Originally Posted by tical

First a little background. Our thyroid gland produces T4, T3, T2, T1, and Calcitonin. T4 & T3 are the most important with regards to metabolism. T3 is the "active" hormone (the one that activates cell receptors to actually raise metabolism) and T4 is a precursor to T3 (i.e., the body *should* convert T4 to T3 as needed).

We naturally produce T4 and T3 at a ratio of around 5:1 along with trace amounts of T2, T1, and Calcitonin.

L-thyroxine is synthetic T4. Today, most doctors prescribe ONLY this hormone to treat hypothyroidism with the notion that the body will convert it to T3 as needed. The problem here is that this doesn't happen efficiently enough for most people. So people will have high T4 levels (that do nothing for metabolism), and sub-optimal T3 levels. But a poorly trained doctor will see that TSH (thyroid hormone demand) has dropped, and they will assume you're fine.

Prior to the development of synthetic T4, in the early 1900s, doctors were treating hypothyroidism using dessicated thyroid (pulverized porcine thyroid) with great success. Dessicated thyroid (Armour, Nature, Westhroid, etc.) have a ratio of T4:T3 that is close to what a human thyroid gland would naturally produce. Unfortunately, a pharma company comes along and synthesizes T4 sometime in the 70s I believe and suddenly the medical community is being "educated" on how this is the best way to treat people with hypothyroidism. Coincidentally, around this time diagnoses of fibromyalgia, depression, and other disorders start to rise. Of course, correlation doesn't equal causation but it's definitely curious to say the least.

Anyway, the medication I would personally suggest is dessicated thyroid (any brand). You would slowly increase your dose until hypothyroid symptoms disappear and/or your lab ranges show your Free T3 near the top of the range (after an AM blood draw BEFORE you take any of your meds). Most people are able to correct their metabolism using between 60mg-180mg of the hormone (some may need more). For example, my mom started at 30mg, a week later went up to 60mg, then a week later 90mg and then held at this dose for 4 weeks. We got labs and her Free T3 was much better than before (on T4 only) but she still needed a little more. So we increased her dose to 120mg and held for 4 weeks again, got some labs done, and now she's just where she needs to be. Nothing has changed and it's been over a year now and she feels much better. My dose is also 120mg. Each small pill is 60mg and I take 1 in the AM and one in the afternoon.

If (a shitty) doctor would review your labs at a point where you're feeling better on the meds, they'd probably say "oh your TSH" is too low, you're taking too much. But in reality, you're not... your brain just has no need to send this signal to your thyroid gland to produce any hormone because you're already supplementing it via your meds. So, if you decide to look for a doctor to treat your thyroid... make sure they focus on markers other than TSH, specifically Free T3. Otherwise you'll just end up at square one.

It really is a very simple process. The problem is people expect results immediately but it takes a good 4+ weeks for symptom alleviation after you've found your dose, so patience is key. You really don't wake up one morning and say "wow I feel it now" because it's such a gradual improvement... instead, after a couple of months you'll look back and realize how awful you felt then vs now.

The hormone is natural and it's cheap. Labwork is cheap (you don't even need to go to a doctor to get it) and once you've found your optimal dose you may need to order labs once a year just to make sure nothing has changed.