A Complete Thyroid Medication Guide
Comprehensive information about thyroid medication for those recently diagnosed with hypothyroidism or looking to make changes to their medication.
In this complete guide to thyroid medication, we look at everything you need to know from thyroid medication names and what they mean to you, through to signs that your thyroid medication is too high or too low. We cover:
- What is hypothyroidism and why does it need medication?
- Thyroid medication regulation
- The difference between T3 and T4 thyroid hormones
- T4 thyroid medication
- T3 thyroid medication
- T4/T3 combination thyroid medication
- Fillers and additives you may find in thyroid medication
- Signs that thyroid medication is too low or too high
- How to choose the right thyroid medication for you
- How to safely and reliably take thyroid medication
What is hypothyroidism
The thyroid is a gland which is part of your endocrine system. It’s shaped like a butterfly and is found at the lower front of your neck. This gland produces hormones which regulate your metabolism (your energy use). As such, it is of vital importance for many different processes throughout many different body systems such as heart rate, blood pressure, temperature and digestion.
If the amount of thyroid hormone is reduced then it has a knock-on effect on all these different bodily processes, forcing them to slow down. When thyroid hormones are too low, this is known as hypothyroidism.
Common symptoms of hypothyroidism include:
- Sensitivity to cold and feeling cold more often
- Weight gain
- Fatigue and tiredness
- Depression and low mood
- Constipation
- Muscle aching and weakness
- Dry skin as well as brittle hair and nails
- Cognitive difficulties such as ‘brain fog’
- Reduced libido
- Carpal tunnel syndrome (tingling/numbness in fingers)
- Irregular and/or heavy periods
- Slow heart rate
Most cases of hypothyroidism can be picked up using simple blood tests which measure the thyroid hormones in your blood.
There are a number of different causes for hypothyroidism. In the US, the most common cause of hypothyroidism is a type of autoimmune problem called Hashimoto’s thyroiditis, often simply called ‘Hashimoto’s’. Unfortunately, with this condition, your body produces antibodies which incorrectly attack the thyroid.
Other causes of hypothyroidism include iodine deficiency (potentially from your diet), hormonal changes during pregnancy, or conditions affecting the hypothalamus or pituitary glands. Hypothyroidism can also be caused by treatment for hyperthyroidism (too much thyroid hormone), such as thyroid gland removal or radiation.
Your doctor will work to determine the cause of your hypothyroidism as it will help to determine which thyroid medication is best for you.
A doctor can perform an iniitial thyroid examination to check for swelling. Source: Medistudents
Thyroid medication regulation
Before we come onto the different thyroid medication names and signs that your thyroid medication or too low or too high, it’s important we first explain how thyroid medications are regulated. This is because an easy temptation is to only consider US FDA regulated medication, when in reality there are good reasons why you may wish to consider safe and reliable natural thyroid medication in some cases. Everyone is unique, and everyone’s management of their hypothyroidism should be unique – it’s important you find the right treatment that works for you.
There are many different thyroid medication names which we will come onto. Broadly, however, they fall into two types:
- Synthetic thyroid medication: Lab-made easily
measured synthetically created thyroid medication which replaces the TX
hormone only. These medications are typically FDA approved. Examples of
synthetic thyroid medication include Levothyroxine, Synthroid, Levoxyl,
Tirosint, Unithroid, Cytomel and Liothyronine. - Natural thyroid medication: Dried and desiccated
porcine thyroid. This was the original thyroid medication before
synthetic thyroid medication was developed. It offers a broader spectrum
of thyroid hormones and is a natural option but dosages are trickier to
determine with the pinpoint accuracy needed for FDA approval. Examples
of natural thyroid medication include Armour Thyroid, Nature Thyroid, NP
Thyroid, Westhroid and WP Thyroid.
Be aware that just because a drug hasn’t received FDA approval does not mean it is harmful or without benefit. Often these drugs are still sensible options, but you will need to understand more about them to make a decision with your healthcare provider about what’s best for you. In the US, natural thyroid medication is unfortunately rarely covered by insurance.
The difference between T3 and T4 thyroid hormones
In order to understand more about synthetic vs. natural thyroid medication, it’s important to understand more about the different types of thyroid hormone included in different medication types, specifically T3 and T4 thyroid hormones.
