The Most Absorbable Form of Thyroid Hormone

If you are someone on thyroid hormone who has been unable to find a steady dose, you are not alone!  But there is good news.  It has been shown that liquid form thyroid hormone is better at stabilizing thyroid hormone levels and therefore may reduce the needed dose of thyroid hormone.  What is this hormone, why does it work and when should you consider it?  Let’s discuss.

If you need help with thyroid medication, click here.

The Most Absorbable Form of Thyroid Hormone

Dr. Michael Ruscio: Hi, this is Dr. Ruscio. And good news if you’re someone out there who is hypothyroid and on thyroid medication yet have been unable to find a stable dose or to stabilize your TSH and T4 levels!

I’ll put this study up here on the screen. But a study recently found that for those who are struggling to stabilize their dose, switching to a liquid form of thyroid hormone may be very effective.

And let me quote the findings from this study. “The change from tablets to liquid oral formulation normalized serum TSH while switching back to the tablets caused thyroid stimulating hormone levels to worsen. These results suggest that liquid T4 formulations are more effective than a tablet one in controlling TSH levels in hypothyroid patients.”

So I give you the science just so you know that this is not some speculative conjecture. But this is legitimate information that can help people with hypothyroidism on medication and struggling to find a dose that works well for them.

It may be that you’re not able to adequately absorb the tablet form. And therefore, it’s very difficult to find a stable dose of your thyroid hormone that works well for you.

Now, I won’t put all the links in here. But there have been other studies that have shown that liquid thyroid hormone—and it’s not technically liquid. It’s liquid in a gel capsule. So you still swallow a pill. But the actual thyroid hormone is a liquid encapsulated in a gel tab.

When patients take the gel tabs, they don’t have to fast. So they can have breakfast and still take their thyroid hormone and still have adequate absorption. This may be one of the key reasons why.

Some people may not always fast. Or they may have slow digestion where they fast for 30 minutes. But because their digestion is slow, they may actually need to fast for an hour in order for the food not to interfere with the tablet form.

So this may be part of the reason why the liquid formulations seem to be better in allowing those who are on a tablet form, which are most forms of thyroid hormones, to find a stable dose and stabilize their thyroid hormone levels.

So one may be because we don’t have to worry about fasting. You can take liquid thyroid hormone with food and still see benefit.

Now, there is some other interesting information starting to surface that suggests that another reason why people may do better on liquid, or gel tab, thyroid hormone is because those who have gastrointestinal damage or inflammation or just any kind of general digestive problem and don’t absorb things well may actually be better able to absorb the liquid forms.

And it makes sense if you think about how easy it is to absorb a liquid compared to a tablet. If someone has something like IBS, SIBO, H. pylori, gastritis, ulcers—these people may not have adequate absorption or the adequate ability to break down and absorb a tablet.

So this may be another reason why those taking the liquid form actually seem to do better at finding a stable dose and stable levels of their thyroid hormone when on the liquid gel tabs.

So what should you do? The first thing you should do is start with your gut. If you haven’t taken the steps to improve the health of your gut, this is a very important aspect of overall health including, of course, thyroid health.

Some evidence shows that improving gut health can help with both thyroid autoimmunity, which is a chief cause of hypothyroidism, and also can help with absorption of thyroid hormone and potentially allow people to minimize the amount of medication they need because they’ve enhanced their absorption.

So first, start with your gut. If that doesn’t work, then speak with your doctor about a trial of a liquid thyroid hormone (one of the more common formulations is known as Tirosint) and see if that is able to help you stabilize your levels and stabilize your dose.

So in recap, liquid thyroid hormone may be easier to absorb and may be better for people who have digestive problems and/or cannot find a stable dose of medication that works well for them.

So this is Dr. Ruscio. I hope this information helps you get healthy and get back to your life. Thanks!


If you need help with thyroid medication, click here.

What do you think? I would like to hear your thoughts or experience with this.

Dr. Ruscio is your leading functional and integrative doctor specializing in gut related disorders such as SIBO, leaky gut, Celiac, IBS and in thyroid disorders such as hypothyroid and hyperthyroid. For more information on how to become a patient, please contact our office. Serving the San Francisco bay area and distance patients via phone and Skype.

Discussion

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26 thoughts on “The Most Absorbable Form of Thyroid Hormone

  1. Tirosint is very expensive and not covered by my insurance. It used to work better for me. I pay out of pocket. I have also had experience with actual liquid compounded T4. Abbott Labs in the Berkeley area does this. Also, Women’s International Pharmacy has a liquid T4 gel cap compounded with olive oil that I would like to try, though no doctor open-minded enough will consider a prescription with them. It is much cheaper than Tirosint by far.

    1. When I research Tyrosint (about a month ago), I thought I learned it was a synthetic drug. Well you can get a coupon online directly from their website, it is still very expensive.. Tyrosint is T4 only…but we need T3 too, I thought?! Kaiser offered it for three or $400. Then I inquired about Armour (cap! Gel?), no generic version but has a ratio of T3 & T4. $100 caps w/ Kaiser is $128.56, (still synthetic I believe)..

