Why Some People Feel Worse on Thyroid Medication & How to Fix it

Why Some People Feel Worse on Thyroid Medication & How to Fix it

Do you Feel Worse on Thyroid Medication? 

The day finally arrives...

Your doctor has finally written you a prescription for thyroid medication

You are so excited to finally have an answer for the weight you've been gaining, the low energy you've been experiencing, your recent hair loss, and more. 

You start taking your thyroid medication each and every day hoping to see a change. 

But what you experience instead is that you actually feel WORSE while taking your medication. 

Instead of having more energy, instead of losing weight, instead of growing your hair back, you experience the exact opposite. 

How can this be? How can you feel worse while taking thyroid medication even though it's supposed to be the answer to your problems?

Well, that's exactly what we are going to talk about today. 

You should be aware that it is absolutely possible for SOME people to feel worse while taking thyroid medication. 

It's not common but it definitely happens. 

Today we are going to talk about...

  • Why some people feel worse while taking thyroid medication
  • How thyroid medication functions in your body
  • The long-term effects of prolonged thyroid medication use
  • And what to do if you are feeling worse on your thyroid medication

Let's jump in... 

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This list includes optimal ranges, normal ranges, and the complete list of tests you need to diagnose thyroid hypothyroidism correctly!

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How thyroid Medication Works in your Body

The first thing you need to understand is how thyroid medication is working in your body. 

Doctors only prescribe thyroid medication to patients who have LOW thyroid function. 

This means that anyone using thyroid medication is doing so because their own body cannot produce enough thyroid hormone on its own. 

The medication that your doctor gives you is supposed to make up for that difference. 

But there's a big problem with that:

Your body was designed to have what are called feedback loops built into it. 

These feedback loops help prevent your body from creating TOO much hormone and from the negative consequences that this could cause. 

So when your doctor gives you thyroid medication (such as levothyroxine) once it enters your body it sends a message to your brain. 

The message it sends is to REDUCE the production of thyroid hormone from your own thyroid gland. 

So the more thyroid medication you take by mouth the more your body will shut down its own production of thyroid hormone. 

This effectively means that you are replacing your body's own thyroid gland for the medication that your doctor is giving you. 

But how can this make you feel worse?

How shutting down your own thyroid can make you feel worse

It's actually quite easy. 

Consider these facts:

This may seem a little bit confusing but consider this example to help set it in stone in your mind. 

Imagine that you are someone who has a thyroid problem such as Hashimoto's thyroiditis which has damaged your thyroid gland. 

A normal healthy thyroid gland may produce something like 100mcg of T4 and 20 mcg of T3 each and every day. 

But because your thyroid gland has been damaged from Hashimoto's, it's only functioning at 70% of normal. 

So instead of producing 100mcg of T4 every day, you are only producing 70mcg and instead of producing 20mcg of T3 every day, you are only producing 14 mcg. 

This is a problem and it makes you feel worse (you experience all of the symptoms of low thyroid as we discussed above). 

You go to your doctor and he/she provides you with a prescription of levothyroxine

As you take levothyroxine you are shutting down the production of thyroid hormone from your thyroid gland even further because it is being replaced by the new medication you are taking. 

Instead of producing the 70 mcg of T4 and the 14 mcg of T3 every day, your doctor gives you a prescription of 100mcg of levothyroxine which contains 100mcg of T4. 

But as you take this 100mcg dose of levothyroxine your own thyroid gland SHUTS OFF. 

And here's where the problem begins...

You are no longer producing ANY T3 thyroid hormone

But if you go up just a few paragraphs you will see why this is such a big problem. 

As I stated, T3 thyroid hormone is roughly 200 to 300x more biologically active than T4 and is the most powerful thyroid hormone!

join 30,000 plus thyroid patients

Your doctor has basically replaced the most powerful thyroid hormone in your body with a much weaker version at a higher dose. 

This is why thyroid patients can feel worse on thyroid medication

It is actually this simple

Now the question becomes:

What can you do to FIX this problem so that you actually feel GOOD on thyroid medication? 

That's exactly what we are doing to discuss now...

Fixing the Brain-Thyroid Connection

In order to feel better on thyroid medication, you must address the brain-thyroid connection. 

This brain thyroid connection is usually referred to as the hypothalamic-pituitary-thyroid axis (3) or the HPT axis for short. 

Here I've just renamed it the brain-thyroid connection to simplify the name and make it easier to understand. 

In order to feel better, you must restore some of your body's ability to regulate thyroid hormone production on its own. 

