Author: Dr. Westin Childs | Page 38 | Dr. Westin Childs: Thyroid Supplements & Thyroid Resources
Thyroid storm vs Thyrotoxicosis: Symptoms, treatment and more

Thyroid Storm vs Thyrotoxicosis: Dangerous Thyroid Conditions to Be Aware of

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Evidence-Based

What exactly is thyroid storm? How dangerous is this condition and how will you know if you have it? This post will concentrate on this medical condition and teach you everything you need to know about it.  Including the difference between regular hyperthyroidism and thyroid storm, the difference in symptoms, how to prevent it from …

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5 Reasons to Avoid Salivary Cortisol Testing

5 Reasons to Avoid Salivary Cortisol Testing

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Evidence-Based

Is salivary cortisol testing worth the price tag? There are many ways to check your cortisol level and the salivary method has gained popularity over the years but is it the best way? In this post, we are going to discuss why you may want to hold out on getting your salivary cortisol levels checked, …

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Subacute Thyroiditis Guide Recovery Time, Treatment, Diagnosis & More

Subacute Thyroiditis Guide: Recovery Time, Treatment, Diagnosis & More

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Evidence-Based

Subacute thyroiditis is not the most common cause of thyroid related-issues, but it’s still important nonetheless.  This condition may result in pain in your thyroid gland and can be confused with other disorders such as Hashimoto’s thyroiditis and Graves’ disease.  Learn how to diagnose this condition, how long it takes to recover, and natural treatment …

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Can medications cause thyroid problems

Can Medications Cause Thyroid Problems? Supplements & Medications to Avoid

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Evidence-Based

Do you have thyroid problems? Are you taking thyroid medication? Are you also taking other medications? It may surprise you to know that there is a long list of medications that can alter thyroid function, interfere with thyroid tests or even interfere with your thyroid medication.  This post will teach you about these medications, what …

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Is it safe to exercise when you have thyroid problems_

Is it Safe to Exercise When you have Thyroid Problems?

Is it dangerous to exercise if you have thyroid disease?

How much is “too much” exercise?

Will exercise help you lose weight or will it hurt your metabolism?

All of these questions and more will be answered in this post which is all about exercise and thyroid problems. 

You will learn the best types of exercises, how much you should be exercising, and the best way to lose weight

Let’s jump in: 

Understanding Metabolism, Exercise, and Caloric Burn

We really can’t have a discussion about exercise without at least touching on the idea of metabolism. 

The term metabolism is often used when referring to the number of calories that your body burns throughout the day. 

It’s also commonly referred to as resting energy expenditure (REE) and resting metabolic rate (RMR) (1).

And it is your metabolism that accounts for the largest number of calories that you burn each and every day (not how much you exercise!). 

Your metabolism is responsible for around 50 to 90% of the total amount of calories that you burn (2) each day. 

Your body uses this much energy because it must keep you alive by beating your heart, helping you think, helping to digest your food, and so on. 

These things MUST happen every single day and they are very energy intensive (meaning it requires a lot of energy). 

So if around 70% (I’m taking an average between 50 and 90% here) of the calories you burn each day is from your metabolism, what accounts for the other 30%?

That other 30% really depends on your activity level and it can change from day to day (3) (which alters your appetite!). 

Activities such as stress, extra walking, going shopping, doing chores around the house and so on all require more energy, and these factors account for the other 30%. 

It may be helpful to look at a 2,000-calorie-per-day example to drive this information home. 

Let’s assume that you burn 2,000 calories per day (on average). 

Using the figures above we know that about 70% of the calories that you burn each day will be from your metabolism. 

This accounts for around 1,400 calories per day. 

Around 50-60% of your metabolism is controlled by your thyroid (4)!

Just keep this information in the back of your head, we will come back to it later. 

The remaining 30% of the calories that you burn comes from other sources and your activity level which accounts for 600 calories per day. 

So, when most people want to lose weight they think they can burn more calories simply by increasing the amount that they exercise (5).

But let’s consider another example here. 

What if your thyroid is sub-optimal and you aren’t being treated appropriately?

If your thyroid is responsible for around 50% of your metabolism and your thyroid is not functioning well that means you may be losing out on an extra 400 calories per day from a damaged metabolism!

It may be far easier to simply address your thyroid problem to help increase the number of calories you burn by an extra 400 per day because trying to burn an extra 400 calories per day would take a significant amount of time through exercise

Does that mean you should avoid exercise?

Not by a long shot!

But it does mean you may want to ensure that your thyroid is working properly before you jump into serious workout routines. 

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Should you Exercise if you have Thyroid Issues?

It may sound like I’m discounting the benefit of exercise and I don’t want that to be the case. 

Exercise is critical to living a long and healthy life (6).

It’s also incredibly helpful if you have thyroid disease and can help manage your hormones. 

So the answer to the question as to whether or not you should exercise is a definite YES. 

But what you need to understand is the amount and type of exercise that you use will vary from individual to individual

It also means that there isn’t one single “best” exercise routine that you HAVE to do. 

Exercising is beneficial to your body (and your thyroid) because it can help improve your metabolism

It does this by increasing the activity and size of your muscles. 

And it takes a considerable amount of calories to keep your muscles happy and active (7).

Increasing muscle mass will help you improve the overall amount of calories that you burn in that 70% portion. 

In addition, exercising also has the benefit of increasing the number of calories that you burn day to day. 

This will help increase the number of calories that you burn in the 30% portion. 

Another point worth mentioning has to do with your goal when you exercise.

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If you are like most people you probably only consider exercising as a means to manage your weight.

And this is the wrong way to look at it. 

You want to exercise because it will help your body manage your hormones, manage the flow of calories, and which tissues utilize those calories as a way to improve your muscle mass

Many of these things may help with weight loss, but that shouldn’t be your goal! 

As you exercise more and more, you may notice that your muscle mass increases accordingly. 

