I get asked a lot about thyroid medications and thyroid hormone effects: which medications I’m taking now, which ones I’ve tried in the past, what worked and what didn’t work, and so on. 

While the most important step here is talking to your doctor, I also wanted to provide some insight so that you can be more informed when you go into these conversations, and work with your doctor to make an educated decision.  

How thyroid hormones work

You have two types of thyroid hormones: T4 and T3. T3 is the active thyroid hormone; T4 is inactive. Our bodies only make about 20% of the active thyroid hormone, so we have to convert T4 into T3. This is where hypothyroidism comes in: most of us with a slow thyroid cannot convert our T4 into the active T3, which is what our body actually uses. Same thing with Hashimoto’s - that condition hinders thyroid hormone conversion.

So, what are the different types of thyroid hormone medication that your doctor might recommend? 

T4-only medications

Synthroid, Levothyroxine, Unithroid, Levoxyl and Tirosint. 

Each of these offers a supply of T4. Of those, Tirosint is my recommendation because it has no fillers in it - it's actually a very natural T4.  

Because many people who have a slow thyroid already have difficulty converting T4, adding more T4 to the mix isn’t always helpful. 

What I see happening is a lot of people get on these medications and they feel crappy. They often either don’t feel any different, or they feel worse. More than likely, they're often not converting their T4 medication over to T3.

The reason why a lot of people end up getting put on T4-only medication is the conventional way for doing a blood panel for your thyroid panel is usually only checking TSH (thyroid-stimulating hormone). A lot of times doctors are not checking T3 on a blood panel, so they can't prescribe T3. They only prescribe a T4 medication because that's what they’re checking for. 

Remember, if you're working with a functional medicine doctor they are more likely going to do more testing and work with you. You are going to get a full panel and you will probably be put on medication that has T4 and T3 in it if you need it.

T3 medication

Cytomel and Liothyronine are forms of synthetic T3. They do have fillers and other things in them that some bodies unfortunately don’t respond great to and so they won't absorb that medication the best. Those fillers can be ingredients such as gluten, lactose, corn, sucrose and dyes. If you are already intolerant to any of those, synthetic medications may not be the best option for you. 

T3 + T4 combination medications

The combo medications are amazing because they have both T4 and T3 in them and they tend to be way more natural. These are medications such as Armour, Nature-Throid, and NP-Thyroid.

For myself, I am currently on a compounded medication. That’s where there can be any ratio of T4 to T3. I needed a more specific amount of T4 and T3 than those other options, so this was the best route for me.

Talk to your doctor

Keep in mind the types of medication and testing available to you as you speak to your healthcare provider.

I am also here as a resource for you! You can reach out to me if you have specific questions, you can download my free guide on The Secret to Reading Your Thyroid Blood Test right here , and come back to the blog for more thyroid-focused advice.