Many patients struggle with energy after losing their thyroid

Thyroid hormones are essential in maintaining and regulating the body’s metabolism.

After the thyroid gland is removed surgically or after it is destroyed with radioactive iodine so that no functional thyroid tissue remains, patients are put on thyroid hormone replacement. In the vast majority of these patients the type of thyroid hormone therapy prescribed is Thyroxine.

Thyroxine (also known asT4) contains 4 molecules of iodine and  must be converted in the body to a much more active form of thyroid hormone called triiodothyronine (T 3). T 3 contains 3 molecules of iodine. T 3 is 10 times more active than T 4 in its metabolic effects of stimulating the energy factories inside the cells to produce energy. Thus this process of converting T 4 into T 3 must be efficient in order for a person to feel well after their thyroid gland is removed or destroyed by radiation.

The conversion of T 4 into T 3 mainly occurs in the liver, muscle and kidneys.

Sometimes the body does not convert the T 4 tablets into sufficient amounts of T 3 and this can be seen in blood tests which show normal T 4 levels and low T 3 levels.

Sometimes the body converts the T 4 into the wrong form of T 3 which is called Reverse T 3. Reverse T 3 is an inactive form of T 3 that cannot stimulate the metabolism. Unless the amount of Reverse T 3 is specifically measured in a blood test, the doctor will not know this imbalance exists.

If the levels of the T 3 are low or normal but the levels of the Reverse T 3 are high, the patient will feel fatigued and depressed and  may gain excess weight.

Why do low levels of T 3 or high levels of Reverse T 3 occur?

  • Lack of the minerals selenium and zinc, which are common deficiencies in patients
  • Gluten intolerance, which is often hidden, and is not the same as celiac disease
  • Liver problems such as fatty liver, liver disease or a liver overloaded with prescribed drugs or toxins
  • Kidney or muscle diseases
  • Stress either excessive or prolonged
  • Removal or destruction of the thyroid gland – a significant amount of T 3 is manufactured and stored in the thyroid gland itself, so losing this capacity can cause low T 3 levels

How can we overcome low levels of T 3 and/or high levels of Reverse T 3?

This is quite easily done by the following –

  • Prescribing T 3 hormone (triiodothyronine) tablets/capsules to the patient. Typical doses of T 3 are 10 to 20mcg twice daily; this dose can be adjusted up or down if needed after blood tests are evaluated so that normal blood levels of T 3 and Reverse T 3 are achieved and maintained.  Blood tests can be done every 2 to 3 months to monitor this. T 3 tablets or capsules can be made in slow release form by a compounding pharmacist. The T 4 (thyroxine) tablets are also given with the T 3 tablets/capsules but in a lower dose
  • Improving liver function with a good liver formula containing Milk Thistle, B vitamins and taurine – see
  • Raw juicing with vegetables to improve liver and kidney function – see my book Raw Juices Can Save Your Life
  • A magnesium supplement to optimise muscle function
  • A supplement containing selenium, zinc and  iodine

These strategies can restore excellent thyroid metabolism in a patient who has lost all their own thyroid function.

In any patient who is taking T 4 replacement but does not feel well, a blood test should be done to measure levels of not only TSH and free T 4, but also free T 3 and Reverse T 3 levels. Otherwise we will miss this common problem and the patient will struggle on for many years. Easy to fix, but often overlooked.

For more information see my book Your Thyroid Problems Solved. You can also watch the following video.