What do I mean by clean?
I’m talking about the additional ingredients that come bundled inside your thyroid medication.
Here’s how all medications work:
They have an active ingredient and, usually, many different types of inactive ingredients.
The active ingredient is the ingredient that does all of the work and is the reason you are taking that medication.
In the case of thyroid medication, this is thyroid hormone.
I’ll go over the specific active ingredients in each section below, so don’t worry, but here I just want to introduce you to what it means.
The active ingredient is then combined with a whole bevy of inactive ingredients.
These inactive ingredients are referred to as excipients and their main purpose is to stabilize the active ingredient, impact its absorption (1) (for better or worse), protect the active ingredient, improve the bioavailability of the active ingredient, and assist in the manufacturing process.
You can already see the tug of war start to develop between the patient’s needs and the manufacturer’s needs with the list I just mentioned above.
Take for instance the idea of assisting in the manufacturing process.
Many prescription medications have ingredients added to them which help the machines that create and manufacture medications work more efficiently and prevent getting jammed or stuck.
These ingredients help the machines but they may not help the humans who then ingest them, and, in fact, may cause problems for certain people (more on this below).
There’s also a cost that needs to be considered.
Sometimes cheaper inactive ingredients are used simply to cut corners and reduce the cost per tablet or cost per capsule during production.
This creates a strange scenario in which the ingredients used for any given medication are not always picked with the patient’s best interest in mind.
One way that you as a thyroid patient can combat this problem is by choosing medications that are clean and free of these binders, fillers, and dyes.
It was previously believed that inactive ingredients (excipients) just existed in the background of prescription medications and didn’t cause any issues.
More research, however, has proven that not be entirely true (2).
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Fillers, Binders, and Dyes Oh My
If we were to line up and rank order different types of patients based on their sensitivity to foods, medications, and ingredients, thyroid patients would be on the highly sensitive end.
Because of how thyroid hormone impacts the immune system, metabolism, cellular function, and gut health, thyroid patients just have a harder time than most in dealing with different types of compounds, chemicals, and medications.
Let me give you a practical example of what this means for you as a thyroid patient:
It means that even a small amount of inactive binders, fillers, and dyes, may impact your ability to use and absorb thyroid medication.
I know it sounds ridiculous, especially given the small volume of these ingredients found in thyroid medication but it’s absolutely true.
We know this because when we look at different thyroid patients and how they react to medications that are otherwise the exact same, we see differences in not only how patients feel while taking these medications but also in how they impact their thyroid hormone lab tests.
Here are two examples that illustrate this point:
#1. Taking the exact same medication but at a different time of the day impacts free thyroid hormone levels and symptoms.
To give you an idea of how fickle thyroid medication can be, we have this study which showed that taking the same thyroid patients taking thyroid medication in the morning vs the evening saw better free t4 levels when taking it at night.
If you think about it, it’s very strange that taking the same medication at different times of day would have a noticeable impact on how it helps your body.
For most prescription medications, the time of day that you take it doesn’t really matter, it just matters that you get it into your body on a consistent basis.
But this isn’t true for thyroid patients.
There are sensitive enough that a change in the time of day that they take thyroid medication is enough to impact how it makes them feel.
#2. Some patients show a preference for levothyroxine vs Synthroid despite these medications being almost identical.
We also have studies that show that simply switching from levothyroxine to Synthroid (3) (or vice versa) is enough to improve thyroid lab tests and reduce thyroid-related medical costs!
And, there’s really no other way to explain why this occurs except to blame the inactive ingredients.
Here’s why:
Both levothyroxine and Synthroid contain the same active ingredient (thyroxine) but differ slightly in their inactive ingredients.
They also contain the same amount of active ingredient dose for dose.
So if you take 100mcg of levothyroxine or 100mcg of Synthroid, you’re getting the same amount of thyroid hormone.
The only difference between these two doses would be the amount and type of inactive ingredients.
And we know that this small difference is enough to impact free thyroid hormone levels and symptom control.
What does this mean for you?
It means as a thyroid patient that you better start paying attention to those inactive binders, fillers, dyes, and ingredients because they can and do have an impact.
