THYROID MEDICATIONS and HORMONES:
OK, for starters, here is some basic background information 
about the function of the thyroid gland. This info is vital to 
understanding why synthroid doesn’t provide full relief from 
your symptoms and why natural desiccated thyroid is a 
superior medication for most people. It is true that not all 
women are alike and therefore what we do with one will not 
necessarily have the same effect on another. However, my 
research has shown that at least 80% of people feel best 
on a natural desiccated thyroid product (such as Armour or 
Westhroid) than on the incomplete synthetic products 
(synthroid, levoxyl, unithroid, cytomel, thyrolar etc). Why? 
Because the healthy thyroid gland does not produce merely 
T4 and T3. It also produces reverse T3, 3 kinds of T2, T1, 
T0, and calcitonin.
What is calcitonin, you ask? Well, this is the hormone 
(produced by the parathyroid gland) which removes calcium 
from your blood and deposits it into your bones. You know 
how there’s the big worry about osteoporosis when you are 
on thyroid replacement therapy? That’s probably because 
95% of people today are given synthetic hormone which 
does not contain calcitonin. The desiccated thyroid products 
do have it. This is just one more reason to take Armour or 
Westhroid or some other natural thyroid product. The 
calcitonin helps counter the bone-destroying effects of 
thyroid hormones.
Don’t EVER forget that people with normal thyroid glands 
have the full spectrum (including T3) of thyroid hormones 
coursing through their blood streams all day long every day! 
So they are at just as much risk for osteoporosis as a 
woman on natural thyroid supplement! A doctor who leaves 
you hypothyroid in order to "protect your bones" is a doctor 
to fire. The best thing you can do for your bones is to 
exercise; light resistance training (weights) will increase 
your bone mass very significantly (you don’t even have to 
use heavy weights). How well does it work? Studies with 
the elderly in nursing homes using just 5-pound weights a 
few minutes daily increased bone mass so well the test 
group got fewer than half as many fractures as those who 
did not exercise with weights. And not only that, it builds 
muscle which will raise your metabolic rate and make you 
lose weight more quickly and easily.
Whenever anyone tries to tell you "natural thyroid is 
dangerous because it has T3," you tell them "Hurry! Run to 
the hospital and get your thyroid gland yanked out QUICK!!! 
It’s pumping T3 into your bloodstream NIGHT AND 
DAY!!!!!!" Did you know those studies that say oral thyroid 
causes osteoporosis were all done on SYNTHROID, not 
desiccated thyroid (Armour)????!!!! And these studies 
showed that the connection existed only in post-menopausal 
women. Meanwhile a whole slew of studies were done that 
showed no connection between oral thyroid and 
osteoporosis, not even in post-menopausal women. In other 
words, there is no proof either way and the doctors need to 
start doing their homework and actually REALIZE this 
instead of listening to the slick marketing techniques 
practiced by the makers of synthroid. Millions of women in 
this country are being forced to take synthroid to protect 
their bones from Armour---not because of scientific 
research proving osteoporosis but because the makers of 
synthroid said so.
Now, back to the various other thyroid hormones…
As you know, the thyroid hormones consist of a tyrosine 
molecule with iodine molecules stuck to it. If 4 iodines are 
stuck on, you have T4. 3 iodines gives you T3. Reverse T3 
is created with 3 iodines stuck in different positions. T2 has 
2 iodines; there are 3 types of T2 all depending on where 
the iodines are stuck. Etc.
The hypothalamus gland takes note of how much thyroid 
hormone there is in the bloodstream and if the amount is too 
low, it releases a hormone called TRH. This is Thyrotropin 
Releasing Hormone. It goes to the pituitary gland and 
stimulates it to release TSH. This is Thyroid Stimulating 
Hormone, and it goes to the thyroid gland to tell it to make 
some more thyroid hormone. So the thyroid gland takes in 
the amino acid tyrosine and the mineral iodine and then 
combines the two, creating the thyroid hormone. There is 
T0 and T1 (0.5%), T2 (4.5%), T3 (15%), and T4 (80%) 
(These percentages are approximate; I have found different 
numbers from different sources). Each of these hormones is 
stored in the thyroid gland and also released into the 
bloodstream. No one knows what T0 and T1 are for. T4 is 
very stable and courses through the bloodstream, ready to 
be taken up by a needy tissue for conversion to T3 and T2. 
