Thyroid Medications That Still Work in 2021 & Which Ones Don't

Thyroid Medications That Still Work in 2021 & Which Ones Don’t

Big Problems with Thyroid Medications in the Last Few Years

It's been a tough few years for thyroid patients. 

Within the last 3-4 years you have had to deal with changes in the formulation of several types of NDT medications, recalls of various types of thyroid medications (including NP thyroid (1) and levothyroxine (2) recalls), and problems with shortages with several types of NDT. 

I'd be lying if I said that these problems didn't affect me, and I know that they certainly affected you guys. 

I see almost daily reports from thyroid patients who continue to have problems with thyroid medications that USED to work well for them

These problems have even caused some people to declare statements like "all NDT formulations are terrible". 

And while I do agree that the current state of thyroid medication is certainly not optimal, it doesn't mean that there aren't options available that still work. 

And I'm not someone to let changes such as these prevent me from helping thyroid patients, so with that in mind, I want to talk about thyroid medications and formulations which I am still seeing GREAT results with. 

Yes, I've had to change some of my preferred combinations up but these new combinations are working quite well and can still help MOST thyroid patients feel better. 

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Thyroid Medications and Regimens that are still working very well

My preferred combination of thyroid medication has always been a combination of T4 and T3

I occasionally have patients who require T4 only or T3 only thyroid medications but these patients represent the ends of the extremes and are certainly not "typical". 

At any given time, I see these recommendations working for probably around 70-80% of thyroid patients:

  • Option #1: Tirosint + SR T3 - Tirosint is a T4 only thyroid medication in a gel cap that is highly absorbable. SR T3 is a sustained release T3 thyroid medication that comes from a compounding pharmacy. 
  • Option #2: Tirosint + Cytomel/liothyronine - This combination replaces SR T3 (sustained release T3) with an immediate release version of T3 in Cytomel and/or liothyronine
  • (Potential option for some) NDT + Cytomel/liothyronine - Finally, if you are someone in whom NDT is still working well, you can use the combination of immediate release T3 in conjunction with your NDT dose. I find the most success with NP thyroid but I still see that Armour thyroid and Nature-throid work for certain people. 

If you are new to the thyroid game, then these medications might look completely foreign to you. 

The medications that I recommend are often not prescribed and may not even be anywhere on the radar or in the wheelhouse of traditionally trained doctors such as endocrinologists and family practice doctors. 

Having said that, there are still ways that you can get them as long as you go to the right type of doctor. 

Why I recommend these combinations:

Let me go into a little more detail on why I like these particular combinations of thyroid medications. 

#1. Ability to titrate individual T4 and T3 levels

One of the biggest benefits of using individual T4 and T3 thyroid medications is that you can easily adjust the dose of each one. 

I find that the T4 and T3 levels that each person needs vary quite a bit. 

I have seen two people who are very similar in terms of their history need completely different doses of T4 and T3. 

thyroid meds that are still working in 2020

Someone might be able to get away with 75mcg of T4 and 25mcg of T3 while another person may need 25mcg of T4 and 5 mcg of T3. 

The good news is that you can easily adjust doses on each thyroid medication to accommodate. 

Individual tweaking of Tirosint and SR T3 allows for adjustments and titrating for thyroid patients. 

#2. These thyroid medications are cleaner than many alternatives

One of the biggest problems in recent years is the contamination of thyroid medications with fillers that can cause serious problems for thyroid patients. 

For instance:

Even small changes in these inactive ingredients can result in inflammation in the gut, inflammation in the body, and reduced absorption of thyroid medication in sensitive patients. 

For this reason, I often recommend just starting right away with Tirosint because most patients feel much better. 

SR T3 is not the most easily absorbed thyroid medication out there but it is cleaner in terms of inactive ingredients. 

The reason being, the inactive ingredients can be closely controlled by the pharmacy which compounds the medication. 

The combination of SR T3 and Tirosint means you get fewer inactive ingredients which can interfere with your gut and thyroid medication absorption. 

#3. Tirosint is highly absorbable compared to other thyroid medications

Another benefit of using Tirosint is that you don't have to worry as much about interference in thyroid medication absorption. 

Tirosint is a T4 only thyroid medication but is the second cleanest thyroid medication on the market (second only to Tirosint-Sol). 

It only contains 4 ingredients in total. 

Thyroid patients are conditioned to constantly think about when they need to take their thyroid medication and what other things may interfere with its absorption. 

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If you are taking Tirosint then these issues are not nearly as important. 

Because Tirosint contains so few inactive ingredients, and because it comes in a gel cap, it's highly absorbed compared to typical formulations like levothyroxine. 

We even have studies showing that Tirosint can be fully absorbed even if taken with food (4) or with coffee.  

This isn't true of SR T3 or liothyronine/Cytomel, but if you end up using Tirosint you don't have to worry as much about when you eat/drink after you take your medication. 

This also applies to supplements too, by the way (with the exception of iron and calcium)!

#4. NDT formulations may contain lactose and other fillers which can limit their effectiveness

You may be wondering why I am bearish on NDT compared to other formulations and the reason is simple:

NDT formulations have seen a continual decline in terms of effectiveness over the last 5-6 years. 