You can do that by following these 4 steps: 

#1. Your goal should be to use the smallest effective dose of thyroid medication possible. 

Remember:

Thyroid medication will reduce TSH (and the brain-thyroid connection) in a dose dependent manner. 

The more thyroid medication you take by mouth the more suppressed your brain thyroid connection will be. 

What's the solution?

You need to use the SMALLEST effective dose of thyroid medication possible. 

This means you will want to avoid taking any extra thyroid medication if at all possible. 

If you or your doctor slips up and gives you too much thyroid medication then you risk shutting down the brain thyroid connection which may result in a drop in highly effective thyroid hormone production (T3). 

You can keep a close eye on this connection by looking at your TSH levels, your free T3 levels, and your total T3 levels

These blood tests will help you understand how much T3 is floating around in your system and how suppressed the brain thyroid connection is. 

#2. Take steps to naturally improve how well your own thyroid gland functions. 

The reason many thyroid patients end up on a higher than necessary dose is because they have problems directly in their thyroid gland. 

These problems ensure that your own thyroid gland is not functioning as well as it can. 

Even though you may have a condition such as Hashimoto's thyroiditis which is damaging your thyroid gland doesn't mean that you have to just let it continue to damage your thyroid gland

You can take steps to REDUCE that inflammation and autoimmune attack which will naturally improve SOME thyroid function. 

If you can salvage or naturally improve thyroid function in your own thyroid gland then you will need less thyroid medication. 

Look for things like inflammation using inflammatory markers as well as autoimmune attack on your thyroid gland. 

#3. Provide your thyroid with all necessary vitamins and nutrients to function optimally. 

In addition to reducing inflammation and damage to your thyroid gland, you should also ensure that your thyroid gland has all of the necessary nutrients it needs to function. 

Your thyroid gland requires at LEAST 13 different vitamins and nutrients to function optimally. 

And thyroid patients are often low many of these nutrients. 

ALL thyroid patients should ensure that these levels are brought back up to normal healthy levels by taking something like a thyroid specific multivitamin. 

My thyroid specific multivitamin contains all of these nutrients at levels which will replace lost levels of nutrients in your body. 

But you can even take it a step further and take ingredients that can boost other aspects of thyroid function like T4 to T3 conversion

These additional vitamins and minerals will help your thyroid function better on its own and may help you reduce your dose of thyroid medication. 

#4. Ensure that other pituitary hormones are functioning well. 

The last thing you will want to ensure is that the OTHER hormones produced by your brain are functioning optimally. 

Your pituitary gland, the same gland that produces TSH, also regulates several other hormones in your body

Your sex hormones (estrogen, progesterone, testosterone) levels, your adrenal hormones (cortisol), and even growth hormone all stem from pituitary function. 

Cortisol, in particular, plays an important role in regulating thyroid function. 

And if you have problems with the brain thyroid connection then you can bet you probably also have cortisol or adrenal problems. 

If you want to feel better you will need to at least take a look at your adrenal hormones by testing cortisol levels. 

If you find that there is a problem you can take certain steps to fix that problem which should improve your own thyroid gland function in the process. 

How to feel better on thyroid medication

Last but not least, you should also take a hard look at what type of thyroid medication you are using. 

Because let's face it:

Levothyroxine is a commonly prescribed medication but it just doesn't work well for most thyroid patients. 

As I mentioned above, levothyroxine contains only T4 thyroid hormone. 

Other thyroid medications, such as natural desiccated thyroid, contain BOTH T4 thyroid hormone and T3 thyroid hormone and more closely match the ratio that your own thyroid gland produces in the healthy state. 

You should aim to use medications that more closely match this normal function because most people tend to do better on them. 

But don't take my word for it, we have medical research studies which show that thyroid patients prefer these types of medications (4). 

We also know that people taking these medications often have more energy and experience spontaneous weight loss simply when making the switch. 

You can also use other thyroid medications that contain T3 such as Cytomel or liothyronine

Final Thoughts

I want you to know that you don't have to accept feeling WORSE on thyroid medication. 

There are things that you can do as a thyroid patient to make changes which will not only help you feel better but may help you reverse part or all of your thyroid problem. 

Be aware that these things will probably not be mentioned by your doctor, however, so you may need to take things into your own hands. 

Now I want to hear from you:

Are you someone who started thyroid medication but felt worse?

If so, what side effects or problems did you experience when you started your thyroid medication?

Were you able to make any changes to fix the problem or are you continuing to suffer now?