The two main types of thyroid hormone that the thyroid gland produces which are relevant when choosing thyroid medication are T3 (triiodothyronine) and T4 (thyroxine). T3 is the active form of thyroid hormone. T4 needs to be converted by the body into T3 to be usable.
T4 thyroid medication
Most doctors start out by using T4 thyroid medication (synthetic thyroid medication). This is based on the assumption that most people are able to automatically convert T4 into T3 and also that synthetic medications are both regulated and easy to measure (and therefore adjust dosing). They are also lower cost and, as such, favored by healthcare systems such as the UK’s National Health Service (NHS).
There are a number of different synthetic thyroid medication names:
Levothyroxine
The most common and best known synthetic thyroid medication, Levothyroxine is a synthetic T4 medication which fully replaces the purpose of the thyroid gland. This is the non-branded name. Brand names include:
Synthroid
Synthroid is a commonly prescribed thyroid medication is the US. It is taken orally and favored amongst prescribing physicians.
Levoxyl
Levoxyl is another brand name for Levothyroxine and has a different combination of fillers and additives so can be a good choice for some patients who are intolerant or allergic to the non-active ingredients in other forms of levothyroxine.
Unithroid
As with Levoxyl, again the fillers and additives are different with this form of levothyroxine.
Tirosint
Once again, Tirosint is another form of levothyroxine with a different filler combination.
You can purchase all of the above T4 thyroid medications for international shipping using the links above.
T3 thyroid medication
It would appear that not everybody finds it possible to easily convert T4 hormones from thyroid medication into the active form of T3. These people may benefit from additionally taking a T3 thyroid medication.
T3 thyroid medications include:
Liothyronine
This is the non-branded version of synthetic T3 thyroid hormone. This is the active thyroid hormone and is rarely prescribed without T4 treatment. It is often prescribed alongside levothyroxine.
Cytomel
Cytomel is a brand named liothyronine medication. It is short acting and needs to be taken twice daily to keep the benefits.
You can buy both Liothyronine and Cytomel from International Pharmacy using the links above.
T4/T3 combination thyroid medications
Synthetic thyroid medications are only available as T3 or T4. In addition, some people prefer natural thyroid medications using natural thyroid which contains a more similar balance of thyroid hormones to that which your thyroid gland produces naturally, if it was able to do so.
There are a number of alternative natural thyroid medications to choose between.
Armour Thyroid (Thyroid USP)
Armour Thyroid is one of the most well-known T4/T3 combination thyroid treatments using desiccated porcine thyroid. Being derived from a natural thyroid source, it contains both T3 and T4 hormones, as well as other thyroid hormones which are found in humans. The ratio is different to the balance in the human body but many people find it very helpful. Indeed, desiccated porcine thyroid was the most common way of treating hypothyroidism in the days before synthetic thyroid medication was developed. It is less commonly prescribed now, and because of the difficulties with regulating the exact dosage, it isn’t approved by the FDA. However, many patients still prefer Armour Thyroid for their thyroid medication.
Nature Throid
Nature Throid is similar to Armour Thyroid in that it is a natural thyroid medication and uses desiccated pig thyroid. However, it is made slightly differently and has a different composition of fillers and additives so it is preferred by some patients.
NP Thyroid
Again, a natural T4/T3 combination thyroid medication, this medication comes in a tablet which you place under the tongue until it is dissolved, making it a good option for those who may find it difficult to swallow pills.
All of the above T3/T4 combination natural thyroid medications are available for worldwide shipping from International Pharmacy using the links above.
Fillers and additives you may find in thyroid medication
When a medication is made, it contains both active and non-active ingredients. For example, in T4 thyroid medications, levothyroxine is the active ingredient. Alongside this, fillers and other additives are used to create the tablet or capsule, and stabilize it as a medication to last in a packet or bottle without sticking together or becoming damp. These ingredients are called fillers or additives and are known as non-active ingredients. Fillers and additives may also help your body to absorb the active ingredient, but most crucially they are included to help ensure the final drug is consistent and can be easily reproduced on the production line.
Non-active ingredients commonly also include coatings (such as sugar or sweeteners) to make them easier to swallow. Preservatives are common too so that your medication can be prescribed for several months at a time and not deteriorate in your medicine cupboard. Very common fillers and additives used in tablets and capsules include cornstarch as well as sugars.