Cleanest Thyroid Medications by Class:
Ok, now that you understand the importance of these inactive binders, fillers, and dyes, let’s talk about how you can eliminate them.
Switching your medication to a cleaner version doesn’t guarantee that it will work for you, but it does eliminate variables that may cause problems which is always a good thing.
So as long as the cost of switching is reasonable and your doctor is willing to work with you, it’s worth considering.
Below you will find a list of the cleanest thyroid medications based on the class of thyroid medication.
I have separated them by categories because it’s important to realize that thyroid patients have the potential to do well on pretty much any type of thyroid medication.
So it’s more about finding what works for you within each class as opposed to trying to pick the cleanest medication out of all of the options.
Some classes of thyroid medication are also easier to obtain than others.
So it makes more sense to have several options available to you as opposed to just one.
Cleanest T4-Only Thyroid Medications
T4-only thyroid medications all contain the same active ingredient: thyroxine.
This is the same bioidentical thyroid hormone that your thyroid gland produces when it is healthy.
T4-only thyroid medications are the most commonly prescribed thyroid medications because they are cheap, cause fewer side effects than T3 thyroid medications, and because doctors are comfortable prescribing them.
The most commonly prescribed thyroid medication is levothyroxine.
Unfortunately, it’s also one of the dirtiest versions available.
The cleaner T4-only thyroid medications also happen to be some of the most expensive options available but there are some generic versions starting to become available now which should cut down their costs significantly.
T4-only thyroid medications are also great options to consider because most doctors will have no problem switching you from levothyroxine or Synthroid to the cleaner options I’ve listed below.
This is not always true for other thyroid medications as we will soon discuss.
With this in mind, here are the two cleanest t4-only thyroid medications available right now:
- Active ingredient: thyroxine (T4).
- Inactive ingredients: gelatin, glycerin, and water.
Tirosint-Sol ingredient list (5):
- Active ingredient: thyroxine (T4).
- Inactive ingredients: glycerol and water.
How easy is Tirosint and Tirosint-Sol to get?
Fortunately, obtaining Tirosint and Tirosint-Sol is not as difficult as some of the other medications that we will discuss but it will require a discussion with your current prescribing doctor.
When switching from something like levothyroxine to Tirosint, the dose stays the same which makes the conversion process very easy.
There’s no clear winner between Tirosint and Tirosint-Sol as some people prefer one over the other.
Tirosint comes in a gel cap and Tirosint-Sol is a solution so preference and ability to swallow also play a role.
One thing is for sure, though, most thyroid patients who make the switch to one of these two medications do see an improvement in how they are feeling.
Cleanest NDT Thyroid Medications
NDT which stands for natural desiccated thyroid has had a bumpy couple of years.
Between multiple formulation recalls and formulation changes, NDT medications are not working quite as well as they once did.
If you went back in time even 10 years, you would find that these were some of the most highly recommended thyroid medications available.
Now due to availability issues, and what looks to be a concerted effort to limit access to these medications, they aren’t as widely used as they once were.
Having said all of this, I’m still hopeful that they will one day make a comeback!
In addition, I want to include this information for completeness’ sake just so you have more information when making a decision as to which medication to use.
NDT thyroid medications are usually porcine-derived and are created by desiccating (drying) up the thyroid gland of pigs.
During the manufacturing process, these medications are standardized to contain specific doses of T4 and T3.
As a result, they also contain different fillers and binders just like levothyroxine and Synthroid.
Unfortunately, some of the cleaner versions of NDT also contain an ingredient that can cause a lot of issues for thyroid patients.
Because of this, it’s a little more difficult to identify the cleanest versions but I will do my best based on the number of inactive ingredients.
The NDT version with the cleanest ingredient profile can be found below:
- WP Thyroid
WP Thyroid ingredient list (6):
- Active ingredients: triiodothyronine (T3), thyroxine (T4).
- Inactive ingredients: inulin, medium-chain triglycerides, and lactose monohydrates.
Unfortunately, WP thyroid isn’t available right now so the next best option would be NP Thyroid.
NP thyroid ingredient list:
- Active ingredients: triiodothyronine (T3), thyroxine (T4).
- Inactive ingredients: calcium stearate, dextrose monohydrate, maltodextrin, and mineral oil.