Are you planning on making any of the changes or using any of my recommendations above?

Leave your questions or comments below! 

References (Click to Expand)

feeling worse on thyroid medication? Here's why

Dr. Westin Childs

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 45,000+ people have used them over the last 4.5 years. You can read more about my own personal health journey and why I am so passionate about what I do here.

30 thoughts on “Why Some People Feel Worse on Thyroid Medication & How to Fix it”

  1. I still don’t know what to do about thyroid meds I’ve tried everything. Levothyroxine, euthyrox, compouned t4 and tirosint, they give me really bad migraines, rashes, pain in bones, extreme fatigue, water retention, depression, inability to tolerate heat. T3 only makes me so fatigued I can’t live a normal life and after 3 months the headaches from it got so bad that I had to stop. I’ve tried liothyronine, cytomel and thybon henning which gave me difficulty breathing. Metavive and Nature Throid both gave me extreme migraines and difficulty breathing and difficulty swallowing. Im in Sweden but I have to go to a private endocrinologist(public healthcare here only provides levothyroxine, they think every other medicine is bad). The doctor has no clue about what to do and neither do I, right now my TSH is 10(0,4-4,0), t4 14(10-22) and t3 4.3(3.3-6.0). Im on a lowcarb, gluten and dairy free diet, my vitals are better than before and I supplement with magnesium and multivitamin daily.

    Reply
    • have you ever had your adrenal glands tested, like cortisol? Magnesium can lower cortisol levels, and you need cortisol to handle your medication, cuz the medication also helps clear cortisol faster. I’d stop the magnesium and get tested for cortisol.

      Reply
  2. Three years ago, I had no hypothyroid symptoms. After a blood test, it showed the deficiency. Once put on meds, the symptoms started to appear – weight gain, hair loss and lethargy. Doctor wants to keep raising dosage. I am debating just going off meds completely to see what happens. I am beside myself.

    Reply
  3. I have Hashimitos. My Dr put me on Armour Thyroid and I never really felt better so it was increased and I began feeling a little better. It was increased to 135mg daily and I starting feeling so tired an hour after I took it. I couldn’t even keep my eyes open. I kept being asked if I was depressed or not sleeping good. I turned down any medications for either of the above. I stopped taking Armour and I felt 100 % better. Its been a month and I just starting feeling cold and my hands like ice. I know its not safe not to take medication and am looking for a new Dr. Besides my hands freezing cold I feel better not taking medication.

    Reply
  4. I have no thyroid and have been on Levothyroxine for 9 years. I have not been the same person since and suffer to the extreme with just about every side effect you can mention. You name it I get it.
    It’s that bad. The worst being pain in my bones and joints and severe facial abscesses/boils. All I have done is constantly changed dosages and brands. I am currently on Eltroxin which seems to leave some side effects behind.
    I am following your guidelines and increasing my medication. I was on 100mcg for 6 days and 150mcg for one day. I am now taking 150mcg for 3 days and 100mcg for 4 days. I have more energy and yet to head to my doctor and get some full on bloods like Dr Westin Childs has recommended.

    Reply
  5. I had one of my parathyroids removed and one half of my thyroid in 2019. I was diagnosed with hyperparathyroid. I have continued to gain weight, still losing hair and still feel fatigue. I am taking 75 mcg of Levothyroxine. Would having a complete hysterectomy when I was 28 and now I am 70 years of age also create issues of not enough hormones and add to the issues of hypothyroid which is now what they say I have. I have gone from a size 6 to a 10-12. Thanks

    Reply
  6. Hi Dr. Childs,
    2things I really need advise on:
    had blood and 24 hr urine for iodine and low end blood and proper amount in urine so…. shouldn’t I continue kelp but Dr Christanesen says do not ingest any iodine even if from whole food?? But I am low in blood and ok in urine test?
    My tsh last test was 26, f t3 4.6 high, t3r-11, ft4-1, cortisol am 17, tsh ab-neg, anemic,r and w blood cells low ( kidney congestion?) vit a- below normal, mag-6.5 high,,tpo 74,
    dont want to take more armour at 6 15mg tabs day. natural doc said take 4 and 3 tsps of kelp. can you help sort this out? organic iodine ok to ingest and lower armour even if tsh is 26 and take more kelp? Many many thanks [email protected]

    Reply
  7. I was given the I131 pill in 1997. I was shaking so bad the nurse had to hold the glass of water for me the swallow the pill. I take .88 synthroid . I have hot flashes and get depressed.

