Treating Hypothyroidism: An Overview of Thyroid Hormone Replacement Options

August 5, 2011

When your thyroid is underactive, this means your master gland of metabolism is not producing enough thyroid hormone to meet the body’s important needs. Effectively treating that deficiency relies on proper thyroid hormone replacement as a foundation for good health.
If you ask conventional doctors about thyroid treatment, you’ll often hear a popular adage: “Low thyroid is easy to treat, you just take a pill every day.” And the pill they will frequently recommend is the prescription drug levothyroxine, which is sometimes called l-thyroxine. Levothyroxine is a synthetic form of the thyroid hormone known as T4. Levothyroxine is considered the “standard” treatment for hypothyroidism. The most commonly prescribed levothyroxine drug is Synthroid. (Actually, some people incorrectly refer to all thyroid drugs as “Synthroid,” even though that is just one brand among several available on the market.) All the brand name levothyroxine drugs — including Synthroid, Levoxyl, Levothroid, and Unithroid — are basically the same in terms of function and quality. Synthroid, however, usually costs more, and Levoxyl’s fast-dissolving formulation means you need to take it sufficient water for proper absorption.
Some people with low thyroid feel better with an increase in their tri-iodothyronine (T3) level. T3 is the active thyroid hormone that delivers energy to cells. For this reason, increasing numbers of practitioners are prescribing either levothyroxine plus liothyronine (synthetic T3) — known by its brand name of Cytomel — or less commonly, levothyroxine plus specially-prepared synthetic T3 made by a compounding pharmacy. Some practitioners prescribe a synthetic T4 plus T3 combination drug known as liotrix, or by its brand name Thyrolar. While this drug is not commonly prescribed (and it tends to be fairly costly), it is a safe and effective option for some patients.
Another thyroid hormone replacement drug is available, but it is controversial among conventional doctors and endocrinologists. Armour Thyroid is a prescription drug, made from the dried (desiccated) thyroid gland of pigs. Some practitioners routinely recommend Armour, and some patients find they have greater relief of symptoms on Armour as compared to other thyroid drugs.
The controversy over Armour Thyroid is surprising in many ways, because the drug has been safely used for more than a century. Armour was actually the only thyroid hormone replacement drug available from the early 1900s until the 1950s, when synthetic thyroid first was marketed.
Armour Thyroid’s reputation has suffered, however, from a barrage of marketing by the big drug companies. When Synthroid was first launched, it was heavily marketed to endocrinologists, medical students, and hospitals as a better, more “modern” option for thyroid treatment. The derogatory marketing message? Armour was “old-fashioned,” and doctors who used it were old-fashioned as well. Even though there a lack of peer-reviewed, double-blind, journal studies to refer to, doctors believed this advertising campaign. Synthroid and other levothyroxine brands dominated the market from the 1960s until the 1990s.
For the past decade, however, due to the increasing interest in natural medicine, and the increased knowledge and empowerment of the patient community, Armour Thyroid has been enjoying a resurgence in popularity, because some patients tend to feel better on natural Armour Thyroid as compared to the synthetic drugs. Armour is particularly favored by innovative holistic, complementary and integrative medical experts, as well as some doctors who specialize in managing women’s hormones.
It’s thought that the combination of the natural forms of T4 and T3 is in part the reason that it works better for some patients. But because Armour is naturally derived, it also contains natural forms of other thyroid hormones – known as T1 and T2 — as well as nutrients typically found in the actual gland. Some practitioners believe that the actions of these additional hormones and nutrients are the key to Armour’s success.
Ultimately, as a patient advocate and thyroid patient myself, I’ve always told my fellow patients that the best thyroid drug is the one that works best — and safely — for each person. But being able to find that drug can sometimes be a challenge, particularly if you are one of the patients who feels best taking supplemental T3, or Armour. One place to find a physician willing to work with you to find the right drug is the web site for Armour Thyroid, located at: , which has an online “Doctor Finder.” (). Another place I’d encourage you to visit is my “Thyroid Top Doctors Directory,” () where you’ll find a cross-section of doctors who are more open to helping you explore options that will work best for you. (And, if you are in the Houston area, or able to travel for your medical treatment, the doctors at Dr. Hotze’s Health and Wellness Centers are also experienced in using Armour Thyroid for patients with low thyroid.)
(April 2006)
Mary Shomon is an internationally-known thyroid patient advocate, and is author of a number of best-selling health books, including Living Well With Hypothyroidism and The Thyroid Diet. Since 1997, she has run the Internet’s most popular thyroid patient sites: Thyroid Site  and 

Written By: Steven F. Hotze, M.D.

Steven F. Hotze, M.D., is the founder and CEO of the Hotze Health & Wellness Center, Hotze Vitamins and Physicians Preference Pharmacy International, LLC.


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