Thyroid Medication: Getting It Right

For those with Hashimoto’s, an autoimmune condition that is the most common cause of hypothyroidism, or underactive thyroid, getting the medication right is key to managing the condition. Finding not only the right medication but the right dosage is a critical part of the healing journey.

Problems with absorption of the medication are common and could be an indicator of the root cause of the condition. Many thyroid medications contain lactose, and dairy intolerance or sensitivity is a common symptom of people with Hashimoto’s. Lactose intolerant people may need higher doses of medication in order to achieve their optimal TSH (thyroid stimulating hormone) level.

Other factors that can influence absorption are underlying infection, low stomach acid, and food sensitivities. Even taking the medication with a morning cup of coffee can hinder absorption. Most thyroid medications should be taken with a full glass of water, on an empty stomach, and at least 30 minutes before the first meal of the day. They should not be taken within an hour of taking other medications or supplements.

It’s estimated that lactose intolerance rates in Caucasians are between 7—20% while for Asian, African, Arab, Jewish, Greek, and Italian populations, the figure is much higher. Sensitivity to other inactive ingredients in thyroid medication, such as dye, sucrose, corn starch, wheat starch, and triglycerides, can also cause malabsorption. Compounding pharmacists can recreate hypoallergenic versions of the medications for sensitive patients.

If patients are not lactose intolerant and are taking their medication correctly, infection could be the cause of malabsorption and should be investigated.