As I mentioned above, it doesn't mean that they don't work or that they are completely useless but it does mean that their quality has been dramatically reduced. 

I used to regularly recommend NDT as a first-line therapy for most thyroid patients but I have since stepped away from that type of recommendation. 

There are well documented problems with NP thyroid, WP thyroid, Nature-throid, and even Armour thyroid. 

It also doesn't seem like the pharmaceutical companies which are in charge of these medications take the problems very seriously and are willing to revert the changes they have made thus far. 

Some Additional Thoughts

You should know that just because I am recommending these thyroid medications doesn't mean that you HAVE to use them. 

It also doesn't mean that other formulations aren't working, because they definitely still are. 

I know from experience that thyroid patients are feeling great on all types of formulations of thyroid medications including NDT. 

When I recommend medications to thyroid patients I am always thinking about what will work BEST for the thyroid gland. 

On a general blog post like this, I can't really take into account important factors such as cost or availability. 

These factors may be incredibly important in your case and may limit your ability to use these recommendations. 

Tirosint, for instance, is not covered by most insurance plans and is quite expensive if you are paying out of pocket

But just because it's expensive doesn't mean it should be avoided, because I feel that the expense is worth it for most thyroid patients. 

It also might not be possible to get certain NDT formulations or T3 formulations depending on which country you live in. 

I know, for instance, that getting T3 thyroid medication is hard in the UK but relatively easy in the US. 

So remember these considerations as you read this!

But now I want to hear from you:

What type of thyroid medication(s) are you using right now?

Are they working well for you? Would you recommend them to others?

Have you had any recent issues with medications that USED to work but which are now not working? 

If so, share your story and experience below! 

References (Click to Expand)

I am recommending these thyroid medications in 2020

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About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 70,000+ people have used them over the last 6 years. You can read more about my own personal health journey and why I am so passionate about what I do here.

P.S. Need more help? Check out my free thyroid downloads and resources.

85 thoughts on “Thyroid Medications That Still Work in 2021 & Which Ones Don’t”

  1. I take Tirosint 50 mcg and 10 mcg Cytomel daily and have been for 6 months. Over last 3 years I have tried all the different thyroid meds with miserable outcomes and side effects. My current regimen seems to be working well though! My one complaint is since starting cytomel and tirosint, I have begun to have (within 1 month of starting) a constant ringing/swishing sound in right ear. Have you ever heard of this or know how I might correct it?

    • You need to have your free t4, free t3, and reverse t3 tested. If your free t3 is low and/or your reverse t3 is high adding t3 would be beneficial.
      I would try regular t3 first since it’s not compounded and would be covered by insurance.

  2. I take thyroid S, however had to switch to armour during the lockdown as Thyroid S was on back order. Didn’t really feel great on armour.

    • What is your thyroid s dose? I just started 1.5 grains daily, hoping and praying it works- I had a total thyroidectomy over a year ago and have felt awful with ten pounds weight gain over the last r year from only being on levothyroxine. The after experience has been worse than the initial cancer diagnosis!!!

    • I recently switched to Thyroid-s from Shiprasit pharmacies because medicare does not pay for medications. Over the months it seems to be sub-potent and I take 3 60mg tabs a day but my dose is 2. I have no symptoms of being hyperthyroid on this dose!! Has anyone else noticed sub-potency on this med?

  3. My doctor recently, at my request, switched me from compounded levo to Tirosint 100 mcg and SR T3 20 mcg. I am starting to feel so much better and I am even beginning to lose some inflamnation. These last 11 years since I was diagnosed with Hashimoto’s have been long and very difficult. It looks like I’m finally starting to see the light at the end of the tunnel and a lot of it has to do with your wonderful blog and awesome supplements, Dr. Childs. Thank you for all you do.

  4. Dr Childs – is it possible that the raw thyroid powder could be the challenge with NDT’s as they all have that ingredient in common?

    • Hi Lynn,

      Yes, I haven’t had confirmation of that yet but my concern is that they are all compromised because one of their websites states that the lactose comes from the Thyroid USP diluent which would be used for all brands of NDT.

      In addition, I just found out that many lots of WP thyroid and Nature-throid are being recalled due to subpotency so that might cause some significant issues for many hypothyroid patients.

      • I was previously taking Naturethroid for about 6 years. I felt wonderful on it and then in 2020 when it was recalled had to switch to Armour. While taking Armour I began to have hypothyroid symptoms again and IBS issues started. I have just not been feeling myself. I recently went to an endocrinologist and she prescribed me 75mcg Tirosint and 5mcg of cytomel generic version. I am hoping this combo can be comparable to the Naturethroid that I loved. Guess I will see in a few weeks how this works for me. Appreciate all your great info and advice especially recommending t4/t3 options.

        • Hi Dana,

          That’s often the best route! Give it a try and see if it works out or not. Unfortunately, we don’t have a great way to predict whether or not thyroid medication will work for any one person.

