One of the more contentious debates in modern medicine concerns the use of natural porcine thyroid versus clean synthetic Synthroid. Armour thyroid, which is porcine derived and contains T4, T3, T2, T1 and calcitonin, the same as the human body, has been in use for over a 100 years.  In the last 40 years however most physicians have been taught that Synthroid, a synthetic thyroid derivative that contains only T4, is far preferable because it maintains steady state levels. In theory T4 should convert easily to T3, which is the active form of thyroid.  In practice, many variables contribute to the ability of a patient to convert from T4 to T3 including genetic issues such as the inability to  transport T3 into the cells  , gastrointestinal and liver issues, mineral deficiencies such as low iron, cortisol from adrenals and elevated cytokines.

A thyroid that doesn’t function properly can be a miserable experience.  Symptoms attributed to a sluggish thyroid include weight gain, brain fog, fatigue, cold intolerance, depression, hair loss, dry skin, constipation and cardiac malfunction.  However physicians are also taught the restoration of thyroid function is a simple as monitoring TSH, thyroid stimulating hormone which is made by the pituitary.   TSH over 4.5 – treat.  TSH under .45, decrease meds.  The patient’s symptoms are rarely addressed. Many patients have had the very frustrating experience of being told that since their TSH is normal, any symptoms they are experiencing such as fatigue, weight gain or depression are due to something else (the implication being that the patient overeats and under exercises or really needs an antidepressant)

Not surprisingly the thyroid is more complicated than this.  Remember that T3 is the active component of thyroid.   Free T3 can easily be measured, and it is very common to find that at so called normal levels of TSH the free T3 is inadequate. Clearly when patients are routinely put on a T4 drug only the chances of not having adequate T3 are greater.

Over the last 10 years this information has spread like wildfire over the internet.  Sites like Stop the Thyroid Madness have educated many people as to how they thyroid should work and why a natural thyroid product produces better results for many people.  Remember not having a functioning thyroid is a miserable experience, and most patients are very eager to lose weight and improve their energy and mood.  Many doctors, however, cling to what they were taught years ago.  While the value of T3 as an antidepressant is well known in psychiatry, the value of T3 is not as widely established in the rest of medicine.  Recently however there have been a number of important studies documenting what many patients know as fact – that taking T3 with T4 actually reduces many symptoms including  weight gain, fatigue and  depression.

The following links are meant to help thyroid patients educate themselves better about their illness and what to expect from treatment.  It is clear that Levothyroxine may be adequate for some patients but certainly not all.

OPEN LETTER TO PHYSICIANS   A number of common medical myths refuted by a nurse regarding the use of natural thyroid medicine instead of Levoxyl

PARADIGM SHIFTS IN THYROID REPLACEMENT THERAPIES  Thirty percent of patients have abnormally low free T3/T4 ratios on replacement T4 only, and 10 percent of patients with normal TSH levels experience impaired wellbeing and depression.  This review of 14 studies indicates that the combination of T4/T3 was definitely preferred by patients AND resulted in better metabolic profiles.

DOES COMBINATION T4/T3 THERAPY MAKE SENSE?  This study found about 16 percent of hypothyroid patients had a genetic polymorphism (Thr92Ala)) that prevented the conversion of T4 to T3 in the brain (which may explain the well documented ability of T3 to help depression)