Those people with hypothyroidism and Hashimoto’s Thyroiditis who have been reading my articles and blog posts for a long time probably realize that I’m not a big fan of thyroid hormone medication. Most cases of hypothyroidism are caused by Hashimoto’s, which of course is an autoimmune thyroid condition which affects the thyroid gland. So my goal with these patients is to try to restore the health of the immune system, and if at all possible get the person to the point where they don’t need to rely on synthetic or natural thyroid hormone. And even with non-autoimmune hypothyroid conditions one should try to detect and correct the cause of the problem. Since in most cases the thyroid gland itself isn’t the cause of the condition, I commonly will have patients, and even non-patients ask me if they can stop taking thyroid hormone medication, and just focus on the imbalances which are responsible for the hypothyroid condition.
Before you stop taking your thyroid hormone medication, you do need to understand the importance of thyroid hormone. Although taking Synthroid, Tirosint, Armour, Nature-Throid, or any other type of synthetic or natural thyroid hormone isn’t doing anything for the cause of your condition, you still might need to take thyroid hormone while trying to address the cause of the problem. While I can understand someone not wanting to take any type of medication, if someone has low or depressed thyroid hormone levels, not taking thyroid hormone medication can lead to serious health issues over time.
Understanding The Importance Of Thyroid Hormone
In the past I wrote an article entitled “Why Is Thyroid Hormone So Important To Our Health [1]?” In this article I discussed some of the more important functions of thyroid hormone, as it’s important for the metabolism of proteins, fats, and carbohydrates, regulates the expression of genes, plays an important role in brain development and function, is important for reproductive health and bone health, and also plays a role in wound healing and peripheral nerve regeneration. So hopefully you realize that having low levels of thyroid hormone isn’t a good thing, and while I’m all for trying to restore someone’s health so they won’t need to take thyroid hormone medication, until they reach this point it might be a good idea to take thyroid hormone. And of course there are people who will need to take thyroid hormone medication on a permanent basis.
Recently I attended a nutritional conference which focused on epigenetics, and one of the presenters spoke about the role of thyroid hormone in the mitochondria. Thyroid hormones, especially T3, are critical for the function of the mitochondria. The mitochondria are located in the cytoplasm of our cells, and they are responsible for cellular respiration, and have many other functions. Also, keep in mind that biosynthesis of the steroid hormones begin in the mitochondria, and so if someone has low levels of T3, this in turn can affect the production of steroid hormones such as estrogen, progesterone, and cortisol. With regards to the mitochondria I’ve written a separate post you might want to check out entitled “The Relationship Between Mitochondria and Thyroid Health [2]“.
Subclinical Hypothyroidism and Thyroid Hormone
Is it important to take thyroid hormone if someone has subclinical hypothyroidism? So for example, if someone has an elevated TSH, but if their thyroid hormone levels are well within the lab reference range, does this person need to take thyroid hormone medication? It really does depend on the situation, as if someone has an elevated TSH and both free T3 and free T4 are well within the functional reference range, and if they aren’t experiencing any symptoms, then they very well might not need to take synthetic or natural thyroid hormone. On the other hand, if they are symptomatic then sometimes taking a small dose of thyroid hormone can help. Plus, one does need to realize that there is a difference between the lab reference range and a functional reference range.
For example, for free T3 many labs use a normal reference range of 2.3-4.3 pg/mL. If someone has a free T3 of 2.7 pg/mL this is considered to be normal, but it’s still on the low side. So if someone has an elevated TSH, elevated thyroid antibodies, has a free T3 of 2.7 with minimal thyroid symptoms, should they go ahead and take thyroid hormone medication? Of course most medical doctors would focus more on the TSH, and if the TSH is elevated they will usually recommend giving thyroid hormone medication, regardless of what the thyroid hormone levels look like.
In addition, even if someone has subclinical hypothyroidism, is completely asymptomatic, and isn’t taking thyroid hormone, they of course will still want to figure out what’s causing the problem. Hashimoto’s Thyroiditis is the most common cause of subclinical hypothyroidism, as what happens is that the person will first develop elevated thyroid antibodies, which in turn will damage the thyroid gland. However, it can take months, or sometimes even years for the TSH and thyroid hormone levels to be affected. Unfortunately most medical doctors don’t screen for the thyroid antibodies unless if someone already has an elevated TSH, even though the thyroid antibodies are present well before the TSH rises.
Anyway, if someone has an elevated TSH and the free T3 and free T4 are both within the functional reference range, then the person very well might not need to take thyroid hormone medication. But if they don’t do anything to address the cause then eventually they might need to take synthetic or natural thyroid hormone. If someone is pregnant and has subclinical hypothyroidism, this is where it gets more challenging. Thyroid hormone is of course very important for the developing fetus, and if a pregnant woman has an elevated TSH and elevated thyroid antibodies, yet her free T3 and free T4 are within the functional reference range, it still might be a good idea to take a small amount of thyroid hormone. And the reason for this is because the person might currently have normal thyroid hormone levels, but then a few weeks or a few months later the levels might drop significantly, which can affect the health of the fetus. Obviously someone with a thyroid imbalance will want to obtain a thyroid panel on a regular basis during pregnancy, but in many cases it’s a good idea for a pregnant women with subclinical hypothyroidism to take thyroid hormone medication, even if it’s a small dosage, just to be on the safe side.
Is There A Natural Substitute For Thyroid Hormone Medication?
I’m sure some people reading this will wonder if there is something else they can take instead of synthetic or natural thyroid hormone. I’ll probably write a separate post on this in the future, but I will say that if someone has a thyroid hormone deficiency then there is no nutritional supplement or herb you can take in place of thyroid hormone. There are herbs which in some cases can help to stimulate the production of thyroid hormone, but these don’t always work, and they usually aren’t a long term solution to the problem. Of course if someone is deficient in a nutrient important for the formation of thyroid hormone such as iodine or tyrosine then this can help with the production of thyroid hormone. However, while many people with hypothyroid conditions have nutrient deficiencies, most cases of hypothyroidism aren’t directly caused by these deficiencies.
How about thyroid glandulars? Well, some thyroid glandulars do have small amounts of thyroid hormone, along with some nutrients and/or herbs (i.e. zinc, selenium, ashwagandha, coleus, etc.), and many people can take these instead of synthetic or natural thyroid hormone and do fine. On the other hand, glandulars without thyroid hormone might provide some support to the thyroid gland, but once again, if someone has low or depressed thyroid hormone levels then this probably won’t be sufficient. I commonly recommend a supplement called Thytrophin PMG, which supports the thyroid gland, but doesn’t contain thyroid hormone. Although there are some people who will take this instead of thyroid hormone medication, it’s important to understand that it’s not a replacement for thyroid hormone.
In summary, although I’m not a big fan of thyroid hormone medication, this doesn’t mean that I recommend for people with hypothyroid conditions to stop taking synthetic or natural thyroid hormone. Having normal thyroid hormone levels is very important, and so if someone has low or depressed thyroid hormone levels then it probably is a good idea for them to take thyroid hormone, while at the same time addressing the cause of the problem. If someone has subclinical hypothyroidism then they might not need to take thyroid hormone medication, but it does depend on the situation. And while there are some herbs and nutrients which can increase thyroid hormone production, there really isn’t a natural alternative for taking synthetic or natural thyroid hormone, although some people with hypothyroid conditions do fine on glandulars which contain thyroid hormone.