      • Dr. Childs, I am taking thyroid-s from shriprasit pharmacies. My dosage of armor was 120 mg a day, but I find with thyroid-s I need 180 mg to have any energy and focus. I am not having any hyper symptoms, increased blood pressure or headache. I feel better taking three 60mg. Have you heard anything about subpotency with this brand? I am on medicare and purchased this brand to save money. The synthetic never did a thing for me. I have Hashimotos. Also, have you heard that full sprectrum cbd from hemp interferes with the thyroid? I have begun taking that recently and wonder if that could be causing the problem? Thank you much for your response.

        • Hi Cynthia,

          I am not aware of any issues with that brand but it’s not uncommon for some formulations to work better than others even when they are in the same class of medications (such as two different versions of NDT). Inactive fillers and binders are thought to cause some of these issues.

  5. I got some Tirosint samples from my Dr today in two different doses. I’ll start with my usual dose and if it’s too much I’ll go to the lower dose. I’m trying to refrain from using cytomel with it so I can get a baseline over the next 6 weeks but it’s a nightmare going from NDT back to T4. Every horrible hypo symptom you can think of is what I have right now. Also, recall trying Tirosint Sol a few years ago in my usual dose as a sample but I went back to my Sandoz generic after a week. I have to try really hard this time to find a reliable name brand.

    • Hi,
      The same thing happened to me when I tried to switch to Armour from Synthroid and cytomel. I was constantly crying and could not stop. I couldn’t handle it.

  6. My question is in regards to T3 medications that work. I have a prescription for cytomel that I filled and was given a generic, manufactured by King Pharmaceuticals. It contains the same fillers as Cytomel. I took up to 10mcg daily and it felt like I was taking nothing. To experiment, the next day I took one grain of NP Thyroid and within the hour I was out of bed, thinking clearly, and able to move.
    I’m aware that both pills by KPI and cytomel contain Talc. Have you know this to cause absorption issues in people? Is there a culprit in one of these that you suspect people are more sensitive to? Is there a pharmaceutical company that manufactures a T3 that has a higher efficacy among patients? I transferred my script over to a pharmacy that supplies T3 by Sigma Pharm, which does not have talc or sucrose however it has manitol. Thanks

  7. I have been using NP Thyroid for the last 6 months and have had wonderful results and I also started taking Thyroid Glandular and am feeling good but my recent lab works showed my moving to the hyper side with TSH at 0.13. My doc is reducing NP from 75 to 60 but not sure if I need to reduce further especially with taking the glandular

  8. I was a longtime user of Naturethroid and loved it. Since it’s decline starting in 2018, I have struggled to find something that works. I tried Tirosint 75 mcg on two separate occasions only to develop extreme pelvic pressure and pain. I am now on Armour but I do not do as well on it as I did on Naturethroid. It has been a fifteen-year nightmare trying to find a medication that works for me. I wish I could find a competent doctor that understands complex thyroid/adrenal issues. I want my life back!

    • From what you are writing on here, I see we all are so different, and whatever works for one person, it might hurt another one. I personally never liked Naturethroid and had many issues with changing Thyroid preparations over the last 8 years.
      I realize one thing – we are at God’s Mercy and our own devices when it comes to getting our Thyroid Medications RIGHT, and a lot of times, I personally feel like I am a subject of experiments. I am saying this is based on my personal experience, and hopefully, nobody else was in my shoes. What I mean is that in September, I was taking 15 mg NP Thyroid, which turned out to have moisture inside of the bottle somehow because it was a mail-in order from CVS and it sure did turned MOLDY inside of the bottle. As soon as I realized that the pills are sticking together inside of the bottle, I called the online pharmacy to let them know that something is not RIGHT… and the very next day, they announced the ” Acella Pharmaceuticals’ ” Recall on All lots of NP Thyroid and all strengths.
      What I am trying to say is: ” I FEEL YOUR pain sister, I have been there way too DAMN long as well! So what do we do when life is giving us lemons all the time, over and over again? Is there any organization in The US or WorldWide that would protect our rights as Patients because it seems like we can not do anything with the Doctors that don’t serve in our best interests…? We can not take them to a court or anything… And we all want the same thing. We want to have a normal life when things are easy and not to have to grind our teeth all the time and burn our adrenals out…!!! Who can be our ADVOCATE? Dr Childs, please, what are your thoughts on this?

      • Hi Marieta,

        It’s a very unfortunate situation but something that I know can change in the coming years. This website exists to provide information to thyroid patients so they can be advocates for themselves until the evidence and pressure become so strong that doctors are forced to pay attention.

  9. Hello,

    I’m fairly new to Thyroid medicine. I took Armour (started at 60mg) back in April. In May went up to 90. My hair began falling out. I tried to tough it out but it continued to fall out. Eventually my doctor put me back on the 60 but it still continued to fall. Finally at the beginning of August after loosing almost all of my hair we stopped and she put me on iodine. I just had new labs done and my TSH has gone from .0539 (done Aug 19th) to 2.0 and my Reverse from 17.3 to 19.3. My T4 is 1.2 and T3 is 2.7. These are labcorp. I know I need to go back on something but I’m TERRIFIED of trying another medication. I suffer from Telogen Effluvium (always triggered by medication) so I’m prone to hair loss if that is a side effect. Which medication causes the LEAST amount of hair loss or hair no hair loss as side effect? I’m desperate for help! I can’t go through another hair loss phase.