How easy is it to get WP Thyroid and/or NP Thyroid?
Getting your doctor to prescribe NDT formulations like WP Thyroid and NP thyroid can be very difficult.
Conventional doctors like endocrinologists and family practice doctors are not familiar with these medications and they are not as frequently used as thyroid medications like levothyroxine.
For this reason, you typically need to go to a holistic type of doctor to get them.
Doctors that specialize in functional medicine, integrative medicine, and naturopathic medicine, are more likely to prescribe NDT.
Obtaining NDT is also complicated by availability issues and insurance coverage as well.
Formulations like WP thyroid and Nature-throid (7) have been temporarily unavailable for around two years now and some speculate they may never return.
There have also been recent attempts from the FDA to label compounded NDT formulations as biologics which would further limit their availability.
The future of some NDT formulations is unclear right now but it doesn’t look like Armour thyroid is going anywhere so that is always a fallback option.
Cleanest T3-Only Thyroid Medications
T3 medications are the most powerful thyroid medications on the market and, unfortunately, are some of the least prescribed.
T3 medications can be safely used, but their dosing and side effects differ from levothyroxine which is why doctors are typically hesitant to prescribe them.
They just aren’t as comfortable with them as they are with other thyroid medications.
Because of the recent issues with NDT, many thyroid patients have been forced to switch from NDT formulations to combinations of synthetic T4 and T3.
And because this might be the future of thyroid medication dosing, it’s very important to understand at least a little bit about T3 medications.
In terms of T3 prescription options, you really only have three choices: Cytomel, liothyronine, and sustained-release T3.
Cytomel and liothyronine are very similar to Synthroid and levothyroxine except that they contain T4 thyroid hormone instead of T3.
Sustained release T3 is unique in that it is only available from a compounding pharmacy and has the potential to be the cleanest option of them all.
Here’s why:
Compounding pharmacies can add or remove most ingredients on demand in order to meet the needs of specific patients.
This is completely different from the approach taken by most big box pharmacies which just mass-produce standard formulations of thyroid medications for the masses.
Using a compounding pharmacy allows you to fine-tune your medication to your needs by adjusting the dose of the active ingredients and by reducing or eliminating inactive ingredients.
For this reason, I can’t give you a list of inactive ingredients like I could for other thyroid medications.
The cleanest T3-containing thyroid medication:
- Sustained Release T3
Sustained release T3 ingredient list:
- Active ingredient: triiodothyronine (T3).
- Inactive ingredients: varies based on the compounding pharmacy and request from the doctor.
How easy is it to get sustained release T3?
The only problem with getting compounded T3 medications is that doctors are typically not familiar with compounding pharmacies.
For this reason, getting sustained release T3 is usually easier with non-conventional doctors.
Sustained release T3 is often best used in combination with synthetic T4-only thyroid medications like Tirosint or Tirosint-Sol but can even be combined with NDT.
Your Next Steps
As a thyroid patient, make sure you are paying attention to not only the type of thyroid medication that you are taking but also the inactive ingredients found inside of it!
These inactive ingredients can have a huge impact on how well that medication works for you.
My motto for inactive ingredients is always when in doubt, leave it out.
The fewer inactive ingredients you take the better.
Just make sure you don’t hyperfocus on this aspect of your thyroid medication, either.
While inactive ingredients are important and can play a role, other factors like your dose of active thyroid hormone are still much more important.
Now I want to hear from you:
Were you aware of how important inactive ingredients are in thyroid medication formulations?
Have you tried any of the clean versions that I’ve listed in this article?
Did they work for you? Why or why not?
Are you planning on making the switch to any of those listed above?
Why or why not?
Leave your questions or comments below!
How can I get Tirosint sol in the U.K. ?
I can’t get NHS dr in the U.K. to prescribe tirosint sol.
Gps and the endocrinologist at the hospital refused as currently unlicensed in U.K.
Is there anyway I can get it sent from another country without a prescription?
Hi Hazel,
Unfortunately, I’m not really familiar with which countries allow Tirosint-Sol or not, or the laws regulating the importation of prescription medications. I know some countries allow these medications to be imported, and I know others do not, but I couldn’t tell you off the top of my head which allows it and which doesn’t. I would say the best thing to do is probably reach out to the manufacturer of Tirosint-Sol and ask them if they provide the medication to the U.K.