This increase in muscle mass is often associated with a decrease in fat mass (this is a good thing) but it may keep your weight “neutral” or the same. 

And this is NOT a bad thing. 

Your goal when losing weight should be to lose fat mass, and that’s exactly what exercise will do. 

Exercise and the Stress it Causes to Your Body (And your Adrenals)

One of the questions I get asked from people on this blog has to do with adrenal function and exercise. 

Many patients with hypothyroidism also happen to suffer from the symptoms associated with “adrenal fatigue” and many of these patients also have abnormal or sub-optimal serum cortisol levels

If you fall into this category is it still safe to exercise?

You have to consider that exercise is a stressful event for your body (8).

The whole goal of exercising is to break down the body slightly while allowing it enough time to heal so it grows back stronger than it was before. 

When you keep this in mind it’s easy to understand that true exercise is not something that you want to do every single day. 

If you do not allow your body sufficient time to heal then your exercise may just be adding more and more stress to your body (this is a bad thing!). 

This element of stress can compound other sources of stress such as lack of sleep, a poor diet, social stressors, and more. 

The net result?

More stress to your body and the worsening of your symptoms such as fatigue, weight gain, crashes in the midday, and more

This means, contrary to popular belief, that doing spin classes for 1 hour each day may not be the best way for you to lose weight and feel better!

So what are you supposed to do? 

You should aim to match the intensity of your exercise routine to your personalized energy level. 

By matching the intensity of your workouts to your energy level you can stay within the “optimal” range of exercise without risking damage to other hormones. 

As you match your intensity to your energy level you will find that your energy level IMPROVES, your fatigue REDUCES and you start to feel better overall. 

I will go over how to match this in a bit but first I want to focus on the types of exercises that you can (and should) be doing. 

Is there a “Best” Type of Exercise if you have Thyroid Problems?

There isn’t a single “best” type of exercise for your thyroid. 

There also isn’t an exercise that will improve your thyroid function!

But, there are several types of exercises that would be considered “approved” and helpful if you have a thyroid problem. 

In general, you want to look at two basic types of exercises:

#1. High-intensity interval training.

Exercises that fit into this category include:

  • Circuit training (body weight)
  • Circuit training (9) (weight training with resistance)
  • Cycling
  • Strength training
  • Virtually any exercise can provide this benefit if taken to the extreme

#2. And low-intensity exercise.

Exercises that fit into this category include:

  • Yoga
  • Pilates
  • Walking
  • Swimming
  • Household chores

How Often Should you Exercise? 

Most people probably know the various types of exercises available to them, but they struggle when it comes to frequency. 

Meaning, how often should you be exercising?

How often should you do high-intensity interval training and/or low-intensity training?

The answer is actually quite simple:

You’ll know if you are exercising at a sufficient rate if you feel energized after you exercise

Exercising should lift you up, it should increase your energy, and should make you feel good. 

If you are exercising and you find that you are wiped out for several days afterward then that is a sign that you are over-exercising! 

You will want to avoid this behavior as much as possible because it can lead to more metabolic damage in the long run. 

If you are new to thyroid-related issues and you want to get started then the goal should be to start low and slow. 

Starting with high-intensity exercise for 15 minutes 1-2x per week is usually a safe bet

As you progress, and as you listen to your body, you can increase both the duration and frequency with which you exercise. 

Something like 15-20 minutes of high-intensity interval training 2-3x per week usually works very well for most people

This can be supplemented with daily low-intensity activities. 

As you determine which exercises you should be doing it’s worth pointing out that you should put preference on those types of exercises that help to build muscle mass in your body. 

The more muscle mass you have the higher your metabolism will be. 

You can do this by focusing on the major muscle groups in your body:

  • Chest
  • Legs
  • Back
  • Shoulders/arms

Focusing on these muscle groups will give you the biggest “bang for your buck” so to speak. 

If you focus on weight training just make sure that you do not exercise muscle groups that are already sore from previous exercise regimens. 

Adding Intermittent Fasting & Sauna to Your Exercise Routine 

Lastly, you can also supplement your exercise routine with a couple of other therapies which have the capacity to enhance your results. 

It may be tempting to take pre-workout boosters, thermogenics,s or caffeine-laced supplements but do your best to avoid these supplements if you have thyroid issues

They can actually make your fatigue worse in the long run by putting excess stress on your body as you exercise. 

As you avoid these therapies you can also consider adding some others. 

Specifically sauna therapy and/or intermittent fasting

You can add sauna therapy to the end of your workout session which will act to increase your body temperature (10), help you sweat and detox and improve circulation (11) to your muscles. 

Intermittent fasting will help you burn more calories and impact your hormones (especially insulin and leptin) if combined with exercise (particularly HIIT). 

As always, proceed with caution if you have never tried these therapies before. 

They certainly have the ability to improve your results but they also may cause side effects if you aren’t sure how much your body can manage. 

Conclusion

Exercising with thyroid issues is an important and complex topic!

Exercising can help benefit your body, help with your weight, manage your metabolism, and more. 

But in order to get these benefits, your exercise routine must be targeted to your body. 

You can do this by listening to your body. 

If you aren’t sure where to start you may find benefit in looking for a functionally minded health coach to help guide you along the way. 

Now I want to hear from you:

Are you struggling with exercise as a thyroid patient?

Have you been able to realize any benefits from your workout routine?

What workouts have helped you? Which have not?

Leave your comments or questions below! 

#1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424457/

#2. https://www.ncbi.nlm.nih.gov/books/NBK218769/

#3. https://www.ncbi.nlm.nih.gov/pubmed/21178922

#4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4044302/

#5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639963/

#6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395188/

#7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3661116/

#8. https://www.ncbi.nlm.nih.gov/pubmed/18787373

#9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562558/

#10. https://www.ncbi.nlm.nih.gov/pubmed/3218894

#11. https://www.ncbi.nlm.nih.gov/pubmed/1837250

the best exercises for thyroid problems
What Causes Thyroid Disease: 14 Common Reasons Listed

What Causes Thyroid Disease? 14 Common Reasons Listed

It is estimated that up to 10% of people have a thyroid problem (1).

