What is the best medication for Hashimoto’s? Unfortunately there is no easy answer to that question. Today Dr. Rutherford discusses this further.
Note: The text below is a transcription from the video above. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors.
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The topic today is the best medications for Hashimoto’s. And I’m assuming that the question is relevant to hormone replacement therapy and for thyroid. And this is a great question and I could go on for a long time on this but I won’t. But here’s the deal, okay. I’m considered an alternative healthcare practitioner and I am functional medicine, functional neurology. And yet even in my world, the research is going more and more towards the earlier you can get the person on hormone replacement therapy, the better. There’s a couple of problems there. The person’s got Hashimoto’s and they got all kinds of triggers hitting them. Their TSH is going to be all over the place. They can have inflammation. It’s hard to get the proper numbers to even put that person on hormone replacement therapy.
I had a lady in here yesterday and she was like, “Yeah, and I go to the doctor and then he gives me the thyroid hormone and then I get shaky and jittery and all that type of stuff. And then he takes this away and then I’m done.” Because that doctor really can’t, she hasn’t even started care yet and she’s got some of the 20 or 30 or 40 triggers that are there. Until you get those triggers under control it’s hard. Really, it’s hard to dose thyroid hormone. Now, the question is, what’s the best one? The answer is you don’t know until you figure out what’s the best one for that patient. I’ll give you a couple of real quick examples. I think you just need to get this idea and this is a challenge for me because if a patient comes in, they have Hashimoto’s they’re not on thyroid hormone we’ll probably say.
It might take 3 or 6 or nine or 12 months to figure out which is the right one for them. Their doctor might have a hard time figuring that out and they might hit it the first time and everything’s off. I usually won’t have that patient consider getting thyroid hormone replacement therapy until we pull all the triggers until we whatever, if it’s their gut or if it’s stress hormones or whatever thing we have to fix to get the thyroid under control. I’ll usually wait but here’s the deal. You go to a doctor and is it natural or is it synthetic or is it compounded or is it not compounded? And all of those things can be relevant to what’s right for that particular person.
Quick examples. Okay. A lot of people who come in here who are on Synthroid aren’t having a good time. Not all but a lot. They go like I’ve got on a Synthroid. It makes me jittery and it makes me shaky. I think there are still eight added additives to the Synthroid and one of them happens to be a gluten. Maybe they’ve taken this out since then but the point is, it just may be that the synthetic Synthroid would actually be okay if there were no sensitivity additives in that capsule. Sensitivity can be an issue. Okay. And then a lot of people take levothyroxine. I take levothyroxine. Okay. I take levothyroxine and I take Cytomel. So levothyroxine is T4 so thyroid hormone comes in two different forms. One’s T4 one’s T3. T3 is the active hormone. Okay. You have to take that into consideration. Synthroid, T4. Levothyroxine, T3.
I’m sorry levothyroxine, T4. You get to natural stuff like Nature Throid, Armour that type of stuff. There, T4 and T3 and I’m not trying to confuse you here. Okay. There is a point. And then the Cytomel that I take is T3. I take a medication that I take in the morning but I have celiac. I have other reasons why that medication doesn’t convert properly to T3. You have to convert from T4 to T3 for the medication to be effective. Okay. I have to take extra T3 because I have to take it separately because my body won’t take that medication and make it into T3. Now, if your body won’t do that, then you need the extra Cytomel but a lot of your T3 is fine. When you do the labs your T4 is off but your T3 is fine.
Now, if you go to the doctor and the doctor says, oh, no, we only use natural. We don’t ever use synthetic and that natural’s the best and so we’re going to give you Armour thyroid, or we’re going to give you Nature Throid or something. Well, it’s got T3 in it. Now the patient gets T3 and goes crazy. They start getting jittery, they start getting… Because they have too much T3 and it’s making them crazy. The major point, it’s not a matter of synthetic versus natural. It’s a matter of what’s right for you. And so the way it goes is for a Hashimoto’s patient is in my world, you have to kind of if the person’s already on thyroid hormone replacement therapy when they come to me, I’m kind of okay with that.
Okay. Because as we get the rest of their system under control, you’re going to start to see the effects of either too much or too little thyroid on their lab. And you’ll be able to send them back to a doctor and a doctor will be happy to modulate it. I’m fine. I don’t make people get off of [inaudible 00:06:01] hormone because I think in the long run, for most Hashimoto’s patients it’s better. Synthetic versus natural is really about the natural doesn’t have any binders in it. It doesn’t have anything that’s going to be allergic. The synthetics can and so it’s a matter of, are you sensitive to those? And then the other thing is what are your T3 markers when you do your lab tests? And if your T3 is 130 which is moderate, which is medium range. If your T3 is 130 and you take Armour thyroid, you might be okay but if your T3 is 170, 160 and you take it, you take Armour thyroid it might just explode you. You’ll get anxiety, jittery, heart palpitations, the whole thing.
Here’s the problem, most endocrinologists don’t know this today. I mean, and I’m not trying to beat it down. It’s just stunning and I know that because I treat these things every day and I have people come in and I hear the stories and the doctor is like, oh my God. Well, okay well we’ll try another one. Okay. And now this is why it could take three or six or eight or nine months because you’ll go in, maybe have a reaction, maybe have no reaction but maybe they can’t get it to work because of a variety of different things. Then they’ll try another one. They’ll try but not relative to all these things that I’m talking about. It’s basically, this is the one the insurance company pays for if your insurance company pay for. It’s usually levothyroxine or Synthroid. And then you go to the alternative doctors minded and they’re like, oh no, it’s got to be all-natural.
And so it’s okay. And each one of them have… And the nature twice seem to be really, really wildly good because of the… So these natural ones, they have a standard ratio of T4 to T3, they have both. Okay. And so if you have that going on and they give it to you and it works great, great. But if it doesn’t a lot of them don’t know why. It’s really crazy. And then the last thing is, of course, the T3 so I take T4 and T3. If the person can, like I have celiac. Celiac people even if they’re doing well, they can have a difficult time breaking down and absorbing things. And converting their thyroid hormones proper. So your thyroid makes the proper hormone or you take the proper hormone but it doesn’t get converted properly.
So now you’re… Then you take some extra T3. I mean, this is thyroid hormone replacement therapy 101 cliff notes in a nutshell. That’s all the things that you have to deal with. I don’t know. Even if your doctor doesn’t know, it’ll help you to be aware of this because then you can start to go, okay Dr. Rutheford said I took the Synthroid and it blew my brains out so maybe I need to change to levothyroxine. Because that’s the other one on my insurance plan. Or maybe you have a naturally inclined doctor and you’ll go like, okay, let me just go straight to trying Armour. And you should try Armour and you feel great, your T3 was probably low or you probably weren’t converting it on your own and you could tell that by looking at your lab.
I know that’s a lot but I just wanted you, I really just wanted you to get the idea. I just wanted you to get the concept of it. It’s not about natural versus synthetic and there are binders in there. You can have sensitivities to certain ones. If you got Hashimoto’s, you could be going into your doctor on a day when it looks like they should be giving you less but actually, you’re about to morph into something where they should be giving you… I’m sorry, it looks like they should be giving you more thyroid hormone but you might be on the way to morphing into a situation over the next several hours where they need to give you less and then they give you more and you go… There’s a lot of nuances to it. It’s not as straightforward as just, okay, I’ll take this one and see what happens.