You only mentioned Armor Thyroid as not going anywhere, but is it clean? I just switched about 6 months ago and it’s the only natural thyroid I haven’t had a problem with. Although I have noticed I am always tired. They had me on too high a dose up till February and I went back to 60 mg, but still if I sit down I fall asleep. I’ve had an endocrinologist, a thyroid specialist and no one had ever talked to me about T4, they test it but thats it. They only talk to me about TSH and T3 only because I’m the one that realized it was too high back in February.
Hi Danielle,
I wouldn’t say it’s clean, but it definitely still has the potential to help some people so it’s worth experimenting with.
Is trosint a bad medicine and if so what is an alternative
Hi Kelsey,
No, Tirosint is not a bad thyroid medication. The best thyroid medication is the one that works best for your body. It can take some trial and error to figure out which one works best for you and you can find the full list of thyroid medications here: https://www.restartmed.com/thyroid-medication/
Is t3 better than t4
Hi Kelsey,
I don’t know if I would say that one is better than the other. T3 is more powerful than T4 but T4 lasts longer in the blood. They both work together it provide your body with balanced thyroid function.
I am 66 yrs old, i had RAI, 23 yrs ago, i first tried Levothyroxin and it was aweful so was immediately switched to Armour, only approx. 5 months ago my doctor switched me to Levo thyroxin again, and dont feel well at all, i finally got her to switch me to NP thyroid, she says that at my age this could be fatal, is this true or not?, i always felt good on Armour?
..please help!
Hi Diane,
No, it’s not true, and if she really thought that she wouldn’t have prescribed it to you. Thyroid medication is considered to be incredibly safe as long as it is dosed correctly. If your doctor prescribed you 10x of what you should be taking then, yes, it could be dangerous. But it sounds like he/she is very conservative so that’s unlikely to happen. Plus, you would start to feel it very quickly if that were the case.
Have been on Armour thyroid for 3 years. Am interested in seeing if something else would work better. Can tell a difference in when I take it- what makes me feel better. Pretty sure I have adrenal fatigue too so I am trying to take care of that first with your supplement I just ordered. What would warrant switching form Armour to something like Tirosint? Just curious
Hi Tammy,
What I typically recommend is making sure you have optimized your dose of thyroid medication prior to switching to a new one. It may be that armour thyroid isn’t the best option for you but it also may be that your dose isn’t optimized. Before you switch, optimize your dose first and then you can determine if you need to switch to Tirosint. By optimizing, I mean making sure your thyroid lab tests are optimal and that your symptoms are controlled. If you are unable to get to that point after manipulating your dose then it’s reasonable to try Tirosint.
What is a good natural thyroid medication
Hi Kelsey,
Right now the only available options are Armour thyroid and NP thyroid and either of those would be a good choice.
I had to switch from Armour because of the Opadry white color it now contains, but didn’t when I first started taking it. I’m allergic to food colors and when I was taking the newest form of Armour I broke out in rashes, especially on my legs. Now that I’m taking NP thyroid I have no rashes from the medication. Also, I’ve switched to dissolving a partial does in my mouth in the evening and finishing with the remainder in the morning (also sublingually).
I was diagnosed with Hashimotis 36 year ago. Doc started me on synthroid which did not work even with high doses. i found an integrative doc who understood and started me on Armour Thyroid. i felt great again. Keep in mind that was 35 years at least 5 different companies since then. A few years ago i began to feel pretty bad again and i asked my GP to switch me to WP thyroid. Eureka i felt great again. Then RCL labs ran afoul fog the FDA and it was taken off the market. So i’m back in Srmour Thyroid ( now manufactured by Abbie). Feeling pretty crummy again. Is it wise to switch to NP Thyroid?
Hi Suzanne,
I would say it’s worth a shot if you aren’t feeling good on the current formulation of Armour thyroid. And, remember, it could also be a dosing issue. Your required dose will change throughout your life which isn’t uncommon. Between changing medications and altering your dose, you should be able to find some combination that works better than what you are currently using.
