How to Switch from Levothyroxine to Natural Thyroid Medication.
- Find a thyroid-friendly healthcare provider who is not opposed to prescribing different forms of thyroid hormone, because even though NDT is a natural hormone, you still need a prescription for it. It is only a bonus if your practitioner is trained or certified in functional medicine.
- Check your current levels of thyroid hormones (TSH, Free T3, Free T4, and Reverse T3) and take into account your current dose of levothyroxine.
- Your healthcare provider will help you with the switch. You can use a chart below or a similar chart found online. For example, if you are on 100 mcg of levothyroxine and your TSH is 1.0, Free T3 – 2.3, and Free T4 0.9, you can switch by starting NP Thyroid 60 mg once a day or 30 mg twice a day. You may experience a lot of symptoms get better right away, even though it may be not an OPTIMAL dose of thyroid hormone FOR you.
- Stay on it for 4 weeks, take it 1 hour away from coffee and 4 hours away from multivitamin, iron, and calcium, and recheck the labs in 4 weeks. Please, do NOT take your thyroid hormone when you go to get your blood drawn. Taking it before the blood draw may falsely elevate Free T3 and alarm you and your provider. Take your thyroid hormone AFTER you got your blood drawn. If your provider is comfortable, he may start you on NP Thyroid 75 mg or 90 mg (taking into consideration your low level of Free T3 – 2.3).
- Pay attention to how you feel and let your provider know if you have INCREASED anxiety, heart palpitations, unusual insomnia, high blood pressure, panic attacks, etc. Sometimes, your symptoms may last 1-2 days as your body adjusts to the new level of thyroid hormone. I personally had a few hyperthyroid symptoms when I was increasing the dose and it just felt like I had a lot of coffee that morning (irritable, hyperproductive, scatter-brained, hungry, jittery). The symptoms went away in 2 days and I felt much better. Taking NDT with food may slow down the delivery of T3 into your bloodstream and take care of the hyper-symptoms. If your symptoms last longer than 3 days, let your provider know, decrease the dose, and follow up to figure out the cause and what to do about it.
- I ask my patients to go ahead and check the labs right away before decreasing the dose to have a better picture of what is going on and why the symptoms are there.
Who Would Benefit from Switching to NP Thyroid (or a different NDT)
- Did levothyroxine work for you for a while, but you are wondering if there is something that may work better for you?
- Are you struggling with weight loss, even though you feel you eat healthy with lower carbs in your diet and you exercise with no results in weight loss or muscle mass increase?
- Are your ankles swollen? Brittle nails and hair that breaks easier than before, but you are blaming it on your age? Dry skin, but what else can you expect in a dry Arizona climate?
- Is you TSH “normal” between 1.0 – 2.0, but your Free T3 and T4 levels are in the low range (<3.0 and <1.2-1.1 respectively)? There are a number of reasons why TSH should not be used as the ONLY marker of thyroid hormone production.
- Have you had a full thyroidectomy or Radioactive Iodine treatment of hyperthyroid?
- Have you felt worse or no changes while on levothyroxine medication?
- Do you have DOI2 gene mutation SNP?
But even if you do not have any of the above-mentioned factors, but you would like to experiment to see if any of your symptoms will get better, I would try NDT.
Natural Desiccated Thyroid Hormone and Weight Loss.
Weight loss is not guaranteed, especially, if the lifestyle and diet are not changed. Overabundance of carbs and processed foods in our Standard American Diet and sedentary lifestyle with no walking. Nevertheless, I had a number of patients with suboptimal levels of Free T3 (<3.0) and high Free T4 (>1.5) who have been treated with T4-only medication (thus, the high level of Free T4), but were not able to convert Free T4 into Free T3 and kept gaining weight slowly, but steadily. Once I switched them to the Natural Desiccated Thyroid which is a combination of T4 and T3, they lost 10+ pounds in the first 6 weeks without changing their diet. Moreover, they got so excited that they started watching their food intake, started making wiser choices when it came to sugar and had enough energy to start light exercise and walking.
Brands of Natural Dessicated Thyroid (NDT) Available in the U.S.
Fortunately, there are several options of Natural Desiccated Thyroid Hormone on the market in the U.S. If one brand does not work, a different brand may work better. All the brands are formulated differently which may increase or decrease the absorption of the pure porcine (pig) thyroid hormone differently.
Persons suffering from thyroid disease have impaired stomach and gut function which may decrease the absorption of any thyroid hormone. Everyone is different, so what works for one person, may not work for another.
I have listed my two favorite brands of NDT as of now. I was a huge fan of Nature-Throid until I developed hypothyroid symptoms on the same dose of Nature-Throid that I have been on for over 2 years. I also had worse results in some of my patients with Nature-Throid lately, when the labs would be all over the place, so as of now I am not prescribing Nature-Throid. Possibly, the labs are different and the symptoms are reappearing due to the recent reformulation of Nature-Throid. Another factor is that several patients complained that Nature-Throid increased in price (double to triple the previous price, even with insurance coverage).
NP Thyroid is made by Acella company. It smells weird, but it tastes sweet. It also dissolves quite fast under the tongue (sublingually) and may help to increase the absorption of the thyroid hormone via mucosa in the mouth. So far, myself and my patients are quite happy with it.
Armour Thyroid It does not taste good, but can be swallowed whole or chewed to increase absorption. It works for a lot of patients. It was also re-formulated in 2008 and caused a lot of symptoms to reappear. So, the bottomline is to watch out for the reformulations of any brand of NDT and pay attention to the possible re-emergence of hypothyroid symptoms. Armour was also reformulated in 2015.
WP Thyroid and Nature-Throid. Both brands are made by RLC labs in Cave Creek, AZ. WP Thyroid has only 2 filler Inulin (from chicory root) and medium chain triglycerides (from coconuts). But just as Nature-Throid it is on the backorder and hard to get at most pharmacies. Nature-Throid can be chewed and swallowed to increase the breakdown and absorption in the stomach. Unfortunately, after the reformulation of Nature-Throid, some people feel it is much weaker than before.
Personally, when I noticed that symptoms of hypothyroidism started reappearing (slow weight gain, increase in fatigue, and the worst of them is terrible itchiness of right leg), the dose increase from 2 grains (120 mg) to 3 grains (180 mg) has not made any difference in my symptoms. Upon switching to NP Thyroid 2 grains (120 mg) split in 2 doses of 60 mg and 60 mg, my hypothyroid symptoms disappeared within 1 week and have not come back since.
What is your experience with Natural Desiccated Thyroid hormone or levothyroxine or Synthroid?