pillsWhy does this page state that for too many thyroid patients, T4-only medications didn’t work well enough?

First know that it’s not based on strong opinion. Instead, the information is based on the reported experiences of a large body of patients worldwide over the years while on their T4-only meds (Synthroid, Levoxyl, Levothyroxine, Unithroid, Eltroxin, Levaxin, Norton, Eutrosig, Oroxine, Tirosint, for example).

i.e. T4-only was NOT doing the job as a sole treatment for all too many…unless you think that an elevator that goes up to the 5th-floor-only on a 50-story building is “doing the job”.

Granted, we do occasionally hear from someone who feels they are doing great on T4-only. And we applaud that! But on the other side of the coin, there simply seem to be far too many who report they aren’t doing great, sooner or later…or who don’t recognize that certain problems they have are in fact due to being on only one of five thyroid hormones, or who see symptoms creep up the longer they stay on.

You can read a lot more interesting information about T4-only in Chapter 1 of the revised STTM book.

But “we’re all different” right?? What doesn’t work for one may work for another, right?

If ten people were playing in a street, and seven were run over, would you still approve of playing in the street because three didn’t get run over at that moment in time…in the name of “We’re all different” and “Whatever works”?

The following represent reported experiences of what seems to be too many T4-only treated patients. Are you below? Please decide because we want this to be totally up to you in working with your doctor.

  • Some never feel totally well on T4-only. i.e. though starting on T4 and raising it, many report seeing either only partial relief of symptoms, or no relief. And it all gets worse the longer they stay on the unnatural treatment of T4-only. The body is not meant to live for one of five thyroid hormones alone!!
  • Some state they are doing well on T4 and saw improvement, but have problems related to a poor treatment. This is very common and those problems can include depression, anxiety, sleep issues, hair loss, low iron, low B12, the need to nap, rising cholesterol or blood pressure…to name a few. It’s individual.
  • Some state they are doing very well, and have for “x-number years”. But over those years, they report suddenly finding themselves with one or more problems (and some serious!), such as what is listed right above…all due to being forced to unnaturally live for conversion alone for years. Additionally, a large body of T4-treated patients start having adrenal problems, first seeing their cortisol going too high, then falling into the problem of low cortisol. 
  • Some never needed treatment in the first place. i.e. the doctor just once caught a higher TSH due to stress or anything else, and onto T4 they went. We discovered this scenario when these folks simply stopped taking their T4-only and have been fine since!!  i.e. what caused the high TSH at one time has gone away.

Tell me more about T4 and the thyroid

Did you know that a healthy thyroid makes five hormones?? They are T4, T3, T2, T1 and calcitonin.

T4, also called thyroxine, is simply a storage hormone meant to convert to T3, the active hormone. But a healthy thyroid doesn’t make you totally dependent on conversion alone, and also gives you a certain amount of direct T3 plus the other hormones above. So in other words, being on a T4-only med means you are missing out on direct T3 as well as the compliment of all five hormones.  Also, calcitonin is a hormone that helps keep calcium from leeching out of your blood. That’s important!

And what do too many uninformed doctors do for the symptoms you might continue to have, or seem to acquire the longer you stay on T4-only meds?

These certain body of medical practitioners put you on anti-depressants, anti-anxiety meds, statins, pain meds, blood pressure meds, and all sorts of bandaid medications to cover the effects of a poor thyroid treatment. Or they conclude that you have “Chronic Fatigue Syndrome”, “Fibromyalgia”, or bi-polar…any which can actually be the result of remaining hypothyroid, not separate conditions.

When you mention your poor energy levels, they tell you to “exercise more”. When you mention your weight problems, they tell you to “eat less”. When you mention depression, they tell you to be on an anti-depressant.

And the worst thing they’ll say when you continue to have, or suddenly find yourself with, symptoms of a thyroid disorder? “It’s not your thyroid. Your TSH is normal, and you’re optimally treated.” :(

But there’s even more to the problem: it’s called the TSH lab.

Around 1973, the TSH lab test was developed. Based on a sampling of several volunteers, a so-called “normal” range was established—.5 to 5.0 (recently lowered to 3.0) is an example. But we wonder if volunteers with a history of family hypothyroid were NOT been excluded, leaving us with a range that leans towards being hypothyroid! In fact, the TSH RARELY corresponds to how a patient feels. There is a large majority of patients who have a “normal” TSH, even in the “one” area of the range, and have a myriad of hypo symptoms. ***There is a complete chapter on the TSH with more information in the revised STTM book.

But what about Tirosint, a newer version of T4-only?

Tirosint is a liquid version of T4 which patients have reported doing better on than Synthroid or Levo. But the clear answer is: T4-only is T4-only is T4-only. We again saw that even on Tirosent, some patients have reported problems by forcing your body to live for conversion to T3 alone. And there are simply enough reported experiences with Tirosint which continue to underscore the latter, even if one feels better on it than the pills. Feeling better doesn’t equal getting rid of all symptoms of hypo, or avoiding the problems that too many encounter down the line from forcing their bodies to get T3 from conversion only.

So what’s a better alternative to being on T4-only if a patient has problems due to it?

Patients are returning to a medication that was successful from the late 1800’s onward: natural desiccated thyroid hormones (NDT). Most are made from pig glands, meet the stringent guidelines of the US Pharmacopoeia, and give patients exactly what their own thyroids give them—T4, T3, T2, T1 and calcitonin. It’s powerful and it works.

Additionally, patients who are working with certain wise doctors are not dosing by the TSH. Instead, they raise their desiccated thyroid (NDT) according to three criteria (and not in any particular order):

  • the elimination of symptoms
  • achieving a mid-afternoon temp of 98.6F/37C using a mercury thermometer, while maintaining a normal, healthy heartrate and BP, and
  • getting their free T3 towards the top of the range (in the presence of healthy adrenal function and optimal iron).

You can read a LOT more interesting information found nowhere else about natural desiccated thyroid in Chapter 2 of the revised STTM book.

Even adding synthetic T3 to your synthetic T4 is miles better than being on simply T4, report patients.

I once tried NDT and it gave me problems! Why?

There are very good reasons you may not have done well on NDT, either because you didn’t raise it high enough (common scenario if your doctor has little experience with NDT or goes by the TSH), or because you have inadequate levels of iron or problems with your cortisol levels. We have seen in each other that either of the latter can cause you to overreact to NDT or do poorly on it. See http://www.stopthethyroidmadness.com/ndt-doesnt-work-for-me This is why patients have found it to be so important to test their adrenals via saliva before being on, or raising too high. Talk to your doctor.

What’s the BOTTOM LINE?

Years and decades of reported patient experiences and wisdom tell us that the risk for problems is far too high with T4-only…sooner…or later, for too many. It’s not a pretty picture. So patients feel strongly: Why risk it…

Work with your doctor on this!

To read more detail on T4, it’s history, why it’s been such a widespread failure for so many, see Chapter One in the revised STTM book


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