When Synthroid Doesn’t Work

When Synthroid Doesn't Work - Sad FaceAre you finding that Synthroid doesn’t work for you?  Perhaps you saw improvement of your low thyroid symptoms in the beginning, but now there seems to be no effect.  For some, it didn’t make a difference from the beginning.  Perhaps you have already gone back to your doctor and he or she has adjusted the dosage of the synthroid medication but you still see no change.

There could be a few reasons why synthroid is not working but I want to focus on this particular reason:  Low thyroid (hypothyroidism) is very often a secondary problem and adrenal gland dysfunction is often the primary problem.

Very often, when women are diagnosed with low thyroid, Synthroid (Levothyroxine), the synthetic thyroxin, is prescribed.  Synthroid is only T4, which is the precursor hormone to the more active thyroid hormone T3.  In many cases, over time doctors keep raising the dose of T4, and eventually, it stops working.

Why?  It is because the primary hormonal issues are not being addressed.

How so?  The hypothalamus sends releasing factors to the pituitary gland.  The pituitary gland is a small gland at the base of the brain that sends stimulating hormones to specific target glands.  Regarding thyroid function, the hypothalamus sends Thyrotropin Releasing Hormone (TRH) to the pituitary gland.  The pituitary gland sends Thyroid Stimulating Hormone (TSH) to the thyroid gland. The thyroid gland then sends mostly tetra-iodothyronine (called T4 or thyroxin) and a little tri-iodothyronine (called T3) to all the cells of the body.  But T3 is the thyroid hormone that does almost all of the necessary activity on the cells of the body.  Since only very little T3 is sent from the thyroid, then our body has to convert most of the T4 into T3, which is dependent on various nutrients, including selenomethionine and iodine in certain amounts.

Should you then consult a clinical nutritionist to get the dosage for these nutrients?

Hang on, there’s one more thing you need to know.  The hypothalamus, pituitary and thyroid glands send and receive, messages to and from each other, based the amount of hormones being made and released to keep the hormones at proper levels.  It’s like a thermostat in your house senses a preset temperature range and keeps the temperature at a comfortable range.  On top of that the hypothalamus sends many other releasing factors to the pituitary gland and the pituitary gland sends many other stimulating hormones to many other target glands.  Associated with thyroid function and in response to certain stressors, the hypothalamus also sends a substance called Corticotropin Releasing Factor (CRF) or Corticotropic Hormone Releasing Hormone (CHRH) to the pituitary, which sends  Adrenocorticotropic Hormone (ACTH) to the adrenal glands.  In response to ACTH, the adrenal glands release various other hormones, including one in particular, called cortisol.  This often affects thyroid function. Cortisol being released in too high an amount for too long a period of time, such as in a long-term stressful condition or in many chronic illnesses, will induce the immune system to send chemicals produced in the body that make antibodies that actually attack the thyroid gland. Subsequently, the thyroid gland function starts to decrease resulting in low thyroid, and then you start to experience low thyroid symptoms.

When this occurs, the following sequence of events is common.  A doctor is consulted and he/she orders lab tests for TSH and T4.  From the lab test, when results show TSH is elevated and T4 is low, Synthroid  is prescribed.  Many doctors are not trained to consider the “web-like” interconnections between various bodily systems that can cause high TSH and low T4.

If this is happening, I recommend checking what’s happening with your adrenal glands by testing cortisol and another adrenal hormone called DHEA by measuring those hormones from your saliva!  Why saliva, not blood?  To answer that, I’ll just quote from a blog post I wrote awhile back titled, “Doctors Are Missing Adrenal Fatigue in Chronic Fatigue Syndrome”:

Typically, these doctors that were consulted by these patients did not test salivary cortisol and DHEA-S levels.   If they did, they used the blood or urine cortisol and DHEA testing methods.  In research studies and in my clinical experience, I found salivary testing is the most accurate and reliable.   Since cortisol levels change significantly depending on the time of day, we should find out your cortisol levels at certain times of the day.  The normal daily range of cortisol output at specific times of the day is known.  Since morning cortisol levels should be at their highest after we wake up, with a dramatic drop by noon, and a gradual decrease until midnight, it is best to take 4 saliva samples during a normal day to ascertain each individuals output.  I often see altered cortisol response and DHEA-S levels which often correlate very closely with each individual’s signs and symptoms.  On the other hand, if cortisol is measured by one blood or urine test, only the cortisol for one time of the day will be reflected.  This is simply unreliable.

Many of those doctors consulted do not believe that salivary testing is a valid measurement for hormonal assessment.  Unfortunately, some doctors end up concluding it’s all in your head.  Some may even recommend you see a psychiatrist.

I’ve seen some posts on nutrition supplement shopping sites where some of the people affected by this condition have moved on with their own research and are using some nutrition and herbal remedies in place of or in addition to Synthroid.  While I’m pleased that they found a remedy, I’m concerned that they are not addressing the underlying problems.

So, what is the best solution when synthroid does not work?  Consult a doctor that will deal with the root causes, instead of just prescribing Synthroid.  He/she will be able to determine if adrenal dysfunction is the primary cause, as well as any other problem that may be going on.  As I mentioned above, because Synthroid is synthetic, there’s issues with that, too.  Thus, I strongly recommend finding a doctor will give you a solution that uses nutrients in therapeutic amounts, dietary remedies and therapeutic lifestyle modifications instead.

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