    Reply
  8. My wife is having thyroid problems and feels real bad
    Blood work shows the T3 reverse value at 16, Tsh at 1.66, T3 free value 2.6, T4 free value 1.1 . She is taking T3 SR 20 MCG every day for the last 3 months. Feels very bad.

    Reply
  9. I am currently taking 75mg of tirosint and 5mg of cytomel. My tsh levels are normal and although I’ve stopped gaining weight, I haven’t been able to lose the extra 20 I’ve gained since diagnosed.

    Reply
  10. Hi,

    My story is long, (as is this post..sorry) but similar to the ones above. First off, I never had any hypothyroid symptoms way back in 2007. Blood work showed I was hypo though. I can tell you that it was only then, once I actually started thyroid meds, that many “hypothyroid” symptoms suddenly occurred. And I’ve haven’t been the same since.
    After going off of them, I’d feel much better…but then symptoms would come back. It’s been a long, vicious cycle over the years because I’ve tried so many different thyroid meds, synthetic, generic, desiccated, T3 etc….over and over, and just cannot tolerate any of them. So I’m usually not on any. Feeling like crap..again..I recently got labs done. My TSH dropped from 12.9 to 8.3 —which is the highest it’s ever been. It usually hovered around 4.5-5 for many years. My Free T3 and Free T4 are always in normal range. I’m working on upping my Vitamin D even more, as it’s still pretty low, which I know is strongly linked to hypothyroidism. Anyhow, what’s a gal to do?!? What does normal even feel like anymore?
    Thank you, in advance. 🙂

    Reply
  11. I feel that you have not been honest. I was expecting to see the
    foods you said you were going to tell us not to eat ! Then all the other stuff appeared. I am not going to look any further.

    Reply
    • Hi N. Bailey,

      I’m not really sure what you are referring to. This blog post is about why people don’t feel better on thyroid medication.

      Reply
      • I was prescribed Armour thyroid 30 mg to start. Before I had been in levo 75mcg but I had weight gain and I felt bloated 24/7. I began taking cynomel on my own which I bought in Mexico since I didn’t have insurance. I felt somewhat better but no weightloss either. If anything more weight gain. I finally have insurance again so I’m on Armour thyroid and dr decided to have me try bupropion 150mg to help with weightloss. I began having horrible headaches after almost 2 weeks taking it and Armour. I like being able to be up all day and do things that I normally wouldn’t do before but I was getting hungry taking bupropion. I stopped taking Armour and just took bupropion and felt so good and 100% normal. Unbelievable but I have been gaining instead of losing. Now I have no idea what to turn to.

        Reply
  12. But if only it were that simple? TSH is not fully suppressed with a dose of 100mcg T4. Exogenous T4 is, according to prevailing medical wisdom, additive, and only *partly* suppressive, to remaining endogenous production, no? A full replacement – TSH <0 – dose of T4 is somewhere between 200-300mcg daily, as indicated in thyroid cancer.
    I'm sure there is something in what you describe, but highly understudied and likely very idiosyncratic to each patient, i.e simple it is not. Does lowest effective dose work for some and full replacement work for others..?

    Reply
    • Hi Jay,

      You can suppress the TSH with virtually any thyroid medication but that’s not really what matters. What matters is whether or not that thyroid medication, whatever you chose to use, can be used by the body.

      300mcg of levothyroxine is just as useless as 100mcg of levothyroxine if your body can’t convert it.

      Reply
  13. I am in the UK, my gp only prescribes levo and only does tsh from thyroid panel.
    Current bloods: tsh: 2.4mu/L (0.30-4.20), ferritin: 23 ug/L (28-200), Serum inorganic Phosphate: 1.83 mmol/L (0.80-1.50), Plasma parathyroid hormone: 9.1pmol/L (1.6-6.9), Hba1c: 47mmol/L (20-41), Vit d3: 50.6 nmol/L (50 plus).
    Currently take 100mcg Levothyroxine, cholecalciferol 400 unit/calcium carbonate 1.25 – 2 bd and cholecalciferol 1000unit – 1day. Forceval multivit, 12 weekly b12 injections, Ramipril 2.5mg and just started on ferrous sulphate 3per day. Feel really lethargic, weight gain, can’t lose even an pound of weight. Brain tiredness. Any advice gratefully accepted.

