Levothyroxine

Um, so medications.

Synthetic levothyroxine.

levothyroxine.It doesn't help because it's, your body can't, doesn't recognize the T4.

It'll change the number.

It'll make your TSH go down, but it won't give you T3, which is the active hormone.

A good example is thyroid hormone, for instance.

Levothyroxine is also known as T4.

Levothyroxine is basically an amino acid, L-tyrosine, with four iodine molecules on it pretty simple process to make that in a laboratory but it's the same copy as what's in our body it's bioidentical to our body it's synthesized in a laboratory many of the other hormones like the sex hormones like testosterone and progesterone are isolated from a yam or a soy source and they're isolated from those sources but then they're manipulated in a lab to be to concentrate them and to make them identical to what's in our body

Does that make sense? It does a little bit.

Still, my caution kind of clicks in there too and saying, okay, identical.

It's the generic version of those.

It's called Levothyroxine and Liothyronine.

It's T4, T3.

But what's great about it and what makes it different from Armor and NP Thyroid, which are great products, and I'm so glad they're available still for now.

The brand name is Synthroid and the generic is Levothyroxine.

So it's essentially it's T4, which then in the body needs to be converted to T3.

A small subset of patients, they'll feel fine on levothyroxine and or synthroids.

For some people, they swear by the brand name.

And that's because it's a little bit more standardized.

When you go with a generic, there's different companies making different ones.

So one time you might get levothyroid, one time you might get levothyroxine.

And there could be subtle differences.

The prescription is essential, but it may not be the whole answer.

Levothyroxine is the prescription medication given to an underactive thyroid.

And it is essential.

And I want to say this clearly because the wellness industry has strangely turned this into a moral argument.

And this couldn't be further from the truth.

Yet, it still doesn't solve the whole story.

Levothyroxine replaces T4.

The hormone and underactive thyroid can no longer make adequately.

So my most recent thyroid decline, my last big flare that took me down was when I was 27.

I was already practicing medicine, I'm a PA, and was already on Synthroid, had moved from Levothyroxine to Synthroid, And I was spending 16 hours a day in bed.

I couldn't function outside of my job.

I would come home from work every day, go to bed, trying to rest to recover and rest enough to prepare for the next day.

These are drugs like Cytomel or Lyothyronine.

Or there are people that benefit from a combination of T4 and T3 together, which are drugs like natural desiccated thyroid, Armour, Ren thyroid, NP thyroid, or compounded medications that blend the two.

Again, the way that you determine, hey, how is this person using this medication? Are they able to use it? Is by checking all the labs and just seeing, is their T4 level good? Is their T3 level good? Meaning, are they converting it on their own? If not, and someone's walking around on a bunch of Synthroid who has persistent thyroid symptoms, if you check their T3 and it's low, doing something like adding Liothyronine or Cytomel to their Synthroid or Levothyroxine can be life-changing in like days, weeks.

It happens so incredibly quickly, but in a country that's accepted, hey, 96% of the time we're not ever going to check free T3.

Right.

experience with hypothyroid was a lot of my patients were on levothyroxine already, Synthroid, Levothyroxine.

The traditional method of treatment is you go to your primary care.

Now, around here, we see a TSH screened annually.

Like, you ...

They most likely would recommend Levothyroxine, and then you'd have to talk them into prescribing desiccated thyroid, and they most likely don't have experience.

I mean, there might be someone out there who does have experience, but I'm just not aware of who that person might be.

Next question: "What is the best way to calm Graves' disease-related anxiety?" I mean, the best way is to, is to address the Graves'.

Keep in mind, there's also a direct connection between thyroid health and your liver.

Hypothyroidism is associated with metabolic dysfunction known as MASH or fatty liver, which means to all the people who are on Synthoid or Levothyroxine, you've had a sluggish thyroid, you can't lose weight, the doctor most likely said, let's check your liver, and they put you on thyroid medication.

All your medications, including your thyroid medication, are regulated and metabolized in your liver.

If you have a fatty liver, one, your thyroid medication won't work as well.

And if you didn't know this, and your doctor who's prescribing Synthroid probably doesn't know this either, which is just flabbergasted.

The liver regulates the conversion of thyroid T4 into thyroid T3.

Seriously, your Synthroid, your Levothyroxine is thyroid T4.

The conversion to T3 is really what we want.

These are manufacturers or you're taking Dottie, which is a brand of estradiol or Beveldot, which is a brand of estradiol and so on.

Why is this important is because specifically this year with the national shortages of estradiol patch, I personally had noticed in my clinic that women can be sensitive and this is very similar to other hormonal replacements like, you know, I prescribe ligothyroxine or the brand version Synthroid, Tyrosine and so on and even changes in Levothyroxine manufacturers can have some subtle impacts on some women not all based on the variations in absorption or the components of how they're being absorbed.

So some women can be sensitive and similar to that Estradiol patch even if it's a different brand or a generic version but different manufacturers you might be sensitive if you're switching from one brand to the other or from generic to brand lang vice versa or different manufacturers from generic one version to the generic two version So that's going to be important.

And very commonly what I see, my women patients will tell me that, Dr. Mukherjee, I was feeling great all this while and suddenly I've started experiencing breast tenderness or suddenly I've experienced a episode of bleeding if they were already in the menopause phase.