Whether you’re already on it, or being recommended to go on it, you want to have one big question to answer: Should you really be on thyroid medication?
In this article, I want to help break down whether you should be considering thyroid medication and various medication risks. Because I want you to be informed. And there are risks. So let’s start with the data.
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The Data Behind Thyroid Medication
The Risks of Thyroid Medication
Why Were You Prescribed Thyroid Medications?
What If You Don’t Take Thyroid Medication?
What About Other Thyroid Medications?
What If You’re Not Taking Enough Thyroid Medication?
What If You’re Already On Medication?
The Final Verdict On Thyroid Medications
The current data is pretty clear. It turns out that for over 90% of people who are currently on thyroid medication, it’s not going to help them. In fact, it may cause more risks than possible benefits for these people.
And, it’s a big deal! Thyroid medication happens to be between the first and third most prescribed medication globally. Somewhere around 30 million Americans are taking it daily, when the vast majority won’t see any benefit from it.
There has been so much energy put into figuring out why certain thyroid medications aren’t working, and the thought is often that it’s the wrong amount – and you need more or a different kind of medication. But, for most, it’s not working because it was never going to work.
Key Insight: There is no debate that low thyroid function causes symptoms, absolutely no debating that. But, for many people, simply taking a pill is not the same as getting your thyroid to work at a level you need it to work.
But, what’s the harm in thyroid medication? Maybe you want to give it a try simply to see if it makes a difference. Unfortunately, that’s not without risk. We now know that when you take thyroid medication, you may be raising the risk of cancer (for both men and women).
This is in pretty substantial amounts, too. We may be looking at 40-50% increases in risk, which is definitely not something to take lately. This is more than what we see from obesity, diabetes, and other commonly-held risk factors.
There are also risks for overall total mortality, heart disease, bone issues, and others. But, let me be perfectly clear: Medications definitely have their place. And, for those with severe hypothyroidism, or who’s thyroid was removed, medication is essential.
The other problem is that these medications can make symptoms worse. While it might seem confusing, when you take medication it can lead your body to resist your own thyroid hormones. While a quick raising of the dose might help, the problem tends to persist.
The first thing to think about is your situation before you went on medication. Did your doctor believe that the medication would help you lose weight or have more energy? Was it given because you had high thyroid antibodies?
For those of normal thyroid function, but who have thyroid antibodies, the case is clear: Thyroid medications do not help. They do not help lower antibodies, and they do not lower the risk of progressing further into thyroid disease.
Key Insight: Many are put on medication for Hashimoto’s disease, but this is simply not a valid reason. The data and studies do not back up the case for it to be used.
We can consider hypothyroidism in three different stages:
The chart below does a nice job of summarizing the ranges for each…
In the case of suboptimal, this is where your labs are normal but not ideal. This is definitely a real thing and can lead to very real symptoms. There is clear data showing that healthy people have a narrower spectrum of thyroid function than reflected by most laboratory ranges.
This is most evident when it comes to TSH scores. Younger adults who have TSH scores greater than 2.0, they may have hypothyroid symptoms, including:
In this stage, the TSH scores are elevated and the T4 has not dropped below range. What is happening here is that the thyroid is still working, but the body needs to give it stronger signals. Your brain is basically begging your thyroid to work harder and harder.
The majority of people who are on thyroid medication are likely to be in this stage, and it’s not really helping. This is also a good example of where adjustments may have an effect at first, but a couple months later things will go back to being the same.
About two thirds of people with subclinical hypothyroidism have the symptoms typically associated with hypothyroidism.
This is where the TSH is markedly elevated, generally well above 20, and the T4 is well below range. At this point, the thyroid is failing and is unable to make enough hormones to meet the needs of the body.
Here’s the catch: At this point, medications are entirely justified. But, even here they don’t always solve the symptoms.
Even if you do nothing, 61% of people with mild to moderate hypothyroidism, spontaneously, improve within as little as eight weeks. Whereas only 2-5% of them have their thyroid disease worsen – meaning the vast majority get better, and a very slim margin actively get worse.
