Are you on thyroid hormone but not feeling any better? Don’t worry, you are not alone. Understanding why this happens is the first step in fixing it. Dr. Ruscio explains the 4 Reasons Why Your Medication Might Not Be Working.
Four reasons that your thyroid medicine might not be working
Dr. Michael Ruscio: Hi. This is Dr. Ruscio, and let’s discuss why your thyroid medication may not be working for you. There certainly are of people, a lot of patients that I see every day who complain that, despite being on the medication, they still don’t feel well.
Before we begin our discussion, I want to make one caution: Some people will certainly need medication. It’s very important that they stay on their medication and keep their thyroid hormone levels within the normal lab values. So, please do not discontinue taking your medication or change your medication in spite of what you’ve heard in this video. Please consult with a doctor who is qualified to comment before you do.
This being said, there are many people who are on medication and still not feeling well. So, let’s discuss four reasons why that might be.
Now, reason No. 1, and maybe the most important, is because medication does little to nothing to treat the autoimmunity. We’ve been discussing autoimmunity, and there will be a whole chapter (in Dr. Ruscio’s next book) dedicated to autoimmunity, and it’s something that you’ll hear me speak a lot about. Autoimmunity or Hashimoto’s is the primary or the most common cause of hypothyroidism in the United States and in most Westernized countries. So, doing whatever we can do to stop or slow down this autoimmune process is very important.
Now, one of the things that is also, I guess I would say, a little detrimental with the medications is it gives patients a false sense that they are doing everything they can to address their Hashimoto’s hypothyroidism. In actuality, they are not.
This is what the autoimmune process can look like – and, again, there will be a whole video and who chapter of the book just dedicated just to autoimmunity. Essentially, autoimmunity is a process in which the body attacks the thyroid gland itself and damages the gland. Over time, as more of the gland becomes damaged, the gland cannot produce enough hormone, so you progressively become more and more hypothyroid. That’s what is depicted in the DIAGRAM here.
The activity of this autoimmune process can be monitored by two lab markers, as we’ve discussed previously – TPO (thyroid peroxidase) and TG (thyroglobulin). If we are doing our work correctly, we should see levels of these antibodies, and therefore, damage against your thyroid gland come down over time and with treatment. Generally speaking, medications do not stop this autoimmune process. There are a few controversial studies showing that medications may have some benefit to the autoimmune process. But, there are many, many other factors that are very important in dampening autoimmunity that, of course, are not addressed by medications.
Reason No. 2: Medications do not address any of the causative factors we discussed in our last video. Here is that list of causal factors again. You see here, something that can cause low pituitary function or low TSH could be inflammation or toxicity. Of course, medications will do nothing to stop inflammation or to rid the body of any sort of lingering toxin. And it certainly won’t do anything to help balance your stress hormone levels. As we’ve already discussed, going further down our chart here, will do nothing to stop autoimmunity, replenish nutrient deficiencies, of course, and will do nothing to balance a woman’s progesterone levels. And finally, things that can interfere with thyroid hormone activation or conversion from T4 to T3 – things like liver toxicity, digestive problems, and, again, inflammation. Again, medications won’t do anything to address these causes.
Remember, these causes are important because, if you have, let’s say, a digestive problem, and high levels of inflammation, those are correlated with developing other diseases or morbidity with time. So, it’s very important that we look at the thyroid dysfunction as a symptom of something more serious going on underneath the surface, and then use that as a prompt to investigate, ‘Hey, why am I hypothyroid? What might be causing it instead of just taking a medication that helps silence the symptoms.
Thirdly, medications will fall to provide even symptomatic relief for many people, as we’ve already discussed. One of the most common reasons for this is a poor conversion of T4 into T3. And, a medication that is T4 only – like levothroid or synthroid – will do very little to help a patient who is deficient in T3. Also, the patient has high levels of a reverse-T3 – this blocks your T3 from working, so even if you are taking something like naturethroid or armour thyroid that contains T3, the reverse-T3 can actually block the T3 from working.
Additionally, some authors have speculated that certain nutrient deficiencies and inflammation may block thyroid hormone’s ability to work on a cellular level – so it may actually blunt what’s called the cellular receptor for thyroid hormone.
Reason No. 4: Your medication may not be the right medication for you. You may not have enough T3, as we’ve hinted to previously, in your medication, because some medications are only T4. And I am putting up a chart here of synthetic vs. natural thyroid medications broken down by which ones contain T4, T3, or T4 and T3. So, you may not have enough T3; you may just be being given synthroid, which is just T4, and you may be deficient in T3, so you may need some T3.
Now, also you may be allergic to fillers in the synthetics. The synthetics tend to have much more dyes, preservatives, and fillers that some patients can be allergic or sensitive to. People we know with Hashimoto’s, especially this autoimmune form of hypothyroidism, tend to be very reactive to foods, environmental chemicals. So here we are putting in the synthetic thyroid hormones more colors and preservatives and fillers that people may be reacting to.
Thirdly, although far less common, someone may actually be allergic to the bioidentical hormones themselves. There is a lab marker available through Quest Diagnostics to help quantify this.
So, hopefully this makes sense. A nice closing analogy to tie this all together is, if we saw a gentleman in a leaky boat, giving that person thyroid hormone, or thyroid medication, is kind of like giving them a bucket . It can certainly help keep them afloat for a little while, but we really need to do some repair work. Get a hammer, some nails, and try to patch that hole in the haul so that you won’t have to be shoveling out water continuously.
So, this is Dr. Ruscio, and I hope you find this helpful. Thanks.
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