Signs Your Thyroid Medication is too Low (What to Look For)

Signs Your Thyroid Medication is too Low (What to Look For)

Is your Thyroid Medication Actually Working?

As a thyroid patient, you need to be aware of a very important fact: 

Thyroid medication will NEVER be as good as your thyroid gland at managing and controlling your thyroid levels. 

But, just because thyroid medication can't make up for the real thing doesn't mean you have to feel poorly. 

Quite the opposite, actually. 

It's absolutely possible, and it should be your goal, to restore your thyroid function to what it felt like BEFORE you had thyroid problems. 

This is easier said than done, though, and that's exactly what we are going to talk about today. 

Whether or not your thyroid medication is actually working and how it impacts how you are feeling. 

Many thyroid patients are often frustrated to find out that even after they start taking thyroid medication, they don't feel as well as they would like. 

As a thyroid patient, you probably imagine that you will feel back to 100% of your normal self a few days after you start taking your medication. 

After all, isn't thyroid medication supposed to take over for your thyroid gland? 

Well, yes, but also no. 

There's a high probability that your thyroid medication isn't working as well as you probably think and there are a few reasons for this. 

In this article we will discuss:

  • How to know if your thyroid medication is working
  • Signs and symptoms which indicate your thyroid medication is too low
  • Reasons why your thyroid medication may not be working
  • And more

Let's jump in...

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Signs and Symptoms your Thyroid Medication is too low

First things first, let's talk about how to know if your thyroid medication is working or not. 

It's actually quite simple and once I explain it to you, it will make a lot of sense. 

How do you know if your thyroid medication is high enough? 

Well, if it is high enough then you will experience NONE of the symptoms of having a low thyroid

So if you are experiencing ANY remaining low thyroid symptoms then you know right away that your thyroid medication is off. 

These symptoms include:

You'll notice that I used the term "continued" in the description list and this was by design. 

Why?

Because the symptoms of low thyroid present with these exact symptoms. 

And if your symptoms did NOT go away when you started your thyroid medication then you know that your meds aren't working. 

If you are experiencing ANY of these symptoms AFTER you start taking your thyroid medication then you need to look at the reasons listed below. 

Reasons your thyroid medication isn't working:

The bad news is that you are still having problems despite taking your thyroid medication each and every day. 

The good news is that you don't have to continue suffering with your low thyroid symptoms as there are many explanations for why you feel so bad. 

#1. You are using the wrong medication

The first thing you should know is that there are MANY different types of thyroid medications available to you as a thyroid patient. 

Unfortunately, most doctors tend to prescribe only one and that is levothyroxine. 

But like other medications, and pretty much everything in life, you are an individual and what you need may differ from what someone else needs. 

This means that even though levothyroxine may work for someone else, it doesn't mean that it will work for you. 

Whether that's because your body just doesn't tolerate it, you can't absorb it, you are reacting to the inactive fillers or binders, or any combination of the above, it doesn't really matter. 

If you can't tolerate the medication or if it's not working for you, you need to swap medications. 

Luckily, you have many options available to you.

Here are some of my favorites that you can read more about:

These medications are all FDA approved to treat thyroid problems and your doctor can swap you over to any of them.

Note: you may have to specifically request that you be switched over, however, as many doctors aren't used to prescribing them

#2. Your dose isn't high enough

What if you are taking the RIGHT medication but you just aren't using enough. 

Believe it or not, this can happen a lot and it's very common for people who are just starting out with thyroid medication. 

It can take a while for your doctor to hone in on the dose that your body needs

And each person will need a different amount of thyroid hormone depending on their age, genetics, body weight, and more. 

It's VERY unlikely that your doctor magically guessed how much thyroid medication you needed and got it right on the first try. 

This does happen but it's definitely not common. 

You should expect that it will take your doctor 3-6 months to get your dose right. 

So if you just started taking thyroid medication then it may just be that you need a higher dose and it's something that your doctor can easily remedy. 

If you've been on thyroid medication for a long time and STILL feel poorly then it's probably due to something else. 

Many doctors have become reliant upon thyroid tests such as the TSH which they use to guide their dosing patterns. 

This test is not the most accurate way to assess how much thyroid medication you should be taking and there are additional tests you should look at to get a better picture of what is happening in your body. 

You can find more information about the complete set of lab tests that I recommend for every thyroid patient here. 

#3. You didn't give it enough time

This is sort of an extension of #2 but I understand exactly why it happens. 

You are probably sick and tired of feeling sick and tired and you just want to get back to normal. 

I get it. 

But your thyroid doesn't! 

Unfortunately, your thyroid moves as quickly as the Titanic can turn away from icebergs. 

That is to say, it does not move very quickly. 

This can be frustrating for thyroid patients who just want to feel better which is why having the right expectations is so important. 

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It takes about 4-6 weeks of DAILY thyroid medication use to feel a difference. 

And even if you aren't feeling well and your doctor makes changes to your medication after 4-6 weeks it will take ANOTHER 4-6 weeks to see if those changes are helping. 

Managing your thyroid is a slow process but having patience will be worth the wait. 

#4. You aren't using it correctly

Lastly, it's also very possible that you are doing EVERYTHING correctly except for one thing...

You aren't taking your thyroid medication the right way

For whatever reason, doctors tend to avoid having this important conversation with thyroid patients who start thyroid medication. 

And that is this:

Thyroid medication isn't the most sturdy of medications and many different things can impact not only how well it is absorbed but how your body uses it. 

It's both possible, and likely, that you are taking your thyroid medication each day but that you are taking it incorrectly and this may negatively impact how well you are feeling. 