  10. I am currently on 120 mg of Armour. I cant take the level or synthroid. I have also been on Naturethyroid. I have experienced thyroid med issues my entire time! So far Armour is agreeing with me. However I am very interested in your advise

  11. Hi Dr.Westin
    I am new to thyroid meds, not new to issues by the Thyroid. I was diagnosed with Hashimoto late 2018, after rough years and weight gain I was able to treat my Leaky Gut, Adrenal and Cortisol issues, still nothing on weight and little on Energy…..
    I started Armour Thyroid 30 mg 3 months ago and I experience headaches, joint pain, my temp is still in the 96’ and sweating.
    I made myself “ smart” about Thyroid and find that I should be taking Tyrosent & Cytomel, because my RT3 is >18.
    What is your thought about T3 only? I am GF, DF, Soy and Nightshade free. Any input is greatly appreciated
    Sabine 56, GA

    • Hi Sabine,

      T3 only can certainly be helpful in some situations! I have my wife on T3 only, as an example, due to metabolic issues and treatment-resistant depression.

  12. Hello Doctor!
    Do you have any information about thai NDT Thyroid-s? I have been taking TS for several years, but for over a year now, tablets from 2018 seem to work worse on me – worse mood, leś energy, water retention. I am frustrated because I react very badly to synthetic t4 and t3.
    Thank you in advance for your answer!

  13. I’m currently on 60mg Armour Thyroid. I was diagnosed August 2020 with my TSH at a 34! My last lab in Jan 2021 was TSH: 7. Does it usually take this long to start seeing results or should I try something new? I did experience a lot of hair loss but supplements like selenium and diet change seem to have helped. I don’t notice as much fall out and I see a lot of new growth. I still think I could be more energetic, but I do feel much better than I did in August of last year. Should I continue to monitor results on Armour or ask my doctor to try Tirosint and cytomel?

    • Hi Ruby,

      No, it sounds like your dose is off. If you are on the right dose you should see improvement in both your labs and symptoms within a few weeks.

  14. I am one of those who was on an NTH, generally NP thyroid, for the last 11/12 years. 20+ yrs since RAI for Graves. First 8/9 yrs was miserable on Synth/ Levo. Educated myself and finally had found a dr who’d prescribe an NTH.
    I noticed some great changes on the NTH. Although, recently my doc & I are believing that it has been the cause of my awful panic attack symptoms which often landed me in the ER a couple times per year- throughout these last 11 yrs or so. Never experienced panic attacks prior to NTH. And, fortunately have never battled with any form of mental illness.
    Have had a consistent battle w palpatations as well through the yrs.
    I was one of those who landed in the ER last fall due to the recall of NP thyroid being 10x more potent then normal.
    Having said all that- 2 weeks ago I left the NTH behind and began 114 tirosint, (with dr approval, my ins covers it w a $25 copay for 3 month supply) along w a tiny dose of t3.
    Too soon to tell if the change is effective for me but I can say the physiological symptoms of those panic attacks have decreased greatly. For some reason, the battle with those and palps had amped up a ton beginning mid December. That is what led me and my dr to take a look at a med switch.
    Is it possible for some that the body simply rejects an NTH??
    Is it possible that since gallbladder removal last August after a long 2 1/2 yr struggle, that thyroid issues can become worse?
    Thank you for your articles- love the simplicity and clarity & have learned a bunch!!

  15. I was prescribed Tirosint in April 2019 by an endo physician and ended up in the ER twice for heart issues that mimicked cardiac arrest. The first time in the ER, the PA found my TSH was dangerously low. When I phone the edno doc after being released from the ER, he told me there was no way that Tirosint could be causing the problem. The second second time in the ER, the attending physician admitted me overnight for observation and an entire cardiac work-up, including nuclear stress test. The team of cardiologists found nothing wrong with my heart. The edno doc still did not believe Tirosint to be the cause. However, my husband read the potential side effects and found all my cardiac symptoms were those listed on the Tirosint leaflet. I fired the endo doc and went back to my holistic doctor who helped me as I went through the process of getting the Tirosint out of my system, where upon I switched back to my NDT and no issues since. The endo doc had not liked NDT and would not prescribe it, saying “we are not pigs and do not take pig thyroid.” Well, oink, oink, I will be a pig if that’s what it takes to feel better. Tirosint may work for some, but rest assured, it is not for everyone.

    • Hi Laura,

      Unfortunately, it just sounds like you were taking too much of the Tirosint and most likely not being monitored correctly. You would have experienced the same issue on any thyroid medication if your dose was too high as well.

      • I am on Tirosint and yes, I too went to a Heart Dr and wore a heart monitor. All is fine with my heart. My endo Dr. told me its not my heart why did I not let him know so he could adjust my Tirosint. So he did and my racy heart went away. He is still trying to find the balance. Its just hard. And yes I also had that problem when I was on Armor Thyroid. I did not know it can be a reaction to the Thyroid Meds. Besides the price I think Tirosint is the best for me. Note: You can get this through Mail Order I get 3 months worth at a time which is 1 month at my local pharmacy because my Insurance does not cover. Hope this helps someone.

