If you have been living with hypothyroidism, you know how draining it can be. Constant fatigue, mental fog, weight gain, or feeling cold when everyone else is comfortable can take a toll on daily life. Starting thyroid medication is an important step, but if your symptoms persist, it can be frustrating and disheartening.
The good news is that not all thyroid replacements are the same. The type of thyroid hormone therapy you take can dramatically affect how you feel. Understanding your options helps you and your provider choose the treatment that supports your body best.
Your thyroid acts like the body’s power plant. It produces two key hormones that regulate metabolism, energy, heart function, and mood:
A healthy thyroid secretes these hormones in roughly a 14:1 T4-to-T3 ratio. When conversion falters due to stress, nutrient deficiencies, gut imbalances, or liver dysfunction, you may still feel hypothyroid even if your lab numbers appear normal.
Hypothyroid symptoms develop gradually and can overlap with other conditions. Look for clusters rather than isolated issues, and talk with your provider about testing if several apply:
Untreated hypothyroidism can increase risks for high cholesterol, cardiovascular issues, and, in rare cases, myxedema coma. Early intervention can help prevent complications.
Most conventional providers begin treatment with synthetic T4-only medications such as Synthroid®, Levoxyl®, Levothroid®, or levothyroxine. These drugs supply T4, the inactive form of thyroid hormone, and rely on your body to convert it into T3.
For some people, this conversion process works perfectly. For others, genetics, stress, nutrient gaps, or digestive issues interfere with conversion. The result is often “normal” bloodwork but persistent fatigue, brain fog, or low energy.¹
If that sounds familiar, your body may need both T3 and T4 to function at its best. Adding T3 or using a therapy that provides both can help restore balance.
Desiccated thyroid extract (DTE) comes from porcine (pig) thyroid glands and contains both T4 and T3, along with other naturally occurring thyroid components. Armour® Thyroid is one of the most recognized DTE brands. Each 60 mg (1 grain) tablet provides about 38 mcg of T4 and 9 mcg of T3, for a natural ratio of approximately 4:1.²
Many patients report improved energy, mental clarity, and overall well-being on DTE compared to T4-only medications. One clinical study found that nearly half of participants preferred desiccated thyroid extract over levothyroxine for symptom relief.³
However, DTE is not without challenges:
Despite these limitations, desiccated thyroid extract remains a valuable option for many patients who do not feel their best on synthetic medications alone.
Compounding pharmacies can create customized thyroid formulations using desiccated extract, synthetic T3/T4, or a combination. This allows your provider to tailor hormone ratios, strengths, and delivery methods specifically to your physiology.
At Physicians Preference Pharmacy, we prepare:
Our compounded medications are free from dyes, fillers, and artificial sweeteners. Ratios can be adjusted closer to the natural human profile (around 13:1) for more balanced replacement, and sublingual options bypass the digestive system for improved absorption and consistency.
| Aspect | T4-Only (Levothyroxine) | Desiccated Thyroid (Armour®) | Compounded T3/T4 |
| Hormones Included | T4 only | Natural T4 + T3 + trace compounds | Custom T3/T4 ratio |
| Best For | Those who convert T4 well | Patients needing both hormones | Personalized care or absorption issues |
| Pros | Affordable, predictable | Natural profile, improved symptom relief for some | Exact dosing, no unnecessary fillers |
| Cons | Relies on conversion | Fixed ratio, cost, shortages | Requires compounding pharmacy |
A TSH test alone does not tell the full story. It measures the pituitary’s signal to the thyroid, not how well hormones are used in your cells. Request a comprehensive thyroid panel that includes:
Track symptoms like energy, weight, and sleep alongside lab results to identify patterns and treatment effectiveness.
Medication is important, but optimal thyroid health also depends on how well your body converts and utilizes hormones. Focus on these key areas:
Addressing these foundational systems can enhance the effectiveness of your thyroid medication and support long-term balance.
Recently, the U.S. Food and Drug Administration (FDA) announced plans to classify desiccated thyroid extract (DTE) as a biologic. This change would prohibit compounding pharmacies from preparing DTE and could create a monopoly for commercial manufacturers such as AbbVie, the maker of Armour® Thyroid.
This decision stems from a technical interpretation involving thyroglobulin, an inactive protein in pig thyroid glands that is broken down during digestion. Despite evidence that DTE’s active components (T4 and T3) are well-established small molecules, this reclassification could limit access for patients.
If finalized, it may:
A 12-month transition period ends in August 2026, after which compounded DTE may no longer be available. Pharmacists nationwide have expressed concern, noting the emotional and physical distress this will cause patients who rely on DTE for stability and quality of life.
You can make your voice heard by visiting Compounding.com/thyroid. It takes only two minutes to send a pre-written letter to the FDA and Congress or to share your story about why preserving access to DTE matters.
Safe, effective thyroid treatment should never be one-size-fits-all. Desiccated thyroid extract and compounded formulations give patients flexibility and access to therapies that align with their bodies’ natural hormone balance.
If you are ready to explore personalized thyroid solutions, contact Physicians Preference Pharmacy at 281-828-9088. Our compounding pharmacists will help you and your provider design a plan that fits your life and supports your long-term health.
Local: 281-828-9088
Toll Free: 877-640-5248
Fax: 281-828-9669
pharmacy@PhysiciansPreferenceRx.com
20214 Braidwood Drive
Suite 140
Katy, Texas 77450
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