Great Smokies Medical Center of Asheville

The Medical Treatment of Hypothyroidism by Dr. Wright

Hypothyroidism is treated by replacing thyroid hormone in pill form. Most physicians use synthetic, bio-identical T4 (Synthroid, Levoxyl, or Unithroid). T4, so named because each molecule contains four molecules of iodine, is a mostly inactive precursor hormone that is made in the thyroid gland. Before it can be useful in the body, T4 has to be converted into triiodothyronine (T3), the biologically active form of the hormone that contains three iodine molecules. The conversion of T4 to T3 occurs outside of the thyroid gland in the body’s cells. For several reasons, including deficiency of zinc, copper, selenium, or iron, and excess cortisol (the adrenal stress hormone), many people can’t efficiently convert T4 to T3. For such a person, taking Synthroid, Levoxyl, or Unithroid will not likely result in improvement, as the body cannot convert synthetic T4 to T3 any better than it can convert its own natural T4 to T3. Unfortunately, in this situation, the blood tests that doctors routinely use to check thyroid status may be normal, which could cause a physician to miss the diagnosis. The patient all too often ends up with the symptoms of hypothyroidism and the doctor’s bill.
Cytomel is a synthetic prescription form of T3, while Thyrolar contains both synthetic T4 and T3.
Because deficient cortisol results in a speeding up of the conversion of the inactive T4 thyroid hormone to the active T3 form, failing to treat adrenal fatigue either before or at the same time hypothyroidism is being treated can result in the patient feeling jittery or anxious, and then wrongly thinking thyroid is bad for them. What may really need addressing is the cortisol deficiency.
Because symptoms of hypothyroidism are also symptoms of other general syndromes and specific diseases and doses required to treat an individual can change from time to time, I recommend regular ongoing monitoring of thyroid blood levels.

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