  16. I did great on Armour (lost weight) until my weight blew up 20lbs due to a highly suppressed TSH. Now, 3 years later on Tirosint and Cytomel, labs are better but the weight won’t come off and I’m still tired. Diet is dairy and grain free. I feel like I’m on a hamster wheel.

  17. Hello could you please tell me what are some of the problems with Armour Thyroid…I know that they are manufactured in Ireland (according to my pharmacy) and do not have gluten added Thanking you in advance

  18. Thank you for keeping us informed! My endocrinologist put me on 30 mg of NP Thyroid and 1/2 of a 112 mcg tab (56mcg) of Synthroid taken together daily three months ago. Have you ever heard of this and if so, is it a good idea? I go for labs next week? Thank you

  19. I have been taking Armour for about 12 years, I’m on 90mg for about 11 of them. My latest blood work was a little off, my TSH was low, but my T4 and T3 were normal. My endo wants to lower my dosage, but I have no symptoms of hyperthyroidism, if anything my symptoms are still of hypothyroidism. What would you suggest. Thank you in advance.

  20. I switched to Armour after the NP change. I also take 10mcg of generic cyomel was doing fine bit over last couple weeks have not felt good a lot less energy

  21. I was tried synthroid, tirosint and tirosint sol and over 3-4 months I gained 40 lbs and swelled. Felt horrible and couldn’t get off of couch. Went back to NDT. Is there something in the synthetics that can cause swelling like this?

  22. After staying so sick on Synthroid for 4 years I was finally able to find a doctor who prescribed NDT. I started on Nature Throid & my health quickly improved. Now I’m using NP thyroid due to Nature Throid not being available. I’m doing well on that but honestly felt better on Nature Throid (used for 4 years). I’m finally going to an integrative functional medicine doctor & am looking forward to more in depth treatment my primary care cannot & will not do.

  23. I was on Tyrosent for a few months and gained 15lbs, I felt like I had something in my throat when I swallowed and swollen lymphs in my neck. I’m so sad because I really wanted it to work. I went back to Armour and then switched to NP. I wonder if I should take the Tyrosent plus some…?

  24. Hello!
    I have been diagnosed with hashimotos 2 years ago. Since then I have been on armour..not bad pain bit extremely tired. NP thyroid..makes me feel very achy and agitated. Synthroid..sent shooting pains down my arms. And finally Tirosint. She had me on too high of a dose and sent me into hyper thyroid. We have decreased the dose bit continue with muscle pain in my legs and swollen lyph nodes that come and go. But will try lowering it and adding T3. Has anyone else also experienced lypg node swelling with hashimotos?? I have no weight gain or hair falling out.

  25. I am currently on Armour 30 mg but still losing hair and have joint pain, constipation, etc. I was on Naturethroid for years without an issue. I’ve tried all the synthetic t4 including Tirosint and I would get weird cramping in my lower legs at night that affected sleep. I seem to be getting that now again with armour. Could that be a result of too much medication or not enough medication (and if I wait it out it will be better?) or another issue? Is that metabolic? My doctors are stumped so I am on my own to figure it out and they are willing to prescribe.

  26. My doctor switched me from levothroxine to levoxyl 100MCG and I feel better less stomach issues since its lactose free. Less constipation more regular. Not so bloated or as I call pregnant belly. Im lactose free and I’ve gone to a sum what gluten diet like pasta bread cereal, waffles, butter and I do coconut yogurt wish is dairy free as well as the butter and gluten free protein bars.
    I still feel tired have joint pain, shed like crazy, and my eye site as far as reading seems to have gotten worse but that may not be related could just be age etc. I have pain in my ears that feel like a dull earache. I get a twinge from time to time in my neck were the thyroid is on my left side since there isn’t much of one on the right after surgery to remove a nodule. Any suggestions. I have your supplements for hyperthyroidism wish I plan to start in March for 30 days to see if it helps along with the Medication

  27. Are you familiar with Euthyrox (levothyroxine)? Walmart pharmacy discontinued generic levothyroxine – now dispensing Euthyrox (T4)

  28. Dr. Childs –
    What do you think of porcine thyroid from a compounding pharmacy?
    Some of my patients don’t want to take Tirosint because it is synthetic.

    • Hi Helen,

      If patients don’t take Tirosint because it is synthetic then they wouldn’t want to take compounded T4 or T3 thyroid medication either 🙂 Right now you can either get your thyroid medication from an animal (sometimes referred to as natural) or from a lab (sometimes referred to as synthetic). In both cases, they are bio-identical and look exactly alike to the body. The main difference is in the active thyroid hormones and the inactive ingredients but not the actual hormone compound.

  29. I was taking Nature-Throid for years until it was recalled. I did well on it. I am now taking NP Thyroid. I honestly do not see any difference in how I feel. I know I don’t do well on Synthroid because that is what I was first prescribed.

