Why Isn’t My Thyroid Medication Working?

If you have symptoms of a hypothyroid or a combination of hypo and hyperthyroid symptoms and your lab tests came back normal, or your medication is not working, it may not be your thyroid that’s responsible for your problems. Your doctor typically runs only one or two thyroid panels to determine whether or not you have the thyroid problem. And even if they run the whole gamut of thyroid panels it may not give them the true cause of the problem.

Symptoms of hypothyroidism:

  • fatigue
  • weight loss even when dieting
  • depression
  • constipation
  • sensitivity to cold
  • poor circulation and numbness in hands and feet
  • muscle cramps
  • catch colds easily
  • have slow wound healing
  • require excess amount of sleep
  • G.I. disturbances
  • dry, itchy skin
  • dry or brittle hair
  • dry skin
  • low body temperature
  • edema, especially in the face
  • loss of cutter most portion of eyebrows

Symptoms of hypothyroidism:

  • heart palpitations
  • inward trembling
  • increased pulse rate, even at rest
  • feelings of nervousness or emotional distress
  • insomnia
  • night sweats
  • difficulty gaining weight

There are many things that can cause the symptoms that you are experiencing, your own immune system could be attacking your thyroid (Hashimoto’s thyroiditis) or the enzymes that help process or facilitate the use of thyroid hormones. A poor blood sugar metabolism could also be causing your symptoms as well as gut infections, adrenal problem, and hormonal imbalances can all depress thyroid function. So if you are on Synthroid, Armor, or Levoxyl and your symptoms aren’t getting any better it might be time to run more tests.

If you been to an alternative healthcare professional they may have recommended iodine, thyroid glandulars or tyrosine but if your thyroid symptoms aren’t being caused by your thyroid this will offer little to no help and can actually make your condition worse.

So what’s the answer to your thyroid symptoms if your thyroid isn’t actually causing the problem?

The only way to find out is to run tests, otherwise you’re just guessing. If you’ve already been to an endocrinologist or alternative health care professional and they were unable to help you then chances are you have something that may not be caused by primary hypothyroidism. There are many different things that can cause the symptoms that you’re experience and you have to rule them all out. You may have more than one underlying cause. Even if you find a positive test which indicates one of the possible causes, and you stop testing, you may have missed something.

There 12 cups on the table turned upside down, you can’t see what’s underneath the cup. The rules of the game are this…there is at least one ball under the cups, there may be more than one ball under the cups. To win the game you must find all of the balls. If you find one ball but there are more balls and you didn’t find them, you lose. How many cups would you like to look under? The obvious answer is you would like to look under all 12 because you want to win.

The best way is to look everywhere the problem or problems may be.

The 4 Deal Breakers

The 4 deal breakers in every difficult chronic health condition are anemia, blood sugar metabolism, gut issues and liver and gallbladder issues. If you have a problem with any of these you have to handle them first, otherwise you’re just spinning your wheels.

After you have dealt with the 4 deal breakers above, you can proceed on to the other possible causes.

A Good Word Picture

Patients typically don’t understand exactly how they can have thyroid symptoms and it not be a thyroid problem. So instead of going into all the physiological processes and using medical terminology that you may not understand, We can simplify the explanation by comparing the inter-workings of the thyroid to ordering something online.

Most of us have at one time or another ordered something online. You go online, find something that you want, and place your order. If you haven’t received your item within a reasonable amount of time you contact the person you placed your order with. The person that you’re talking to verifies on their computer that you have indeed placed an order. This is much like running a TSH panel because a TSH panel is simply verifying that your thyroid gland received an order to ship out thyroid hormone to your body.

If that is the only test that is checked, to see if our order was received, it doesn’t solve your problem because your real problem is that you haven’t received your item. But there are many other places where the problem may have occurred.

The second most obvious place is the thyroid gland itself. It’s like the warehouse where the item that you ordered is being stored. If the warehouse is damaged you may not get your package at all. This is a good case for using thyroid hormones.

If the worker who actually places your item into the package and hands it off to delivery person, doesn’t show up for work or is unable to work it will affect you getting your package. If, when the delivery person arrives to picks up the package, there are more boxes than he can fit in his truck, that will delay you from receiving a package. If, when the delivery person takes your package to their central hub or warehouse for rerouting to its final destination, that warehouse is backed up that can delay your package. Once your package is handed off to the delivery person who is responsible for delivering it to your home, if you’re not there to receive it, you don’t get your package.

Now that’s a very simplified explanation to the process but I think it helps to see that there are many places where things can go wrong that have nothing to do with the thyroid itself.

Taking the above example you represent the brain, you send an order via your computer (hypothalamus), the message is forwarded to the operator (pituitary), who then relays the message to the warehouse (thyroid) where a worker (TPO enzyme) puts your item in a box and hands the box over to a delivery person (TBG, a protein that transports thyroid hormones in your body) who delivers the package to the central hub or warehouse (liver, which can be sluggish, delaying your package). The next delivery person (TBG, again) delivers your package to it’s final destination (gut, reversed T-3 and the peripheral tissue).

If you don’t have normal gut flora 20% of the thyroid hormone can’t be utilized, it’s like not being home when the delivery person attempts to deliver your package.

There are several other places where things can go wrong that were not mentioned in the story above. For example, you can have too many TBG proteins. It may not seem like a problem to have too many transport vehicles but when there is not enough of the thyroid hormone these proteins will not release their package. You may have a case where you have too much of one thyroid hormone (T3, T4) and not enough of the other( over conversion or under conversion). You also have a situation where the thyroid hormone is delivered to the cell but the cell cannot accept it because of damage to the cell wall caused by inflammation or infections.

Another problem can occur when your body’s 5’deiodinase, an enzyme responsible for converting T4 to T3 in the heart, muscle and nerve cells, isn’t working properly. This can happen for a variety of reasons, you can have a deficiency of cofactors, you can have gut dysbiosis, elevated cytokines, elevated cortisol, deficiencies of serotonin, deficiencies of dopamine or elevated testosterone (even in women).

As you can see there are many places where things can go wrong that have nothing to do with the thyroid itself. So if you’re still suffering from thyroid symptoms in your medication continually needs to be adjusted or isn’t working at all you may need to have further testing to find the underlying cause of your problem.