**Note: It’s important to realize that thyroid medication is not one size fits all, and there is no ONE right solution for everybody. Dosage is incredibly important, your specific thyroid labs will impact what type of medication is needed and we all have different needs, budgets, goals, and symptoms. So work with a functional medicine practitioner to find the thyroid medication that makes the most sense for YOU!
"Secondary" or "tertiary" hypothyroidism occurs when the decrease in thyroid hormone is due to a defect of the pituitary gland or hypothalamus. A special test, known as the TRH test, can help distinguish if the disease is caused by a defect in the pituitary or the hypothalamus. This test requires an injection of the TRH hormone and is performed by a doctor that treats thyroid conditions (endocrinologist or hormone specialist).
Before you read on, it’s key to know that 90% of hypo- and hyper-thyroidism results from an autoimmune disorder. (Most people do not realize this, as doctors often don’t take time to explain things.) Most hypothyroid conditions are Hashimoto’s and most hyperthyroid conditions are Graves’ Disease, which means that your immune system is attacking your thyroid. Since the immune system resides in the gut or our intestine (Did you know that?!) a lot of what you will read here is about rebuilding the digestive system.
With the availability of multiple forms of thyroid hormone replacement, early clinical trials were designed to assess efficacy and dose equivalency among natural thyroid (typically desiccated), synthetic l-thyroxine, and/or l-triiodothyronine. These were not designed as superiority trials, their therapeutic goals were the normalization of serum PBI or BMR, and doses were dramatically higher than used today. For example, desiccated thyroid and intravenous l-thyroxine monotherapy normalized BMR, pulse, and body weight in myxedema (29), l-triiodothyronine monotherapy was likewise effective (30), and the potency of l-triiodothyronine exceeded that of l-thyroxine (31).
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Fine needle aspiration biopsy of the thyroid is used to obtain tissue for analysis. Fine needle aspiration is also performed to treat thyroid cysts. The fine needle aspiration biopsy procedure may be recommended to make the diagnosis and/or select therapy of a thyroid nodule. Fine needle aspiration biopsy may also be recommended to drain or shrink a thyroid cyst.
Clinicians noted several differences in the ability of l-thyroxine monotherapy to normalize markers of hypothyroidism at doses that normalized serum TSH (45). For instance, in many l-thyroxine-treated patients with a normal serum TSH, the BMR remained at about 10% less than that of normal controls even after 3 months of therapy (53). At the same time, doses of l-thyroxine that normalize the BMR can suppress serum TSH and cause iatrogenic thyrotoxicosis (28, 45, 46). The clinical significance of this was not fully understood because many patients appeared clinically euthyroid with a BMR between −20% and −10% (36, 37).
You may have read that green, leafy veggies like kale, bok choy, broccoli, and Brussels sprouts can make hypothyroidism worse. But before you keep reading, ask yourself a question: Do you live in the United States? That’s key — because if you do, you likely don’t need to worry about these cancer-fighting veggies messing with your hypothyroidism management. (7)
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Please Note: The material on this site is provided for informational purposes only and is not medical advice. Always consult your physician before beginning any diet or exercise program.
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