But what is causing thyroid disease in all of these people?

It turns out that there are many causes of both reversible thyroid disease and irreversible thyroid disease. 

But which type do you have?

In this post you will learn the most common causes of thyroid disease, how to spot problems that may impact thyroid function in your body, and what to do about these problems

What Does it Matter What Causes Thyroid Disease?

The main reason you should be interested in the cause of your thyroid disease is that it can help you target your treatment!

And, it may surprise you to know, that most physicians are not concerned about the cause of your disease. 

Doctors are trained to find the name of diseases, but they don’t always look for the root cause of those disease states. 

It may be depressing to hear this, but there’s really no other way when a Doctor only gets to spend on average somewhere around 15 minutes with each patient with only around 5 minutes on each “topic” or problem (2).

5 minutes is not a sufficient amount of time to find the cause of a disease, so it’s much faster to “name” a disease and then treat it with medication. 

But this approach is not ideal, especially if your condition can be reversed! 

For these reasons, it’s important for you to have a basic understanding of your thyroid so that you can learn what is happening in your body and attempt to fix or reverse that issue. 

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Foods to Avoid if you Have Thyroid Problems:

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The list includes optimal ranges, normal ranges, and the complete list of tests you need to diagnose and manage thyroid disease correctly!

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Thyroid Dysfunction vs Hypothyroidism

When we discuss the causes of thyroid disease we really need to differentiate between two important conditions: thyroid dysfunction and hypothyroidism. 

Thyroid dysfunction is a condition that results in disordered thyroid hormone signaling (3).

This means that you can still create thyroid hormone but the hormone that you create isn’t working as intended by your cells or by your body. 

Thyroid dysfunction is often a result of some other condition and can usually be reversed!

Hypothyroidism, on the other hand, is a condition that results in a DECREASE in the amount of thyroid hormone that your body produces. 

Those with hypothyroidism usually have problems with their thyroid gland itself, or with their pituitary/hypothalamus, and their thyroid disease is their primary problem. 

Hypothyroidism may or may not be reversible so it’s very important to distinguish between thyroid dysfunction and hypothyroidism if you are experiencing hypothyroid symptoms. 

These conditions can often be confusing because they may both present with similar symptoms and with similar thyroid lab tests. 

But, with the right information, you can easily distinguish between these entities. 

Causes of Thyroid Dysfunction

#1. Obesity

Obesity may be one of the most “silent” causes of thyroid dysfunction out there today. 

If you are overweight by even as few as 10 pounds you may have some element of thyroid dysfunction. 

Emerging research and studies have shown that obesity may be a CAUSE of thyroid dysfunction, not the other way around and this is why it’s so important. 

If you are overweight you may be causing damage to your thyroid which will make weight loss more difficult until you treat that problem. 

People who are overweight often have lower than normal free T3 levels compared to healthy adults (4) and you can check for this with a simple blood test. 

#2. Calorie restriction or Dieting

Calorie restriction of as few as 1,500 calories per day can cause long-term damage to your metabolism through your thyroid. 

As you restrict your calories your body will respond by reducing free T3 and by increasing reverse T3 (5).

This signals to the body that you are burning too many calories compared to what you are eating and this is how the body responds to stop that process. 

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This process is also referred to as starvation mode and it is probably the main reason why people gain weight after they undergo a diet. 

If you are doing this make sure you STOP, even if it means temporarily gaining some weight. 

#3. Nutrient Deficiencies

There are more than 10+ vitamins and minerals that are required for proper thyroid hormone creation and conversion. 

As people become more reliant upon unhealthy snack foods found in the Standard American Diet, it’s not uncommon for people to have many sub-optimal nutrient levels. 

These minor deficiencies typically do not cause a tremendous problem but they can definitely make you feel run down or sluggish and prevent you from feeling at 100%. 

Some of these nutrients, especially Zinc and Selenium, are involved in the T4 to T3 conversion process with your thyroid. 

Taking certain supplements can help replete these levels in your body and may help you feel much better!

#4. Insulin & Leptin Resistance

Both insulin and leptin resistance, which are quite common, have been shown to interfere with thyroid hormone signaling (6).

Both of these conditions can lead to weight loss resistance (the inability to lose weight) which can further complicate thyroid function. 

If you have thyroid disease AND you have either of these conditions then you can focus on treating these which may improve your thyroid. 

#5. Chronic Illness and Chronic Infections

Chronic illness refers to medical conditions that are with you for life and conditions that often require the use of medications to treat them. 

Conditions such as high blood pressure, cardiac disease, high cholesterol, chronic pain, fibromyalgia, and so on all result in stress to the body. 

Small stressors day in and day out may result in thyroid dysfunction (7) which you may feel as fatigue, weight gain, or depression. 

In addition, these medications often also require the use of medications which is #6 below. 

#6. Prescription Medications

It is well known that many commonly prescribed medications may cause problems with thyroid function at all levels (8).

Medications can interfere with thyroid hormone creation, TSH production, and thyroid conversion. 

And the medications which cause these problems are actually used by many patients!

Medications that fit into this category include:

  • Beta-blockers and other medications for high blood pressure
  • Diabetic medications and medications that control blood sugar
  • Anti-seizure medications
  • Narcotics and pain medications
  • Antidepressants and bipolar medications
#7. Inflammation

Lastly, any cause of inflammation in your body will also result in decreased thyroid function. 

This is because inflammation slows down the T4 to T3 conversion process (9) and results in smaller amounts of free circulating active thyroid hormone. 

Inflammation is really a non-specific entity but, in hypothyroid patients, this type of condition is most often caused by intestinal-related issues such as gut dysfunction and intestinal overgrowth syndromes. 