  30. This is so scary to me. I’ve been told I’m subclinical hypo for years but never given medication. My tsh is at 4.5 and my t3 and t4 and reverse t3 are a tad low. No antibodies. My doctor wants to put me on lowest dose of WP or NP thyroid medication. I don’t feel I have horrible symptoms now, but I don’t feel optimal or great. However, all these comments of people getting worse or feeling worse and losing hair is freaking me out. I’ve been without medication for years and years. I almost don’t want to start any now.

    • Hi Diana,

      Thyroid medication can be great provided it’s used correctly. The problem is not the medication but the doctors who don’t use it/dose it correctly.

  31. I have Hashi’s and Adrenal Insufficiency. I have always had issues with converting T4 to T3. My doctor sent me to an Endo who put me on Synthroid and although my TSH, T3 and T4 were “in range” on tests, the T4 only mad me sicker. I was told I’d go hyper if we raised the dose and it was was possible I was depressed. He offered antidepressants and I refused, what was that going to do for my thyroid? I went back to my PCP in tears. I asked him if I seemed depressed, he said no, I was hypothyroid and exhausted. He asked if I wanted to talk to another Endo, NO WAY! After a lot of discussion we decided to do a trial run of Armour. I felt better almost instantly at 1 grain but that quickly went away within a few weeks. I updosed myself to 2 grains and felt better. I went back to see the doc and he told me not to go any higher than 2 grains, my blood test showed my TSH was almost 0 and clinically I was now considered hyperthyroid. I couldn’t understand how me having enough energy to get out of bed and take care of 3 kids was a bad thing. My BP and heart was normal. It didn’t take long for the 2 grains to stop helping as much and I wondered if it was all in my head. I saw my holistic gyn for my annual and he could tell I was off. I told him about my thyroid issue, I had recently developed a itchy rash and he knew immediately I was allergic to the fillers. He switched me to 2 1/2 grains of Naturethroid, the rash went away and I felt better for a while but then started lagging in energy again. He took a TSH, RT3 test along with Free T3, Free T4 and 2 antibody tests and diagnosed me with Hashimotos and high RT3. He said he wasn’t concerned about 0 TSH given I had Hashimotos and said I didn’t need my thyroid making the hormone as it was causing my antibodies to attack my thyroid and would eventually destroy it. The RT3 & T3 tests also showed why I wasn’t feeling good, I wasn’t converting the T4 to T3 and was very hypothyroid. We began a journey of slowly lowering the NDT and introduced 5 mcg of Cytomel T3. We found that at 2 grains of NDT I was having RT3 issues so he lowered me to 1 grain and upped T3 to 25 mcg. Through the years I’ve needed adjustments on T3 but my recovery has been very steady. Occasionally I’d need to add an extra 12.5 mcg of T3 at a time. My Free T3 stays about 1/2 to 3/4 in range. Long story short, my optimal dose was 1 grain of Naturethroid with 75 mcg. of T3. Then all hell broke loose when Naturethroid was recalled. I briefly tried NP Thyroid and it worked fine but it was recalled about the same time. By then I had a WHNP who was my Primary Care and against my better judgement we decided to try Armour again. Immediate problem with a rash, I know they redid their formula but whatever caused it with the old formula is still in the new one. We put our heads together and decided to try Tirosint. My insurance refused to pay for it even though it was medically necessary so I decided against it. With the little bit of T3 and T4 I had from NDT fading away by the day, I was starting to get cold, fatigued, hypo again. We decided to do a trial run with straight T3. I’m now taking 100 mcg. of T3 daily and feel great. I’ve heard some doctors say 75 mcg. is the max but I was fading on the vine without the 1 gr. of NDT. I’ve been taking straight T3 spread out 4 hours, 4 times a day with my Hydrocortisone doses since September 2020 and have never felt better. No dips in energy, I sleep a good 8 hours at night and wake up feeling refreshed. I was sick for so many years trying to find what my body needed to function, at 65 years old I finally feel normal. I was told the medical board frowns on that much T3 at my age but they can frown all they want. I spent years being sick with their gold standard of care and have gone through so much trial and error trying to stay well, I’m not willing to allow anyone to make me feel ill again over test ranges or age. My Cardiologist did a thourough check up and the ticker is fine, he almost lost it when I told him how much Cytomel I was taking but did admit we’re all different and what works for one person doesn’t always work for someone else. He insisted I take my BP daily and I do. I average 125/75 and not bad even if I am overweight. If that changes then I’ll go back to the drawing board, until then I’m going to enjoy my family, grandson and life.

    • Thank you so much Kem, for leaving your response!! I am on 200mcg of T4 Levothyroxine and 20mcg of T3 Liothyronine and I don’t feel well. I was hospitalised for a month late last year with myxedema and a TSH over 300 (not a typo), and no detectable T4 or T3. My TSH is currently 0.002, my T4 and T3 are ‘normal’ and my endo wants me to stop taking T3 despite me repeatedly telling him I feel awful without it and I don’t feel the T4 does anything. He says I need my TSH to be at least 3. I’m looking for a new doctor! I asked two GPs if it was possible that I wasn’t converting T4 into T3 and both of them said that wasn’t possible! My reverse T3 has never been tested and I am sure that I am having the same problem you did, that my body is converting too much T4 into rT3!! I hadn’t understood what a big deal this was until I read your comment! It fits because I trialled not taking the T4 just out of curiosity and I felt better! The last few days I’ve been self-dosing by taking extra T3, 40mcg is what I needed to even feel not-bad, still don’t feel good though. I’m going to reduce my T4 dose and see how I feel whilst I hunt for a better doctor.

