You should wait four to five hours between taking cholestyramine or colestipol and your thyroid hormone medication. Estrogens may increase thyroxine-binding globulin TBg , one of three transport proteins responsible for carrying the thyroid hormones in the bloodstream. Your doctor may need to adjust your thyroid dosage if you also take estrogens or estrogen-containing oral contraceptives. Natural desiccated thyroid has been available for more than a century as a treatment for hypothyroidism. Other natural desiccated thyroid drug brand names include:.
There are also synthetic formulations of each thyroid hormone - known as levothyroxine synthetic T4 and liothyronine synthetic T3. Some brand names of levothyroxine include Levoxyl, Synthroid, Tirosint , and Unithroid. A popular brand name of liothyronine is Cytomel. To legally get a prescription for medication, you first need to consult with a doctor.
Then, your doctor can send the prescription to a pharmacy to fill. Paloma Health offers virtual consultations with thyroid doctors. Free guide Claim your free guide to thyroid meds Check your mailbox for your guide. Medically Reviewed by:. Something went wrong while submitting the form.
Request a phone call. This ratio is roughly about which is somewhat close to the ratio of T4:T3 that your thyroid gland produces naturally.
Some doctors will suggest that Armour thyroid and other NDT formulations should not be used because they contain too much T3 compared to what the body produces naturally. I think the most important reason is that T3 is by far the most biologically active thyroid hormone 6. Pretty much everything you want thyroid hormone to do stems from the direct actions of T3 thyroid hormone. Most doctors are simply not comfortable using it or feel that it is too powerful or too difficult to dose.
They can't, nor should they try, to downplay the effectiveness of T3 in stimulating thyroid receptors. This is probably one of the main reasons that many people do better on Armour thyroid compared to thyroid medications which contain just T4.
I mentioned this previously in another section when I discussed that Armour thyroid contains both T4 and T3. Because Armour is sourced from animal thyroid glands, it also contains additional ingredients which are also found inside of thyroid glands.
This includes hormones, proteins, additional thyroid hormones, and probably other pre-cursors that we aren't aware of. Most important to this conversation is the fact that Armour contains the thyroid hormone T2 and Calcitonin. T2 is a biologically active thyroid hormone which is found in humans and seems to play an important role in regulating fat burn and metabolism 7. As long as you have a functioning thyroid gland your body will produce T2 in addition to T3 and T4. But, if you have had your thyroid gland removed by surgery or destroyed by RAI then your body isn't producing it anymore.
For this reason, it has been suggested that Armour thyroid and other brands of NDT may be preferable to this patient population over T4 only formulations such as Synthroid. Because it can be argued that Armour provides a more complete array of thyroid hormones and other hormones which the body needs. This concept has become more popular recently as studies have shown that people without a thyroid tend to have lower T3 levels than healthy people if they only take T4. I suspect that over the coming years perhaps around 10 years or so it will be much more common for people without a functioning thyroid to be placed on a combination of both T4 and T3.
Surprisingly, this is not only my own personal opinion but also the opinion of certain clinical studies. Researchers have already done some of the heavy lifting for us so let's evaluate one study to get a better idea of how people respond to medications such as Armour thyroid. In this study 8 , researchers placed patients on either levothyroxine or thyroid extract another name for NDT.
They kept these patients on these medications for 16 weeks and then swapped them to another medication. So some patients were placed on levothyroxine first for 16 weeks and then transitioned to thyroid extract for another 16 weeks.
The other group of patients were on thyroid extract first for 16 weeks and then transitioned to levothyroxine for another 16 weeks. At the end of this 32 week period they then simply asked patients how they felt on the different medications.
They found that those people who were on thyroid extract abbreviated DTE which stands for desiccated thyroid extract experienced more weight loss compared to the people who were only levothyroxine alone. The study also concluded that about half of the people or around One important factor that this study revealed was that people who are overweight and those with a higher reverse T3 level tend to prefer NDT over T4.
If, on the other hand, your weight is relatively normal or just slightly higher than you'd like , T4 only medication may be preferable. Lastly, another important point worth mentioning is that people in this study did NOT experience any negative side effects on either therapy which suggest that Armour if dosed correctly is quite safe. This is important to understand because your pharmacy likely considers Armour thyroid to be the name brand for NP thyroid.
Both medications are formulations of Natural Desiccated Thyroid but they are certainly not the same. Both medications have the same amounts of T4 and T3 in them grain for grain but they do differ in their inactive ingredients. Armour thyroid contains the following ingredients 9 :. Because the inactive ingredients found in these medications may have an impact on how well you tolerate it!
