Hypothyroidism Medication Comparison
The tables below have details to compare synthetic and natural medication for hypothyroidism. Some of this information is also on the Hypothyroidism Medication page but organized differently. For more information about treatment for hypothyroidism, see the links in the column at the right.
On this page:
Which thyroid medications can I take?
| Drug | Availability | Dietary considerations |
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Synthetic T4 Brand names: Eltroxin, Levothroid, Levoxyl, Oroxine, Synthroid, Unithroid |
Available in most or all countries, and virtually all doctors will prescribe it for patients they have diagnosed with hypothyroidism. |
Most brands contain lactose as a filler. Levothroid and Levoxyl do not. |
Synthetic T3 Brand names: Cynomel, Cytomel, Tertroxin |
Available in many countries. |
Contains lactose as a filler. |
Synthetic T4/T3 Brand name: Thyrolar |
Available in the US only. |
Contains lactose as a filler. |
Desiccated thyroid Brand names: Armour, Nature-Throid, Thyroid, Westhroid |
Available at most pharmacies in the US and Canada; in other countries, it often has to be specially imported. |
Derived from pigs.
Doesn't contain lactose. |
How long and well does it keep?
| Drug | Shelf life | Stability |
|---|
Synthetic T4 Brand names: Eltroxin, Levothroid, Levoxyl, Oroxine, Synthroid, Unithroid |
May be reduced "...in the presence of light, temperature, air, and humidity." |
Known to have "significant stability and potency problems." |
Synthetic T3 Brand names: Cynomel, Cytomel, Tertroxin |
No known problems. |
No known problems, but T3 is faster-acting than T4. See T3 Disadvantages on this page. |
Synthetic T4/T3 Brand name: Thyrolar |
No known problems as long it's kept refrigerated. Can be unrefrigerated for up to a week without adverse results. |
No known problems. |
Desiccated thyroid Brand names: Armour, Nature-Throid, Thyroid, Westhroid |
Documented minimum shelf life of up to 17 years. (Testing was ended at 17 years.) |
Doesn't have the stability problems that synthetic T4 medications are known for. |
What are some other treatment considerations?
| Drug | Adjustment flexibility | Physician knowledge |
|---|
Synthetic T4 Brand names: Eltroxin, Levothroid, Levoxyl, Oroxine, Synthroid, Unithroid |
For people on T4 alone, dose adjustment is easy; pills come in a variety of sizes.
See Synthetic T3 adjustment flexibility for people on separate T4 and T3 medications. |
Virtually all doctors will prescribe it for patients they have diagnosed with hypothyroidism. |
Synthetic T3 Brand names: Cynomel, Cytomel, Tertroxin |
When taking both synthetic T4 and T3 as separate pills, the ratio of T3 to T4 can be adjusted. However, the absorption of T4 is so variable (from 40 to 72 percent) that the ratio can't be said to be constant. |
Despite the large number of medical articles on treatment with T3, it can be difficult to find a doctor who is willing to prescribe T3 in addition to T4. |
Synthetic T4/T3 Brand name: Thyrolar |
The ratio of T3 to T4 can't be adjusted unless T4-only or T3-only pills are taken as well. |
It isn't a well-known drug at this time. |
Desiccated thyroid Brand names: Armour, Nature-Throid, Thyroid, Westhroid |
The ratio of T3 to T4 can't be adjusted unless T4-only or T3-only pills are taken as well. |
Teaching about it in medical schools stopped suddenly in 1975, and many doctors are untrained in its use. |
What are some other advantages and disadvantages of each type of medication?
| Drug | Advantages | Disadvantages |
|---|
Synthetic T4 Brand names: Eltroxin, Levothroid, Levoxyl, Oroxine, Synthroid, Unithroid |
For many thyroid patients, synthetic T4 alone is enough to return them to normal health.
Each brand has different fillers, and with a variety of brands to choose from, patients can try different brands if they react to the fillers in one brand. Also, some patients do better on one brand than on another. |
Contains only one of the four thyroid hormones.
Although lab results may not indicate a problem, T4 alone or sometimes even a combination of synthetic T4 and T3 doesn't alleviate all of the symptoms of hypothyroidism. |
Synthetic T3 Brand names: Cynomel, Cytomel, Tertroxin |
For many patients, taking T3 in addition to T4 relieved the symptoms that weren't reversed on T4 alone.
A large body of research supports the use of T3 in addition to T4 for hypothyroid patients. |
T3 is faster-acting than T4; patients usually split their dose to avoid having their energy levels crash when the effects of T3 wear off. (However, timed-release T3 is also available.)
Those taking synthetic T3 with T4 need to take two types of pills and have two prescriptions filled instead of just one.
Pure T3 can't be used by itself during pregnancy. Much of the fetus depends on a good supply of T4. |
Synthetic T4/T3 Brand name: Thyrolar |
For many patients, taking a T4/T3 combination relieved the symptoms that didn't reverse on T4 alone.
Only one pill and one prescription are required to obtain both T4 and T3. |
The ratio of T3 to T4 can't be adjusted unless T4-only or T3-only pills are taken as well. |
Desiccated thyroid Brand names: Armour, Nature-Throid, Thyroid, Westhroid |
Contains a natural form of T4 and T3, and may also contain the thyroid hormones T2 and T1.
Absorbed more completely and more consistently than pure T4.
In the natural, desiccated form, T3 appears to spread out its effects more evenly.
For many patients, taking desiccated thyroid instead of T4 alone or even a T4/T3 combination relieved the symptoms that weren't reversed on the other medications. |
While many thyroid patients do very well on it, some people can't tolerate it or don't do well on it. |
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Hypothyroidism Treatment Files
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Hypothyroidism Treatment
An overview of treatment for hypothyroidism and the pages in this section
Hypothyroidism Treatment History
Early treatment, synthetics until the present, the standardization hoax, and links to more information
Hypothyroidism Medication
Brand names, content, availability, physician knowledge, and other information about synthetic T4, synthetic T3, synthetic T4/T3 combination, and desiccated thyroid
Hypothyroidism Medication Comparison
A side-by-side look at synthetic T4, synthetic T3, synthetic T4/T3 combination, and desiccated thyroid comparing the above information
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