Often, allergies to medications actually center on the fillers and additives which are used, rather than the active ingredient. This means that as long as you aren’t allergic or intolerant to the active ingredient, then it can be useful to choose a different brand of the same medication which uses different fillers or additives.
Please see the table below to identify the main fillers and additives in the different thyroid medications listed above:
Thyroid Medication Names | Fillers and additives |
Levothyroxine
Synthetic T4 thyroid medication |
Gluten, lactose, cornstarch, sucrose and dyes |
Synthroid
Synthetic T4 thyroid medication |
Lactose, cornstarch and dyes |
Levoxyl
Synthetic T4 thyroid medication |
Dyes. Levoxyl is gluten-free |
Unithroid
Synthetic T4 thyroid medication |
Lactose, cornstarch and dyes. Unithroid is gluten-free |
Tirosint
Synthetic T4 thyroid medication |
Supplied in a gel capsule so no similar fillers to the above |
Liothyronine
Synthetic T3 thyroid medication |
Various including cornstarch |
Cytomel
Synthetic T3 thyroid medication |
Gluten, cornstarch and sucrose |
Armour Thyroid
Natural T3/T4 combination thyroid medication |
Cornstarch |
Nature Throid
Natural T3/T4 combination thyroid medication |
Lactose |
NP Thyroid
Natural T3/T4 combination thyroid medication |
Gluten-free, dye-free |
Both active and inactive ingredients in all medications may cause adverse side effects, reactions and allergies. If you have known allergies or intolerances then you should tell your doctor before they prescribe thyroid medication. Symptoms of allergies and intolerances vary but may include rashes, puffiness, bloating, digestive issues and headaches.
Signs that thyroid medication is too low or too high
Getting the right dose of thyroid medication can take some time and it may also need adjusting or changing over time in order to fully manage the symptoms of your hypothyroidism. When you get the dose right, there should be no side effects of thyroid medication because it is replacing the thyroid hormones that you lack – indeed, you should only feel better. However, getting the dose spot on can be tricky. There are signs that show that your thyroid medication is too low or too high.
Signs that thyroid medication is too low
Signs that your thyroid medication isn’t delivering enough thyroid hormone for the body’s needs include:
- Fatigue and tiredness
- Sluggishness
- Depression and low mood
- Constipation
- Muscle weakness and soreness
- Dry skin
- Hair loss
- Cold intolerance
- Period irregularities
These symptoms may be new, or may be continued from how you felt before going on thyroid medication. All could be signs that thyroid medication is too low.
Should you experience these symptoms on thyroid medication, speak to your healthcare provider about changing doses. Sometimes you may need to try changing thyroid medications, including using a T3/T4 combination natural thyroid medication.
Signs that thyroid medication is too high
If your thyroid medication is too high then it can also cause problems. Signs that thyroid medication is too high include:
- Rapid or fast heartbeat
- Insomnia and difficulty sleeping
- Sensitivity to heat
- Excessive sweating
- Increased appetite
- Weight loss
- Shakiness
- Anxiety and nervousness
- Dull and brittle hair
- Tiredness
Should you notice signs that your thyroid medication is too high, speak to your healthcare provider about changing doses or changing the type of thyroid medication you take.
If you are concerned that your thyroid medication is too high or too low then a blood test may help to determine a more suitable dose. However, be aware that some thyroid symptoms are possible with sub-clinical thyroid blood test results and you may need to be guided more by symptoms in these cases.
How to choose the right thyroid medication for you
With all of the information above, it’s easy to see how overwhelming it is too choose between the different thyroid medication names. In reality, the solution to your hypothyroidism is a tailored approach that is unique to you. There are some basic advantages and disadvantages of the different types of thyroid medication which can help you decide which is best for you.
Advantages and disadvantages of T4 thyroid medications
T4 thyroid medications are approved and most commonly prescribed by physicians. They work well for many individuals and are the least expensive thyroid medications available. Generally they have minimal side effects and are easy to take with one pill a day.
Unfortunately, a significant disadvantage of T4 thyroid medications is that they rely on the body’s ability to convert T4 into the active T3 which not everyone can do adequately. They also typically contain fillers and additives.
Advantages and disadvantages of T3 thyroid medications
Synthetic T3 thyroid medications increase the active form of T3 hormone for those who struggle without it, but it needs to be taken with a T4 medication as well. As such, you need to take more pills each day. These medications typically include fillers and additives. Dosing can be tricky.
