Treatment Options

Treatment

The approach to help treat hypothyroidism is to replace the hormones (T4 & T3) that the body is not producing itself. T4 is credited with 20% of activity within cells while T3 is credited with 80% of activity within cells. There are synthetic and natural forms of both hormones, with GPs commonly prescribing T4 in its synthetic form.

Thyroxine

Once hypothyroidism has been diagnosed, most GP’s will prescribe Thyroxine. Thyroxine is a synthetic brand of the human thyroid hormone, T4. It is a prescription only medication. Dosing for optimal health is a process where several visits and tests are usually required to establish the correct dosage. The process may take some number of weeks before the majority of symptoms diminish.

The government funded form of Thyroxine (levothyroxine sodium)(T4) tablets varies from country to country. Currently, the New Zealand government funded brands of thyroxine tablets are:

  • Eltroxin (Aspen)(100mcg and 50mcg)
  • Levothyroxine (Mercury Pharma)(100mcg and 50mcg)
  • Synthroid (BGP)(100mcg, 50mcg and 25mcg)

In October 2007, the suppliers of Eltroxin (GlaxoSmithKline) made a formulation change and advised Drs & pharmacists. A number of people noticed the difference quickly. A growing number of people complained about side effects on the new medication when previously they had been well. The Centre for Adverse Reactions Monitoring received more than 1300 reports, with more reports being filed. Itching eyes, sensitivity to light and nausea were common reactions.

Whole Thyroid Extract

Whole Thyroid Extract (or desiccated whole thyroid extract powder) is obtained from domesticated animals (usually pigs) that are used for food by humans. While thyroxine contains T4, whole thyroid contains T1, T2, T3 and T4. Whole thyroid was once a registered medicine (in New Zealand) and was widely used to treat hypothyroidism.

Some GPs are comfortable prescribing whole thyroid (a prescription only medication in NZ) while others are not. There have been minimal side effects reported from patients on whole thyroid, although patients allergic to porcine products are likely to have adverse reactions. The same process is followed as on Thyroxine, where patients are tried on a dosing regime and adjustments made as required, patients can monitor their temperature to also gauge their progress. Whole thyroid is available as a compounded medicine and can be provided by a number of pharmacies in New Zealand. Pharmaceutical Compounding NZ Limited (PCNZ) specialises in compounded hormone supplementation and is an informative resource for Doctors and patients who wish to pursue this avenue of treatment.

Synthetic T4/T3 Combination

For those who are unable to tolerate pig or pork products synthetic T4/T3 combinations (similar to the content present in whole thyroid extract or in proportions to suit the patient needs) can be compounded, using vege capsules (not gelatin), upon request from PCNZ.

Nutritional Support

Supplementing the diet with vitamins and minerals has been shown to help alleviate symptoms of hypothyroidism in conjunction with prescription medication. Supplementation can also be a good form of preventive medicine for ‘at risk’ age groups (typically middle aged and older women).

Many GPs stipulate that if a patient has a healthy diet then supplementation is unnecessary in the general populace. Whilst theoretically true, the reality for many people in a western society with constant demands on their lifestyle is that their intake is insufficient to match their requirements.

Iodine and Selenium are very important minerals (as discussed in the ‘Thyroid Function’ section on page 1). Iodine makes up the molecular composition of each thyroid hormone – T1, T2, T3,T4 (Iron is also necessary for the bonding process of making these molecules). Selenium is necessary (along with Zinc) for the conversion process of T4 to T3 in the cells. Iodine and Selenium are recognised as being deficient in New Zealand soils, implicating any food grown and rendering them also deficient and unable to provide RDA (recommended daily allowances) for the general populace. Iodine is added commercially to regular table salt to help offset this deficiency (however not everyone buys the iodised brand and there has been discussion to add iodine to bread instead).

Vitamins B2, B3, B6, B12 and Vitamin A are also involved in thyroid function. (however when supplementing with one or more B group vitamins over a length of time, it is more beneficial to supplement the whole group – see below)

The best approach to deciding a supplementation regime is to find a health care practitioner who is familiar with nutritional medicine and is able to give pertinent advice to the respective individual.

A second option is to try the following guide. (Please note again that this is recommended as a guide only and it is difficult to advise an accurate supplementation regime as variables such as sex/age/diet/body mass all influence an individual’s dosing requirements).

*Zinc – some pharmacies are able to conduct a zinc taste test which can help determine zinc levels.

**Vitamin C is important for adrenal function which in turn supports thyroid function.

There are various products on the market that contain some or most of the above nutrients above, in the recommended doses. Most pharmacies stock appropriate ranges (or are able to order them in) and are able to give advice on choice of supplements. A starting product that may produce benefit is Clinicians Thyroid Support Plus capsules.

In addition to supplementation, there are also dietary changes that can benefit the hypothyroid sufferer. Some foods known to suppress thyroid function if eaten frequently in large amounts are: cabbage, (and other brassica family vegetables like cauliflower, broccoli etc) turnips, soy products and walnuts. The brassica family of vegetables when cooked though are no longer a risk.

Reducing or eliminating these foods from the diet can help support healthy thyroid function.

Resources for understanding Thyroid function, problems and treatment

Many people have embarked on a ‘personal journey’ of investigation after their quality of life slowly diminished to unbearable lows. There are a number of resources available to help sufferers better understand how their thyroid functions, treatment options and dietary considerations that ultimately influence the final outcome. Healthcare is not an exact science as each individual is different. It is important for the individual to be ‘actively’ responsible for their own health through education and care.

Pharmaceutical Compounding NZ Limited have been helping many sufferers with advice and guidance.

Contact Details:

Phone: 09-442-1727
Fax: 09-442-5851
Email: info@pharmaceutical.co.nz

Website: www.pharmaceutical.co.nz

There are a number of books written by professionals who have experience at successfully treating thyroid ‘mis-function’ (particularly hypothyroidism).

*Your Thyroid problem Solved by Dr Sandra Cabot
*Solved -The Riddle of Illness. (How managing your Thyroid can help you fight and control: Arthritis, Cancer, Diabetes, Obesity, Heart Disease, Fibromyalgia, Sexual problems) by Stephen E Langer M.D. and James F Scheer.

Here are the contact details for a Thyroid Advocacy group that emerged during the time many Eltroxin users had adverse reactions, called New Zealand Thyroid Association.

Phone: 03-382-0498
Email: tracey@keenkiwi.co.nz