What your gland does is to make a little bit of T2 and T3 
and release them to the body for instant usage. Then your 
gland also produces a stockpile of T4 which it releases to 
travel around in your blood, ready for any needy cell to 
convert over into useable T3 (and T2). To convert T4 into 
T3 (and T3 into T2), your tissues use an enzyme, 
deiodinase, to knock one of the iodine molecules off. Well, 
some of your tissues require a supply of T2 in order to 
make this enzyme (while other tissues are able to make 
deiodinase without T2). Now, there are also several 
different deiodinase enzymes and they knock different 
iodines off. This means you will sometimes get reverse T3 
instead of T3. And this is how your body creates the 3 
different types of T2.
http://www-hsc.usc.edu/~hkaslow/Teach/Handouts/Thyroid-
2000.pdf This is a scientific treatise about how thyroid 
hormone is made, the different deiodinase enzymes that are 
necessary to convert the various hormones, and what 
happens next.
Synthroid (levoxyl, unithroid, and all other levothyroxine 
products) consist only of T4. The theory is that since T4 is 
barely active metabolically, when you take it you won’t 
notice any metabolic effect on your body (heart palpitations, 
etc). But then it will start to break down into T3, reverse T3, 
(which go down to the T2s, etc) and your body will use 
these hormones. Well, that’s the THEORY.
OK, why doesn’t synthroid make us feel great then? Well, 
because some cells in our bodies need the T3 that is made 
by the thyroid gland directly. They cannot convert T4 into 
T3; they must have T3 directly from the bloodstream. About 
75% of the T3 your body uses is converted by your tissues 
from T4. But at least 25% of the T3 your body needs 
comes directly from the thyroid gland. Your different tissues 
throughout your body use T3 at different rates. And some of 
the tissues, such as your brain, require serum T3 for good 
function. These tissues are not adept at converting T4 into 
T3. Because people with healthy thyroid glands receive at 
least 25% of their T3 directly from the thyroid gland, 
hypothyroid patients should also receive direct T3, either 
from their glands or from their medication. NO ONE 
SHOULD BE EXPECTED TO GET ALL OF HER T3 FROM 
T4 CONVERSION. IT SIMPLY IS NOT ENOUGH. And 
other cells must have T2. So you see, you just don’t get the 
same effect from synthroid. Your body demands all 9 of the 
thyroid hormones that a healthy thyroid gland makes. 
Desiccated thyroid products come closest to providing the 
exact hormones your body would make if it could. http:
//freespace.virgin.net/smokey.quartz/gaby.html
NOTE: Forest Pharmaceuticals does not "add" calcitonin, 
T0, T1, or T2 to their product. These hormones are present 
already because of what Armour is. Armour is desiccated 
pig thyroid. The thyroid gland is removed from a pig, dried, 
and then ground to powder.  The glands from many pigs are 
mixed together until testing shows that the T3 to T4 ratio is 
exactly 1:4.22 (there is 1 mg of T3 for every 4.22 mg of 
T4).  Then binders and fillers are added to produce tablets. 
So every hormone present in the live gland is also present in 
the tablet. However, since medical professionals currently 
believe that only T4 and T3 are active hormones, Forest 
does not measure or even acknowledge the presence of 
calcitonin, T0, T1, or T2 in their product. They only measure 
and guarantee the amount of T3 and T4 in each tablet.
Here is a scientific study proving the body needs T3; notice 
the last sentence of the "conclusions" section clearly states 
that this study shows your body needs the T3 DIRECTLY 
SECRETED by the thyroid gland (not the T3 made from T4 
conversion). http://content.nejm.
org/cgi/content/abstract/340/6/424?
maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author
1=Prange%2C+A&author2=Bunevicius%
2C+R&titleabstract=triiodothyronine&fulltext=neuropsycholog
ical&searchid=QID_NOT_SET&stored_search=&FIRSTINDE
X=&fdate=1/1/1975&tdate=5/31/2001&journalcode=nejm
OK, now here is some scientific proof that T2 is not some 
inactive substance ignored by the tissues. You’ve heard that 
I’m sure. I just got a comprehensive thyroid labwork done 
and it talked about the T4 levels, the reverse T3, the active 
T3, and then mentioned T2 as "an inactive byproduct." 
WRONG! This study is contained in the below link and it is 
very technical. Several hours with a medical dictionary 
unlocked the mysteries. Here’s what it basically says, in 
layman’s terms:
--T3 is taken up by the cells and used for protein synthesis. 
Protein synthesis means the actual building of cells (to 
replace dead cells, fix damaged cells, and make new cells). 
So you see, T3 is needed to maintain the tissues of our 
body.
--T2 is taken up by the cells and acts directly on the 
mitochondria. The T2 is used to produce ATP. ATP is the 
fuel for our cells; it is the energy our cells use to function. 
