this assumes our body will convert effectively to T3)

  • While may proceed with caution, perhaps Cytomel, solely T3 is an option

  • Going au natural: Per person, depending no the healing, from both optimizing lifestyle and genetics, you may not need medication after all.

Our organ systems are more complicated than a ‘one size fits all’ treatment, and we have not yet even explored the healing that comes with the thyroid/throat chakra- speaking, communication, how we present ourselves to the world. These concerns are incredibly common where there is thyroid disease, so regardless of whatever combination you choose for healing your thyroid, the best option is being able to employ specific strategies geared towards your health to heal your whole body.