Different types of thyroid hormone replacement pills

When you have been diagnosed with an underactive thyroid, your doctor will most likely recommend that you start taking thyroid hormone pills.  The intent is that these hormone pills replace the hormones that your thyroid cannot produce anymore.  

So what are the options?

First, is synthetic T4 medication.  T4 is the inactive thyroid hormone, and your body must convert this into T3 for the body to be able to use it.  T4 medication is called levothyroxine, and there are various brand names under which it is sold.  In South Africa, we have Eltroxin™ and Euthyrox™.  In the USA it is sold under the names Synthroid™, Levoxyl™, and Levothroid™.  This type of hormone is the gold standard that most conventional doctors will prescribe.  

Second, is a combination of T4/T3 medication.  This type of thyroid hormone pills are derived from the dried glands of pigs or cows. It is called ‘natural desiccated thyroid’, or NDT in short.  Many patients who struggle with T4-only treatment feel better using a combination treatment, but not many doctors will prescribe it. It is available as Armour Thyroid™, Nature-Throid™ and WP Thyroid™ in the USA. In South Africa, compounding pharmacies can provide NDT or it can be imported.  

Third, is the synthetic T3 medication.  T3 is the active hormone that the body can use. It is called liothyronine.  T3 can be prescribed in conjunction with synthetic T4 medication, or it can also be used as a stand-alone therapy.  In the USA it is marketed under Cytomel™, Triostat™, Levoxyl™, and Levothroid™. In South Africa it is marketed as Tertroxin™.

 

While some patients feel that the T4 medication work for them, there are many patients who feel that they still struggle with hypothyroid symptoms despite taking their T4 medication and their doctors telling them that their lab results are “normal”.  Unfortunately, many doctors will stick to the “gold standard” T4 medication, and many thyroid patients will continue to suffer.  

There are other options.  If you are taking T4 medication, and you don’t feel better, it is time to speak to your doctor about alternative options.