I am a 76 years old female . I feel good on alternateing 175 mcg synthroid and 150 mcg Synthroid 1 time daily . I also take 5 mcg Liothyronine twice a day. My Pcp now says the Thyroid is suppressed and wants me to start 150 mcg Synthroid daily. I have even gone to an endocrinologist and same thing wants to lower me to 150 mcg Synthroid. I have told then I feel fatigue and my memory issues get worse on lower Synthroid. They won’t listen . Years ago I went to a endocrinologist and was told . Your levels are going to look high to people but it needs to be . Can’t remember that Doctors name . I don’t know what to do . I do not feel good on the dose of Synthroid my current Doctors want me on . I understand the risks of a suppressed TSH and I have read the article about it . I would rather feel good , have some energy and a better memory. I live in the San Antonio area. Are there any Doctors in this area that can help me .
Thank you
Hi Suzanne,
As you mentioned, the key to getting the right dose of thyroid medication is all about seeing the right type of doctor. Please see this resource which can help you find one: https://www.restartmed.com/how-to-find-a-doctor-to-treat-your-thyroid/
What about Thyroid-S? I checked and the active ingredients t3 and t4 are identical to Armour and it also includes the small amount of t1 and t2. Because I had a Dr that only insisted on poor management of my hashi’s by TSH, I was forced to find an non prescription alternative. I have been on Thyroid-S for over a year at the dose my Ft3 and Ft4 warranted. My levels were near optimal within 4 months and I gave been symptom free since Dec 2021. I am interested in your assessment of this medication, please?
Hi Shelli,
I will add that to the list of future topics to write about.
Dr Child, Have you had a chance to research and write about the Thyroid-S?
Hi Denise,
I have researched it, but haven’t had time to write about it yet.
Hi Dr. Child’s,
I am a 48 year old woman in perimenopause with a history of diagnosis of subclinical hypothyroidism greater than 10 years, never medicated. Over the past 8 years I have experienced times of TSH outside of optimal levels ranging from most recently ordered by myself with a 3.01 TSH to a 12.5 TSH in early 2019. During these times were I was fortunate enough to capture these fluctuations I have had both hypo and hyper symptoms with anxiety, panic and huge weight loss to now weight gain, some depression, fatigue headaches, etc. I had a yearly physical in November of this year and although my doctor did check my TSH and at that time was 4.35 they did not check Ft4 or Ft3 or antibodies, hence the recent order I made myself which included the following: TSH of 3.01 with range of 0.40-4.50. My Ft4 was 0.9 with range 0.8-1.8. My Ft3 was 2.8 with range of 2.3-4.2. Thyroglobulin antibodies <1 range <or=1. Thyroid Peroxidase antibodies 299 with range <9. If in the past I have been fortunate enough to have a doctor order the Ft4 or Ft3 my numbers are always similar to these, always near the bottom. We do have a history of thyroid disease on my mother's side of the family. I was just wondering with the antibodies present should I be concerned about Hashimoto?Thank you for your time.
Hello
I know you don’t do comments on individual #’s but can you point me in a direction to go.
I’m on NP thyroid and I use your supplements but just had my labs done and the lab range for TSH is .40-4.50 mine each time every 8 weeks the #’s are continuing to go up. At this point it’s almost 10.0
What direction would you generally suggest?
Also can this cause High blood pressure? I “Normally” have good pressure 128/78 and I’m 72, but when #’s started going up (thyroid) my BP started going up too.
Thank you,
P.Kavanaugh
This article was highly informative and helpful.
I looked at your supplements and found that the majority of them contain magnesium stearate which causes vomiting and extreme dizziness for 7+ days following its consumption for me.
Do you have any ‘clean’ supplements without magnesium stearate?
Hi Colleen,
For the vast majority of people, magnesium stearate is very well tolerated and doesn’t cause any issues. Having said that, I’m currently in the process of switching out magnesium stearate in favor of rice concentrate which will eventually be incorporated into all of my supplements. We have thousands of bottles, though, so it will take several months to go through our existing inventory. But every new lot from here on out will not contain magnesium stearate.
Hi Dr Westin Child,
I have been following you on Instagram and reading your website. I have been on the ketogenic diet for almost 2 years to reverse insulin resistance, help my PCOS, and lose weight. I did everything fasting (Omad Fast, 48hrs fast), keto, and exercise but could not lose weight.
