Still feel unwell despite being on thyroid medication?
Under treated thyroid patients are the most common patient I see on a daily basis.
Most thyroid patients who come to see me are frustrated that their other doctors don’t seem to listen, aren’t willing to try other medicines and aren’t willing to optimize thyroid levels versus just get them into normal ranges. They give the patient the lowest dose that will minimally bring them into normal ranges and patients still have terrible fatigue, cold intolerance, weight gain, aches and pains, hair loss, dry skin and dry hair and irregular periods, to name a few of the lingering symptoms of suboptimal thyroid treatment that leaves patients under dosed, under treated and feeling miserable still, despite “treatment”.
My thyroid patients often complain that they have been to several other doctors sometimes for years, trying to get help with their low thyroid (hypothyroidism) but still do not feel well, and cannot seem to find a doctor willing to change the medication, adjust the strength, or even listen to the symptoms that they still experience. If I had a dollar for every patient I see with this same complaint I’d be a millionaire by now! It’s a sad state of affairs out there with thyroid treatment. I know firsthand, having been a patient myself at one time for hypothyroidism and Hashimoto’s Thyroiditis. It took me years to get my thyroid properly treated and optimized to a point where I felt good again!
I am shocked at how many doctors, including Endocrinologists, under treat and under dose their thyroid patients. Perhaps they are stuck in old models of treatment, have not kept current on the latest studies and journal articles, or are simply too stubborn about sticking with how they were taught to treat hypothyroidism with T4 (synthroid, levothyroxine, levoxyl) only therapies at the lowest dose possible. I’m not sure how that trend started but it’s entrenched in conventional medical practice. This is despite current information in their own medical journals! The Journal of Endocrinology concluded that most patients feel best on combinations of T4/T3 medications, in the way of either adding in cytomel (synthetic T3) to the T4 medication, or using dessicated thyroid in the way of Armour or NatureThroid brands, for example. My belief is the best thyroid replacement comes from dessicated thyroid because it is the most complete, containing not only T4 and T3, but also T1 and T2.
Many times the fix is so easy that all it takes is switching to dessicated thyroid medication like NatureThroid and raising the dose to a more optimal strength to affect a major, positive change in how patients feel. Of course monitoring levels is important on follow up visits and labs to watch for dosing too high or overshooting the mark when optimizing levels. That is just as important too, but most patients are suffering terribly from under dosing. I don’t think I have ever had a patient come in to see me complaining that their doctor won’t lower their dose and they feel like they’re on too much medicine! Not even once!
Several times a day I see patients complaining that they don’t feel well despite being on synthroid, levoxyl, levothyroxine, even cytomel, and in every single case it is simply that they are not on the right medicine and/or not on the right strength to optimize the levels to the point that their symptoms resolve. It’s really that simple. It doesn’t even take an endocrinologist to figure that one out! Once that happens, it’s a big wow moment….no more need for antidepressants once the thyroid is balanced either! I see that a lot too. Of course not in every case, but in many many patients they’ll see moods lift and the brain fog dissipate, making antidepressant therapy unnecessary. For me personally it was definitely a huge change. My moods became even, and the mild depression I felt lifted completely once I was on the right dose of NatureThroid. That simple.
Helping thyroid patients get to an optimized level where they feel better, have more energy and see all the symptoms disappear is such a passion for me and also very personal. For years I too suffered from under treated, under dosed thyroid and it wasn’t until I finished medical school and practiced in this area that I was able to optimize it well for myself, finally.
I have Hashimoto’s Thyroiditis and suffered for years before it was properly diagnosed and then more years while the hypothyroidism I experienced was undertreated by the endocrinologists and other multiple thyroid doctors I saw. So I can more than empathize with the patients who come to see me as I was in their shoes at one time. Because of that intimate understanding of thyroid disease, along with my medical training and knowledge of the subject, I feel I can offer patients something truly unique in the way of expertise and with great compassion for their struggles.
Many patients ask what optimal looks like on the lab numbers. My goal is to get TSH under 1, ideally as close to the .30 new range as possible. So if your TSH is at 2 or 3 or 4….you may need better optimizing. I also test T3 Free and my goal is to get that level up over 4 and in the highest point of the normal range. If yours is at 2 or 3…you may need optimizing. Same goes for Free T4 levels. Are your thyroid levels just in the normal ranges? Go for optimal, not just normal! And if your doctor has never tested thyroid antibodies to rule out Hashimoto’s Thyroiditis, be sure to ask for that test too.
Do not give up if you still don’t feel well on your current thyroid treatment. Keep looking to find the right doctor! If your doctor is not open to switching medications or getting your levels better than minimally normal ranges, find a new doctor. Don’t settle for less. You deserve to feel the best you possibly can with balanced, optimized thyroid levels!