Ask the Pharmacist: Two steps to making thyroid hormone

Your thyroid gland sits at the base of your throat and under normal circumstances it produces thyroid hormone that gets distributed throughout your body. Every cell in your body has a receptor for thyroid hormone which most people don’t realize.

So, if you’ve had your thyroid gland surgically removed, you should still be restoring thyroid hormone with prescription medications such as Nature-Throid, Armour Thyroid, Synthroid or something along those lines. Thyroid hormone isn’t just one hormone, it is borne from your thyroid gland as T4 known as thyroxine. 

This must undergo several chemical reactions. If you have genetic polymorphisms in your genes, and most people do, then you may have difficulty making the biologically active form of thyroid hormone dubbed T3 for triiodothyroidine. This is what your periphery requires, what your tissues and cells need for you to feel well. Certain vitamins and hormones are required for the activation of T4 to T3.  

Just because your thyroid gland secretes T4 and your lab value for “Total T4” is normal doesn’t mean you’re well and healthy. For T4 (inactive) to become T3 (active), it has to be converted and the conversion takes place primarily in your liver, as well as your kidneys, brain and intestines. 

So, step one is to be sure that your liver enzymes are in the normal reference range and that you’re not abusing your liver with too much alcohol, cigarettes or pesticides.

More than 90 percent of the thyroid hormone produced is T4 (inactive storage form) and seven percent is T3 which is the active form. That may sound bad, but it’s not because T3 is the gas pedal here, and if you take too much T3, you’ll feel wired, anxious, sweaty and sleepless. These symptoms occur in people who take too much Compounded T3 medications, Liothyronine (Cytomel) or T3 activating supplements. 

About 20 to 25 percent of your thyroid hormone is activated to T3 in your gastrointestinal tract, compliments of friendly microorganisms. So, step two is probiotics. This explains why people with poor GI status, or those with Crohn’s, IBS or diarrhea develop hypothyroidism secondary to the lack of healthy microflora. 

Treatment for a thyroid disorder varies on the specific disorder you have. Therefore, there are so many drug treatments, vitamins, herbal remedies and lifestyle factors. There isn’t one single approach that work. For example, Hashimoto’s or Graves’ disease require medications or supplements to calm down the body’s immune attack. Medications may be required to either raise or lower thyroid hormone depending on which direction it was swinging.

Compare that to someone who has hypothyroidism because they are iodine deficient and perhaps eats poorly. Now compare that to someone who is unable to convert their T4 to T3 and simply needs some probiotics, ashwagandha, B vitamins and a smidge more Vitamin D!

Physicians have their hands full trying to figure out how to treat each person with a thyroid disease, because it presents differently and therefore the treatment is different. Trial and error and experimentation is required, and so are routine blood draws to gauge where you’re at with all these hormones. I have a longer version of this article which you can receive via email after signing up for my newsletter at suzycohen.com.

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Suzy Cohen is a registered pharmacist. The information presented here is not intended to treat, cure or diagnose any condition. Visit SuzyCohen.com.