Compounded Thyroid Options for Optimal Hypothyroidism Treatment

Author: Kimberly Bennett, RPh

Are you suffering from hypothyroidism? Is your current treatment not relieving your symptoms? If you are on a product like Synthroid, which is only T4, the inactive form of thyroid hormone, you may still be experiencing many of the symptoms of low thyroid function. Let us share with you the benefits of customized compounded bioidentical thyroid preparations that contain both T4 and T3 (the most active form of thyroid hormone).

First, what is hypothyroidism?

Hypothyroidism occurs when your thyroid gland is not making enough thyroid hormones for your body’s needs. It can also occur when you are making enough thyroid hormones, but they are not being used properly at the cellular level (also known as functional hypothyroidism).

Common Symptoms of Hypothyroidism

• Loss of energy/fatigue
• Difficulty losing weight
• Weight gain
• Fluid retention
• Enlarged tongue with teeth indentations
• Cold extremities and cold sensitivity
• Cold intolerance
• Difficulty concentrating and short-term memory loss
• Muscle pain and cramps
• Joint pain
• Tiredness after a full night’s sleep
• Recurrent and chronic infections
• Decreased mental sharpness, “brain fog”
• Hair loss
• Dry skin
• Brittle fingernails with ridging
• Low basal body temperature
• Elevated cholesterol and triglycerides
• Depression or mood swings
• Constipation
• Menstrual irregularities
• Headaches
• Enlarged thyroid gland

Customized Compounded Thyroid Hormone Replacement

There are several types of thyroid hormone therapies available to treat the symptoms associated with hypothyroidism, most of which are oral products. At Physicians Preference Pharmacy, we specialize in compounded oral thyroid hormone replacement, offering customized doses, in both oral capsule and sublingual tablet dosage forms. Thyroid hormone medication has a narrow therapeutic index, so choosing a customized dose and dosage form for the patient is crucial to assist them in achieving optimal thyroid support and function.

Compounded thyroid hormone replacement options available at Physicians Preference Pharmacy:

• Desiccated porcine thyroid capsules (contains both T3 and T4)
• T3/T4 slow-release capsules
• T3 slow-release capsules
• T4 slow-release capsules
• T3/T4 sublingual tablets
• T3 sublingual tablets
• T4 sublingual tablets

Because of our commitment to complete health and wellness, all our compounded preparations are free of lactose, parabens, artificial sweeteners and any unnecessary dyes, binders and fillers which may negatively impact treatment.

Choosing the Right Form of Thyroid Supplementation

Physicians Preference Pharmacy compounds different types of bioidentical thyroid medications: desiccated porcine thyroid and synthetic T3 and T4, singularly and in combination with one another.

Desiccated porcine thyroid powder is extracted from the thyroid gland of pigs whereas T3 and T4 are typically sourced from plants. Both desiccated porcine thyroid and T3/T4 are bioidentical, that is that they are chemically identical to the hormones produced by the human body.

• Desiccated Porcine Thyroid capsules are good for patients requiring supplementation of both T3 and T4 who respond better to a higher ratio of T3 to T4, or for those who have previously shown a sluggish response to T3/T4.
• Bioidentical T3, T4 and T3/T4 are sufficient for the majority of patients requiring supplementation and are appropriate for vegans, those who prefer a non-animal-derived product and individuals who request vegetable capsules.

When choosing a thyroid replacement dosage form for the patient, prescribers should specifically consider patient preference, compliance, cost and hepatic and gastrointestinal health. Most individuals respond well to oral capsules, while others, specifically those with poor gut health or liver function, should consider sublingual products for improved absorption and drug efficacy.

Examples of patients who may require sublingual therapy may include those with:

• Poor or altered gut microbiome due to diet, infection or chronic use of medications such as antibiotics, laxatives, opioids and proton pump inhibitors
• Bowel resection procedures
• Hepatic function impairment

It is imperative to consider a patient’s gut health (microbiome) and hepatic function, as both are important in performing most of the conversion of T4 to T3, which is required to maintain optimal thyroid levels. These bodily systems are frequently overlooked, which is why prescribing T4-only products, such as Synthroid®, often produces little benefit for the patient.

To provide a complete assessment of thyroid function and activity in patients exhibiting symptoms of hypothyroidism, a comprehensive thyroid panel is recommended, along with evaluation of lifestyle choices such as diet, vitamin and mineral intake and bodily stressors. Considering patients’ cellular requirements and personal preference is crucial when choosing an appropriate thyroid supplementation product.

In addition to thyroid supplementation, optimizing thyroid health requires a functional assessment of other related body systems, such as adrenal function, gut health and the immune system. If you are a provider seeking guidance in choosing the appropriate compounded thyroid hormone replacement products for your patients, please contact our pharmacists at Physicians Preference Pharmacy at 281-828-9088. A full list of T3 and T4 doses that we compound can be found by clicking here.

We Are Here to Help

Do you have hypothyroidism? Our compounded thyroid preparations do require a prescription from your provider. Please call our pharmacists today with any questions at 281-828-9088. It will be our privilege to serve you!