Advantages and disadvantages of T3/T4 combination natural thyroid medications
Typically you will only need to take one pill a day and these options are natural and usually have fewer fillers and additives. You can get a more natural balance of all thyroid hormones and it can be useful if you don’t easily convert T4 to the active form T3. Natural thyroid medication may be more expensive and doctors can be unwilling to prescribe them as they are not regulated.
How to safely and reliably take thyroid medication
Getting used to taking thyroid medication can take some time. It’s important to do it safely as these are powerful medications. It’s always best to have the support of a knowledgeable physician to help you tailor your thyroid medication to suit your needs. You may also be recommended dietary and lifestyle changes.
These tips will help you take your thyroid medication safely and reliably:
- Take your pill/s regularly, at the same time every day. Make it
part of your routine and set alarms if necessary. If you are taking T3
medications, timing is particularly important as they are
shorter-acting. - Take thyroid medications on an empty stomach and not at the same
time as other medications for best absorption. Avoid eating for 30-60
minutes after taking thyroid medication. Thyroid medications should be
taken at considerably different times to medications such as statins,
metformin (for diabetes) and blood pressure medications. - If you enjoy dairy milk be aware that it can reduce levothyroxine
concentration and you may need to take your medication at different
times or adjust your dose. - Swallow your thyroid medication with water (except Tirosint which
dissolves in the mouth or can be dissolved in water). Avoid taking with
coffee, grapefruit juice or soy milk. - Take care to know what interacts with your thyroid medication. This
includes calcium and iron. Taking supplements or medications including
these could reduce how effectively your body can absorb your thyroid
medication. - When you have found a brand that works for you, stick to this.
Different brands of thyroid medication for hypothyroidism can vary. If
you think the brand or dose isn’t working for you, seek advice from your
healthcare provider. - Be aware of serious symptoms of high thyroid levels including chest
pain, a fast or irregular heart rate, swelling of the hands and feet,
as well as seizures. Seek emergency medical support.
If you miss a thyroid pill
Take the medication as it has been prescribed. However, if you forget your pills occasionally, it shouldn’t be overly noticeable. It may be more obvious with T3 medication. However, you should restart treatment as soon as possible and aim not to miss more than one or two doses. It’s important that you take your medication reliably and regularly.
Learn more about how long you can go without thyroid medication.
Changing thyroid medication
Each brand has a slightly different formulation and combination of fillers and additives. Aim to stick to one brand which you know works for you. If the brand you are prescribed isn’t working for you then consider changing. Ask your pharmacy to fill prescriptions based on the brand you’ve been prescribed, not another brand. Alternatively, you can ensure you always have enough of the right thyroid medication by buying through International Pharmacy.
Stopping thyroid medication
Once you have started taking thyroid medication, it is essential that you do not stop unless advised to do so by a doctor. Untreated hypothyroidism can cause a wide range of health complications, some of which are not immediately evident, such as blood pressure problems. Stopping your thyroid medication could lead to weight gain, memory problems, depression, raised cholesterol, fatigue and constipation. You may experience increased risk of infection. It could also lead to infertility, miscarriage, premature labor or still birth.
It can take 4-6 weeks to feel better on thyroid medication or when you’ve had a change in dose. Give it time and speak to your physician if you feel that you’re still not benefiting from the medication. You may need to change dose or use a different type of thyroid medication.
If you want to take a natural thyroid medication then the only option is desiccated porcine thyroid treatment. These natural thyroid medications are not often prescribed without persuasion. You can also make changes to your lifestyle, but you will likely need medication as well.
Natural thyroid medications are available through International Pharmacy.
If you are worried about the cost of thyroid medications, choose affordable thyroid medications shipped worldwide at International Pharmacy.
Find out more about the dangers and difficulties of stopping thyroid medication suddenly.
A note from International Pharmacy
Thyroid medication is often necessary to improve your health and reduce the signs and symptoms of hypothyroidism. Choosing your thyroid medication is complex and you need to take a tailored approach. Once you’ve found the right medication and dose for you, take your medication consistently, and you will soon feel that hypothyroidism needn’t affect your daily life.
The information provided by International Pharmacy is designed to support your decisions about hypothyroidism treatment. It is intended as a guide only and personalized medical advice from your physician should be followed.