Aug 242009

Recently, I was asked the following question:

My doctor said I was hypothyroid and put me on Synthroid. I have been on Synthroid for 6 month, but I don’t feel any better. Why don’t I feel better and what can I do about it?

Synthroid contains T4 (levothyroxin) the main hormone produced by the thyroid gland, however T4 is not very active. The major active hormone is T3 (triiodothyronine). T4 has to be converted by the body to T3 to exhibit benefits as only T3 stimulates activity at the receptor sites.

There are many reasons why supplementation with just T4 may not be effective. If for any number of many reasons, the T4 (even with sufficient dosage) is not being converted to the active T3 form, you will not see the benefits of the thyroid supplementation.

There are many reasons why you might be hypothyroid. The most prevalent factor might simply be a lack of iodine. We all need some form of iodine. If we don’t get it in our diet, it is essential to take it in the form of supplements. The need for and lack of iodine is the reason why salt was iodized. However, with the current emphasis on decreasing salt intake, salt has lost its importance as an iodine source.

There are also many cofactors that are necessary for T4 to be converted to T3 such as zinc, copper, vitamins A, B2, B3, B6, and C. If any of these are missing in sufficient amounts, your supplemental T4 (Synthroid) will not be converted to T3 and you will still exhibit the symptoms of a low thyroid.

There are many factors that influence the enzyme which converts T4 to T3 such as: selenium deficiency, stress, heavy metal toxicity, dieting, inadequate protein intake, high carbohydrate diet, elevated cortisol, chronic illness, and decreased kidney or liver function.

In addition there are many medications that block this conversion such as beta blockers,   birth control pills, estrogen, lithium, phenytoin, theophylline, chemotherapy, glucocorticoids and clomipramine. There are also environmental toxins to consider such as dioxins, PCB, phtalates (chemicals added to plastics).

As you can see hypothyroidism can be very complicated and may need further investigation. Paying attention to your diet, supplementing with the appropriate supplements as previously mentioned, and dealing with stress issues are important first steps.

A better scenario than synthroid might be the use of dessicated thyroid. Dessicated thyroid derives from pig thyroid which is very close in composition to human thyroid i.e. a mix of T4 and T3. Adding supplemental sustained release T3 made by compounding pharmacists, along with adjustment to your synthroid dosage might also be helpful.

Treatment of thyroid dysfunction should be individualized and customized to each patient. It is therefore very important to work with your physician to solve your thyroid issues, keeping some of these options in mind.

Marvin Malamed,B.Sc.Phm.,C.C.N., has owned Haber’s Compounding Pharmacy for over 17 years. He is an award winning pharmacist and a certified clinical nutritionist. He can be contacted at marvin@haberspharmacy.com
© 2008 Haber’s Compounding Pharmacy. All Rights Reserved.

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