Thyroid Treatment Options:
At The Compounding Lab we compound many preparations that support and assist in creating wellness to improve your Thyroid function. Your Classic Thyroid Symptoms are Cold Hands, feeling sluggish, thin hair, thin dry skin, constipation and I just don’t feel well. Extreme Fibromyalgia and at the extreme Chronic Fatigue. We need to treat the syptoms as well as the desease.
Synthetic Hormones Vs. Desiccated Thyroid:
The traditional approach is to use synthetic hormones like Oroxine (levothyroxine). These products only contain T4 hormone, they have no T3. The common argument for using the synthetic T4 is it provides steady hormone levels. What is overlook is that the vast majority of people cannot convert the T4 to the active form of thyroid that is T3. This is easy to confirm by measuring the free hormone levels. There 7 (seven different) reasons as to why the Thyroid is not function and low conversion is common.
1. Pituitary (low TSH)
2. Low T4
3. Poor Conversion (T4 to T3)
4. Low TBP
5. High TBP
6. Insulin Resistance (Adrenals)
7. Autoimmune (Destruction of Thyroid)
Desiccated Thyroid -- The Natural Alternative:
When one has low T3 levels, which are typical with synthetic hormone use, the brain often does not work properly. The symptoms patients explain are Foggy or brain Fog. It is important to use a preparation with T3 because T3 does 90% of the work of the thyroid in the body. This is when it’s a place to use a combination of T4 and T3, which compensates for the inability to convert T4 to T3. Desiccated thyroid has both T3 and T4
Recently published in the New England Journal of Medicine, showed that the natural hormone product, such as Amour, was far better at controlling the brain problems commonly found in hypothyroidism. Many Integrative doctors tend to use Desiccated thyroid which is a mixture of mono and di-iodothryonine and T3 and T4, the entire range of thyroid hormones. Desiccated Thyroid Dosing should be TWICE a day.
Our Natural Thyroid capsules can also be prescribed in grains (gr) and are available in the many strengths:
• 16.25mg thyroid extract (¼ grain) contains 9.5mcg levothyroxine (T4) and 2.25mcg liothyronine (T3)
• 32.5mg thyroid extract (½ grain) contains 19mcg levothyroxine (T4) and 3.5mcg liothyronine (T3)
• 48.7mg thyroid extract (¾ grain) contains 28.5mcg levothyroxine (T4) and 6.75mcg liothyronine (T3)
• 65mg thyroid extract (1 grain) contains 38mcg levothyroxine (T4) and 9mcg liothyronine (T3)
• 130mg thyroid extract (2 grain) contains 76mcg levothyroxine (T4) and 18mcg liothyronine (T3)
• 195g thyroid extract (3 grain) contains 114mcg levothyroxine (T4) and 27mcg liothyronine (T3)
The most common starting dose for patients with hypothyroidism is Desiccated thyroid, 90 mg a day which ideally is taken twice a day, 10 to 20 minutes after breakfast and dinner. (45mg twice a day). Taking it after meals also helps to reduce volatility of the blood-level of T3.
Taking the Desiccated thyroid twice a day overcomes traditional medicine's major objection and resistance to using natural thyroid preparations - its variability in its blood-levels. Most doctors using Desiccated thyroid are not aware that natural thyroid should be used twice daily and NOT once a day. The major reason is that the T3 component has such a short half-life and needs to be taken twice daily to achieve consistent blood levels.
Initial dose for hypothyroid states, 60 to 300 mg daily. Usual maintenance dose is 30 to 125 mg daily.
Note: Desiccated thyroid 60 mg is usually considered equivalent to thyroglobulin 60 mg, levothyroxine sodium (T4) 0.1 mg or liothyronine sodium (T3) 25 μg.
Combined Synthetic T4/T3:
Only recently have had the opportunity to compound a combined Synthetic Combination of T4/T3 into one capsule. This can allow for cost reductions and allows both hormones to be replaced in one capsule. Starting Combination 50mcg T4 / 12.5mcg T3
Dose Adjustments With Lab Monitoring:
Once on thyroid hormones the dose should be increased until the TSH falls below 0.4. Then one needs to optimize the 2 thyroid hormones by using the Free T4 and Free T3 levels. It takes 4-6 weeks to see the maximal benefit once started.
The Free T3 and Free T4 are used to monitor the treatment. They should be above the median (middle) but below the upper end of the laboratory normal reference range. The goal for healthy young adults would be to have numbers close to the upper part of the range, and for cardiac and/or elderly patients, the numbers should be in the middle of its range.
