We often see patients who are already on thyroid replacement therapy ,yet continue to complain if fatigue. The may have tried various doses of commonly used medications like Synthroid, Levoxyl, or levothyroxine yet only receive partial or no improvement of their symptoms. Hypothyroidism typically encompasses complaints such as ; fatigue,weight gain ,dry hair and skin, cold intolerance and hair loss

Usually we check lab tests for TSH and base our treatment plan on that result. However , when we check free T4 and free T3, often these levels show that the patient may still be functioning at under active levels ,despite being on therapy. At this point,we can add T3 to the patients current regimen or change the dose entirely to a compound that includes T3 and T4.

Remember , Synthroid and medications like it, are merely T4 and must be converted in the body to the active version, called T3. Oftentimes ,patients are unable to convert their current prescription to T3 for reasons such as, hormone imbalance,poor nutrition,vitamin deficiencies ,cortisol abnormalities and many other causes .

Therefore,if you still feel tired and are on treatment already,be sure to check the other thyroid labs ,not just TSH . Also,when one is placed on therapy, be positive that both T4 and T3 are appropriately managed.