      Be. nice to have a liquid version, that had T3 & T4 that was a bio-identical vs. synthetic. One can hope!

      1. Hi Viva,
        I wouldn’t overthink the T4 and T3 piece. If you have tried a tablet version of T4 and a T4/T3 combo and still not responded, then a liquid form might be worth trying. But speak with your doctor first of course.

  2. Would like to become a patient. Have tried to start twice but have not received an answer.
    Please respond.

  3. Tirosint is very expensive and not covered by my insurance. It used to work better for me. I pay out of pocket. I have also had experience with actual liquid compounded T4. Abbott Labs in the Berkeley area does this. Also, Women’s International Pharmacy has a liquid T4 gel cap compounded with olive oil that I would like to try, though no doctor open-minded enough will consider a prescription with them. It is much cheaper than Tirosint by far.

    1. When I research Tyrosint (about a month ago), I thought I learned it was a synthetic drug. Well you can get a coupon online directly from their website, it is still very expensive.. Tyrosint is T4 only…but we need T3 too, I thought?! Kaiser offered it for three or $400. Then I inquired about Armour (cap! Gel?), no generic version but has a ratio of T3 & T4. $100 caps w/ Kaiser is $128.56, (still synthetic I believe)..

      Be. nice to have a liquid version, that had T3 & T4 that was a bio-identical vs. synthetic. One can hope!

      1. Hi Viva,
        I wouldn’t overthink the T4 and T3 piece. If you have tried a tablet version of T4 and a T4/T3 combo and still not responded, then a liquid form might be worth trying. But speak with your doctor first of course.

  4. My Endocrinologist sat that the ratios of T4 to T3 in natural desiccated thyroxine were not the same ratios as the ones in humans, that if desiccated the the T3 at that ratio could cause long term consequences on bone density and heart function. He’s pretty clued up on stuff and very open minded. He said I could take it or take t4 and T3 separately but that we don’t really know the long term consequences. I was once on T3 only (magical stuff but I had to stop taking it because it contained maize starch) but I guess it’s always better to get to the route cause of why your body is not converting it in the first place. I am now on a very low maintenance dose of liquid t4 (as it has no maize in it) and I feel great partly due to having no maize in my system many more and partly due to faecal micro-biotic transplant that’s means my t4 conversion much higher!

  5. Oops a few typos in the first draft.

    My Endocrinologist says that the ratio of T4 to T3 in natural desiccated thyroxine is not the same ratio as the ones in humans, that desiccated T3 levels, because much higher, could cause long term consequences to bone density and heart function. He’s pretty clued up on stuff and very open minded. He said I could take it or take t4 and T3 separately but that we don’t really know the long term consequences. I was once on T3 only (magical stuff but I had to stop taking it because it contained maize starch) but I guess it’s always better to get to the route cause of why ones body is not converting it in the first place. I am now on a very low maintenance dose of liquid t4 (as it has no maize in it) and I feel great partly due to having no maize in my system any more, as that made me so ill and partly due to faecal micro-biotic transplant that’s means my t4 conversion is much higher!

  6. My Endocrinologist sat that the ratios of T4 to T3 in natural desiccated thyroxine were not the same ratios as the ones in humans, that if desiccated the the T3 at that ratio could cause long term consequences on bone density and heart function. He’s pretty clued up on stuff and very open minded. He said I could take it or take t4 and T3 separately but that we don’t really know the long term consequences. I was once on T3 only (magical stuff but I had to stop taking it because it contained maize starch) but I guess it’s always better to get to the route cause of why your body is not converting it in the first place. I am now on a very low maintenance dose of liquid t4 (as it has no maize in it) and I feel great partly due to having no maize in my system many more and partly due to faecal micro-biotic transplant that’s means my t4 conversion much higher!

  7. Oops a few typos in the first draft.

    My Endocrinologist says that the ratio of T4 to T3 in natural desiccated thyroxine is not the same ratio as the ones in humans, that desiccated T3 levels, because much higher, could cause long term consequences to bone density and heart function. He’s pretty clued up on stuff and very open minded. He said I could take it or take t4 and T3 separately but that we don’t really know the long term consequences. I was once on T3 only (magical stuff but I had to stop taking it because it contained maize starch) but I guess it’s always better to get to the route cause of why ones body is not converting it in the first place. I am now on a very low maintenance dose of liquid t4 (as it has no maize in it) and I feel great partly due to having no maize in my system any more, as that made me so ill and partly due to faecal micro-biotic transplant that’s means my t4 conversion is much higher!

  8. Hello — is it possible to take desiccated thyroid sublingually? And can the liquid synthetic thyroid hormone be taken sublingually? Thanks.

    1. Hi Antonnette,

      I’m not aware of any dessicated thyroid that’s offered in a sublingual form – keep us updated if you find one!

  9. Hello — is it possible to take desiccated thyroid sublingually? And can the liquid synthetic thyroid hormone be taken sublingually? Thanks.

    1. Hi Antonnette,

      I’m not aware of any dessicated thyroid that’s offered in a sublingual form – keep us updated if you find one!

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