The Free T3 and Free T4 levels should be checked every 2 months and the hormone therapy readjusted until the FT3 and FT4 levels are in the therapeutic range described. Once a therapeutic range is achieved the levels should be checked at least once a year. A small number of large, overweight, thyroid-resistant women may need larger dose of Natural Thyroid to see results.
Autoimmune Thyroid: (Hashimotos)
Treating this is difficult as the T3 & T4 are irregular and the patient experiences from Hypo to Hyper Thyroid Symptoms. The patient needs Hydrocortisone to control the Inflammation and destruction of the Thyroid gland. The addition of Hydrocortisone to T4/T3 capsules of 1 to 5 mg each morning allows a great improvement to their overall improvement.
Symptoms of Excessive Thyroid Hormone Patients need to know:
There are frequently only temporary during the adaptation stage. The symptoms may include: palpitations
• Nervousness, feeling hot and sweaty, rapid weight-loss, fine tremor, clammy skin
If patients cant tolerate Desiccated Hormones:
Over 90% of people do much better on Desiccated thyroid. However, there are a small number of people who do not tolerate it. However, Tertroxin, which is synthetic T3 only, can be used in combination with one of the T4 only synthetic preparations. It is important to recognize that T3 should always be prescribed twice daily due to its shorter half-life. This is typically after breakfast AND supper for compliance reasons.
If patients are currently taking Oroxine (thyroxin), the Free T4 level is usually at or above the high end of its normal range and your Free T3 level is usually below. In this situation, one may then add 5-12.5 mcg Compounded T3 (pure-T3) after breakfast and supper daily, rather than Desiccated Thyroid.
Once or twice daily dosing one can then optimize both the T4 and T3 levels, with whatever thyroid preparation is required. This is not possible in most hypothyroid patients with T4 only preparations.
People Who Should Not Take Compounded T3:
The only exception to using compounded Thyroid hormones is in severe acute cardio-pulmonary conditions, such as congestive heart failure, when the metabolic slowing effect of a low FT3 level can actually be life-saving. However, the vast majority of hypothyroid patients do not have this problem.
All our Thyroid compounds are lactose & Gluten free and can have a filler of choice such as Tyrosine, Magnesium, Theanine or Cellulose.
1. L-Thyroxine may be prescribed for
The dosage form available for L-Thyroxine is Capsule. The Compounding Lab compounds more than 2,000 formulations in capsule form. The potency of each compounded capsule is verified through weight and yield checks before it is dispensed and mixed with precision in our RAM mixer.
2. Levothyroxine may be prescribed for Hypothyroidism
The dosage form available for Levothyroxine is Capsule. The Compounding Lab Pharmacy compounds more than 500 formulations in capsule form. The potency of each compounded capsule is verified through weight and yield checks before it is dispensed and mixed in our RAM mixer. Levothyroxine is also available in this dosage form. Different strengths may be available for different dosage forms such as Oral suspension.
The dosage form available for Levothyroxine is Oral Suspension oral. Oral suspensions and solutions can be administered directly into the mouth using a dosing syringe or mixed with a small amount of food. They offer a wide range of flavoring options, and flexible dosing adjustments.
Many strengths of Levothyroxine Oral Suspension is available staring from 0.0125 mg/ml.
3. Levothyroxine Sodium/Liothyronine may be prescribed for
The dosage form available for Levothyroxine Sodium/Liothyronine is a capsule. The potency of each compounded capsule is verified through weight and yield checks before it is dispensed.
AN example of strength combination of Levothyroxine Sodium/Liothyronine Capsule is available.
- Levothyroxine Sodium 16.2 ug/cap + Liothyronine Sodium 3.8 ug/cap
4. Liothyronine (t3) may be prescribed for Hypothyroidism
The dosage form available for Liothyronine is capsule. The potency of each compounded capsule is verified through weight and yield checks before it is dispensed. Many strength combinations of Liothyronine capsule , slow release are available.
- Liothyronine (T3) 5 mcg/cap
- Liothyronine Sodium from 1.5 mcg/cap to 30 mcg/cap
- Liothyronine Sodium 75 ug/cap
5. Dessicated / Natural Thyroid may be prescribed for Hypothyroidism
The dosage form available for our Natural Dessicated Thyroid in compounds has more than 500 formulations in capsule form when dispensed. Starting Natural Thyroid Capsule is 15 mg/cap.