The Right Thyroid dose for Energy and Fat Loss

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Dr. Khoshaba

February 6, 2023

Do you have hypothyroidism and struggle with fatigue and unintentional weight gain? What’s the right thyroid dose for energy and fat loss? Well, the answer is, unfortunately, not so black and white. To answer the question simply, there is no universal thyroid dose that will increase energy and promote fat loss for everything.

That being said, there may be an appropriate dose and type of thyroid medicine for each individual that will help optimize energy levels and promote healthy fat loss. So how do you find the right dose for you?

How to find the right dose for you  

Firstly, it is important to note that sometimes less is more in this case. While symptoms of hypothyroidism or being in a hypothyroid state can include weight gain and fatigue, you also want to make sure you’re not on too much medication as being overmedicated on thyroid medicine can lead to dangerous side effects including elevated heart rate, cardiovascular disease, and even eye conditions. 

The right dose of thyroid medicine is where your thyroid levels are not only within range but within an optimal range. While having optimal thyroid levels is one piece of the puzzle, you also want to see that your symptoms are being managed on that thyroid medication and dose.

As Naturopathic Physicians, we seek to normalize thyroid levels but also see improved symptomatology. For this reason, we look at your thyroid stimulating hormone (TSH), but we also look at your free thyroid hormones (Free T4 and Free T3) as well as your nutrient status and thyroid antibodies. 

How does TSH work in relation to thyroid hormones?

The thyroid gland
The thyroid gland

When your bloodstream has insufficient thyroid hormone, also known as hypothyroidism, your thyroid will signal to your pituitary gland. This signal will cause your TSH levels to increase in an effort to increase the signals to your thyroid to make more thyroid hormones (T4 and T3).

So therefore, your healthcare provider will most likely assess your TSH to assess your thyroid function but may also assess your thyroid hormones, including free T4 and free T3. In a normal functioning thyroid, TSH levels range between 0.45 and 4.5 mu/L. However, every healthcare provider has a different value that they believe is optimal.

At Natural Endocrinology Specialists™, we like to see a TSH value between 1-2 mu/L. A TSH value above 4.5 often indicates low free thyroid hormone, indicating hypothyroidism. While healthcare providers will also look at your free thyroid hormones, TSH is still clinically the best indicator to assess for hypothyroidism.

When you dive deeper into an ideal thyroid dose, looking at your free thyroid hormones and making sure you produce a sufficient amount of free T3 will likely make sure you are receiving the right medication for the most symptom improvement. Your T3 is your active thyroid hormone that is mainly responsible for energy metabolism.

You can have a normal TSH value but low or suboptimal T3 levels and still present with classic hypothyroid symptoms. You want your Free T3 levels to be at around a 3.0 and your Free T4 levels around a 1.0. This shows that your body is able to convert from T4 thyroid hormone to active T3 hormone. If you are not producing enough T3 thyroid hormone, you should assess your nutrient status (selenium, zinc, iron, iodine) to see if any of these are low, as they are necessary for the conversion to T3.

You can start by repleting the nutrients that need to be repleted and assess to see if your body is able to convert to free T3 thyroid hormone on its own naturally. If you are still having trouble converting to T3, then you can speak to your Physician about dual thyroid therapy.

Thyroid Dose and Medication

Pills and alternative medicine: How to wean off thyroid medication
Various medication

There are several different types of thyroid medication to treat hypothyroidism. The most generic or common medication is levothyroxine. This is generic T4 and is used to help treat hypothyroidism. You may have seen levothyroxine in its branded form, Synthroid.

There is another branded T4 medication known as Tirosint. This medication is free of any excipients or fillers and only contains T4 hormone, water, and a little bit of sugar. Depending on one’s ability to absorb medications, we’ve seen patients have improved symptoms and better thyroid scores (even on less thyroid medication!) due to increased ability to absorb.

Sometimes these medications are given alone, and other times, they’re prescribed in addition to liothyronine (also known as T3). T3 comes in much smaller doses due to its strength, and often, patients are started on 5 mcg of Liothyronine. You may have also seen it in its branded form, Cytomel. In other cases, patients are prescribed NDT (natural desiccated thyroid). This medicine comes from the thyroid of a pig and already has both T4 and T3 thyroid hormones.

All of these medications have a place, but it varies from person to person. Our advice would be to take note of your symptoms on your thyroid medicine and speak to your Physicians about further testing but also inquire about different types of thyroid replacement therapy. 

So your right thyroid dose for energy and fat loss? That will depend on your thyroid levels but also on the type of thyroid medication you are on. You want to make sure that you are on a thyroid medicine you’re able to absorb and one that you find more improved symptoms with. At times, this may take experimentation, but with frequent testing and awareness of how your body responds to the medicine, you can find the right thyroid dose to help promote energy and healthy fat loss. 

Take the first step towards getting your thyroid back on track:

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Dr. Linda Khoshaba is the Leading Integrative Health and Hormone Doctor in Scottsdale, Arizona. She has extensive experience working in the field as a Hormone Specialist and Natural Endocrinologist.

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