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What Is Thyroid Hormone Replacement Therapy?

For most medical providers, thyroid hormone therapy involves the use of synthetic thyroid hormones to raise low levels of natural thyroid hormones in the body. Underactive thyroid condition is called hypothyroidism and is usually treated by taking daily hormone replacement pills called levothyroxine (T4 replacement). Unfortunately, for many clinics thyroid replacement therapy with Synthroid® (brand name for levothyroxine) is pretty much the only option. When Synthroid® is used to restore T4 levels, your T4 levels and your TSH levels do return to normal, but your T3 levels remain unchanged. With age, the body’s natural ability to convert T4 into T3 is not as efficient as it was when you were younger. As a consequence, the symptoms of hypothyroidism might persist when people receive this therapy. Also, some patients may have genetic abnormalities converting T4 to T3. In both cases, T3 and T4 levels need to be carefully monitored and these individuals may benefit from the addition of a small dose of triiodothyronine (T3). Therefore, thyroid hormone replacement with a combination of T3 and T4 is the most effective form of thyroid hormone replacement.

What Is Thyroid Hormone? What Is Its Function?

Thyroid hormone is not a single hormone, but rather two hormones produced by the thyroid gland: thyroxine (T4) and triiodothyronine (T3). T4 is the primary and the most abundant form of thyroid hormone comprising about 95% of thyroid hormone released by the gland whereas T3 accounts for the remaining 5%. T4 has to be converted to T3 in order to be used by your cells. The conversion is by the liver (through a process called de-iodination) and certain tissues, such as the brain. T3 and T4 are responsible for multiple functions in the human body, such as:

  • Metabolic rate – the rate at which your body uses energy
  • Heart rate
  • Thermoregulation and Homeostasis
  • Peristalsis
  • Brain development.
  • Muscle contraction
  • Cell division/regeneration/apoptosis

Production of thyroid hormone is regulated using a complicated loop-back system that involves the hypothalamus and pituitary glands and involves the release of two other hormones thyroid-releasing hormone (TRH – produced by the hypothalamus and thyroid-stimulating hormone (TSH – produced by the pituitary gland)

What Are The Possible Complications Of Untreated Hypothyroidism?

In the long run, untreated hypothyroidism can lead to:

  • Thyroid gland enlargement (goiter). A goiter can cause problems with swallowing and/or breathing.
  • Heart disease – Underactive thyroid tends to advance an increase in low-density lipoprotein (LDL) cholesterol, which in turn can cause atherosclerosis.
  • Peripheral neuropathy – if left untreated, hypothyroidism can lead to peripheral neuropathy, which can cause pain, numbness and tingling in the extremities.
  • Infertility – Low levels of thyroid hormone can harm fertility.
  • Anemia
  • Hearing loss
  • Birth defects. Babies born to mothers with untreated thyroid disease may have a higher risk of birth defects
  • Myxedema coma – Although very rare, untreated hypothyroidism may cause myxedema coma. Myxedema coma requires emergency medical treatment.

Benefits of Thyroid HRT

A malfunctioning thyroid that is not producing sufficient amounts of thyroid hormones, can cause a number of serious health effects such as:.  

  • Thinning hair/Hair loss
  • Dry skin
  • Low libido
  • Cold sensitivity
  • Low blood platelet count ( slow wound healing, heavy menstrual cycles, etc)
  • Muscle aches, weakness, and cramps
  • Weight gain
  • Chronic fatigue/tiredness
  • Depression

Patients need to weigh these short-term effects as well as long-term issues of hypothyroidism against potential side effects of the therapy.  Because thyroid health plays a critical role in our overall well-being, some simply see no other choice.

What Are the Side Effects of Thyroid Hormone Replacement Therapy?

Doctors normally start you on a low dose to gauge how well it works for you.  If the dose is too high for you, you may experience these symptoms:

  • Irregular heartbeat
  • Sleeplessness
  • Weight loss
  • Irritability and anxiety
  • Hypertension
  • Feeling very warm
  • Diarrhea
  • Fatigue

Virtual or In-Office Consultations

Thyroid hormone replacement therapy requires a high level of expertise and professional care from your provider. Put simply, it is complex as the doctor needs to test and account for TSH, TRH, T3, T4, Total T3, Total T4, TPO, and Tg (thyroid antibodies tests). A low TSH may stem from an abnormality in the pituitary gland, which prevents it from producing enough TSH to stimulate the thyroid gland (secondary hypothyroidism). Thyroid hormone replacement therapy is a very individualized treatment process, however, it is highly effective when done by Beso Wellness doctors. Please contact Beso Wellness to discuss what treatment option will best alleviate your hypothyroid symptoms, allowing you to live a healthy, normal life.


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