  32. Dr.
    I am taking 150 mcg of Tirosint and 5mcg of Cytomel since 5 months ago.
    When will be a good time to adjust a dose?
    It seems to me that 150 mcg is too much?
    I usually see my doctor twice a year.
    Please advise me when will be a good time to adjust a dose?

    My labs are fine base in the lab range.
    I feel muscle weakness and I am not able to lose weight, I am doing intermittent fasting and low carb style of eating, 5 days of intensive work out trainings.
    Thank you in advance.

  33. Hello, I am an American woman who has moved to France. I was taking NP Thyroid when we came to France, and I was suffering from severe heart arrhythmia from the medication. A doctor in Paris took me off the desiccated thyroid and put me on Euthyral, which is a combination of T4 and T3. It is only available in France. This doctor told me that most doctors would have me take only T4; he said to avoid that. My heart is now perfect. I no longer have any heart problems at all. I am so grateful to have my life back.

  34. I am new to the thyroid game. My tsh a few months ago was 6.5 and t3 was 2.9. Retested after starting supplements and tsh was 4 and t3 dropped to 2.3. Just had labs repeated again but haven’t gotten results. This time I had full panel with reverse t3, t4 and antibodies. I tried t3 alone but couldn’t sleep. My leptin was 31, fasting glucose 109 and triglycerides 114. I’ve been very low carb for almost a year but eating too much protein. I’ve switched but I cannot get any weight to budge. I do t know what to do at this point.

  35. Hi.
    I was on synthroid for many years and felt like it was an irritant in my body. An integrated physician prescribed NT and I was on it until recently until they no longer are in business it seems. I am on NP generic even though I pay out of pocket they can’t seem to get the authentic brand. About five weeks ago I decided I wanted to get off my bio identical hormones which I believed where causing me to create more squamous cell skin cancer lesions which then had to be shot with 5FU to kill. Didn’t have any problems but when I also went off my thyroid, my back and stomach/intestinal area (back especially) is so painful I can hardly move. I found you by researching the effects of going off thyroid. Should I go back on for a time and wean myself off rather than trying to white knuckle through this?

  36. I live in the UK you cannot get NDT or T3 unless you go private. The combined cost of private doctor + prescription is ridiculous.
    I was diagnosed with hashimoto ~2years ago. It’s been though going ever since. I was able to get Tiche which is gel cap with the purest type of T4 (it seems the same as tirosint from what I can tell). I didn’t do well at all on it. My issue since I was put on levothyroxine had been the swallen legs, burning feet sensation at night that keeps me awake, restless mind. I have put on so much weight that it’s ridiculous even watching very carefully what I eat and walking 6miles daily. I used to run but can’t with the extra weight & low energy.
    Out of desperation I ordered from the US T3 & NP-thyroid to see if this would improve my symptoms. I tried NP first 90mcg. Felt better than with T4 only, at least restless mind and burning feet has gone. I tried to add T3 25mcg but maybe it was too much my TSH fell to 0.4.
    I am now only taking T3 and I feel much better. My weight is not increasing but not falling either. I soldier on, still hoping to find the right combination.
    I am lactose intollerante but my GP is not listening to me. Covid-19 is taking up all their time and they don’t really care about a patient who complains about weigh gain, hair loss, foggy brain. Duty of care is to provide the NHS recommended meds. So as fare as my GP is concerned she is in the clear.

  37. Hi Dr. Child’s,
    I am 43 and was dx with a multi modular goiter at age 18 and started taking levo. I had to have a thyroidectomy 10 years later and ever since have felt extremely fatigued, depressed, brain fog, and have weight gain. Have been to multiple doctors who just try to increase my antidepressants and say it’s all in my head because my numbers are all in range. I am currently taking syntroid and cytomel. I have tried to switch to Armour twice but each time and start crying uncontrollably and can’t handle the symptoms. Any advice?

    Thank you!!!

  38. I had a thyroidectomy 6 yrs ago started out on levothyroine 150 mg and then to 175 levothyroine and 25 cytomel The weight just kept piling every year 20 lbs so finally I enough and tried a endocrinologist who prescribed tirosint that was the worst experience of my life I thought I was dieing I went from 150 tirosint all the way down to 88 and I just felt death knocking on my door and he said it was all in my head and tried to prescribe me antidepressants so I immediately went back to my primary care physicians and went back on levothyroine and the death feeling left but weight gain and acne is depressing Is their another medicine that might work for me please help I tried armour with no luck I’m afraid to try other medicine because of the way tirosint did me I had to choose between weight gain or feeling like death I lost a quality of life on tirosint and levothyroine I can function but weight gain help

  39. Hello, I’ve been following you and wondering what you think about BioThyro by Nutra-biogenesis? I was on Levythyroxine and my new doctor weened me off and put me on this. Seems good. I was on 2 per day, thyroid tests were good so now trying 1.