Causes of Hypothyroidism

#1. Hashimoto’s Thyroiditis

Perhaps the most common cause of hypothyroidism in the United States is the autoimmune disease known as Hashimoto’s thyroiditis

This condition, if untreated, results in complete destruction of your thyroid gland over a long period of time. 

As your thyroid gland is slowly destroyed your ability to produce thyroid hormone is compromised and you will begin to experience the symptoms of hypothyroidism. 

It is estimated that anywhere from 50-90% of patients with hypothyroidism may have Hashimoto’s to blame for their disease. 

#2. Thyroiditis

While Hashimoto’s thyroiditis is a cause of thyroiditis it is certainly not the only cause. 

Thyroiditis simply refers to inflammation of your thyroid gland and this can be caused by other conditions such as infection or trauma. 

Any inflammation in your thyroid gland may reduce the function of the gland in the process which will leave you feeling symptomatic. 

These conditions are often easy to diagnose as long as you understand them and you can learn more about them here.

#3. Treatment for Hyperthyroidism (Thyroidectomy and RAI)

Would it surprise you to know that another very common cause of hypothyroidism is the treatment of hyperthyroidism?

Hyperthyroidism is the exact opposite condition of hypothyroidism but the treatment often entails either the complete removal of the thyroid gland or the destruction of the thyroid gland with radioactive iodine

If you have either of these procedures done you will become reliant upon thyroid medication for life. 

Why?

Because your thyroid gland will no longer be functioning. 

Even medications for hyperthyroidism, such as Methimazole, may result in hypothyroidism if they are used in excess. 

#4. Pituitary & Hypothalamic Issues

Your pituitary and hypothalamus can be considered the master regulators of your hormones and that includes your thyroid. 

These organs are located in your brain and then sense what is happening in the body and respond by telling your body how much thyroid hormone you need. 

If they are damaged, for any reason, your thyroid may not get the signal and may not produce enough thyroid hormone. 

Even if your thyroid gland has the capacity to function correctly it won’t if it doesn’t get the signal. 

Conditions such as tumors (prolactinoma) (10) and extreme stress or trauma (11) can cause damage to the HPT axis. 

These are not very common causes but they should always be considered. 

These conditions are usually not reversible. 

#5. Iodine Deficiency

The only way that you can get iodine is from your diet and if you don’t get enough you may develop a condition known as a goiter. 

This is because iodine forms the backbone of all thyroid hormones floating around in your body. 

If you don’t have enough iodine then your body won’t be able to produce enough thyroid hormone (12).

One of the problems with iodine consumption is that we really only get it from very special foods such as sea vegetables and iodized salt.

Your body needs up to 150-200mcg of iodine each day and if you don’t get enough you may be at risk for iodine deficiency. 

The good news is that this condition is readily treated once you give your body back what it needs!  

You can learn more about iodine supplementation here. 

#6. Pregnancy & Lactation

Pregnancy and lactation don’t necessarily cause hypothyroidism by themselves but they lead to it indirectly. 

Both conditions put an increased strain on your body to produce more thyroid hormone because you are effectively producing it for two people!

So, if you have any minor deficiencies or problems, these issues may be exacerbated by lactation or by pregnancy. 

As they are exacerbated you may start to experience the symptoms of hypothyroidism even though you technically have enough thyroid hormone for “you”. 

These conditions can usually be treated with thyroid hormone while you are pregnant or breastfeeding and the medication can usually be stopped afterward (13).

#7. Congenital Issues

Occasionally, someone may be born without a thyroid or with an issue relating to thyroid function. 

These problems are not reversible but luckily they are quite rare and they can be treated with thyroid medication. 

How to Focus Your Treatment

So what are you supposed to do if you have thyroid disease?

The first step is to try and find out what is CAUSING the issue. 

You can do this by ordering a complete set of thyroid lab tests designed to look at all stages of thyroid function. 

The complete thyroid panel will give you information about how your brain is functioning, and how your thyroid gland is functioning and give you insight as to how well thyroid hormone is working at the cellular level. 

During this process, you may also need other tests such as insulin, leptin, and other sex hormones. 

Don’t let this seem intimidating! 

If it does then you should actively seek out a physician who is willing to help guide you along the way (you can find resources on how to do that here). 

If you can find out what the main cause of your symptoms is then you can usually determine if you have hypothyroidism or simply thyroid dysfunction. 

In your workup, you may find that you have multiple causes of thyroid dysfunction, which isn’t uncommon, and areas that you need to treat. 

If this happens to you then you can pick one and treat that issue and then systematically move down the list until you’ve “fixed” all major issues. 

As you do this you should feel better and better. 

Conclusion

There are many different causes of both thyroid dysfunction and hypothyroidism. 

Finding out the cause of your thyroid disease is probably the single most important step you can take to feel better. 

Finding this information will help direct your treatment and may allow you to reverse your condition (in some instances)

Now I want to hear from you:

Are you suffering from thyroid dysfunction or hypothyroidism?

Do you know which issues may be causing your thyroid disease?

Have you taken steps to address these issues?

Why or why not?

Leave your comment or questions below! 

Scientific References

#1. https://www.ncbi.nlm.nih.gov/pubmed/7641412

#2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2254573/

#3. https://www.ncbi.nlm.nih.gov/pubmed/6479377

#4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911848/

#5. https://www.ncbi.nlm.nih.gov/pubmed/12055988

#6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC377492/

#7. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(74)92070-4/abstract

#8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2784889/

#9. https://www.ncbi.nlm.nih.gov/pubmed/27051079

#10. https://www.ncbi.nlm.nih.gov/pubmed/27105040

#11. https://www.ncbi.nlm.nih.gov/pubmed/16020927

#12. https://www.ncbi.nlm.nih.gov/pubmed/16704348

#13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2425446/

14 causes of thyroid disease: find your root cause
High TSH normal T4: What does it mean?