Here is how to take your thyroid medication correctly:

  • Take your medication FIRST thing in the morning or RIGHT before bed
  • Wait 30-60 minutes AFTER you take your thyroid medication to eat or drink coffee (1)
  • Do NOT take your thyroid medication with over the counter supplements
  • If you are taking iron or calcium, take your thyroid medication at least 4 hours away from these supplements

These rules are important to follow if you are taking any thyroid medication except Tirosint. 

Taking your thyroid medication without following these rules is a good way to ensure that it will NOT be absorbed and that it will NOT be utilized by your body. 

If it isn't absorbed then you won't feel better no matter how long you wait. 

How to adjust or make changes to your thyroid medication

What if you have waited the appropriate amount of time but you are still feeling poorly?

It's time to make some changes to your thyroid medication. 

In order to do this, you need to follow two steps:

#1. Get your thyroid tested (and make sure you get the full thyroid lab panel)

#2. Make changes to your thyroid medication (if you have the symptoms above then you would need to INCREASE your dose)

Why do you need to get your thyroid tested first?

Because you need to see how well your previous dose of thyroid medication was working. 

You should have a baseline set of labs that you received in which you were diagnosed with a thyroid condition. 

When you re-test your thyroid you can compare your new set of labs to the old one. 

Did your TSH go down? If you are taking thyroid medication you should see it drop (which is a good thing). 

Did your free T3 increase? If you are taking the right type of thyroid medication you should see your free T3 increase. 

Did your free T4 increase? If you are taking levothyroxine then you should see your free T4 increase. 

After comparing your old lab tests to your new ones, you should be able to see if your thyroid medication was working and how well it was working. 

If all of your lab tests are going in the wrong direction then you know you need to make dramatic changes (like swapping to a different thyroid medication). 

Alternatively, if your lab tests are trending in the right direction but just not quite there yet then you know you just need to make some small changes to your medication (like increasing your dose slightly). 

There is no one size fits all pattern that you can apply when it comes to your thyroid which makes getting these lab tests all the more important. 

Final Thoughts

It's actually not common for thyroid patients to start taking thyroid medication but still feel poorly 2-3 months later. 

These symptoms usually stem from either an inadequate dose or because you are taking your thyroid medication incorrectly. 

If you are experiencing signs of hypothyroidism or low thyroid then you KNOW right away that your thyroid medication is off and needs to be adjusted (usually upwards). 

This is an easy problem to fix and requires that you get your thyroid labs retested and that you compare your new labs to your old labs. 

Some doctors are not as good as others when it comes to managing thyroid problems so don't be afraid to find a new doctor if your current doctor is not up to par with the latest medical research. 

Now I want to hear from you:

Are you struggling to feel better even after starting thyroid medication?

If so, what type of symptoms are you still experiencing?

Are you sure that you are taking your thyroid medication correctly and that you've given it enough time?

Or are you struggling to get your doctor to listen to your concerns?

Leave your questions or comments below to keep the conversation going! 

References (Click to Expand)

is your thyroid medication dose too low? Here's how to find out
Dr. Westin Childs

Dr. Westin Childs is a Doctor of Osteopathic Medicine. He provides well-researched actionable information about hormone-related disorders and formulates supplements to treat these disorders. He is trained in Internal Medicine, Functional Medicine, and Integrative Medicine. His focus is on managing thyroid disorders, weight loss resistance, and other sex hormone imbalances. You can read more about his own personal journey here.

10 thoughts on “Signs Your Thyroid Medication is too Low (What to Look For)”

  1. My NO and previous ME both say my thyroid tests are ok. That I don’t need retesting. I’m on the same meds and dosage I’ve been on for aprox the last 12 yrs. My hair is still thinning, my skin is very dry, I’m always colder than others in the same room, and I’ve been steadily seeing my weight inch up. He’ll me please.

    Reply
  2. I have had to get my dose raised because I have went from feeling yuck to ok and bk to yuck. No I feel like I’m falling again its been a few months. My numbers are always in “range” shouldn’t I want them higher? I am told to cut carbs for my weight loss. I have been crawling up in weight even with exercise.

    Reply
  3. I realise after nearly 20years I am taking my thyroid tab wrongly. I am devastated. My dose has been increased to 25mg now. Is it too late for me to correct the damage I’ve done to myself? No one ever told me there was a specific way to take it…..Hope to hear from you.

    Reply
  4. I have been taking armor thyroid for years. Still have dry skin, hair loss. Along with bouts of depression and increasing weight gain despite workouts twice a day. I take thyroid meds at 4:30am and take over counter vitamins E,D, probiotic, apple cider vinegar pill, magnesium and spirnolaticne at 7am. I wait until noon to take multivitamin with iron and calcium. Is this order ok for thyroid absorption ?

    Reply
  5. So Ive been taking NP thyroid for 3 months- 60mg dosage. I have more energy, but all the other symptoms as mentioned above are the same except one thing- I have developed hive looking things just on my shins! And they it h like crazy! Never had a dry skin problem, but this is the only place it’s showing up since about 3 weeks into the meds.

    Reply
  6. I’ve been on Armour Thyroid 30mg for years, still having hair loss, weight gain even with prescription weight loss meds, fatigue and bouts of being in a “funk” because I’m so fatigued. Dry skin, which I’ve never had a problem with. My labs are always within range, sometime closer to the lower end. I’ve told my physician I feel like I am operating at about 75-80% and she says I’m depressed. Is it time for a med and/or dosage change? I’ve always taken it first thing in the morning and have waited at least an hour to eat or drink and only drink enough water to swallow the pill

    Reply
  7. Hi,Dr Childs
    I been following you for many years and taking your advice One of my doctor told me he can’t treat me because I’m taking NDT (erffa).after I went to see an other endo and he is given me a combination of 50 mg Syntroid and 90 mg of NDT alternate with120 mg My question is my TSH is allways suppressed it is normal?(0.01) or is needs more adjustment .

    Reply

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