Thyroid medicine not working? Here is what you should do

The thyroid is an important endocrine gland which regulates metabolism or the speed of energy production in the body. Thyroid primarily releases two hormones T3 and T4 directly into the bloodstream, which then transports these chemicals to different parts of the body. These hormones act as signals telling the body what to do and when to do it. Many people take thyroid medicine to regulate its functioning.

Thyroid condition and its causes

Thyroid conditions – hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) – develop due to many underlying causes and are extremely common and treatable. The treatment approach depends on the type of condition and its cause. While, hyperthyroidism is addressed by antithyroid drugs, radioactive iodine therapy, beta blockers and surgery, those facing hypothyroidism issues need to take thyroid replacement medication. This is a synthetic way to add thyroid hormones back into the body. Levothyroxine is a common drug prescribed by healthcare practitioners to manage hypothyroidism.

Why does thyroid medicine not work for some people

Many people with thyroid disorders report unchanged symptoms even after they are treated with thyroid medication. Dr. Akanksha Singh, Senior Cosmetologist, SENS Clinic says, “As with any treatment, different people respond differently to thyroid medication, some patients may find that their symptoms are not improving despite sufficient medical intervention. This could be because of other existing conditions or drugs and supplements used alongside thyroid medication that inhibit their impact.”
For example, people may experience issues with levothyroxine absorption into the bloodstream. The American Thyroid Association has found that taking levothyroxine 30-60 minutes before breakfast or three or more hours after dinner maximizes absorption to a high of 80% as compared to just 64% absorption when the medicine is taken before or after a meal or a snack. Antacids and supplements containing calcium and iron may also interfere with absorption, so health experts recommend not taking such medicines within four hours of levothyroxine.

It should be noted that the impact of medicines takes time. Some people may feel better within a few weeks of starting the treatment while others may take a month or two to show improved symptoms. Several diagnostic tests may be needed before the optimised levothyroxine dosage can be identified and then administered to see the desired effect.
Also, it is important to stick to the same medication throughout the treatment duration. Deepak Pal, Sports and functional nutritionist, SENS Clinic said, “We often see patients switching between branded and generic thyroid hormones or levothyroxine. Even if these medicines claim to be of the same dosage, they may impact overall treatment.”
The American Thyroid Association says that even small variations in dosage delivered make a difference. Therefore, individuals who have changed their medication and have concerns about their thyroid health are advised to consult their doctors.

“Also, it is recommended to undergo regular tests to see how the medication is impacting TSH levels so that your healthcare provider can tailor the treatment according to your body’s response,” said, Dr. Akanksha Singh, Senior Cosmetologist, SENS Clinic.
A complex network of glands and hormones controls various maintenance and repair functions of the body. Glands and hormones are stimulated by other glands and hormones in a sort of chain reaction that ensures optimal functioning of the body. The thyroids too depend on upstream consignment, so to speak, of signals to release T3 and T4 hormones. This signal originates in the hypothalamus that secretes the thyroid-releasing hormone (TRH), which stimulates a part of the pituitary gland to secrete thyroid-stimulating hormone (TSH). TSH in turn stimulates the thyroid follicular cells to release T4 and T3 in the presence of adequate levels of iodine in the body.

Some of the early signs of thyroid malfunction are a slow or rapid heart rate, unexplained weight loss or weight gain, difficulty tolerating cold or heat, depression or anxiety and irregular menstrual periods. Thyroid disorders can be diagnosed by a blood test which measures levels of TSH – this is a screening test for both hypo and hyperthyroidism. Besides, healthcare providers may also ask for levels of T3 and T4 hormones.
Studies say that thyroid disorders affect 10-12% of the Indian population. It is also well known that females are five to eight times more likely to have a thyroid condition. Therefore, it is important to address symptoms when they arise. Thyroid disorders can be effectively managed and controlled, allowing most individuals diagnosed with the condition to lead a productive and stress-free life.