logoThe People's Perspective on Medicine

Show 1196: What to Do If Thyroid Treatment Doesn’t Work for You

People who find that the standard thyroid treatment doesn't resolve all their symptoms of hypothyroidism may wish to discuss combination therapy.
Antonio Bianco, MD, PhD
Current time

What to Do If Thyroid Treatment Doesn’t Work for You

0% played0% buffered

Low thyroid function is a very common problem, affecting an estimated 20 million Americans. That is nearly 12 percent of the population. Most doctors are convinced that all they need is one lab test–TSH–and one medication–levothyroxine–to treat hypothyroidism. Why don’t all patients agree?

The Problem with Thyroid Treatment:

The thyroid gland produces at least two essential hormones that your body needs every day. The primary hormone is T4, also known as levothyroxine. This hormone contains four atoms of iodine as part of its molecular make-up. The thyroid also makes small amounts of T3, or tri-iodothyronine. There are three iodine atoms in this molecule, which serves as the active form of the hormone in body tissues.

In the early 1970s, when doctors first realized that the body could convert T4 to T3 by knocking one atom of iodine off the molecule, they embraced synthetic levothyroxine (Synthroid). Around the same time, the radio-immunoassay for TSH (thyroid stimulating hormone) became available. This laboratory test soon gained prominence as the main and sometimes the only measure of how well the thyroid gland was working.

Genetic Differences:

Only recently have investigators identified the genetic basis for some variation in how well different people convert T4 to T3. These variations may help explain why a proportion of hypothyroid patients complain that they are still suffering symptoms despite taking their levothyroxine. Dr. Antonio Bianco, one of the leaders of this research program, discusses when and why certain individuals might feel better with combination therapy.

An Ayurvedic Approach to Thyroid Treatment:

Symptoms of thyroid dysfunction are, unfortunately, common and not very specific. Problems such as fatigue, constipation and muscle weakness could signal a number of illnesses. Even dry skin, weight gain and sensitivity to cold are not completely diagnostic for hypothyroidism. Nonetheless, the ancient Indian medical tradition of Ayurveda has been treating people with symptoms suggestive of hypothyroidism for centuries if not millennia.

Dr. Marianne Teitelbaum, a chiropractor who has been studying the use of Ayurvedic principles for decades, describes how she has adapted them for thyroid treatment. Ayurveda emphasizes the use of diet and herbs for treating imbalances. The Ayurvedic approach also calls for individualizing thyroid treatment for each patient, since the source of an imbalance are unique to every person.

This Week’s Guests:

Antonio Bianco, MD, PhD, is a Professor in the Section of Endocrinology, Diabetes and Metabolism at the University of Chicago Department of Medicine. The review he co-authored of combination therapy in thyroid treatment was published in Frontiers in Endocrinology (July 9, 2019)

Marianne Teitelbaum, DC, has been incorporating the principles of Ayurveda, a 5,000-year-old tradition of holistic medicine that comes from India, in her practice for over 30 years. Dr. Teitelbaum lectures and writes extensively about Ayurvedic treatments for all diseases. Her latest book is Healing the Thyroid with Ayurveda: Natural Treatments for Hashimoto’s, Hypothyroidism, and Hyperthyroidism. Her website is http://drmteitelbaum.com/

You may find our eGuide to Thyroid Hormones of interest.

Listen to the Podcast:

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99.

Buy the CD

Download the mp3

Rate this article
4.2- 57 ratings
About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
Thyroid Hormones

What symptoms signal thyroid trouble? This extensive guide to Thyroid Hormones has critical info on testing, treatment, and side effects.

Thyroid Hormones
  • McAninch EA & Bianco AC, "The swinging pendulum in treatment for hypothyroidism: From (and toward?) combination therapy." Frontiers in Endocrinology, July 9, 2019. DOI: 10.3389/fendo.2019.00446
Join over 150,000 Subscribers at The People's Pharmacy

We're empowering you to make wise decisions about your own health, by providing you with essential health information about both medical and alternative treatment options.

Showing 5 comments
Add your comment

Hi. This was an informative show, thank you. What was the second natural treatment/herb Dr. Teitelbaum mentioned after ashwagandha?

I switched from Synthroid to Armour Thyroid and really improved my mood, functioning, and felt much better.

So glad to see your column and comments on Thyroid, and why standard treatment doesn’t work for some. It sure didn’t work for me. I asked my GP to please switch me over to a natural thyroid (Armour, NatureThroid, etc) but she refused. So I changed doctors, to one I knew did prescribe a natural thyroid. Six months later all the knots in my back were gone, no more muscle pain, and I was back down to my lifelong weight (130 lbs from 165lbs) I felt like my old self. My wit was back, and no longer felt stupid or foggy.

I have never been able to understand why MDs think that if a broken thyroid can’t produce thyroid hormones, that it can convert T4 to T3. An over-simplification for sure, but not too far off.

Thank you so much for all you do. Seventy-seven years and counting thanks to you and others who really understand so much about how our bodies work and what keeps them working!

Great topic! Thank you so much. I had no idea why I had all these symptoms, take levothyroxine, eat a healthy diet and am tired all the time. I had no idea it could be my thyroid treatment that is causing it.

I just had my blood work done and my liver functions are slightly elevated, my LDL and cholesterol are slightly elevated, but according to my doctor’s letter, “they are stable.” And then she says my thyroid functions are normal.

I am now in search of a doctor who is familiar with Ayurvedic principles to treat the thyroid. And find some spring water. Thank you again for such a timely topic.


My question about thyroid treatment: Introducing a compound that closely resembles that which the thyroid gland produces could result in the thyroid reducing its own production level farther as more artificial hormone is introduced. Is there a way to safely stimulate the thyroid glad to the proper level in hypothyroid condition? Conversely, the way to reduce a hyperthyroid condition may be as simple as prescribing Synthroid.

* Be nice, and don't over share. View comment policy^