How to Understand Thyroid Hormone Replacement Therapies

When hypothyroid conditions develop, treatment must be administered to prevent a chronic worsening of the condition, which can eventually lead to myxedema coma and/or death. Moderate to severe hypothyroidism can also cause other problems in the body, if left untreated, including increasing weight gain, fluid retention (edema), worsening depression, high cholesterol and heart disease.

Thyroid Supplements versus Hormone Replacement

While some manufacturers of thyroid boosting supplements, would have you to believe that these natural remedies will reverse or treat hypothyroidism, this is not true if they contain no thyroid hormone. The Federal Drug Administration (FDA) will not permit the adding of actual thyroid hormones to non-prescription supplements and so thyroid booster supplements cannot treat cases of true hypothyroidism, which occurs in diseased thyroid glands. In non-diseased glands, it is possible that some of these supplements do boost thyroid function to some degree but when overt (full blown) deficiency in thyroid hormones is present, there is no substitute for replacing them via prescribed hormone therapy, administered by a qualified medical doctor.

Types of Thyroid Hormone Replacement Drugs

Most hypothyroid patients are prescribed T4 medications to restore bodily metabolism that begins to run low as a result of the condition. This hormone, also called "thyroxine" and "levothyroxine" is usually prescribed in the synthetic form, such as the name-brand called Synthroid (TM). The hormone will then also convert into another major thyroid hormone called the T3 (triiodothyronine), via the available globulins, enzymes and proteins that are present in the body. Much of this conversion process occurs within the liver and kidneys.

Some hypothyroid patients are believed to have a problem with converting T4 into the also essential T3 due to a lack of these conversion elements in the body (impaired conversion). This may be discovered when the hormone replacement is monitored via blood lab tests, of these two hormones. When this failure to convert is found to be occurring, a treating-doctor may switch patients to a T3 and T4 combination medication, such as the brand Armour (TM), which is natural or the brand Thyrolar (TM), which is synthetic. Other doctors may simply add a T3 medication to a current therapy, such as the synthetic brand Cytomel (TM), which is also synthetic.

How Hypothyroid Treatment is Monitored

As a hypothyroid patient takes their prescribed, daily dose of replacement hormones, this will cause levels in the body to increase, until they reach normalized states (euthyroid). This can however take several dose adjustments to be made, over a period of several months, before optimized levels are achieved. The method for monitoring the treatment is by repeat blood testing, ordered at regular intervals of 6 to 8 weeks between dose changes. Once the proper level is reached, a doctor may only require patients to be retested, two or three times yearly.

The tests that are ordered usually include the TSH, the T4 and the T3. The TSH (Thyroid Stimulating Hormone) is actually a pituitary hormone that stimulates thyroid function and that decreases when thyroid hormones (T4 and T3) increase in the body and increases when they become lower in the body. For example, an abnormally high TSH indicates hypothyroidism or under-treated hypothyroid cases and an abnormally low TSH indicates hyperthyroidism or over-treated hypothyroid cases. The opposite is true of the T4 and T3, which both decrease with hypothyroidism and they increase with hyperthyroidism.

How Patients can help with their Treatment

Hypothyroid patients should take their daily hormone dose, as directed by their doctors and they should not make adjustments to the amount taken, unless approved, following a check up or blood lab testing. The dose should be taken first thing upon waking, mornings and on an empty stomach to allow-for optimal absorption through the digestive tract and it should also be taken with a full glass of water. Breakfast should be delayed if-possible for at least 30 minutes and preferably for an hour after dosing.

Foods containing high-fiber content, should be avoided for at least two hours following the morning dose and any supplements containing calcium or iron, should be taken about 6 hours afterward, to also prevent malabsorption of the hormones.

A hypothyroid patient should not switch from a name-brand thyroid hormone, to a generic version, without the knowledge of their doctor. Even if the same amount of T4 and/or T3 is listed on a prescription generic, to be contained in each pill, as is contained in a major brand, there can still be differences in the potency. This can be due to differences in the fillers used in each drug and in whether it is animal-derived (dessicated) or synthetic (lab produced).

Thyroid hormone replacement therapy can resolve the symptoms of hypothyroidism and restore a better quality of life to patients.

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