Important Considerations for Those on Thyroid Medications

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Important Considerations for Those on Thyroid Medications

Important Considerations for Those on Thyroid MedicationsIn this week’s video, I discuss three important things those on thyroid medication should consider. If you or someone you love is on any thyroid medication, be sure to be aware of these three things for an improved quality of life.

Important Considerations for Those on Thyroid Medications

If you have hypothyroidism or you’re on hypothyroid medication, you know firsthand the impact your medication can have on your day-to-day well-being.

In an effort to improve your experience with thyroid medications, I want to offer you three critical considerations:

  • Gluten presence in a common thyroid medication
  • How gut health can impact medicine absorption
  • Different methods for finding your optimum thyroid medication balance

Firstly, you’ve likely heard news surrounding gluten content and Synthroid. I’d like to take a moment and clear up the issue of whether or not Synthroid still contains gluten.

According to recent studies, Synthroid no longer contains gluten.

A recent study examined Synthroid (also known as Levothyroxine sodium tablets) for its gluten and aluminum content through sampling and testing of multiple random batches.

The study concluded “that Synthroid tablets are not a source for dietary gluten and are a minimal source of aluminum.”

This may be contrary to what you’ve heard regarding gluten content in Synthroid, but this is simply because Synthroid used to contain gluten.

This is comforting for those with celiac or gluten sensitivity.

However, if you’ve been on Synthroid for a while now and aren’t feeling better, not only is that frustrating, it can be downright worrying. Don’t give up yet, because there are a couple of things you can do right now to help yourself.

With the help of your doctor, consider the following:

Correct dosage

Look at your lab work and make necessary dose adjustments to be sure you aren’t underdosed or overdosed. This can take some time and should always be done with doctor supervision.


This occurs when your body isn’t absorbing the medication as it should. This can be confusing because your body is absorbing inconsistent levels and therefore your lab results are inconsistent.

What makes matters worse is that this sometimes causes people to unnecessarily increase or decrease dosages, which can make nailing down a proper dose tricky.

Malabsorption can happen in a few ways.

First, you shouldn’t be eating with your thyroid medication. I hope most people know they shouldn’t be eating when they take their thyroid medication, but this is such an important point I wanted to reiterate it here.

Taking thyroid medication while you eat negatively affects absorption rates. It can cause fluctuating lab results and unnecessary dose adjustments.

Second, malabsorption can be caused by underlying gut issues. This is a fairly common problem so I want to take a moment to dig a bit deeper.

Common gut conditions that may interfere with thyroid medication absorption include:

Working with your doctor to identify and treat any of these prevalent gut conditions will not only help you absorb your thyroid medication better, it will help you absorb all nutrients better, which can significantly improve your overall quality of life.

Consider taking a liquid form of your medication

If you suffer from gut issues that interfere with absorption, including those listed above, consider taking a liquid form of your thyroid medication.

Promising results have been observed in trials on patients with various gastrointestinal conditions. Those that were struggling with Synthroid or Levothyroxine absorption found that they often had better results when switching to a liquid form, such as Tyrosine and liquid Levothyroxine. In these trials, patients who switched to a liquid form of thyroid medication experienced more stable results and an improved overall condition.

Whether or not you have identifiable absorption interrupting conditions like the ones listed above, if you are struggling to maintain consistent thyroid results, I’d say it’s still a good idea to consider taking a liquid form of your medication.

Your path to an improved quality of life

I encourage you to find the optimum hormone combination for your best quality of life.

There’s no need to settle for a mediocre existence because of your hypothyroidism or thyroid dysfunction.

Comparing different dosage combinations is a relatively simple experiment you can complete with your doctor.

For those without underlying gut issues, consider a trial of comparing T3 and T4 medications individually, and then T3 and T4 together.

*A trial comparing these different thyroid medication combinations found:

  • About 20 percent of patients prefer a T4 only treatment
  • About 43 percent of patients prefer a T3 and T4 combination

You can also compare the different brands of thyroid medications until you find exactly the right dose, brand, and combination that makes you feel best.

What if the problem isn’t your thyroid?

This is a very important piece of the puzzle I want to make sure we address. Too often people with thyroid conditions end up getting tunnel vision and search only for issues with their thyroid. This can cause them to miss other health conditions contributing to their issues.

That being said, I want to bring you back to the gut.

Often, symptoms of poor gut health can manifest into symptoms that look and feel similar to thyroid issues.

Remember, many thyroid and gut health symptoms are nonspecific, including:

  • Weight gain
  • Fatigue
  • Constipation
  • Depression
  • Dry hair, skin, and nails

These are all examples of symptoms of both thyroid dysfunction and poor gut health.

So, if you’ve gone through the thyroid fundamentals in the discussion above, and you are still struggling with these frustrating issues, I encourage you to have a thorough gut evaluation. You might want to really focus on your gut health first before going too far down the thyroid rabbit hole.

Remember, you don’t need to be a victim of your thyroid condition. There’s a lot you can do with the support of your doctor to tackle core issues that accompany thyroid dysfunction. I want everyone to feel their best and I truly hope these considerations help you on your path to a healthy and fulfilling life.

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.


I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!