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If you have Hashimotos and have an increased TSH, you may want to discuss using thyroid medication with your doctor. Getting on the right kind of thyroid medication, given at the right dose and at the right time can make a tremendous difference in your symptoms, especially in energy, weight and hair appearance. If youre taking thyroid medications and still not feeling well, be sure to read this entire post. Types of Thyroid Medications: Synthroid was the most commonly prescribed medication in the United States in 2013, but it isnt the only thyroid medication (2014 data will be out soon, and it looks like Synthroid is in the lead this year as well). There are three types of medications that can be used to treat underactive thyroid: T4 containing medications (include Synthroid, Levoxyl, Levothyroxine and Tirosint T3 containing medications (Cytomel and compounded T3) and combination T4/T3 medications (Armour, Nature-Throid, WP Thyroid, compounded T4/T3 medications). Some people with Hashimotos, may not be able to properly convert levothyroxine (T4 the active ingredient in Synthroid, to liothyronine (T3 the more metabolically active thyroid hormone, leading to unresolved thyroid symptoms, including fatigue, depression, weight gain and hair loss, despite being on medications. For more information on various thyroid medication options, heres an article I wrote: Which Thyroid Medication is Best? Medication Monitoring: Thyroid medications are Goldilocks hormones, which means that they have a narrow therapeutic index. They are dosed in micrograms (1/1000th of a milligram and very slight changes in doses can lead to symptoms due to under-treatment or over-treatment. . The most common side effects of the medications such as the ones listed in the package insert are often due to overtreatment (rapid or irregular heartbeat, chest pain, irritability, nervousness, insomnia, weight loss, diarrhea, excessive sweating, ) or under treatment (hair loss, fatigue). . Careful dosage titration is necessary to avoid the consequences of over- or under-treatment. In addition to tracking your symptoms, you should have the following tests done: TSH, Free T3, and Free T4 to monitor your response to medication. While reference ranges of whats normal may vary depending on the lab that produces the test reports, most thyroid patients feel best with a TSH between.5-2, and with Free T3 and Free T4 in the top half of the reference range. Postpone your thyroid medications on the morning of the test as some medications (esp. T3 containing medications) may skew your r a symptom tracker and a letter to your doctor about medication adjustments, see my article: When Your TSH is Normal, But You Are Anything But. Switching Medications: Switching between brands of thyroid medications, though sometimes necessary, can mean that a person who was previously stable on a particular dose of medication may require a higher or lower dose of the new brand. Retest your thyroid 4-8 weeks can you take synthroid and nature throid together after switching from one brand of medication or dose increases to be sure you are dosed appropriately. For more information read my article. Thyroid Drug Interactions: Thyroid medications are notorious for drug interactions with other medications. This means that some medications can cause alterations in thyroid hormone levels and side effects, and in turn, thyroid medications can impact the effectiveness and toxicity profiles of other medications. Always be sure to check with your pharmacist when taking new medications or over the counter drugs. Ideally, you should fill all can you take synthroid and nature throid together of your prescriptions at the same pharmacy so your pharmacist can do a check of your drug interactions every time you fill a prescription. Addisons Disease and Thyroid: Testing for Addisons disease involves sodium, potassium, cortisol, and acth blood tests. However, these tests will be normal until 90 of your adrenals glands have been destroyed by the immune can you take synthroid and nature throid together system! Testing for 21-hydroxylase antibodies, which are antibodies against the adrenal glands, can tell you if you have Addisons disease up to a decade before the traditional tests reveal that diagnosis and may prevent a life-threatening adrenal crisis. As most thyroid conditions are autoimmune in nature, and autoimmune conditions tend to go hand in hand, I recommend adrenal antibody testing for all thyroid patients! Pregnancy and Thyroid: Thyroid medications are Pregnancy Category A, which means that they are considered to be safe medications for using during pregnancy. Being on a correct dose of thyroid medication can actually help women conceive as well as prevent miscarriage. If you get pregnant while taking thyroid hormones, be sure to see your doctor asap to test your levels. You will very likely need to increase your dose, as pregnancy increases the requirement of thyroid hormones. If you are thinking about pregnancy, be sure to read this guest post: Hashimotos and Pregnancy. Fillers in Medications: Some people may react to fillers in Synthroid (corn starch, confectioners sugar, lactose, can you take synthroid and nature throid together magnesium stearate, povidone, talc and color additives). People who are lactose intolerant, in particular, may have trouble absorbing many of the thyroid hormones that contain lactose.
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