So you see, T2 is absolutely vital for the cells to function. 
Yes, it is true that a healthy thyroid gland does not make 
very much T2. But certain cells in the body depend on it.
http://physiology.cup.cam.ac.
uk/JPhysiol/1997/505p2/7060/7060
This would explain why so much of your overall body pain 
goes away when you take Armour and are thus getting 
plenty of T2; without T2 your cells are starving for ATP. I 
experienced this firsthand myself; when I switched to 
Armour most of my pain was relieved. I immediately told my 
hypothyroid sister who has been on 100 mcg synthroid plus 
100 mcg of cytomel daily and still hurting all over (100 mcg 
cytomel is FOUR TIMES the normal daily dose!). She 
lowered the two synthetic hormones to 75 mcg each and 
added in a grain of Armour; her body aching improved 
tremendously within 2 weeks. Even though this provided her 
with LESS oral T3 intake than she had before, nearly all of 
her fibromyalgia disappeared! She was left only with some 
foot and leg pain on one side, but the rest of her body was 
completely better. We all know that Dr. John Lowe has 
recommended using T3 to cure those pains (fibromyalgia) 
and he is right. (http://thyroid.about.
com/health/thyroid/library/weekly/aa042799.htm). The T3 is 
VITAL. However, I offer up my sister as proof that it is more 
than just T3 we need to use. I have no proof of this, but I 
believe that it is the T2 (and perhaps the T1---no one has 
figured out what it does yet) in Armour which produces the 
kinds of results she had.
I myself was on only synthroid last year, but at Christmas I 
took some of my sister’s cytomel. There was a minor 
improvement in my fibromyalgia but I still hurt all over. 
However, when I switched to Armour in January, my pain 
went away almost instantly (all except my feet, which were 
cured by supporting my adrenals) even though I was getting 
less oral T3 from the Armour than I had taken over 
Christmas with cytomel. Dr. Lowe states that it can take 
months or even years to undo the fibromyalgia using T3, but 
he feels it is the cure. I plan to write him a letter and tell him 
the story of my sister and me and also include the research 
on T2 which I have found. My sister and I had lived with our 
pain for years, and for both of us, it was alleviated in less 
than a month using natural thyroid. T3 breaks down into T2, 
but the body cannot perform that transformation without 
deiodinase. I have found research suggesting that cells 
need some T2 directly from the thyroid gland in order to 
make deiodinase at all. I wonder if Dr. Lowe’s treatment 
with oral T3 takes so long because the cells have such 
trouble converting the T3 into T2. I have no proof of any of 
this, but I think it warrants research. And if you are a thyroid 
patient with aches and pains, it’s worth trying natural thyroid 
to see if it will go away.
Here is another article proving that T2 is a metabolically 
active hormone:
http://journals.endocrinology.org/joe/149/joe1490319.htm
And another! http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=PubMed&list_uids=8921356&dopt=Abstr
act
T2 is so metabolically active, as a matter of fact, that it is 
used by bodybuilders to lose fat and buff up:
http://www.t-mag.com/html/body_119dawg.html
http://www.vitaplus.ws/newt2120cap.html
This is actually quite exciting news for us thyroid patients. 
First of all, this could explain why many hypothyroid women 
struggle to lose weight: they are on synthroid so their 
bodies are deprived of T2. And if you read these articles, 
you’ll see that oral T2 does not make you hyPERthyroid. 
This suggests that an overweight thyroid patient on a TSH-
suppressive dose of oral thyroid hormone might be able to 
use oral T2 as a weight-loss aid. I just began taking T2 last 
week; my “T2 Weightloss Journal” is below so you can 
follow along with my progress.
NOTE: If you wish to do your own search for info on T2, 
you must type "diiodothyronine" into the search engine; you 
don’t get results if you put in "T2."  To purchase T2, put 
“BioTech T2” into your search engine; there are many 
places to buy this product and lots of different prices so you’
ll want to shop around.
This does not mean that the body does not need T4!! I 
cannot find the reference right now but we also have 
research showing that certain cells must have serum T4 to 
convert to T3; these cells cannot use serum T3. Well, the 
same is true for all 9 thyroid hormones; almost every one of 
these hormones is required by a particular type of cell. This 
is why you cannot take just synthroid and be fully healthy.