Actually, did an advanced thyroid test and I have just got the result from the lab so according to them it’s normal but I have symptoms like weight gain, fatigue, dry skin, and insomnia, scalloped tongue recently. And based on what I learned My FT3 and FT4 are low.
Thyroid-stimulating hormone (TSH): 2.43 mIU/L
– Free thyroxine (FT4): 13.1pmol/L
– Triiodothyronine (FT3): 3.5 pmol/L
– Thyroid peroxidase antibodies (TPOAb): 9.4 kIU/L
– Thyroxine (T4):105nmol/L
– Thyroglobulin antibodies (TgAB): 27.6 kU/L
Also, I have just started to use Bioidentical Progesterone Cream to help my oestrogen dominance. Would you please let me know if it is ok to use an l-tyrosin 500 supplement to help my FT3, and FT4? Should I go for a specialist not through GP(I live in Uk) because they don’t accept it and say it’s normal?
Thank you in adsvance,
Sahar
Hi Sahar,
There’s no reason not to try l-tyrosine but it probably won’t have a huge impact on your free thyroid hormone levels as that’s typically not how thyroid supplements work. You can learn more about l-tyrosine here if you’d like: https://www.restartmed.com/l-tyrosine/
Hi!
I have Hashimoto’s. At diagnosis in 2013, my atpo antibodies were 300 and thyroglobulin antibodies were 25,100. For the past several years, I’ve stuck to gluten and dairy free diet, improved stress management, good sleep. I feel so hopeless that I’ll improve because my thyroglobulin antibodies have never went below 2500 and atpo 100. I feel much better, but it is so disheartening. Just wondering if you could point me in a direction to figure out why.
Hi Alesha,
Thyroid antibodies do not always correlate with disease state so it’s definitely possible to have elevated antibodies even though you are on the right track. The problem is that it’s also just as likely that you are missing something and that your antibodies may be an indication of that.
I would recommend checking out the root causes of Hashimoto’s to see if you are missing anything: https://www.restartmed.com/root-causes-of-hashimotos/
I wish I had found this article 10 years ago! It took me 6 years to figure out that the Acacia additive was a huge problem for me. My doctors thought I was just being dramatic. Tirosint has been a life changer. One of my symptoms was my skin smelled like grilled onions. It was so bad that other people would ask me if I worked at a fast food restaurant! I never could figure out what that was about. If you have any ideas, id sure love to know.
Thank you for providing all this amazing information!
Hi T. E.,
I’ve never heard of that particular symptom but I’ve seen all sorts of interesting reactions so it’s possible it could be related.
Found your article very interesting..
My issues is I have a server allergy to GM corn and as you know it’s a widely used filler and binder for most all medications especially in the US ..
any suggestions for steering clear of GM corn..
Hi Susan,
The best thing you can do is to reach out to the manufactures of whatever medication you are taking to make sure it isn’t included in any capacity.
It was recommended to me to try a Lyophilized Bovine Thyroid gland product from New Zealand for my sluggish thyroid. At 65 mg. It’s an over the counter gland product. It’s clean with just gelatin, L lycine, Slica and L Leucine in it.
How well does bovine thyroid gland work compared to porcine gland thyroid?
Hi Hidee,
They can’t really be compared because one contains standardized doses of thyroid hormone and the other does not. It’s an apples to oranges type of comparison.
Can you list all the ingredients in the T3 medications? I’ve heard there is gluten in Cytomel. Thank you.
You said cytomel contains only T4 … above. Its the opposite..cytomel is T3
Hi Marlena,
Are you referring to this statement? “In terms of T3 prescription options, you really only have three choices: Cytomel, liothyronine, and sustained-release T3. Cytomel and liothyronine are very similar to Synthroid and levothyroxine except that they contain T4 thyroid hormone instead of T3.”