High TSH & Normal T4: What Does it Mean? + Other Thyroid Lab Patterns

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Evidence-Based

Are you experiencing a high TSH but normal T4? Are you confused about interpreting these values? Is your Doctor telling you that your tests are normal even though you are experiencing abnormal symptoms? This article will help shed light on this thyroid lab pattern and help you understand what it means.  You’ll learn more about …

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Is Natural Desiccated Thyroid (NDT) the Best Thyroid Medication?

Is Natural Desiccated Thyroid (NDT) the Best Thyroid Medication?

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Evidence-Based

Natural desiccated thyroid is a thyroid medication that comes from pigs!

This medication contains a more “complete” profile of thyroid hormones when compared to almost all synthetic thyroid medications out there. 

This has led many people to tout NDT as the “best” thyroid medication. 

In this article, we are going to explore this claim while also discussing the pros and cons of this medication. 

You’ll learn who should use this medication, who should avoid it, and the pitfalls of using it

Let’s dive in: 

What is NDT or Natural Desiccated Thyroid Hormone?

NDT or natural desiccated thyroid hormone is simply a type of thyroid hormone medication. 

It can be used to treat people who have low levels of thyroid hormone in their body from conditions like Hypothyroidism and Hashimoto’s thyroiditis. 

NDT is often claimed to be one of the “best” thyroid medications out there because it’s considered to be all-natural. 

So, with this in mind, let’s break apart what NDT actually is. 

First:

Where does NDT come from?

NDT is porcine-derived which means that it comes from pigs. (1) 

To get NDT, people must take the thyroid gland of pigs and desiccate or dry it out. 

From there it is standardized to a specific dose and contains 38mcg of T4 (the inactive thyroid hormone) and 9mcg of T3 (the active thyroid hormone) in each grain. 

Grain is just a way to standardize the dose of NDT between different brands. 

Natural desiccated thyroid also contains other hormones and prohormones such as other types of thyroid hormone (T1 and T2).

These hormones are not nearly as active as T4 and T3 but they are thought to play an important physiologic role in the body otherwise, (2) why would your body produce them?

Each grain of NDT contains around 76% T4 and around 23% T3 which is a ratio close to the 80% T4 and 20% T3 that your thyroid produces naturally when it is healthy. 

For this reason, and because it contains prohormones, and because it comes from a natural source, (3) many people believe it is one of the most complete thyroid medications out there! 

While this may be true, it doesn’t mean that it works equally well for every single person. 

Let’s dig into the basics of NDT and talk about why it may not be the best medication. 

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Foods to Avoid if you Have Thyroid Problems:

I’ve found that these 10 foods cause the most problems for thyroid patients. Learn which foods you should avoid if you have thyroid disease of any type.

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The Complete List of Thyroid Lab tests:

The list includes optimal ranges, normal ranges, and the complete list of tests you need to diagnose and manage thyroid disease correctly!

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Natural vs Synthetic Hormones

NDT is considered to be natural because it is sourced from a “natural” source, pigs. 

This sourcing of thyroid hormone is different from the approach used to create other formulations of medications such as Levothyroxine and Synthroid

Other medications are created in a laboratory from other basic compounds. (4) 

But you must always remember that ALL types of thyroid medications are considered to be bio-identical which is very important. 

Bio-identical means that the hormones you are taking by mouth are considered to be IDENTICAL to the hormones that your body produces naturally!

Where these medications differ is in the SOURCE. 

The source for NDT is from pigs while the source for Levo and Synthroid is other chemical structures. 

Some people believe that naturally sourcing thyroid hormone is superior to creating it chemically in a lab. 

From my perspective, there is no difference between thyroid hormone from a human or a pig when compared to thyroid hormone created in a lab

Both compounds look the exact same and function in a similar way in the body. 

Where they differ is in the other hormones and pro-hormones that come in NDT formulations. 

NDT Brands

Let’s take a second to discuss the various brands of natural desiccated thyroid hormones out there. 

There are several “well-known” brands and some less well-known brands. 

What you need to understand is that these medications do differ in the type of active and inactive ingredients in them but they all contain both T4 and T3 thyroid hormones. 

While it may not sound like the inactive ingredients make a big difference, they actually may be the reason that some people simply can’t tolerate certain types of NDT brands. 

For instance:

It’s not uncommon for someone to be on Armour thyroid but not feel well when switching to Nature-throid or WP thyroid even if their dose stays the same. 

These differences are likely the result of how your body interacts with the inactive ingredients and how difficult it is for your intestines to break down and absorb the hormones in the medication. 

What that means for you is that if you don’t tolerate one type of NDT brand it doesn’t mean you won’t tolerate all of them. 

Instead, you may want to switch to a couple of different brands to see if you can find one that works for you. 

With that in mind you can find a list of NDT brands below: 

Is NDT Superior to T4 Medication for Hypothyroidism?

It is largely felt by many online communities that natural desiccated thyroid is the single “best” thyroid medication out there. 

This logic has led people to believe that if you are taking NDT and it isn’t working for you that the problem must be with your dose and not with the medication itself. 

I’m not a fan of this approach and don’t believe that when it comes to your thyroid that there is a single “best” thyroid medication

A better approach is to always listen to your body while you look at other problems beyond your thyroid

Thyroid tunnel vision can lead you to believe that every problem you have is associated with your thyroid and that adjusting your dose is the solution to this problem. 

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This approach to management has led many patients to take higher than necessary doses of thyroid medication which can be dangerous! 

So, while NDT is a great medication, it’s certainly not the “best” or the only thyroid medication available. 

The type of thyroid medication that you use, and your dose, should be individualized to YOUR body. 

Natural Desiccated Thyroid for Weight Loss

One important note worth mentioning is that of weight loss and NDT. 

Some studies, like this one, have shown that switching to NDT does result in modest weight loss in certain patients. (5) 

This particular study took a look at 70 patients that were already taking T4 medication (Levothyroxine). 

