Dear Pharmacist,

I take Synthroid for my thyroid condition and also Wellbutrin for depression. I am in pretty good health other than my hair still coming out, and I have cold hands and feet, but I feel better overall. What else can I take or do to help myself?

—R.P., Boston, Massachusetts

Answer: It sounds like your getting somewhere but not fast enough. The symptoms you describe are commonly associated with low thyroid. I suggest you ask your doctor for added support. By that, I mean a slight dosage increase, or a different medication altogether and/or supplements. Let’s talk about this more.

Synthroid contains synthetic thyroxine (T4). It’s pure T4 and it’s a bio-identical match to our own natural thyroid hormone. Some people can easily convert that drug to it’s active form called T3, but not everyone. The problem is that in people with depression, they have a very hard time converting T4 to active T3 which is what your cells are starving for. It sounds like this could be happening to you. It’s what I call being “thyroid sick” as opposed to “hypothyroidism” which is where your gland fails you. There are ways to overcome this:

One way is to switch to a “natural dessicated thyroid” (NDT) drug such as Armour Thyroid, Nature-Throid or WP Thyroid (very clean ingredients). Since NDT drugs are combinations of T4 and T3, you’ll probably get better results.

Another way is to take a T3 drug with your Synthroid each morning (2 pills). This offers the active T3 to your body which could ease your depression and other symptoms. T3 drugs are compounded at special pharmacies and you can buy a ready-made brand called Cytomel at any pharmacy.

Yet another way to help improve T4 to T3 conversion is to take natural herbs and vitamins that help your body activate the Synthroid. I’m thinking of a high quality trace mineral formula that contains zinc, magnesium and so forth. Selenium is particularly important because it improves T3 activation while reducing antibodies that would otherwise destroy your thyroid gland. Here are tips for everyone:

Thyroid Healthy Tip #1: Wear a “thyroid collar” whenever you get a chest X ray, or any X ray where your thyroid gland is exposed to the radiation. Your thyroid is extremely sensitive to radiation so do whatever you can to protect it.

Thyroid Healthy Tip #2: Before you become pregnant, have your thyroid checked properly. Hypothyroidism is a risk factor for infertility, premature birth, low birth weight, miscarriage and poor fetal neurological development.

Thyroid Healthy Tip #3: I often hear a person describe obvious symptoms of hypothyroidism several weeks or months after surgery. This is termed non-thyroidal illness and it happens after surgery. It’s detrimental to not treat this condition. Your cells could be starving (what I call “thyroid sick”) even though your TSH test is normal so if you feel hypothyroid despite a normal lab test, ask for a trial course of medicine and see how you respond.

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