Holistic Thyroid Treatment Options
Whether you have had thyroid issues for many years or have been newly diagnosed, it can be hard to find the best treatments. At Cormendi Health, we’re here to help you through this journey to feeling better.
Let’s talk holistic thyroid treatment options.
Q: Ok, you’ve talked a lot about me feeling better. How, precisely, do you intend to do that?
A: This will depend on your unique situation, including how your body processes thyroid medication.
Let’s talk Thyroid 102 for a minute. The TSH (the level most physicians look at) is not actually a thyroid hormone, but a brain hormone. It comes from the pituitary gland at the base of the brain and is the primary way that the brain communicates with the thyroid (which is located in your neck). If the thyroid starts to fail and become underactive, then the TSH level will rise as your pituitary more urgently encourages your thyroid to make more thyroid hormone. Conversely, if your thyroid is overactive, the TSH will fall as your brain tries to slow the system down.
Your thyroid is a storage receptacle for thyroid hormone, and T4 (thyroxine) is the main storage form of the hormone. It’s packaged in such a way that it’s hard for it to do much of anything, the way that cookie dough might be stored in the freezer; it’s got limited utility as a snack but works much better once it gets baked into actual cookies. Your body actually does this on purpose for safety’s sake. It doesn’t want thyroid hormone to be available just anywhere, it wants to purposely turn it into active thyroid hormone when your body needs it because you need more energy, more hair growth, more muscle growth, better concentration, better bowel function, better metabolism, and the other characteristics that go along with good thyroid function.
The way your body does this is for cells that need more energy to signal that they’re ready for a thyroid molecule to enter them and to turn the energy production machinery of the cell so that it has access to more energy. The thyroid then releases the T4 into your blood circulation, then the cells that need the energy will send out a receptor and grab the T4s and bring them inside the cell membrane, into the cell. Once the T4 is there, it gets grabbed by a protein called a deiodinase that removes one of the four iodine molecules on the hormone, thereby turning the hormone from thyroxine (T4) to triiodothyronine (T3). The T3 then slips inside the nucleus of the cell and activates DNA in a way that it will produce more energy. This helps you to feel better and helps you meet the challenges of your day in terms of work, relationships, physical activity, thinking, digesting, and so on.
The issue is that not all deiodinases are created equally. Some people have a form that works quite well, so the T4 easily converts to T3. Other people, though, have variants that aren’t quite as good, so it can actually be quite difficult to produce enough T3 hormone to create the energy needed to meet the demands of the day, especially in the 21st century.
When I meet people using thyroid medication who are not feeling well, I can often pick out those people with poorly functioning deiodinases because their T3 levels are low and their reverse T3 is high; without being able to convert to T3, the T4 has to go somewhere, so it converts to reverse T3 (which is inactive) and then gets excreted from the body. Often, we can also pick this up in the lab readings.
People who have the poorly functioning deiodinases frequently feel tired, cold, constipated, depressed, heavy, dry, and spacey despite the fact that their TSH and T4 look normal. You, in fact, may have had the experience of not feeling well, getting your labs checked, and talking to your endocrinologist who says “I’m sorry, your labs are in the normal range, my job is done. Maybe you should take an antidepressant.”
Luckily, not all is lost. Most people who take thyroid medication take a version of levothyroxine, or T4. This can be generic or a brand such as Synthroid, Unithroid, Tirosint, Levoxyl, or others. The standard teaching is that the T4 will be converted into T3 as your body needs it, but as I just said, this doesn’t always happen.
It’s less well known that there’s a second thyroid medication available called liothyronine (brand name Cytomel), which is an analog of triiodothyronine (T3). Studies have shown over time¹ that using a combination of levothyroxine and liothyronine can actually work quite well for people, so I’ve found that using combination therapy is an effective answer for some people who are not feeling well. I usually lower the levothyroxine dose, which pulls down the reverse T3 level, and I add liothyronine, which raises the T3 level. For many people, this works quite well and they feel much better, with those symptoms of low thyroid gradually fading away.
Congratulations! You now know significantly more about thyroid physiology and treatment than 95% of physicians.
Q: What about Armour Thyroid?
A: Armour Thyroid is a brand of Natural Desiccated Thyroid (NDT). It’s not, honestly, my favorite brand (I prefer NP Thyroid) but I use Armour in about 3-5% of my patients.
For those not familiar with it, Natural Desiccated Thyroid is medication derived from the thyroid glands of pigs, meaning it’s porcine-based. My experience is that though most physicians believe it to be archaic, it actually works quite well. It has a fixed ratio of T4 and T3 in the medication, so for those with poorly functioning deiodinases, it can be quite effective. It’s a bit more natural than levothyroxine and liothyronine, so it can be smoother in people’s systems and a little bit easier to dose. If I, personally, had thyroid issues, I would use this medication as opposed to the more popular synthetic versions.
Interestingly, physicians have heard all kinds of rumors about NDT—it’s unreliable, dirty, imbalanced, dangerous, not regulated, and more—that aren’t actually true, but that doesn’t mean they won’t tell you those things and try to convince you not to use the medication.
For Armour, specifically, it came off the market in 2010 due to production issues and wasn’t as well liked by my patients. Around that time, I switched people to other brands (NP Thyroid, Nature Throid, Erfa, and others) or had the medication made by compounding pharmacies that make their own medication. Currently, only NP Thyroid, Armour Thyroid, and compounded medication are easily available, but all three seem to work effectively for the people who take them.
Q: What if I don't want to take medication?
A: I believe in medication as a last resort, so I’m always happy to discuss what it looks like to manage your health without using prescriptions.
If your TSH is above about 20, I will strongly suggest that you consider medication and we can have a discussion of the risks and benefits of not taking medication with thyroid disease. You are a consenting adult, and I’m happy to engage you in a conversation about what you’d like to do.
If your TSH level is below 20 and you'd prefer not to take medication, I can talk to you about trying to manage the thyroid disease using diet, vitamins, supplements, and other holistic strategies. Some of my patients have found over the years that these strategies work well for them.
It’s also worth noting that some people feel fine with a TSH in the 5–15 range and seem not to need any treatment at all. Usually these people are being pressured to take medication since, as noted above, physicians believe their job is to regulate your levels. If you are in this category, with abnormal labs but feeling fine, I’m more than happy to monitor you and provide input on whether you are safe to continue over time without medication.
If you have more questions about thyroid treatment options, schedule a consultation with Dr. Stracks. He will create a custom treatment plan designed around your health goals and desired outcomes. You deserve more personalized care.
1. Bunevičius R, Kažanavičius G, Žalinkevičius R, Prange, Jr., AJ. Effects of Thyroxine as Compared with Thyroxine plus Triiodothyronine in Patients with Hypothyroidism. N Engl J Med 1999; 340:424-42.