Q about meds

~*andrea-J*~ · 11-09-2003, 12:40 AM

In your oppinion what is the best med to treat hypothyroidism? Cost is not an issue. thanx for your input!

Chigal · 12-03-2003, 10:43 PM

Hi Andrea,

The general prescription for an underactive thyroid is called Synthroid. I've been taking it since about 1999 or so. My doctor started me on 100 mcg (that's micrograms, btw, not milligrams), that's the standard starting dose. Then after a few months, you'll go back to the doctor and they'll do a fasting blood test on you again and check the thyroid levels. This is an inexact science because everybody's body is different. It may take a little while before they get it right. For me, 100 micrograms was too much, so my doctor switched me to 75 and that was too low. I've been taking 88 micrograms for about 2 years now, and oh the difference it makes! I don't have the symptoms of a pounding heart or sleeplessness anymore. The pill I take is green and tastes a little sugary. It's a pretty inexpensive pill, it depends on your insurance and your pharmacy. CVS doesn't charge me my co-pay because it's over what the out of pocket cost for the drug is. You're welcome to e-mail me if you have any more questions. I hope this has helped.

rosern1 · 01-08-2004, 01:40 PM

The BEST med for you may be different than what other's take. I take Armour Thyroid (natural dessicated thyroid) 210mg a day. Armour works well for some people and not for others. The same goes for any thyroid drug. It depends on your body. Synthroid came about in the 70's as Armour Thyroid was used exclusively before then. We didn't always have testing for TSH levels either. At one point in time, doctors EXCLUSIVELY used physical signs and symptoms and not labs, to diagnose and treat hypothyroid. That is something to keep in mind when you are tested. Doctors rely far too heavily on lab results, even though your body may be screaming that is is hypo.

shenacat · 01-08-2004, 04:41 PM

There are two types of thyroid drugs, and two main chemicals they are made up of.

The first type is natural. This is thyroid tissue that is naturally harvested from animals, mostly pigs, and then ground up, tested for potency, and formulated into a pill. Natural thyroid contains all thyroid hormones.

The second type is synthetic. This is a thyroid hormone (only one) that is created in a labratory.

The main type of thyroid hormone prescribed is synthetic, and T4 only. T4 is the "starter" thyroid hormone; your body creates it and then converts it to active form. Some people have trouble with conversion, and it's hard to test for this trouble. They only know that they feel worse or still sick on T4 only.

T3 is the active form of thyroid hormone. It is what actually gets taken up by your cells and used. It is much faster acting, much more potent (because it is ready to use) and it is required for your body to function. This is more rarely prescribed but most people generally respond to its use well. (Because it is faster acting it can "boost" how you feel the same day whereas T4 takes much, much longer to make you feel better. Up to 6 weeks for some people!)

T2 & T1 are considered byproducts of the breakdown of T3 and their use in the body is unknown. There are no synthetic T2 & T1 medications that I know of; you can only receive it in a natural thyroid pill.

Synthroid is the most commonly prescribed medication for hypothyroidism. It is a synthetic T4 only medication. It was only recently awarded FDA approval after years of being denied due to issues with consistent potency (some pills would be more potent than others, making it hard to manage consistent dosage). Synthroid is backed by a large company with very much money to spend on marketing. They actually put together "retreats" for doctors where they pamper them and tell them all about the drug... they practice other methods of persuasion as well.

Levoxyl is a synthetic T4 which is considered a "generic" for synthroid.

Bio-Throid and its generic "thyroid" are natural T4 medications.

Cytomel is a synthetic T3.

Armour thyroid is dessicated pig thyroid and contains all thyroid hormones. It's ration of t4:t3 is roughly 80:20. It works for a lot of people because it gives them that T3 "boost" which clears out the brain fog while giving them T4 to work on a long term basis. Sometimes the ratio is off for people and they need supplementation with additional T4 or more rarely, T3 in conjunction with Armour.

I personally was started on Armour Thyroid. I used exclusively Armour for a year, and then added in some additional Levoxyl to bump up my T4 ratio.

Most doctors start someone on a T4 only medication, and will only prescribe T3 after a trial period (6 months is common) where you do not show improvement in your symptoms. While T4 only will push your TSH back down to normal limits, The Free T3 and Free T4 levels can actually show continued hypothyroidism if you need T3 supplementation. A lot of doctors will only ever test TSH, and will consider you well treated as soon as you are in the lab ranges - but you can still feel like crap! A good doctor is one who tests TSH, T3, and T4, and generally keeps digging if you still feel like crud after going on medication.

My doctor and I both agreed that time and quality of that time was more important than playing around with pills, so we started right off with the Armour, and it has paid off. I like my T3 component, I like being able to take an extra quarter of a pill if I am feeling low that day, and watch myself pick up within an hour. I like being able to vary my dose with my menstrual cycle, which you can do with T3; I need more medication after ovulation than I need before. There is more flexibility offered with T3 because it is fast acting, but you have to be sensitive to your body's needs and to how you react to medication or lack thereof in order to manage it this tightly. If you are not the type of person who does this, T4 only is probably best for you.

Good luck.