Levothyroxine for Hypothyroidism: Does it Work?
By Bill Lovett, MD
I want to talk about thyroid today, perhaps a little differently than you may have seen thyroid discussed before. We have patients coming to our office on a weekly basis saying there is something wrong with their Thyroid, yet their numbers indicate otherwise. Their blood tests typically look “normal” by the suggested range.
However, using a test called a TPO, we can find antibodies within their thyroid. This will tell us if they have Hashimoto’s disease or Hypothyroidism. In our practice, 1 in 15 women that walk through our doors have “normal” thyroid labs, but show all the signs of Hashimoto’s disease. In addition, 1 in 30 men are experiencing the same situation. These patients have been neglected and not treated for years because their levels indicate a healthy Thyroid.
A Recent Study Shows Levothyroxine to be Ineffective
I recently saw an article by Dr. Anthony Bianco, who was a past president of the American Thyroid Association from the Rush Medical Center in Chicago. His article, posted in October of 2016, shadows almost exactly my own feelings about how thyroid works and should be treated.
Oftentimes, I will say that Levothyroxine, or Synthroid, which is the most common thyroid medication prescribed in the United States, treats the patient’s doctor or insurance company, but not the patient themselves.
One thing to remember is that free T3 within the thyroid complex, is the most active form of thyroid. While free T4 is actually the least active. Levothyroxine and Synthroid are comprised of T4. These companies are hoping that the T4 eventually converts to free T4, and then into free T3. Which is unfortunately an unlikely scenario. See the graphic to the right for help in understanding this. (Source: Red Tail Wellness Centers)
The Results of Dr. Bianco’s Study
First, Dr. Bianco found that Levothyroxine-treated patients had higher levels of free T4 and lower levels of free T3 (the one they actually need). This is compared to the control patients not on Levothyroxine. In other words, Levothyroxine raised the least active form of thyroid. In addition, it lowered the more active form, therefore making the patients feel worse.
Secondly, Levothyroxine-treated patients were more likely to be overweight. This is despite consuming considerably less calories. We see this all the time here in our office. Patients come to us for weight loss, only to discover that their family physician or endocrinologist has them on Levothyroxine. This is prohibiting their ability to actually lose weight, despite the lowered calories.
Thirdly, he found that the Levothyroxine-treated patients were more likely to be taking antidepressants and cholesterol-lowering statin drugs. This is again compared to the controls within the same study. In my opinion, this suggests that patients with abnormal labs are being treated with a cheap and ineffective medication.
How We Should Be Treating Thyroid
Many other countries in the world actually treat patients with proper thyroid medication, not Levothyroxine or Synthroid; medications that elevate the T3 in free T3, which again is the more active form that makes patients feel better. These countries understand that patients can be deemed “normal” by their labs, yet still suffer from Hypothyroidism or Hashimoto’s Disease.
I was taught in medical school to treat the patient, not the number. As providers who choose to treat the patient and not the numbers, we often get questioned by and find it difficult to get coverage from many of the insurance companies. Those that know me, know that I’m a proponent of thyroid and think that it makes people feel better. Even just a little thyroid can tremendously alleviate the symptoms of Hypothyroidism. This, combined with other treatments such as hormone replacement therapy, can be the key to patients regaining balance in their lives.
If you have any questions or would like to schedule an initial consultation with either myself or Judy Couch, FNP-C, please give us a call at (513)-791-9474 or fill out our initial consultation form. We look forward to hearing from you.