While I believe that natural desiccated thyroid is the best 
medication to take, each of us has different amounts of 
semi-permanent damage to our bodies from years of 
untreated hypothyroidism or years of synthroid. If you are 
making too much reverse T3 out of the oral T4 in your 
Armour, your doctor will have to add in a dose of Cytomel 
to the natural hormone (take BOTH). I have also found in 
myself and other women that T4 levels may not be quite 
high enough when using Armour (or other natural products) 
alone. No one is sure exactly why yet. Some theorize that 
T4 isn’t absorbed through the gut well. Others theorize that 
pigs make more T3 than humans do so that natural products 
aren’t quite the right proportion. Others think that it is so 
easy for the body to convert the T4 in natural products that 
the result is high serum T3 and low serum T4 levels. 
Whatever the reason it happens, probably the best solution 
is to take mostly Armour and then add a very small dose of 
synthetic T4 to it. So if you are taking 100 mcg of synthroid 
daily, perhaps you should switch to 2 grains of Armour and 
50 mcg Synthroid. Perhaps you’ll need 2.5 grains Armour 
and 25 mcg synthroid. Or maybe YOUR body will need only 
1.5 Armour and 75 mcg synthroid. Mine needs 3 grains of 
Armour and 25 mcg of synthroid. Everyone will need a 
different amount depending upon how long she had 
untreated hypothyroidism and how resistant her cells have 
become to T3, etc. The dose will vary between individuals, 
but this is probably the best combination of medications for 
most of us and is the most likely to make us feel good (and 
ideally, you won’t be given Synthroid at all; they’ll give you 
Unithroid instead since synthroid is so unstable. I am using 
the term "synthroid" to refer to any pure levothyroxine 
product). There is nothing wrong with combining the 
different thyroid medications and a really good doctor will 
do this if it is necessary to optimize your health. In addition, 
your doctor should be willing to try different brand names 
because of the different binders and fillers used. 
Naturethroid, for example, is natural desiccated thyroid 
made with different binders to be gentle on your stomach. It 
is made by Western Research Labs.
And it is important for the doctor to allow you to take 
ENOUGH hormone (haven’t we all heard that before?!). I 
had a doctor finally switch me to Armour but he wouldn’t let 
me take more than 2 grains because his boss had decided 
that no one should take more than 2 grains. Never mind that 
I was half dead and barely functioning (I was fine as long as 
I just stayed in my house and didn’t do anything except cook 
a bit and fold the laundry). Just 3 months ago he told me "I 
will not give you more than 2 grains of Armour.  You have 
an incurable disease so you will always feel bad. You’ll 
never feel really healthy again." Well, I changed doctors to a 
man who said for me to increase my medication at the rate 
of ½ grain per week up to 4 grains. I stopped at 3 grains 
because I felt great at that level. So much for feeling bad 
forever! If you have thyroid disease, you just don’t have to 
feel bad. Period. What you need is a doctor who is willing to 
treat you as an individual and figure out what replacement 
therapy works on YOU.  
Your doctor may tell you that he cannot give you Armour or 
any other medication containing T3 because it is 
"dangerous." But T3 is natural and your body must have it in 
order to live. Without it you DIE. Your doctor has it in HIS 
body! However, when taken orally it does enter the 
bloodstream quickly. The solution is simple; patients using 
Armour (or other T3 medications) simply split their dosage 
up and take a little bit throughout the day. How can you tell 
if you are taking too much T3 at once? Your heart-rate will 
increase and you may start to sweat. So just break up the 
dosage and don’t take it all at once. If this means having to 
break your pill, get a pill-splitter from Wal-Mart and break it!
The only people who need to be concerned about taking 
oral T3 are cardiac patients. Does this mean they should be 
deprived of T3 just because they have cardiac issues? No! 
They need it just as much—if not more than—the rest of us. 
They just have to take it in very small doses throughout the 
day and should be carefully monitored.
The fact is that a thyroid deficiency CAUSES cardiac 
problems. Hypothyroidism will give you heart disease. So if 
you already have a heart problem, you sure aren’t going to 
get any better if you leave the thyroid only partially treated! 
You will only get worse. My aunt who is 84 years old has 
been on synthroid for 30 years (she had her gland removed 
in the 50s). She’s had heart disease so bad she’s had 
quadruple bypass surgery 4 times already. Well, she just 
started showing the signs of Alzheimer’s, and Alzheimer’s is 
related to low T3. Her doctor just switched her to 3 grains 
of Armour and she is doing great. As a cardiac patient, it’s a 
miracle she was able to get the Armour. Thank the Lord she 
has a reasonable doctor.