  40. My doctor put me on 56 mcg of Synthroid and 30 mg of NP Thyroid taken together daily. Have you heard of this, and if so, do you think it’s a good idea?
    Thanks so much!

  41. I am taking only T3, 100mg Liothyronine (Cytomel). Feel great. Not taking any T4 med. My TSH is slowly inching up as a result. It was barely negligible. I used to take Armour Thyroid which stopped working for me.

  42. In the UK we have no access to any form of T3. (Too Expensive apparently)
    If I was to go privately I was quoted £200 a month which I can’t afford.
    What would you recommend I trialled as a form of T3 to see if it would help me?
    I am told that I am within range and therefore I should feel fine!
    I stopped work because of my lack of energy and clearness of thought. Grain free and dairy free has not improve any of my symptoms apart of at last losing weight which is great.

    • Hi Claudine,

      I know it’s possible to get T3 in the UK, I’m just not sure how exactly. Someone may chime in here and tell you, though.

  43. I started out on Armour thyroid about 25 years ago and was doing well. My GP decided to switch me to lexvoxtherone for a year I was lethargic and gained 16 pounds and was tired all the time. When she saw me and ran tests a year later she apologized and put in my notes that I needed to be on Armour again because my levels were horrible. Fast forward 2 years ago the price of Armour skyrocketed to $90.00 every three months. I switched to Nature thyroid about 3 months ago I could not understand why I felt so tired all the time so did my own research and found out it had been recalled. My doc nor my pharmacy called me to let me know. I switched clinics and my new GP said she would put me back on Levoxtherone only. I told her it does not work for me and after quickly gaining 21 pounds I just did not want to try her plan.
    I went to see an endocrinologist whom said Armour worked for you before so I will just put you back on it again.
    Well it is not working. I have a full headache, the pregnancy belly which I have never had before, could sleep my life away no energy. I am also achy. I use to teach exercise and even did a stint on my own local show for a year. I also hardly ever touch breads and eat clean. I also have sensitivity to gluten and lactose. Any ideas
    On 60 mg of Armour.

  44. Hi All:

    I had my thyroid removed in 2005 and I’m currently 57. I have struggled just like the rest of you with weight gain, hair loss, muscle loss, Joint soreness, inflammation, brain fog and more.

    I was orignally on Synthyroid and begged my Doctor to put me on Armour Thyroid ( I currently take 60mg for 6 days and 90mg for one day) an increased amount because my labs were different from last Dr.’s visit. The 60mg was okay and much, much better than the Synthyroid. But, In the past two years I have felt a change and I had no idea that they were changing the formula. I have gained weight with no change in my diet and am experiencing increased hair loss again. I really am skeptical about changing back to T4 and T3 again.

    I read most of your comments and I realize that I am not alone and that this is a real injustice. I really want to know why we can’t manufacture a great Thryroid medication? This doesn’t seem like rocket science, but, rather greed. My family owned a manufacturing company and we created formulas and batches so I understand that it is always a moving target but, honestly if the company has intregrity and knowledge then it should not be an insurmountable task.

    I’m also, so disappointed in the Doctor’s too. This is not impossible for them either. Yes, they have to take each case individually, so aren’t they suppose to give individualized care? It seems to me that we need to create a group that will lobby effectively to change the current Thyroid climate. This really is crippling many people and I feel like the Doctor’s just bundle us in with mental health and write us off entirely. I’m also, sure that the fact that women suffer more symptoms and are more susceptible to Thyroid diease than men isn’t helping our cause.
    I so appreciate that Dr. Childs is attempting to change the climate and thus the care that we as Thyroid patients deserve.
    Thank you, Dr. Childs

  45. Doctor switched me from Nature thyroid to Armour Thyroid several months ago. Now I am experiencing very low energy and rash-like itchy sores on my legs and several on my forehead. Could this be a reaction to the Armour Thyroid med?? I never had any symptoms like this with Nature thyroid.

    • Hi Pat,

      It’s unlikely to be related to the medication unless it happened right when you started taking it.

  46. Hi Dr. Childs and everyone,

    There is a new generic out for Tirosint. The ingredients appear to be the same. Wondering if anyone has tried it & had good results compared to the original.


    • Hi Sarah,

      Thanks for sharing! There is a generic version available through Teva Pharmaceuticals which was approved recently, within the last few months or so.

  47. I am on T3 only based on your earlier writing. My energy and moods are good, and my TSH is around a .5/1 but I still sometimes have hair issues and I can’t shed the pounds (though at least I am not gaining).

    I’ve had issues with T4 meds causing mood swings and anxiety, so I am very skeptical of them, but I would REALLY like to be able to lose weight. Do you think it’s worth it to try one of these combos? Or keep doing what I am doing if my TSH is ok? Thank you!

  48. I’m
    On 90 mg of Armour & 25 mg of cytomel. I guess I need to stop taking Armour since it’s not working and maybe try Tirosint, correct?

    • Hi Susana,

      Not necessarily! It depends on whether or not you’ve made adjustments to your dose and what your labs look like.


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