Better Thyroid Treatment to Banish Fatigue

Q. My thyroid gland was removed and I have been on Synthroid or generic levothyroxine for more than 20 years. Although I am 52, I feel 20 years older.

I am always tired and my muscles ache. One doctor told me I had to learn to live with these symptoms, but they are getting worse. It feels like the generic levothyroxine varies in dose from month to month. What can I do to feel better?

A. Questions about the variability of generic levothyroxine pills remain controversial. You are not the first person to tell us that different levothyroxine formulations affect them differently. We generally tell people to stick with a single manufacturer if its product works for them.

Who Needs to Take T3?

A far more contentious issue is whether levothyroxine alone is appropriate for all hypothyroid patients. That has been the standard of treatment for more than half a century, but recent research has helped to explain why some people have long maintained they don’t feel good on levothyroxine (T4) alone (Journal of Clinical Endocrinology and Metabolism, May, 2009).

In the body, an enzyme converts T4 to T3, the active hormone, by knocking off one iodine atom. A genetic variant of the enzyme occurs in about 15 percent of people. These are the folks who feel better if they get T3 along with levothyroxine to treat their thyroid condition.

Trish is an example. Here is her story:

“My regular doctor put me on compounded meds to get me at a level where I could function on a daily basis. I was allergic to all thyroid drugs on the market, my levels would never equalize and I could barely function on a daily basis. I’m now taking a compounded T4 and T3 formula (insurance won’t pay for the prescription) and I am almost back to my old self. It really is a blessing to have a doctor that listened to me and helped me get my life back.”

FBL had a slightly different experience, but she too feels better on a combination of T3 and T4. She wrote:

“It took my family doctor years to figure out the right formula for my thyroid. The blood tests were fine but I had severe symptoms.

“He had me take my temperature first thing in the morning before getting out of bed. My temp was way below the bottom line! It had no number so I have no idea where we started with my body temp.

“Then came the trial and error. My body doesn’t react to meds the way most folks do. After several years of playing around with different options, we finally came up with a combination of NatureThyroid and Cytomel. I have been doing great since.

For more details about this treatment program you can download our newly revised Guide to Thyroid Hormones. You will learn about testing, treatment and side effects to help you discuss your situation with a physician. You should not have to get used to feeling terrible. Instead, it should be possible to find a treatment that works for you.