I wanted to talk about something I see ALL the time in my community... You're taking your Levothyroxine faithfully. Your doctor says your TSH is "perfectly normal." Yet you still feel absolutely terrible. Sound familiar? Let me tell you why this is happening - and more importantly, what you can do about it. The Problem with Levothyroxine MonotherapyHere's the truth I've come to after years of working with thyroid patients (and being one myself): T4 monotherapy just doesn't work. Not for most people. Honestly? I don't think it works properly for ANYONE long-term. Your thyroid naturally produces two main hormones:
When you take Levothyroxine, you're only getting T4. Your body is supposed to convert that T4 into T3. But here's the kicker - many of us simply CAN'T convert enough. This conversion happens primarily in the liver and gut, and for countless reasons, this process fails us. The result? Your cells are literally starving for thyroid hormone, even though you're taking your medication exactly as prescribed. My Personal NightmareMy own doctor kept cranking up my T4 dose when I complained about fatigue. My TSH looked "perfect" on paper. But I ended up with such severe muscle pain I could barely walk! When I finally ordered my own private blood test, I discovered my free T3 was in my boots while my T4 was sky-high. My body simply wasn't converting properly. The Testing ProblemMost doctors only test TSH. If you're lucky, they might check T4 levels. But almost NONE of them test T3 - the active hormone your cells actually need! Without knowing your T3 levels, you're missing the most crucial piece of the puzzle. You could be severely deficient in the active hormone while your doctor keeps telling you everything looks fine. What Actually WorksI believe everyone with hypothyroidism needs combination therapy:
My personal preference is the synthetic combination (Levothyroxine + Liothyronine) because it allows you to dial in the perfect dose of each hormone for YOUR unique body. NDT comes in a fixed ratio, which makes it harder to customize, but it works beautifully for many people. Key Action Steps
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