I took synthroid for many years, then insurance demanded i switch to generic levothyroxin. 2 weeks and I couldn’t stay awake. Thyroid removal 10 years ago to cancer.. About 6 years ago I was switched to ndt. I felt so much better. My osteopenia diagnosis turned to normal. Yes, its been a difficult ride to get ndt, but I’ve been stable on Npthroid for several years. Now, my hashimotos has flared. My dr says I must switch to levothyroxin as she feels the autoimmune is attacking the pork thyroid. I do not want the bone loss to start again. I’m doing AIP diet and low dose naltrexone in hopes the antibodies will reduce enough to allow me to continue the NDT
I’m on methamazole is this clean?
Hi Mary,
Methimazole would not be considered clean but there are very limited options when it comes to anti thyroid medication.
Hi Dr. Westin, I was on Levoxyl 88mcg for yrs. Jan. 2022 because of insurance change I was sent Synthroid. It took me 6 to 7 months to figure out I was not feeling well on this medication. I had lots of different problems, hair thinning, palpitations, anxiety and a few others. I finally called the pharmacist and told her what was going on and she switched me back to Levoxyl, within days I could feel the difference. I am so thankful that I figured it out. Thank you for all your information.
Hi Joy,
Glad to hear you were able to find something that worked for you!
I have been taking natural porcine thyroid plus liothyronine for several years. I was taking NP before this was taken off the market for however long. I switched back to Armour (which I had had some trouble with quite a few years ago, but seem to be doing all right with now.
Thank you for listing the inert ingredients of Tyrosint. I in the past tested allergic to glycerin, so I wouldn’t consider taking that.
I had been taking 30mg Armour in the a.m. with 5 mcg liothyronine for maybe 3 or 4 years and seemed to do ok. In recent months I developed some palpitations (which may or may not have to do with the t3). The T3 was in the high end of the range but not above it. I stopped the T3 in February and will be following up with labs to see what they show. My dr. will only test TSH, Free T3 and Free T4. (at least he goes beyond TSH).
My question for you is there a time of day that’s best to test these levels. I have read that if one is taking a thyroid medication containing T3, it is best to wait 13 hours (not really possible) after the dose. That TSH will drop to base levels in 4 hours and gradually rise for 13 before leveling off. I’m not sure why taking T3 affects the timing when T4 alone does not. The suggestion was to either wait 13 hrs. or test first thing in the morning before taking and then take the medication after testing.
Do you have an opinion regarding the time of day labs should be done given when the medication is taken?
Hi Robin,
Yes, you can learn more here: https://www.restartmed.com/thyroid-testing/
Apparently, NP Thyroid is now being made in China which does not make me feel confident. Just got a script for NP but did not know about the China thing. Also, MRNA genetic technology is being used on some of the pigs in the US which is troubling and some of these animals are being used in pharmaceuticals. No idea which ones.
I forwarded an article to you Dr Childs, and hope you can get some clarity on this. Im concerned about potential effects on thyroid meds for thousands, like myself and hope pharma would at the very least disclose this change, before dispensing to patients. The covid shots were and remain problematic and used experimental mrna technology. I hope disclosure is forthcoming and Im wondering if this is behind the questionable reformulating of trusted thyroid meds and if this is causing some of the problems people are experiencing.
Did Armour go with mrna injected pigs?
Did NP?
I hope you can find out if this is whats happening with some of the thyroid meds. Also, NP thyroid has mineral oil as a filler-which is a hormone disruptor. Big Pharma is really losing their credibility and seem to have no issue with non disclosure on new technology.
I am temporarily back on New Zealand grass fed bovine NDT. Its not perfect, but it is, so far, very clean and has all the components needed, including calcitonin. I believe thats a good thing, but please let us know Dr Childs, what are your thoughts? How do we find out what is really happening with all these meds and why do they not use bovine sources as well. And Ty for being such a great wealth of info !
I have tried every conceivable thyroid replacement medication for the last 15 years and the only one that finally worked to get my numbers in optimal range was to have NDT custom compounded and encapsulated by a compounding pharmacy with ascorbic acid as the only filler. This is pure USP thyroid powder, the same used in the commercial NDT products but without all the unececssary garbage fillers and excipients. I can always get a certificate of analysis to check to see how much T3 and T4 is in each batch. It is a bit of work to find a compounding pharmacy that will source the pure powder and encapsulate it to your specs and then it depends on the cost – about $1.75 per cap. I was fortunate to get it covered through my insurance miraculously.