Switching from Armour to NP thyroid or from NP thyroid to Armour may actually be enough to trigger the onset of hypothyroid symptoms. You should be aware of the difference between these medications so that you know if your pharmacy tries to swap the medications on you without you knowing it.
And yes, pharmacists can do this because these medications are considered " bioequivalent " 10 from the insurance perspective. So if your insurance wants the cheaper formulation which is NP Thyroid , your pharmacist can make the switch. If you want to ensure that you get Armour thyroid filled you may need to have your doctor write "dispense as written" on your prescription. In addition, you can make a special request for Armour thyroid when you go to pick up your medication and just pay the cash price.
If you are switching from levothyroxine or Synthroid over to Armour thyroid then you must consider how to adjust your dose during the transition. Unfortunately, it's not as easy as just saying "well, I'm taking mcg of levothyroxine so I will need mg of Armour thyroid".
And, because T3 is so much more powerful when compared to T4 it's difficult to pinpoint what an equivalent dose would be. Most people who go by this conversion chart end up with a rising TSH and persistent symptoms of hypothyroidism when they transition. If you fit into any of these categories then it is very unlikely that you will not be able to wean yourself off of your thyroid medication.
But not everyone is in a position where they HAVE to take it, there are still some groups of people who can potentially either get off of their medication or reduce their dose.
Believe it or not, there are some people who have been placed on thyroid medication incorrectly. Most people like to think that they have the best doctor around, but trust me when I say that not everyone can have the best doctor! Doctors tend to make mistakes from time to time, and it's certainly possible that you were incorrectly placed on your thyroid medication at some point in your life. I've personally seen a great many patients who were placed on thyroid medication years ago for one reason or another and they have just stayed on their medication since that time.
And each subsequent doctor that they go to looks at their medication and just assumes that they need to be on it. There is some percentage of thyroid patients who take thyroid medication who fit into this category. There are several known conditions which can cause a temporary increase in the TSH such that it may mimic the lab results seen in hypothyroidism. But just because you have a high TSH on a one-time test doesn't guarantee that you have hypothyroidism.
If you were someone who was placed on thyroid medication because you had one isolated high TSH at some point in your life and you weren't experiencing any of the symptoms of hypothyroidism then you may have been subjected to one of these issues.
If so, there is a decent chance that you probably don't need to be on thyroid medication long-term. People who fit into this category also find that they felt no difference on or off of their thyroid medication.
Several conditions, including thyroiditis, some cases of Hashimoto's, hypothyroidism from obesity, hypothyroidism from iodine deficiency and other nutrient deficiencies , and so on, may be reversible causes of hypothyroidism.
It is true that people with this condition may go on to develop fully fledged hypothyroidism, but a small percentage of patients with this disease experience spontaneous and complete remission 7 even without therapies!
So, it may be that you were placed on thyroid medication because it was necessary at some point, but it doesn't mean that you have to stay on it indefinitely. These are just a few of the causes of temporary hypothyroidism and there are probably many others. If you aren't sure why you were placed on thyroid medication in the first place then you should go to your doctor and try to figure out when and why you were.
From there you can determine if your issues are potentially reversible or require the use of thyroid medication long-term. Even if you don't find yourself in a position where you can get off of your thyroid medication completely, you might find that you can reduce your dose somewhat.
I've seen many patients who require much less thyroid hormone once they start losing weight. And if you are able to lose pounds on your own then there is a very high chance that whatever thyroid medication you required at your heavier weight will not be required in the future.
Believe it or not, it can actually be dangerous to stop taking your thyroid medication abruptly and I've written about why this is the case in previous articles.
I've been accused of being a shill for pharmaceutical companies for this recommendation but I still stand by it. The truth is that it can be dangerous for some individuals to suddenly stop taking their thyroid medication, especially if they just don't understand why they were started on it to begin with.
I've seen some people who don't have a thyroid because it was removed who want to stop taking their medication. Because thyroid hormone is required to sustain life, you MUST take thyroid medication if you don't have a thyroid.
But, what if you are among those people who can potentially stop taking their medication? What do you do? The best thing you can do is go to seek help from your current physician and ask if they are willing to help you get off of your medication.
Make sure that they know that you are aware of the risks read about them here and that you understand you may need to be placed back on it. If they are on board with the idea then you can proceed in a very slow and cautious manner. You should then attempt to slowly decrease your thyroid dose by 25mcg every week if you are using Synthroid or levothyroxine until you are completely off of your medication.
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