What if Your Synthroid Doesn't Work?

What if Your Synthroid Doesn't Work?

thyroid doctors

A reader wrote recently to ask, "My Synthroid isn't working! What should I do?"

She had started Synthroid (also known as levothyroxine) three or four weeks earlier, and was still exhausted and gaining weight. So her first thought was that the Synthroid wasn't working.

It's common. Patients think that the medication isn't working if after a few weeks, they still have troublesome symptoms.

But if this happens to you, does this mean your medication really isn't working?

Not necessarily.

Before you make any assumptions, you should explore the following questions...

Are you taking the right dose of your thyroid medication?


Not enough -- or too much -- can both cause a variety of symptoms, including fatigue, weight changes, and mood swings, among others. Your doctor will probably use the TSH test to determine your response to the medication. Be sure you understand the TSH normal range your doctor and laboratory are using. Often, it takes some adjusting to get the right dosage.

Should you try a different brand name?

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Sometimes patients taking Synthroid switch to another brand of levothyroxine -- for example Levoxyl or Unithroid -- and find that even at the same dose, they feel better. It's definitely worth discussing this option with your doctor.

Do you need additional T3?

Some people also seem to need supplemental T3, the active form of thyroid hormone, to feel well. While controversial, some studies have shown that patients have improvement in overall symptoms when they add T3 to their treatment. And anecdotally, many patients favor T4+T3 therapy, versus T4 alone. If you are taking Synthroid or another levothyroxine drug, you can ask your doctor about adding Cytomel (the brand name synthetic T3 drug) to your treatment. Other practitioners add compounded, time-released T3, switch patients to Thyrolar (a synthetic T4+T3 drug) or even shift patients to Armour Thyroid, a natural desiccated thyroid drug. For more information, read Do You Need T3 or Natural Desiccated Thyroid Drugs? 

Would you do better on natural thyroid medication?

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Some people simply feel better taking one of the natural, desiccated thyroid drugs instead of a synthetic. The most popular and easily obtained brand is Armour Thyroid, but RLC Labs also makes Nature-throid. All the desiccated thyroid drugs are prescription drugs, and made from dried porcine (pig) thyroid.

Do you have an adrenal problem that is interfering with thyroid function?

tired exhausted fatigued thyroid

According to Drs. Richard and Karilee Shames, if you continue to have problems even after being prescribed proper amounts of thyroid hormone, you could have an adrenal problem. Unless the adrenal problem is identified and addressed, thyroid medication is not as effective as needed.

Could you have an underlying or related autoimmune condition?

tired fatigued hypothyroid

Most thyroid disease is due to an autoimmune condition such as Hashimoto's or Graves' disease. But having one autoimmune disease also puts you at risk of developing others. And symptoms can be similar enough that you may assume, for example, that your dry eyes, joint aches or hair loss are thyroid-related, when they are actually related to another autoimmune condition. Certain symptoms have even been identified as what are called "super-symptoms," which you tend to see in almost all autoimmune conditions. Find out about them now.

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