This group of patients was taking this medication and despite having a normal TSH still had some symptoms of hypothyroidism. 

Thyroid lab tests in patients taking natural desiccated thyroid compared to T4

These patients were then randomized and given NDT (desiccated thyroid extract) for 16 weeks and then placed back on their old medication. 

During the period that these patients were taking NDT, they noticed around a 3-pound weight loss on average and roughly 50% of patients taking NDT wanted to stay on it. 

Not only did they lose weight but they also reported feeling much better on the medication in a subjective sense (based on their own opinion). 

3-4 pounds may not sound like a big deal to you, but when you realize that weight is incredibly difficult to lose when you have hypothyroidism this is actually a great feat. 

But does this mean that the weight loss is due to NDT itself or simply due to the T3 in the medication?

While we don’t have definitive studies, it’s logical to believe that the same results would have been achieved by simply adding T3 (in the form of Cytomel or Liothyronine) to existing doses of T4 in these patients. 

So, while NDT can certainly help you lose weight if you have hypothyroidism, don’t fall into the trap of believing that the weight loss is caused by the NDT itself. 

Instead, the weight loss is most likely the result of IMPROVING the total T3 and free T3 levels in your body! 

And this can be done with T3 medication of any type. (6) 

Common Problems and Symptoms when using NDT

Let’s talk about some of the problems associated with NDT use. 

The way that your body responds to NDT is going to be different from other people out there. 

This means that the type of NDT that you use, and the dose that you use, all may potentially lead to problems. 

What’s important is to focus on how YOU feel and how YOU tolerate the medication. 

By listening to your body, and by checking your thyroid lab tests, you can be certain that you are taking the right dose for your body. 

You can find a list of the most common problems that patients experience when they use NDT below: 

  • Some people take too much natural desiccated thyroid hormone – (7) Overdosing on NDT is a common problem because many people believe that higher doses will somehow improve their thyroid function. This leads to overdosing and symptoms of hyperthyroidism in some patients. This problem stems from “thyroid tunnel vision”.
  • Dosing is static which means you can’t tweak the T4 and T3 concentrations – NDT comes in a static dose of 38mcg:9mcg of T3. This means that you can’t individually adjust the amount of T3 in the medication without also adjusting the T4. You might do great on 38mcg of T4 but may need something like 5mcg of T3. If you fall into this category then you can’t adjust your medication. 
  • May lead to variations in free T3 & Free T4 levels – Some people experience very high free T3 levels and very low free T4 levels even when using low doses of NDT. This problem probably has to do with how each individual processes thyroid hormone in their body. 
  • Symptoms arise from the use of T3 which can be difficult to manage in some patients – (8) Some patients are exquisitely sensitive to even incredibly low doses of T3. These are patients that would probably do fine on certain types of T4 medication (such as Tirosint) but do poorly when they start even low doses of NDT. 
  • May be hard to break down for some patients in the intestines – This problem isn’t unique to NDT medications, but it’s worth considering if you have intestinal issues. Inactive dyes and fillers may cause reactions and may make the digestion of NDT difficult. 
  • May lead to immunogenic reaction (may not be ideal for patients with Hashimoto’s) (9) – There is a theoretical risk that taking a foreign pig-derived substance can “flare” up the immune system and worsen thyroid function in patients with Hashimoto’s thyroiditis. I don’t think this is a reason to completely avoid NDT if you have Hashimoto’s thyroiditis but you should be aware that it can happen.

Overdosing on NDT

Believe it or not but doctors have been using NDT since the 1950s!

Even back then it wasn’t uncommon for doctors to prescribe high doses of NDT (up to 3 to 8 grains per day) to patients. (10)

This was way before thyroid lab tests were created, so dosing was often based on the “Basal metabolic rate” which is a marker for metabolism. 

These doctors found that increasing the dose of NDT did result in modest weight loss by increasing the metabolism, but once the dose was lowered, the metabolism of the patient went back down to below-normal levels. 

This is as relevant today as it was back then. 

Currently, many people believe that by simply increasing their dose of NDT that they will finally feel better and relieve their symptoms. 

This happens frequently in patients who are suffering from weight gain. 

This leads to higher and higher doses of NDT which dramatically suppresses the TSH and temporarily helps with weight loss. 

But the unintended effect is that it may also cause long-term harm because of the high dose of NDT being used. 

Studies dating back to the 1950s showed that if you are responsive to NDT you only need a small dose (usually 1-2 grains) to improve your symptoms and improve your metabolism. (11) 

If you are still feeling symptomatic at that point then some of your symptoms are likely related to some other problem or some other hormone imbalance!

You can avoid these potential negative side effects by using only the appropriate dose and by monitoring your thyroid lab tests in the process. 

Who should use NDT

NDT is a great medication and many people out there stand to benefit from its use. 

I’ve compiled a list of just some of the patients that tend to do the “best” on this medication below: 

  • Those who have failed T4 medication – If you’ve been on T4 medication such as Levothyroxine or Synthroid and you just aren’t feeling well after 6-8 weeks then it may be time to consider a T4/T3 combo medication. 
  • Those with low free T3 levels (usually need a T3 medication) – Up to 15% of the population suffers from thyroid conversion issues which means they don’t convert T4 into T3 as well as other people. If you fall into this category you may have a “normal TSH” but your free T3 and total T3 levels may be lower than normal. If you fall into this category then adding T3 (from either NDT or Liothyronine) may help bring these levels up and help you feel better. 
  • Those who are post-thyroidectomy – Your thyroid (when functioning normally) produces around 80% T4 and around 20% T3. If you don’t have a thyroid, because it was removed or destroyed, then it makes sense to supplement with thyroid hormones close to this ratio. Most post-thyroidectomy patients take only T4 medications (so 100% T4) which do not contain T3. Some of these patients don’t feel well despite having a normal TSH. Taking NDT can provide your body with T3 in a ratio that is close to what your body produces naturally and may help those without a thyroid. (12)

This is not an all-inclusive list but it can help get you started! 

