"I am regular with my thyroid medication, then why do I still suffer from weight gain?"
"My blood test shows my thyroid stimulating hormone (TSH) levels are normal. Is thyroid hormone replacement still required?"
Many such doubts are common in the minds of those suffering from hypothyroidism or an inactive thyroid. The thought of having to take a synthetic medicine long term only brings to mind anxiety and potential side effects.
This leaves them with only one main question- how to cure thyroid permanently ?
Let us delve deeper and understand why medication is used in the treatment of hypothyroidism.
What is the problem with your thyroid gland?z
Hypothyroidism refers to an underactive thyroid. This means your thyroid gland is not producing hormones in the required levels.
The solution might seem pretty direct. Just stimulate the gland naturally to produce more hormones. However, the reality is not so simple.
What is thyroid medication?
These tablets, prescribed for hypothyroidism, are synthetic forms of the hormone levothyroxine (T4) which is produced by the thyroid gland. This is the inactive form.
This is converted by the body to the active form, which is T3. This process occurs in various organs such as the liver, kidney and gut.
In case the conversion is inadequate, you will continue to experience the symptoms of hypothyroidism. At the same time, the presence of T4 hormones will normalise the TSH levels.
This leads to a common complaint in many patients where despite normal TSH levels, they continue to experience weight gain, tiredness, depression, cold intolerance and lack of concentration.
Hence, ultimate effect of relief of symptoms of hypothyroidism depends on:
- Absorption of drug
- Effective conversion to the active form
- Disease severity
- Other illnesses such as diabetes
- Underlying conditions
So why do we give T4 supplements and not T3 directly which is the active form?
There are many types of thyroid problems. In certain patients, T3 is effective and is added in addition to T4. As suggested by experts, this is useful in patients with defects in the conversion process.
How is the dose of thyroid medication decided?
It is confusing to understand how treatment for the same disease can have such varying doses of medication. Commonly prescribed daily doses range from 25mg to 150mg.
This is because the levels of hormones in your body are not constant. Dose adjustment is needed for fluctuations which means that after every blood test, your doctor may change the dose.
These may be difficult to interpret when medication is given at incorrect doses at the initial stage itself. It may result in you being prescribed much higher doses than you actually need.
Doses above 100mg daily are said to indicate deep-seated problems and multiple dysfunctions. In such cases, it becomes even more important to diagnose the root cause and address it directly.
Precautions to take with thyroid medications
These are the steps we at Jeevam Health take to ensure that your medication works for you.
Optimise the dose
The same dose of medication does not work for everyone. Throughout the course of your treatment, the dose will have to be adjusted several times. A thyroid specialist is best qualified to assess what dose you need.
Take the tablet on an empty stomach
There are a lot of minerals such as iron and other foods which block the absorption of thyroid medication. For the best effect it should be taken half an hour to 1 hour before breakfast.
If you want to take it at bedtime, there should be a gap of at least 4 hours from the last meal.
Fix a schedule
The tablet should ideally be taken around the same time everyday. Try to stick to the same brand as well.
Although, if you accidentally miss a dose, take it as soon as you can. It is better than skipping the dose completely even if it means taking 2 doses in a 24 hour period.
Do not self medicate
Thyroid medication interacts with a lot of other prescribed treatments for various conditions.
Always inform your thyroid doctor if you are taking any other medicine such as antidepressants, contraceptive pills or other hormonal supplements.
Special care in pregnant women
There are a lot of hormonal changes associated with pregnancy. Usually, this means an increase in the size of the thyroid gland.
This would require an increase in your dose of levothyroxine. This medication is safe during pregnancy and should not be suddenly stopped. Instead, talk to your doctor for dose adjustment.
Side effects to watch out for with thyroid medication
The purpose of informing about side effects is to caution you in case the medication is not suiting you. All side effects are not equally common and it does not mean that every person taking the medication has to face them.
Some common ones include:
- Rise in heart rate
- Feeling hot and sweating
- Feeling hungry
- Shaking of hands
- Feeling tired or drained of energy
If the medication you are taking is of the appropriate dose, chances are you will not face any of these. If you do, bring it to the notice of your thyroid specialist so the dose can be adjusted accordingly.
With these, the symptoms of hypothyroidism will also remain for some period of time. Hence, you may continue to gain weight or feel lethargic and face skin and hair problems.
Will I have to take the tablet forever?
Thyroid diseases can not only be controlled but can also be reversed. But that requires more than just taking the tablet.
It is important to understand that in the early stages, thyroid medication is essential. You have to give your body time to recover from the disease.
This includes various types of physical and mental stress and other lifestyle and diet factors promoting inflammation. This process can take several months.
This means that in a functional medicine approach we address several factors at once. This includes a thyroid diet chart and other lifestyle changes.
First, we relieve the excess strain on the thyroid gland by the use of supplementary thyroid hormone replacement.
At the same time we control the factors which are preventing the thyroid gland from functioning. Blood tests are essential to monitor what is working well for you in this process and what still needs more time.
TSH levels are only one part of evaluating your treatment process. When used in isolation, they do not give any indication of where potential dysfunction lies. Therefore, a panel of tests is done.
Also, treatment should not only be evaluated by numerical data. The dose adjustment also depends on how you feel subjectively. This means following up on whether complaints of the patient are reduced or not to relieve them of discomfort.
With the help of these, the dose of thyroid medication can be continually adjusted and brought to a minimal level of 25mg. In due course, it can even be stopped completely. This is subject to other precautions being taken.
There is a difference between hypothyroidism and hyperthyroidism. The latter requires different medications and may also include surgical treatments.
Hypothyroidism is a chronic condition and any treatment you take will take a few months to show its full effect.
The aim of functional medicine is to provide a sustainable treatment which you can comfortably continue as long as required. Thyroid medication is a part of that protocol. Instead of eliminating it completely, understand how it can help you better your health and how to use it effectively for your benefit.
We’re here to help. Please get in touch with us and we can help address your concerns and assist you in your journey to better health. Book a call with Jeevam Health Team NOW!