    Reply
  14. Wow! Time after time, the stories seem to be the same. I started studying nutrition to try to help myself. I completed my certification and there are still so many missing links in terms of understanding and regulating thyroid function. When I stopped taking Levothyroxine for 10 months in 2020, during lockdown while teaching seven groups of grades 7-12, single parenting (my husband moved before us, now we are back together). Anyway, if I am saying all this is because even though I was facing never seen stress conditions in my life, I was also meditating, doing yoga, eating super clean, 80% vegetarian + good fats & lots of fish, I had enough energy to do all I needed to do, and you bet I was tired, but I was also feeling great!
    By recommendation of my OGB, I resumed taking Levothyroxine before moving to another country, I took enough for 3 months with me. And then, I had to start over: new country, new city, new family doctor… not only did I not find openness to order a complete thyroid panel. It was like hitting a wall. The new doctor prescribed 88mcg of Synthroid and I have never felt worse in my life (at least since I was diagnosed with Hashimoto’s). It as if all the symptoms were showing up in a row to complete the checklist. Symptoms I did not have for almost a year, started to show up. So, what’s going on with medical care these days?
    I decided to do more research and take matters in my hands again. I am taking so many supplements right now because I deserve to feel better. Apparently, my conversion from T4 to T3 is still quite good and I am just waiting for results on my Reverse T3 test.
    This guessing game needs to stop. Too many people, specially women, are suffering from this condition and there are not enough up-to-date doctors to help us all…
    Thanks Dr. Childs for all the valuable information you give! I don’t live in the US and I don’t think I can even get Tirosint to give it a try…

    Reply
  15. I don’t have a thyroid and I been on Tirosint sol for about two years . I have had all kinds of.problems, I have taken synthod.i wanted lev in generic but my doctor will not change. This medication has harm just about every part of my body. I dream a lot and grit my teeth, it like my nervous system. now my testosterone is high. I don’t know what to do. I changed doctor still no help.

    Reply
    • Hi Addie,

      It would be worth considering swapping medications entirely or combining both natural therapies with your thyroid medication.

      Reply
  16. Hello Doctor Childs,
    I have found all of your info. to be invaluable. I have researched over the past month everything I can on thyroid function from your material and other resources. I thank you for your continued talks and articles available. Its helped me become my own doctor. Its helped me take control of my opportunity for health.I have supplemented my diet with supportive foods, and vitamins and mineral supplements to especially support thyroid function. I also took the desiccated thyroid beginning with the lowest dose. After 6 weeks my energy is beginning to climb. Is a slow go but I know patience is a part of this journey. My Doctor is working with me and considering extra test I have requested. I have showed him such charts that you have provided! I did visit an endocrinologist who proved to be arrogant and uncooperative, and refused to prescribe the desiccated thyroid.! She also did NOT approve of vitamin and mineral supplements. She spoke nothing of diet. Many of my decisions to get to the right place for healing is due to the knowledge you share. So thank you so much for your articles, chats, research, charts, diet suggestions…..the list goes on. You have helped me to find answers and take unravel myths about disease.
    L

    Reply
    • Hi Lynda,

      So glad to hear that they are helpful! Thanks for sharing and it sounds like you are definitely heading in the right direction.

      Reply
  17. I feel tired especially right after I eat. I am only on
    .05mg Levothyroxine. Is it true that it may not be my Thyroid, it may be something causing my thyroid to not function properly? Could it be from leaking gut syndrome? Should I take a probiotic?

    Reply
    • Hi Jeris,

      It is true that it could be virtually anything including your gut, liver, or thyroid. It’s best to get a full set of labs to help direct the treatment if you don’t know for sure what the issue is. If you know, for instance, that it is your gut, then you could start with probiotics.

      Reply
  18. Nothing works for me and I dont know what to do since no doctor will look into solutions for me. I was on levothyroxine for a year and a half, side effects got worse and worse. I had hot flashes, pain in my body, rashes, extreme heart palpitations, diarrhea every morning. Doctors wouldnt listen so I tried to reduce my dose but then got severe migraines, so bad nothing helped and I had to be on bedrest for the rest of the day. This was 2019 and I’ve tried several brands of t4, the same thing happens and I get a feeling of being drunk. I’ve tried ndt bovine and porcine with the same reaction and I get difficulties breathing. On t3 only I get so tired, I stuck it out for 3 months but then started getting daily severe migraines. I have hashimotos and live in Sweden and the doctors just say if you get these side effects it is what it is. What am I suppose to do? T3 is low, t4 just above range and tsh is between 10-20. Literally no doctor will investigate why this happens and most of them tell me to take my levothyroxine otherwise they cant help me, but I cannot take it but they wont listen.

    Reply

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