Good day Dr Child, I had my thyroid removed 2017 because it was growing and then got infection. The other glen is also growing. I’m not on medication for it but are concern of the growth. Is there anything I can use to get it back to normal.
I switched to Tirosint a few of years ago l, I noticed a huge difference in just 2 weeks. I had more energy, didn’t feel as fatigued, slept better. After switching I saw an article that if you have tree or grass allergies you should not take Levothyroxine or Synthroid. I have both allergies!
After having cardiac ablation for SVT and Afib, my TSH levels went from .2 to over 50 in 30 days due to dr prescribing Pantoproxzole. Figured out anything ending in “ole” blocks thyroid medications from working. Still trying to get stabilized. Ugh! Just ordered a T2 to see if it will help.
Hi Beverly,
Glad to hear the switch helped! Even though Tirosint is great, it still only contains T4 thyroid hormone and many people benefit from taking additional T2 and T3.
For those wanting to switch to Tirosint but insurance is expensive, drs can give you a prescription card from the manufacturer that drops the price dramatically, the highest cost is $25 a month or $50 for 90 days. If they don’t know about it, go to Tirosint website and get it yourself.
https://tirosint.com/patient-savings-resources/ways-to-save/copay-savings-card/
Hi Beverly,
Thanks for sharing! There are also generics available for Tirosint as well. The manufacturer of Tirosint lowered their coupon price to match them when the generics were released.
I’ve been on NDT since 2005, and was fortunate enough to have found (and still have) a great naturopathic doctor who monitors my health. With the shut down of Naturethroid and WP, I began taking a compounded NDT, and was doing well until I recently began feeling some fatigue and other discomforts that may have been related to low thyroid, so he switched me over to NP. Whether it was coincidental or not, I began feeling better. However, I’ve since learned that there are other factors involved that could produce symptoms similar to those of hypothyroidism, as my thyroid tests all showed me well within the normal range. I went back to using what was left of my compounded formula and still feel well, so I know my symptoms were caused by some other imbalance, which I’m researching and testing as we speak. I am 72 years old, and believe that the gut microbiome plays an incredibly important role in overall health and well being, and that we all should be aware of the metabolic changes that occur as we age. How we metabolize thyroid hormone supplements are also affected by our digestive processes.
Thank you, Dr. Childs, for all your valuable insights and for sharing vital information to us all!
In Canada we now have the generic alternative to cytomel called TEVA. Can you evaluate this generic for “cleanliness”. Of note, the ootency is different than the equivalent cytomel dose. My husband is allergic to TEVA but fine on cytomel.
Thank you
Hi Lisa,
It looks like T3 from Teva pharmaceuticals contains starch (corn source), edetate disodium, magnesium stearate, and microcrystalline cellulose.
Hi Doctor,
My husband was on NDT which became unavailable, so his doctor put him on Armour. I’m wondering if there is a topical, bio identical thyroid cream or gel in he could use instead of pills? Thanks, Daisy
Hi Daisy,
I’m unaware of any topical thyroid creams, but there is some research to suggest that thyroid hormones can be absorbed transdermally.
I have been on Armour Thyroid for around 3 years now. Before then, I didn’t even know I had thyroid problems until this Dr did bloodwork and found it. Since then I found I also have Hashimoto’s.
The Armour thyroid was life changing for me! I lost the weight, no more fatigue or brain fog! I had energy all day! In my 50’s and feeling better than I did in my 30’s!
Then, last year was a big stress year. Dad died, left mom who had a stroke with dementia and taking care of all that this past year. I still felt good until about the end of the year, then I started gaining weight, feeling tired again, etc. I have a great Dr, and when I asked if he could up my dose, he did. I’m now taking 150 mg per day.
Now my T3, T4, etc all look good but I’m still gaining weight. My stress level is down but not back to normal yet. I’m still moody and feel like I have symptoms even though my numbers all look pretty optimal.
I will order some of the T2 to see if I can lose the weight but wondering… am I missing something since all this stress hit me? Is there something else I should be doing to make my symptoms go away even though my bloodwork looks good?
Hi Tina,
Yes, there are many ways to help reduce the impact that stress has on your body. Please see this article for more information: https://www.restartmed.com/cortisol-and-weight-gain/