Why Your Thyroid Medication May Not Be Working

Common Questions about Hypothyroidism & Hashimotos

As an expert in hypothyroidism and Hashimoto’s, I get a lot of questions (especially on Instagram) So, every once in a while, I like to dedicate an episode to answering these questions. In this edition of “Ask Inna”, I’m tackling some of the most common questions including why medication doesn’t always make us feel better (even if it used to), whether being a little bit out of range can cause symptoms, and whether or not thyroid medicine is a forever commitment.

If you have hypothyroidism or Hashimoto’s, chances are you’ve wondered these things yourself – so let’s get to the answers.

Why You Might Not Feel 100% Better on Thyroid Medication

So many people who take thyroid medication think that they should feel completely healed and so when they don’t, they wonder what’s going on. The answer, like most things in our world, isn’t a simple one. There can be a few reasons why you might not be feeling 100% even on medication.

Knowing Your Thyroid Type

There are over 12 different types of thyroid medications. The right medication needs to match your specific thyroid type for it to work effectively. If you haven’t figured out your type yet, that might be the missing piece. I have a free Thyroid Type Training you can join to learn more, sign up for the next Zoom session here.

Knowing your type is critical because standard tests often just tell you your thyroid is “slow” (hypothyroidism). But there are different ways a thyroid can be sluggish, and each type might respond better to a specific medication. Knowing your type is crucial to getting the right medication, and that can make a big difference in how you feel.

Absorption Issues

Even if you have the right medication, it might not be getting absorbed properly by your body. This can happen for a few reasons, and that’s why some medications come in different forms (like with or without fillers). Absorption may also be related to your thyroid type if you are the “unavailable hormone type.” In this case, your body might actually have the thyroid hormones, but it can’t utilize them effectively. So, taking more medication wouldn’t necessarily solve the problem.

Finding the Right Dosage

Sometimes, the issue might be the dosage itself. It could be too low, leaving you under-supported, or too high, causing other issues. Life throws curveballs and things like stress, pregnancy, or menopause can affect your hormone needs. So, the perfect dose you started with might need to be adjusted over time to keep you feeling your best.

Hashimoto’s: Addressing the Immune System Attack on the Thyroid

We can’t forget that Hashimoto’s is an autoimmune disease. Your immune system has decided your thyroid is the enemy and is attacking it. Medication replaces the lost hormones, but it doesn’t address the underlying issue with your immune system.

This immune system attack creates inflammation, not just in your thyroid, but throughout your body. This inflammation can cause a whole host of unpleasant symptoms, from brain fog and fatigue to achy joints and stubborn weight gain. So, even with medication, you might still feel crummy if your immune system isn’t under control.

The Key to Feeling Your Best with Hashimoto’s – A Two-Pronged Approach

To truly feel your best, we need a two-pronged approach:

Support Your Thyroid: Take the right medication for your thyroid type and make sure it’s getting absorbed properly.
Calm Your Immune System: Identify and address the triggers that are causing the attack in the first place.

This two-pronged approach is exactly what I focus on in my Customized Hashimoto’s Roadmap program. Because remember, those triggers are individual, and addressing them in the right order is crucial for feeling your best.

Don’t Let Lab Ranges Fool You: Feeling Off Even with “Normal” Thyroid Results?

Another question I hear a lot is, “Can I still have thyroid symptoms even if my TSH is just a smidge outside the normal range, or my thyroid hormones are just a little off?” Absolutely! Here’s why: the lab ranges for thyroid tests are often very wide.

Think of it like a target. The lab range might be the entire target board, but the optimal zone, the bullseye, is actually much smaller and right in the center. So, you could technically be hitting the target, but you’re nowhere near the bullseye.

For example, with TSH, the lab range might say something like 0.45 to 4.5 is normal. But ideally, you want your TSH to be closer to 1.8 to 3. So, if your TSH is at 3.7, that technically falls within the lab range, but it also tells us something’s going on. It’s a sign you might not be hitting that optimal zone.

The same goes for your other thyroid hormone levels. Even if they’re just a hair outside the lab range, it can still make a big difference in how you feel. That’s why it’s important not to get hung up on the broad lab ranges. We want to aim for optimal levels, right in the sweet spot of that target range.

Will I Be on Thyroid Medication Forever?

This is a big question I get all the time! The answer, like most things with Hypothyroidism and Hashimoto’s, is it depends.

Let’s break it down by looking at what’s happening to your thyroid:

Hashimoto’s Causes Inflammation and Thyroid Damage: The hallmark of Hashimoto’s is inflammation that attacks and destroys your thyroid. The speed of this destruction varies from person to person.
Destruction Levels Dictate Medication Needs: The amount of thyroid destruction determines how much medication you might need. Some people see slow destruction, while others experience a more rapid attack. When the immune system is well supported, it can decrease thyroid destruction.

There are some nuances here, so let’s explore a few scenarios:

High TSH, Normal Hormone Levels: This can be a specific subtype of the “high TSH” thyroid type. Here, inflammation might be the culprit, not necessarily a need for medication. (Remember, this is for educational purposes only, consult your doctor for medication decisions.)
High TSH and Low Hormone Levels: In this case, medication is usually necessary to replace the missing hormones.

Flare-Ups and Medication:

Post-Flare-Up Medication: Sometimes, people are put on medication immediately after a Hashimoto’s flare-up when thyroid hormones are low. However, hormone levels often balance out on their own after a flare-up. If you were put on medication right after a flare-up, there’s a chance you might be able to get off it later with your doctor’s guidance.

Long-Term Needs and Supporting Your Thyroid:

Long-Standing Hashimoto’s and Extensive Damage: If you’ve had Hashimoto’s for a while and there’s significant thyroid destruction, the damaged part might not recover. In this case, you’ll likely always need medication to replace the missing hormones.
Prevent Further Damage: By supporting your immune system, we can slow down the attack on your thyroid. This allows you to potentially stay on a lower dose of medication and avoid needing more over time.

Thyroid Medicine is Not the Enemy

There’s a misconception, especially in some natural health circles, that medication is inherently bad. But think of thyroid medication more as a replacement of an essential hormone that your body needs to function properly. It’s not a “bad” thing, but rather a form of support.

The ultimate goal? To find the right balance – giving your body what it needs while keeping your immune system strong to prevent further damage and potentially reduce your medication needs in the future.

Your Next Steps in Securing Thyroid and Hashimoto’s Optimal Health

If you have thyroid questions, please reach out to me on Instagram @InnaTopiler. If you’re ready to take control of your thyroid health, you need your personalized Thyroid or Hashimoto’s Roadmap. To access it and get so much more support, join my next free Zoom training. Register here.

Eliminating Thyroid Mysteries

I hope by answering these questions, I was able to help you find that missing piece of the thyroid health puzzle and so you can regain your health. Could this also be the missing clue for someone in your life? Please share this episode.

Links:

Resources mentioned

https://www.thyroidmysterysolved.com

Related Podcast Episodes:

[Ask Inna] Your Thyroid and Hashimoto’s Questions Answered [Ask Inna] More Answers to Your Hashimoto’s Questions (Part 2) [Ask Inna] What You Want to Know about Losing Weight & Feeling Good with Hashimoto’s [Ask Inna] Answers to All Your Hashimoto’s Questions

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PLEASE NOTE

All information, content, and material on this podcast is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.

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