Conclusion

Natural desiccated thyroid is a thyroid medication that contains both T4 and T3. 

Because of this, it may be one of the better thyroid medications (but not the best!) out there. 

If you have thyroid issues and are struggling with low free T3 levels, weight gain, and/or other symptoms despite having a normal TSH, then this medication may help you

When using it be careful to watch for side effects such as anxiety, heart palpitations, or hot flashes which may indicate that your dose is too high. 

Now I want to hear from you:

Are you taking NDT? Is it working for you?

Are you not tolerating NDT?

Is it causing negative symptoms?

If so, leave your comments or questions below!

I’ll do my best to respond to each comment. 

#1. https://www.ncbi.nlm.nih.gov/pubmed/10365676

#2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4272398/

#3. https://www.ncbi.nlm.nih.gov/pubmed/15253676

#4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146262/

#5. https://www.ncbi.nlm.nih.gov/pubmed/23539727

#6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965938/

#7. https://www.ncbi.nlm.nih.gov/pubmed/29942726

#8. https://www.sciencedirect.com/science/article/pii/B9780323189071000883

#9. https://www.ncbi.nlm.nih.gov/pubmed/9545109

#10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1642898/?page=1

#11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980994/

#12. https://www.ncbi.nlm.nih.gov/pubmed/23072197

NDT thyroid medication vs other thyroid medications
Why free T3 and total T3 are the most important thyroid lab tests

Why Free T3 & Total T3 are the Most Important Thyroid Lab Tests

The free T3 and total T3 lab tests are among the most important for evaluating thyroid function in your body.  These tests give vital information as to how your body is processing thyroid hormones.  And they give you information about the hormone which is responsible for activating your cells and turning on your genes.  These …

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T4 to T3 conversion_ factors that decrease thyroid function

T4 to T3 Conversion: Factors That Decrease Thyroid Function

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This is lesson #5 in the thyroid beginner series. 

As you know, this series is designed to help you understand the most basic concepts about thyroid function so you can be a better advocate for your own health

Today is all about T4 to T3 conversion. 

This is the process by which your body creates and activates thyroid hormone. 

It’s important because there are steps that you can take to actively enhance this conversion process and help reduce (or improve) your symptoms. 

Let’s jump in: 

T4 to T3 Conversion Explained in Plain English

This is really a continuation of the concepts that were built upon in lesson #3 and lesson #4 which discuss T4 and T3 thyroid hormones. 

They are short videos (less than 10 minutes each) so if you don’t feel like you have an understanding of thyroid hormones then go watch those before you jump into this lesson. 

As I stated previously, T4 to T3 conversion is the process by which your body takes inactive thyroid hormone and activates it (1).

This process is also known as thyroid conversion or peripheral thyroid conversion but don’t let this confuse you because they are all referring to the same process. 

In this conversion process, your body takes T4 thyroid hormone, which it either produces on its own or that you’ve taken by mouth, and cleaves off a portion of the molecule which changes its shape and structure. 

This change alters the hormone to T3 (triiodothyronine) which is the active thyroid hormone. 

Why is this important?

Because the more T3 you have in your body the better your thyroid functions

The less T3 you have in your body the more symptoms you will experience

What that means for you is that you want this process to be working at 100% because if it isn’t then you will be producing less active thyroid hormone. 

It turns out that the way that your body increases or decreases this conversion process is through the activity of special enzymes

These enzymes, known as deiodinase, are responsible for “cleaving” off an iodine moiety on the T4 hormone. 

T4 is named T4 because it contains 4 iodine portions on the hormone base. 

Once it loses an iodine portion it now only has 3 and we call it T3. 

Approximately 80% of the T3 in your body is created through this conversion process which means it’s very important for thyroid health. 

This conversion process matters if you have a thyroid, if you don’t have a thyroid, if you have Hashimoto’s, if you have thyroid nodules, if you have thyroid cancer, and so on. 

Basically, it matters for everyone.

Why?

Because even if your thyroid isn’t working you still have to take thyroid hormone by mouth and most thyroid medications contain T4 (not T3). 

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Factors that DECREASE T4 to T3 Conversion (These slow down thyroid function)

There are certain factors that can slow down the conversion of T4 to T3 by interfering with the efficiency of the enzymes responsible for this conversion.

These factors act as a brake on your entire thyroid system. 

They slow down the amount of T3 that your body is able to produce and may make less efficient the medication that you are taking.  

If you can address and reverse these issues then you can “release” the brake on your thyroid and finally start feeling better! 

I’ve created a list of the most common factors that blunt this conversion process below: 

  • Dieting & Calorie restriction (slows down your metabolism) – Calorie restriction, as little as 1,500 calories per day for 3 weeks, is enough to blunt thyroid function and reduce T4 to T3 conversion (2). This might be the #1 problem for many thyroid patients who also tend to struggle with weight. They get trapped in a situation where they are overweight but try to diet to reduce the weight, only to further reduce thyroid function which leads to weight gain
  • Inflammation (from any cause) (3) – Inflammation is really nonspecific but inflammation from any cause (if systemic) can damage thyroid function. You can identify inflammation by looking for markers such as CRP and ESR. If elevated, these markers may be an early sign of inflammation. 
  • Lack of sleep (4) – If you are sleeping less than 8 hours per night then you may be reducing your thyroid function without realizing it
  • Intestinal issues (Dysbiosis, IBS/IBD, etc.) – A large portion of thyroid conversion actually happens in the GI tract or gut (5). If you have problems in the gut then this may limit your ability to convert T4 to T3. Problems such as intestinal dysbiosis (changes in gut bacteria), inflammatory conditions such as SIBO/SIFO/IBD, and other issues can all cause issues. Treating gut-related issues should be a priority if you have thyroid disease. 
  • Stress (emotional, physical, etc.) – Stress, from any cause, will limit thyroid function and block thyroid conversion (6).
  • Chronic and acute infections – Acute infections such as pneumonia can cause issues but also more chronic infections such as viral or bacterial overgrowth syndromes can also cause issues. 
  • Medications – It is well known that certain prescription medications can block thyroid function (7). Included on this list are blood pressure medications, diabetic medications, seizure medications, iodine, PTU/Methimazole, steroids, and heart medications like amiodarone. It may not be possible for you to stop taking your medication but you should look for alternatives if possible. 
  • Endocrine-disrupting chemicals (those you come into contact with daily, some people are more sensitive than others) – Endocrine-disrupting chemicals are chemical compounds that humans come into contact with on a daily basis that look like real hormones but aren’t. These hormones can trick your body into thinking the real hormones are there and they may compete for binding on cellular receptors (8). EDCs are found in plastic bottles, receipts, foods, plastics, and many other items that you come into contact with daily. Limiting your exposure to these chemicals may help improve your thyroid function. 

