So, you’ve been on thyroid medication for a long time, but don’t feel like it’s doing its job. Maybe you are still really lethargic, maybe the weight isn’t coming off as you thought, maybe your brain is still super foggy. 

No matter what, if you feel like your thyroid medication isn’t working the way it should, there are a few potential culprits to explore.

I will first start by saying that you should not change or stop medication without the advice of your doctor. However, this blog post will help provide some guidance on what to look for. 

You’re medicating the wrong thyroid hormone

One of my main issues with a lot of medical professionals is that they only test your TSH levels. This will not necessarily give a clear understanding of what’s really going on in the thyroid. Plus, when checking for TSH, it usually means they will only prescribe synthetic T4 hormone medication.

Here’s why this can be an issue: many people with an underactive thyroid already have difficulty converting the inactive T4 hormone to active T3 for the thyroid to use. If you’re adding more T4 to the mix, this could make things worse. In fact, you might not need more T4 at all!

Instead, doctors should be conducting a full thyroid panel so they can get a complete picture of all of the thyroid hormones, and then medicate accordingly. For example, I am on a compound T3/T4 medication with a ratio specific to my needs. Whereas you might only need T3! 

Here are a couple of resources that can help you figure out which thyroid medication you need:

• Everything you should know about thyroid testing

• Everything you need to know about thyroid medication

Your medication includes common allergens

If you’ve been reading my blog posts for a while, you know I love to talk about the connection between your gut and hormone health. Everything you ingest has the potential to impact your hormones.

Why is that an issue here? Many synthetic thyroid medications include ingredients and fillers that you might be allergic or intolerant to - things like gluten, lactose, corn, sucrose and artificial dyes. If your body already doesn’t tolerate these ingredients well, they might continue causing issues with your thyroid hormones, regardless of what else is in the medication. 

You are taking supplements that counteract your medication

Supplements are a tricky topic that I am asked about frequently.

Yes, some supplements can be really helpful and supportive to thyroid health and function. However, there are others, such as zinc, vitamin D, and copper that might mess with your thyroid hormones. This is because they can alter things like sodium and calcium, get in the way of other hormones, including estrogen, and just throw everything off balance.

If you’re also medicating your thyroid hormones and taking some of these supplements, they might counteract one another. 

So, I am not saying that every person should avoid all supplements, but it is really important to know what you are supplementing and why! Talk to your doctor before starting any supplement. And if you are currently taking supplements, check to make sure they won’t hinder your thyroid medication. 

Your lifestyle or diet factors are getting in the way

Many of us with a slow thyroid need medication. But, if that is the only step you are taking to heal your thyroid, you are doing yourself a disservice.

Your diet, stress levels, sleep quality, environmental factors, and so much more also impact your thyroid health. So, your medication might be giving you all the right ratios of T3 and T4, but if there is something else in your body stopping your thyroid hormone conversion process, the medication might not be as effective.

So, don’t just take the pill and think you’ll be in the clear! Look at other areas of your life that might influence your thyroid health.

Here are a number of great resources:

• 4 ways to keep your thyroid healthy & happy

• What I eat in a day as a thyroid health coach

• Foods to avoid with an underactive thyroid

• 3 key lifestyle changes when living with hypothyroidism

• The Best Exercises for Women with Hypothyroidism

With all of this, it’s important to advocate for a personalized approach to your thyroid health, as each person’s needs are so different. So, do your own research, talk to your doctor, and ask them to look into some of these things so you can find the best medication for your thyroid.