One of the first thyroid treatments that was commercially available was Armour Thyroid, which was a natural product made of desiccated pig and cow thyroid glands put into pill form. It is still available today. It contains both T3 and T4 hormones. It fell out of favor over the years because quality control of this medication was difficult. In recent years, however, production has become much more stable and it is back in use again. Your doctor may prescribe Armour Thyroid if you have had problems with a synthetic therapy, or if you or your doctor prefer natural products.
The most commonly prescribed synthetic drug for hypothyroidism is called levothyroxine, known under the brand names Synthroid, Levothroid, Levoxyl, and Unithroid. A more recent addition is a drug called Tirosint, which is made in Switzerland and distributed in the United States. It has fewer additives and preservatives than the other synthetic medications, so it may be a good choice for you if you find you're allergic to any of the other brands.
Another popular drug is called Cytomel, which contains only T3. Synthroid contains only T4, which must be converted to T3 by the body. Some people respond better to T3 preparations because they have trouble converting T4 into T3; those people fare better with either a combination of T3/T4 or T3 alone.
The mineral selenium decreases the antibodies that form in Hashimoto's thyroiditis, thereby decreasing the inflammation, which is why I recommend selenium to everyone who has hypothyroidism. It is also useful as a messenger in the brain helping with the communication between the thyroid and the adrenal gland.
How to Take Thyroid Medication
Although thyroid problems are usually easily treated with medication, it can be tricky to take because of how thyroid hormones react with other substances. Tell your doctor about all the prescription and over-the-counter medications you use because there are many other medicines that can affect thyroid medications. This includes vitamins, minerals, and herbal products. There are also some substances that block the absorption of thyroid medications (e.g., soy, calcium, iron, some mood altering prescription medications), which is why some patients don't see the results they'd like.
- Do not take thyroid medication within two hours of eating as food may delay or reduce its absorption.
- Do not take estrogen, birth control pills, or hormone replacement therapy in the pill form at the same time you're taking thyroid medication (you can take them in the same day, just not at the same time of the day). Any form of oral estrogen may be a problem if taken at the same time as thyroid because both estrogen and thyroid hormone share the same binding globulin (a protein to which thyroid hormone binds in the blood and from which it is released into tissue cells) in the liver. If you take them both at the same time, you're not absorbing as much of either one. This does not apply if you are taking other forms of birth control, such as the patch or the NuvaRing; transdermal (through the skin) hormone replacement; or sublingual (dissolving directly into the bloodstream from drops or lozenges into the mouth) hormone replacement. That's another reason why I treat my menopausal women who have hypothyroidism with a hormone CREAM instead of the standard oral prescription pill.
- Calcium also prevents absorption of thyroid medication, so they should not be taken at the same time.
- Iron, whether alone, or as part of a multivitamin or prenatal vitamin supplement, interferes with thyroid hormone absorption. You should not take your iron supplements or your vitamins with iron at the same time as your thyroid hormone, and should allow at least two hours (four being the optimal time frame) between taking them.
Your Thyroid and Menopause
Although it is very rarely mentioned, your thyroid and your reproductive cycle are closely related. Thyroid problems can cause irregularities in the menstrual cycle, and even infertility in extreme cases. As you get older, these problems can become exacerbated. In fact, untreated hypothyroidism can cause a woman to be in an artificial premature perimenapause or even throw her into menopause.
It's important to remember that the thyroid is part of the overall endocrine system, and when any of this system's hormones get out of balance, all of the parts suffer. So when you go through times where hormonal imbalance is more than likely—such as pregnancy, perimenopause, and menopause—your thyroid is also more than likely to get out of whack as well.
That is why women over 50 should be tested for thyroid problems every few years (earlier if you have a family history) and woman over 65 should be tested annually. Any woman of any age should be tested at any time and as frequently as needed if she has symptoms of hypothyroidism. Your doctor will then be able to determine whether you need thyroid hormone medication, and/or iodine or other supplementation.
In dealing with thyroid problems, it's important to find a doctor who will listen to your symptoms and be open to the newest research, the latest reference range recommendations, inclusive testing, and who understands that each patient will react differently to various treatments. You may need to see an endocrinologist, someone who is trained in the art and science of working with hormones, to get the results you need and deserve.
It makes me frustrated to know that there are so many women who suffer unnecessarily for so many years. I hear it over and over again, how finally being diagnosed and treated for thyroid problems has changed women's lives. They have accepted their "lot in life" for so long that they have almost forgotten what it's like to have energy and focus and fun in their lives. I'm here to tell you, don't just accept it. Get tested. Check your results. Ask for a copy of your labs. See a specialist. Don't settle—if you don't agree with your doctor, go somewhere else. You know your body better than anyone else. Listen to it and get your life and your health back in your hands.
The "Check Your Thyroid" Jump Start Tip
Taking Matters into Your Own Hands—or Armpits. If you suspect you're having thyroid problems and you want to check yourself out at home, there is a simple test you can do called the basal temperature test. Here are the steps:
- Get a basal thermometer (the kind you can use under your tongue). Leave it overnight on your bedside table.
- First thing in the morning, before you get out of bed, tuck the thermometer under your armpit and lay completely still for 10 minutes. Set a timer before you begin so that you don't have to move around to look at the clock.
- Record your temperature for there to five days. If your temperature is consistently below 97.8°F, you may have a thyroid problem, and you should have yourself evaluated by a health professional.
Remember, thyroid disease is not just about fatigue, it can ultimately affect your morbidity as well as your mortality. Take control, but do it with the assistance of an expert.
Excerpted with permission from The Fatigue Solution by Eva Cwynar, MD, published by Hay House. For more information on Dr. Eva Cwynar, visit www.dreva.com.
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