Thyroid Medication: When Is It Necessary, and When Isn’t It?

Do you need thyroid medication?

It can be a big decision. If you are diagnosed with thyroid disease, and suffering from symptoms, it makes sense to want to immediately take some kind of action.

And yet, knowing when to take thyroid medication (and IF you really need it) is massively important.

In this article, I want to help you determine whether you should be on thyroid medication. Should you start? Should you stop? I want to clarify so you know which actions to take to benefit your health. So, let’s talk about it.

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Table of Contents

The Key Levels of Hypothyroidism
Quick Recap: When To Take Thyroid Medication
What Are Other Reasons You Might Be Offered Thyroid Medication?
How Do You Support Your Thyroid Beyond Medications?
Helping You Know When To Take Thyroid Medication

The Key Levels of Hypothyroidism

First, I want to talk about the different levels of hypothyroidism that exist. This is going to give us a clear understanding and a common vocabulary. We will save hyperthyroidism for later.

Suboptimal Hypothyroidism

This is the mildest version of low thyroid function. This is where all of your lab levels are normal, but an argument can be made that they are not optimal.

There are definitely ways in which levels like these can result in symptoms for you. But, that doesn’t mean that these are situations that would benefit from medication.

To contextualize a term like ‘suboptimal,’ let’s talk a bit about what we mean when we say words like ‘normal’ and ‘optimal.’ This is mainly in respect to our TSH, T3, and T4 scores.

Regarding your TSH, good data says that healthy people have a low-normal TSH (running between 0.4 and 2.0) – with some variation.

There is also data saying that those who need medication can sometimes feel better when their TSH is down at that low end of the range.

The next thing you’ll hear about are optimal levels of T3 and T4. There is a popular argument that these hormones need to be on “the high side of normal.”

Given the assumption that the TSH, when compared to T3 and T4, are the opposite of one another, that can begin to make sense. But, is it true?

The evidence doesn’t think so. The inverse relationship between the TSH and T3/T4 is only true at the extremes (when you have way too much or way too little).

Between those extremes, that inverse relationship doesn’t really exist. For healthy people, their T3 and T4 levels can be all over the place. It’s totally normal and fine.

Subclinical Hypothyroidism

In the world of suboptimal hypothyroidism, we were discussing splitting hairs within what we’d consider a normal range. Now, we’re outside of that normal range.

In this stage, your TSH is elevated. Most ranges say that it is normal up to 4.5, but with subclinical disease, it is higher – almost as high as 10 or 20.

But, the T4 is not way below range (it is somewhere in range). This is what we know as subclinical hypothyroidism.

As it happens, in the conventional world, this is where most folks are identified as having thyroid disease and subsequently put on thyroid medication. But, is that truly beneficial?

Again, the data doesn’t think so. Studies have found that it doesn’t lower the effect of symptoms, health risks, or even the progression to other versions of thyroid disease.

Here’s the thing, though: There are plenty of people in the world of natural medicine who have taken thyroid medication and felt better in both these cases, so what’s the issue there?

The fact is that rarely do we do one thing and nothing else. The advice to take thyroid medication often comes packaged up with other health advice.

Sometimes, that advice can be truly beneficial. In fact, a lot of that surrounding advice around thyroid medication can move the needle far more than any medication ever could.

Overt Hypothyroidism

Going one step further, we have overt hypothyroidism. This is where the TSH is really high, often over 20, and your T4 is way below range.

Looking to figure out when to take thyroid medication? At this stage, it is a totally reasonable option. But, it’s not the only option…

When I was putting together the Thyroid Reset Diet, some of the studies done were performed on those with overt hypothyroidism. And, many people did better.

Total Thyroidectomy (TT)

This one is quite simple. Those who have had their thyroids removed need medication. They will benefit from it, and it makes total sense.

Quick Recap: When To Take Thyroid Medication

Here’s a little summary to help you determine when to take thyroid medication:

• Suboptimal hypothyroidism: Medications do not help.
• Subclinical hypothyroidism: Medications do not help.
• Overt hypothyroidism: Medications might help (not the only option).
• Total thyroidectomy: Medications will help.

What Are Other Reasons You Might Be Offered Thyroid Medication?

There are some other scenarios where medications might help. I want to quickly detail those here. They include:

• Post-thyroid cancer: This is helpful when tighter control of TSH scores to cut the risk of recurrence of thyroid cancer.
• Subclinical hypothyroidism with infertility: There is data saying that controlling thyroid levels may help with issues of infertility.

Barring those situations, thyroid medication is only really necessary in cases of lacking a thyroid completely or suffering from overt hypothyroidism.

But, what are some other instances where thyroid medication might be offered? And, is it a good idea to take thyroid medication when that comes up? Let’s dive in.

Autoimmunity

If someone has clear signs of Hashimoto’s disease, they are often told that they need medication to help them. Unfortunately, that is incorrect.

Medications do not help with symptoms stemming from autoimmunity. Ultimately, medications alone are not suitable for helping to treat autoimmune thyroid disease.

Not only do they not help, but they can worsen all of these problems when they are not needed. They can make you gain weight and amplify your other symptoms, too.

Other Examples

There are a few other ways specific tests may cause a practitioner to think that someone needs medication. This could include:

• A lower body temperature
• Delayed Achilles tendon reflex
• Certain gene abnormalities

I want to continue emphasizing that thyroid medication is only helpful for those who lack a thyroid or suffer from overt hypothyroidism. While these things are real, medications won’t help.

How Do You Support Your Thyroid Beyond Medications?

The first step is to get your iodine levels in a healthy range. The window of thyroid recovery is getting your iodine somewhere below 100 micrograms per day.

The second step is to focus on finding the most helpful nutraceuticals. The Thyroid Quiz is designed to help you determine which can be the most helpful.

The third step is to identify and treat any comorbidities. There are a whole lot of diseases that fly under the radar alongside thyroid disease.

I’ve quickly put together the top five to give you a better sense of how it might look:

1. Latent iron depletion: This is where your iron levels are normal but below ideal. It is very real and can lead to a whole lot of symptoms.
2. HPA abnormalities: Formerly known as ‘adrenal fatigue’ or ‘adrenal stress’ – this can be a big issue for a lot of people.
3. Calcium disorders: Both too little and too much calcium are very common and can contribute to symptoms like joint pain, hair loss, and plenty of others.
4. Fatty liver disease: Extremely common in all populations and a big driver of chronic pain, poor digestion, weight loss resistance, and others.
5. Sleep apnea: Fatigue and unstable blood sugar levels are big symptoms here.

These are just a few, but there are many other diseases that come part and parcel with thyroid disease. In many cases, they are the true culprits but they are not identified and alleviated.

Helping You Know When To Take Thyroid Medication

I hope today’s article painted a clearer picture of the complexities of thyroid medication and knowing when to take it. We covered:

• How to identify the earliest signs of thyroid disease
• If you need thyroid medications or not
• What to do if you don’t need thyroid medications

The most important message is that you can do plenty of things to help your thyroid including following the Thyroid Reset Diet and using Thyroid Specific Formulations supplements.

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.