What Type Thyroid Hormone Replacement is Best?

Which Hypothyroid Therapy Drug Works Better?

Aug 16, 2009 Jim Lowrance

The question, as to which type or brand of thyroid hormone replacement drug is superior, is sometimes a major one in the minds of patients needing hypothyroid treatment.

Finding the right drug to replace low thyroid hormone levels for some patients depends on a number of details in regard to patient-individuality. There are issues that can be involved in making this choice, depending upon things such as a patient’s tolerance for ingredients and fillers found in different types of thyroid hormone drugs, their religious or belief affiliations and the type of hypothyroidism they are experiencing.

T4 and Combination T4/T3 Brands

The majority of newly-diagnosed hypothyroid patients are prescribed synthetic T4-only thyroid hormone replacement drugs or what is also called “levothyroxine”. Once the dose is taken, the body will then convert the T4 into the also needed T3 thyroid hormone that is needed to regulate bodily metabolism. Most patients do well on T4 replacement drugs if their dose is set at the correct level to restore thyroid hormone levels.

For some patients however, their bodies do not convert enough T3 from the T4-only drug successfully which is referred to as “impaired conversion”. This problem will only be detected if the treating doctor blood retests both the T4 and T3 levels in follow-up to monitor the treatment. If the T3 remains low with adequate T4 dosing, the patient will need to be switched to a brand or combination therapy that also contains T3.

Allergies and Intolerances

A small percent of patients placed on certain types of thyroid hormone whether synthetic or natural brands will have allergic or intolerant reactions to them. Many medications contain fillers that help manufactures process them into pill form or that help the drug to better absorb in the systems of patients who take them. These patients, whose systems recognize these fillers as allergens, will experience symptoms such as hives and stomach upset. This will require the treating doctor to switch the patient to a brand that is better tolerated.

Some thyroid hormone brands are derived from the glands of pigs (porcine source) and there are people who are intolerant to any type of pork or related products. In cases like these it may be either the synthetic or the natural brand that works better for these patients with sensitivities. Some natural brands of thyroid hormone are “hypoallergenic”, meaning all know allergy-causing ingredients have been removed.

Generic Vs Major Brands

Some patients will see their doctors change their prescriptions from a major thyroid hormone brand, to a generic for insurance purposes or to save self-pay patients on their costs. Generics in all types of medications have been found to sometimes be slightly less potent when compared to major brands. In the case of thyroid hormone therapy, this can mean that the patient’s T4 and T3 levels may drop slightly as a result of switching to a generic brand. This will require the treating doctor to increase the dose level to compensate for the different in potency. With any switch of a thyroid hormone prescription, whether from synthetic to natural or from major brand to generic, patients need blood retested about eight weeks following the switch-over. If blood retesting is set at a longer interval of three to six months, the patient may experience a period of hypothyroid symptoms.

Additional Reasons for Brand Preferences

In addition to the aforementioned, there are other reasons some patients require a particular brand of thyroid hormone or who must be restricted from certain brands. Some patients for example, experience a less-common condition called “low T3 syndrome” that requires replacing only the T3 thyroid hormone until the condition resolves. The reverse can also be true, demonstrated by the fact that some hypothyroid patients are highly sensitive to T3 supplementation. They will have hyperthyroid type side effects from even low doses of oral dosing which in some cases may be due to another type of deficiency or hormone imbalance present in their bodies.

In other cases, a person’s religious beliefs or convictions restrict the use of products made from certain animals. This can also be true of people who practice firm beliefs in the area of animal advocacy or who, are vegetarians. All of the preceding described reasons demonstrate the reasons for the existence of synthetic, natural and variation of T4 and T3 brands.

The copyright of the article What Type Thyroid Hormone Replacement is Best? in General Medicine is owned by Jim Lowrance. Permission to republish What Type Thyroid Hormone Replacement is Best? in print or online must be granted by the author in writing.

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Comments

Aug 26, 2009 10:05 PM

Guest :

What about natural hormone relacement verses synthetic hormone replacement therapy?

Aug 27, 2009 9:04 AM

Jim Lowrance :

I believe there are patients who see better results with natural thyroid hormone. I'm personally an Armour Thyroid patient but I know for a fact there are people who cannot take Armour due either to intolerance for porcine products or high sensitivity to oral T3. So the superiority of synthetic or natural varies among patients. There are hardcore advocates on both sides but from my view, because of these individual issues with patients that can be very real factors, were fortunate to have both types.

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