That involves doing nothing proactive. That means that if you do some good things, and work in some good habits through diet or exercise, there is a growing level of confidence that you are not simply going to survive – you’re going to thrive.
The studies above primarily referenced people who were on T4-only medications, like synthroid or levothyroxine. Does natural thyroid or T3 work better?
These are not based on large data sets, mainly observations. So, I have to push back because we simply do not know the full story. And, for those who are recommending it, it typically comes part and parcel with other changes like:
We know that, when you look at just the variable of medications, they do not help. But what we do know is that these other variables can help a lot. So, it’s not necessarily fair to conclude that other medications will help – because we are rarely studying the meds on their own.
Key Insight: We are likely too quick to undersell the power of natural medicine and lifestyle. They can be significant movers for your health which medications simply can’t replace – and, they often replace the risks that medications bring with them entirely.
There is a common argument that dose amounts simply need to be higher. The argument is that you need to give enough to push your T3 levels to the high side of the range.
This is causing what is called hyperthyroidism. While it may give some folks a temporary boost, it does not bring about lasting benefits.
You can keep chasing this momentary relief with higher and higher doses, but then you begin to create these hyperthyroid side effects. Which are just as bad as hypothyroid symptoms.
Key Insight: Higher doses might feel like a solution, especially if you feel relief, but they are not really treating the root cause. They can also end up doing more harm than good.
So, what do you do next? Somewhere around 84% of people can successfully lower their dose of thyroid medication and about half of them can come off it all together. By successfully, I mean that they feel fine (or better) and their blood levels stay stable.
But, what it doesn’t mean is that you quit cold turkey. I definitely do not recommend this, because it simply won’t work the way you want it to. You might feel good at first, but things will take a turn unless you come off your medications gently.
Key Insight: If you don’t come off your thyroid medications gently, you may “shock” your thyroid and deprive it of the opportunity to recover. Please take your time!
Most importantly, it helps with guidance. There are also things you can do to make things more successful, like regulating your iodine intake.
I outlined this as a big part of the Thyroid Reset Diet. What happens is that you can get your body into a certain window which gives it the best chance to recover.
The other approach is to add in nutrients. There’s a lot of great evidence discussing various micronutrients and how they help the thyroid recover more quickly.
As part of my Thyroid Specific Formulations, the Daily Reset Bundle is the ideal starting point. Hypothyroid Support is also appropriate for those looking for less thyroid medication.
Ultimately, it does take knowing how to deprescribe and how to interpret lab tests. There can even be symptoms that emerge during the process, which you need to know about.
Key Insight: The best thing is to work with a doctor who has done this process before, can guide you, and can help you get your health to where it needs to be. You can also consult with me for a second opinion if you’d like guidance on this process.
If you need them, that’s great. Stay on your medications, be on the best ones for you, and feel good knowing you’re doing the right thing. But, if you don’t need them, they may be bringing you additional risk while making your symptoms worse. That’s a tough combination.
I want to help. Please take a moment and take the Thyroid Quiz today to get a sense of where you stand with your thyroid, and what steps you can take to feel better today.
P.S. Whenever you are ready, here is how I can help you now:
1. Schedule a Thyroid Second Opinion with me, Dr. C, Click Here for Details
2. Need A Thyroid Supplement Recommendation? Take My Thyroid Specific Formulations Quiz Now
3. Need a Personalized Supplement? Check out My Thyroid Specific Formulations
4. Download and use my Favorite Recipes Cookbook Here
5. Check out my podcast Medical Myths, Legends, and Fairytales Here
Dr. Alan Glen Christianson (Dr. C) is a board-certified Naturopathic Endocrinologist, and the author of The NY Times bestselling Adrenal Reset Diet, Metabolism Reset Diet, Thyroid Reset Diet, and the Healing Hormone Cookbook.
Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, diabetes, and regain energy. Learn more about the surprising story that started his quest.
