Thyroid Hormone Replacement

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The thyroid gland is a small, butterfly-shaped gland found in the lower part of the neck that plays a primary role in regulating your metabolism and energy. There are different types of thyroid problems: an overactive thyroid (known as hyperthyroidism) and an underactive thyroid (known as hypothyroidism). People struggling with thyroid issues experience symptoms that affect weight gain and loss, energy levels, memory and cognition, moods, skin, nails, hair, and bowel habits, among other things.

Thyroid imbalances occur when your thyroid hormone production is reduced or excessive. The primary hormones are triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH). Thyroid-stimulating hormone is produced by the pituitary gland in the brain. TSH is responsible for stimulating the thyroid gland to manufacture and secrete T3 and T4. Restoring balance is often challenging, as there are several hormones produced by the thyroid gland. All must work in sync to maintain optimal thyroid function.

An estimated 12 percent of the United States population will develop a thyroid condition at some point in their lifetime, yet as much as 60 percent of those individuals will be unaware of the condition. Without treatment, many Americans with thyroid disorders will experience a reduced quality of life and put their health in danger.

What is thyroid hormone replacement therapy?

Thyroid hormone replacement therapy has become the most common and reliable treatment of hypothyroidism. Hyperthyroidism, on the other hand, requires a different kind of solution. We will discuss the two main forms of thyroid dysfunction below.

Thyroid Disorders

Hyperthyroidism

When the thyroid produces too many hormones, this is known as an overactive thyroid (or hyperthyroidism). Hyperthyroidism affects about 1.2 percent of the U.S. population. The condition is more common in women than men and is more likely to be diagnosed over the age of 60. It is often caused by an autoimmune disorder known as Graves’ disease.

Failure to treat hyperthyroidism can result in an increase in metabolic rate, which leads to undesirable symptoms. Symptoms of hyperthyroidism include frequent heart palpitations, sweating, anxiety, weight loss, heat intolerance, and muscle weakness. Patients with heart disease and diabetes are at a greater risk of complications associated with an overactive thyroid. Radioactive iodine and anti-thyroid medications are the most common ways to treat hyperthyroidism. Removing the thyroid gland via surgery (known as a thyroidectomy) is another option, although that is usually done when other options have been proven unsuccessful.

Hypothyroidism

Hypothyroidism, or an underactive thyroid gland, is by far more common. In fact, some estimate that as many as 1 in 7 adults suffer from hypothyroidism. The disorder tends to affect women more than men. Hypothyroid symptoms come on slowly as the thyroid gland produces fewer and fewer of the hormones necessary to keep the metabolism operating effectively. In the earliest stages of the disease, few patients notice symptoms, as the symptoms seem like the normal side effects of stress. However, over time, these symptoms like weight gain and fatigue can quickly add up and become serious health issues that include obesity, infertility and joint pain.

The most common symptoms of hypothyroidism include:

  • Fatigue
  • Unexplained weight gain
  • Constipation
  • Dry skin and hair
  • Hair Loss
  • Puffiness or swelling in the face
  • Muscle aches and weakness
  • Heavy menstrual periods
  • Brittle hair and nails
  • Depression
  • Cold intolerance

Some patients may suffer from what is known as subclinical hypothyroidism. This is a milder form of hypothyroidism. The condition is characterized by an elevated TSH level, but normal free T3 and T4 values.

Advanced forms of thyroid disease can occur for a number of reasons. Hashimoto's disease, also called Hashimoto's thyroiditis or chronic lymphocytic thyroiditis, is an autoimmune disease and among the most common forms of hypothyroidism. This disease occurs when the immune system attacks the thyroid gland and impairs hormone production. Hashimoto's disease can put patients at an increased risk of thyroid cancer.

Differentiated thyroid cancer (DTC) comes in a few forms: papillary thyroid cancer, follicular, medullary (affecting the parafollicular cells that produce calcitonin), and Hurthle cell carcinoma. Papillary thyroid cancer is the most common form and is a slow-growing cancer that can generally be cured, especially when caught in the earliest stages of the disease. Medullary thyroid cancer is rare. Follicular and Hurthle are more aggressive and may quickly metastasize to the lymph nodes, leading to a grim prognosis.

Other causes of an underactive thyroid can include thyroid nodules or a multinodular goiter, both of which increase the risk of thyroid cancer. If you are experiencing symptoms related to thyroid disorder, testing is vital to early diagnosis and treatment.