If you have any of these issues going on in your body then your thyroid function may suffer. 

These conditions may lead to an increase in a metabolite known as reverse T3 (a topic for another time). 

Reverse T3 is the metabolite created when your body is having trouble with the thyroid conversion process. 

Therefore, it can be used as a marker of thyroid conversion in your body. 

You can test for reverse T3 with a simple blood test. 

Factors that INCREASE T4 to T3 Conversion (You can use these to improve how well your thyroid works)

So what are you supposed to do if you have any of the factors listed above?

This section will discuss some of the available therapies that you can use to potentially help improve T4 to T3 conversion. 

  • Fixing the problems listed above (you must know what is causing the issue!) – The first, and most important, option is to try and find the root cause of your issue and address that problem. This may require a physician to help but in many cases, it will not. For instance: if you know you are struggling with calorie restriction then the first step is to stop that behavior! If you have known gastrointestinal issues then you can address that problem with basic therapies such as probiotics or enzymes. If you are struggling with stress then adding yoga or meditation to your daily regimen can help. If you are having issues with sleep then you can focus on ways to improve that and so on. Some issues, such as the use of medications, may require that you find a physician to help (and even then you may not be able to adjust your medications). In many situations, you may find that you have a number of factors that are limiting your T4 to T3 conversion. Each of these factors may contribute 5-10% so you may have to address many issues to see noticeable improvement. 
  • The use of certain supplements – Another strategy to improve T4 to T3 conversion is to use certain supplements. Supplements such as zinc, selenium (9), and guggul may all help your body naturally improve this process. The use of minerals such as zinc and selenium will only help if you are deficient, but many people around the world most likely are due to poor widespread dietary patterns. I’ve included the most effective mix of nutrients and vitamins in my T3 conversion booster which has helped many people improve thyroid function. You can learn more about that supplement here
  • Exercise (the right amount for your body) – Exercise is one of the easiest ways to increase both T4 and T3. A moderate amount of exercise can improve thyroid hormone production from your thyroid gland while simultaneously increasing thyroid hormone levels. The only catch here is that you must be exercising enough while avoiding overexercising. Overexercising can actually cause the opposite effect and lead to decreased levels of both T4 and T3. Learn how much is enough in this guide
  • Diet – While your diet doesn’t directly influence thyroid conversion it can absolutely indirectly affect thyroid conversion. Consuming unhealthy foods can lead to things like low-grade inflammation and gut problems. Both of these variables can negatively impact thyroid conversion. Learn which foods to avoid and which foods you should be eating to promote healthy thyroid function in this guide
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Using these strategies can help you increase thyroid function naturally and may even help if you are taking medication. 

Remember:

If you are taking thyroid medication your body still must convert T4 into T3. 

So all of these factors still matter if you are taking thyroid medication or if you don’t have a thyroid at all. 

The good news is that almost everyone with thyroid-related issues can benefit from this information. 

Bypassing T4 to T3 Conversion with T3 Medication

Another strategy that we will discuss (briefly) is the use of T3 thyroid hormone to bypass T4 to T3 conversion. 

We already discussed the importance of T3 and how it does pretty much all of the heavy lifting when it comes to thyroid function in your body. 

Normally, thyroid medications that contain T4 must be activated to T3 before your body can really use them

But you can skip out on this process by using T3 medications such as liothyronine or Cytomel

If you ingest T3 medications then they do NOT require activation in the way that T4 medications do. 

This allows you to bypass the conversion process and start feeling better almost immediately. 

This doesn’t mean that you should skip out on all of the therapies listed above, but instead, combine them all together for maximum benefit. 

I find that using medications that contain T4 + T3, using supplements designed to improve thyroid conversion, and addressing issues that blunt thyroid function all at the same time cause the best results clinically. 

You can learn more about using T3 medications here

Conclusion

The bottom line?

Addressing this tiny concept known as thyroid conversion may be one of the most important things that you learn about your thyroid. 

Most of the time, patients feel helpless with their thyroid because so much depends on their doctor and what he/she is willing to do. 

But if you understand your thyroid you can take steps to optimize whatever thyroid function your body is capable of producing

Just remember:

This is a process and it takes time!

Don’t expect immediate results, but instead, give your body weeks to months to improve. 

Now I want to hear from you:

Are you struggling with T4 to T3 conversion? 

Have you tried therapies designed to improve this process?

Have they worked for you? Why or why not?

Have you tried T3 medications?

Leave your comments and questions below! 

Scientific References

#1. https://www.ncbi.nlm.nih.gov/pubmed/6479377

#2. https://www.ncbi.nlm.nih.gov/pubmed/1249190

#3. https://www.ncbi.nlm.nih.gov/pubmed/27051079

#4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2910542/

#5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1411539/

#6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3148770/

#7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070767/

#8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5751186/

#9. https://www.ncbi.nlm.nih.gov/pubmed/25758370

how to increase T4 to T3 conversion
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