If you are a thyroid cancer patient, hormone replacement therapy must be approved by your physician. Cancer patients are advised to speak with a physician that is familiar with their case and is able to advise on the safety of other medical treatments. Patients who have had thyroid cancer and are in remission will need consent from their primary care physician before seeking treatment with a specialist for hormone replacement therapy. Hormone therapy is a common treatment for patients whose thyroid has been removed. However, consent is still required.

Thyroid Hormone Replacement Therapy Applications

Testing Thyroid Function

Thyroid function tests are quite common due to the prevalence of symptoms that match a thyroid disorder diagnosis. Most women are told their lab results are "normal," when they are anything but normal. This is because the line between normal and optimal is much broader than most people realize.

In conventional medical practice, a blood test for thyroid disorders often only looks at TSH levels and may not be using the most current benchmark levels for that particular hormone. While elevated TSH levels indicate low levels of T3 and T4, TSH can actually be suppressed by high levels of cortisol. If levels of T3 and T4 are not assessed directly, then a person could be dealing with hypothyroidism without even realizing it. In 2002, the Society of Endocrinologists announced that the standard testing ranges for TSH were inaccurate and that many people with hypothyroidism were undiagnosed. To this day, many thyroid lab tests have not been corrected to test for the accurate range of thyroid hormone levels.

Unlike most doctors, practitioners of the BodyLogicMD network measure free T3 and free T4 levels as well as serum TSH levels. At BodyLogicMD, your practitioner will also check for thyroid antibodies, which can help determine the presence of an autoimmune thyroid disorder. If such a disorder is diagnosed quickly, treatment may be able to prevent permanent damage to your thyroid gland and reduce the risk of thyroid cancer.

Treatment of Hypothyroidism

Once thyroid levels have been assessed, there are a number of treatment options for correcting hypothyroidism. Typically, most thyroid hormone replacement options consist of some form of synthetic T4 (levothyroxine sodium) or desiccated thyroid. The most common forms of levothyroxine include Synthroid, Tirosint, and Levoxyl. The most common forms of desiccated thyroid are Nature-Throid, and Armour Thyroid.

Side Effects of Thyroid Hormone Replacement Therapy

As is the case with most medications, taking too much of any thyroid medication can have a negative effect on your body and overall quality of life. This can happen at the beginning of treatment for hypothyroidism when a person's doctor/practitioner is trying to figure out the proper dose of thyroid medication. Here are just some of the most common symptoms of overmedication with thyroid, some of which resemble the most common symptoms of hypothyroidism:

  • Fatigue
  • Diarrhea
  • Feeling overheated
  • Sleep problems
  • High blood pressure
  • Anxiety, irritability, and depression
  • Weight loss
  • Difficulty smoking

Benefits of Thyroid Hormone Replacement Therapy

Within the BodyLogicMD network, practitioners take a more thorough approach to treating thyroid problems and disorders. You will not leave the office with a blanket diagnosis of "adequate" or "normal". Instead, each practitioner carefully examines your results and strives to get and maintain your thyroid levels in an optimal range, so you feel your best.

Thyroid disorder treatments may include iodine supplements, thyroid replacement hormones, and even desiccated thyroid hormone from animals. Again, hypothyroidism is usually treated with synthetic T4 (levothyroxine), which can correct your T4 and TSH levels. However, many people cannot efficiently convert T4 to T3. This is a problem because T3 is the more active form of thyroid hormone. Even if your T4 and TSH levels are optimal, a decreased T3 level may still cause symptoms. The expert practitioners in the BodyLogicMD network know that it takes a thorough investigation of the conditions and affected hormones, as well as a customized regimen of bioidentical hormones to achieve balanced thyroid levels.

At BodyLogicMD, your thyroid treatment plan begins with comprehensive lab testing that examines TSH, T3, T4 levels and thyroid antibodies. Your physician will also discuss your symptoms and how your lifestyle has been affected since symptoms began. This information will help your physician develop a tailored treatment plan that not only includes precise hormone therapy involving bioidentical hormones, but also nutrition and lifestyle recommendations to maximize your results and enhance overall health and well-being. There is no "one-size-fits-all" treatment plan for optimal health—you are unique and so is the harmony of your hormones.

If you find yourself struggling with thyroid problems, contact your local BodyLogicMD-affiliated practitioner today to find out how you can improve your quality of life by balancing your thyroid levels.

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