OK, what will happen to you if you are currently taking pure 
T4 (synthroid, levoxyl, unithroid) and do not get switched 
over to a natural thyroid medication? Well, your body will 
suffer. Left completely untreated, hypothyroidism will kill 
you. And if you treat it "halfway" (meaning that you take only 
T4 and do not take natural hormone), your tissues develop 
T4 resistance, which means that they lose the ability to 
convert the T4 into T3. Also, cell receptor sites shut down 
and cease to function, which can leave you semi-
permanently damaged. The longer you leave it untreated, 
the harder it is to respond to the medication when you do 
get it. You will spend the remainder of your life in a state of 
cellular hypothyroidism, regardless of how high your blood 
serum levels are. Thus you will be at risk for all long-term 
effects of hypothyroidism (Chronic fatigue, fibromyalgia, 
high blood pressure, diabetes, emphysema, arthritis, sleep 
apnea, speech impairment, depression, weight problems, 
ME, carpal tunnel syndrome, high cholesterol, heart 
disease, cancer, etc). Your body will continue to be in a 
constant state of partial hypothyroidism; some of your 
tissues will be just fine because they are capable of using 
the Synthroid, but the rest of your body will always be 
"hungry" for T3 and will be chronically sick without it. This 
can be true even if you are feeling pretty good on your 
synthroid; even if you feel no physical pain, there are tissues 
in your body which are still deprived of the hormones they 
need.
And any patient who still has hypothyroid symptoms while 
on hormone replacement therapy is at risk for two major 
catastrophes:
a)she may permanently lose the use of her cell receptor 
sites
b)she will be at risk for all the long-term effects of low 
thyroid (high blood pressure, diabetes, emphysema, 
arthritis, depression, weight problems, ME, carpal tunnel 
syndrome, high cholesterol, heart disease, cancer, etc).
Overweight thyroid patients will also need more thyroid 
hormone (just as a 140-pound woman needs more than a 
90-pound woman). They have a lot more cells in their 
bodies and will therefore require their serum levels to be 
closer to the higher end of the normal range. Low serum 
levels will only serve to create a low metabolic rate which 
means they will only get fatter. More supplementation 
should be given, raising serum levels and increasing 
metabolic rate. The patient will then be able to lose the 
excess weight and will require a lower dose of thyroid 
hormone in the future to maintain good health. Does this 
mean that switching to Armour is going to result in an instant 
weight loss? No. Thyroid hormone does control your 
metabolism; without thyroid, you have no metabolism and 
you will gain weight. But once you have good high serum 
levels of T3 and T4, you are now on a level playing field 
again, and the equivalent to all the others out there who 
don't have thyroid disease. This means you have to exercise 
and eat properly for good health and weight, just like 
everyone else.
Is your doctor a Synthroid Nazi? If I get a urinary tract 
infection and the doctor gives me amoxicillin and the 
infection persists, does the doctor just keep handing me 
amoxicillin and tell me to learn to live with it? No! He 
changes medications until he finds one that kills the 
infection. I recognize that a hormonal imbalance is different 
from an infection; I understand the differences quite clearly. 
But when you consider that there are over a dozen 
medications for thyroid disease, why should a patient be 
forced to use only synthroid if it is not making her better? 
Synthroid lowers TSH very well, but that does not mean 
your tissues and cells can use it. As a matter of fact, our 
research has shown that T2 is necessary for the creation of 
certain deiodinases and you just don’t get T2 from 
Synthroid. No wonder your serum T4 levels go so high! The 
synthroid just goes into your bloodstream and circulates 
'round and 'round, lowering your TSH and shutting down 
your own thyroid gland, but depriving your cells of hormone 
since they cannot use T4 as easily as they use T3 and T2. 
Did you know that T4 is what lowers TSH when it enters the 
pituitary? This is why synthroid is so effective at lowering 
TSH. But a low TSH doesn’t mean the patient is healthy. If a 
person eats rocks and they lower her TSH, does that mean 
that her hypothyroidism is controlled? Health comes only 
when the cells and tissues of the body are getting T3 and 
T2. And most doctors measure only TSH. Sometimes they’ll 
go ahead and measure free T4 as well, but they rarely 
measure T3. You know, if I eat potatoes, there will be 
potatoes in my stomach. Well, if I eat T4 tablets every day, 
there will be T4 in my blood! How about we see if it’s 
actually being used and converted to T3????? But it took 
me almost a year to convince someone to measure my T3 
levels; prior to that I’d had only TSH tests and free T4 tests.
And while we're on the subject of lab tests, I would like to 
emphasize that lab tests should be only secondary to clinical 
presentation (symptoms). Why? Well, there are several 
reasons. We'll start with the TSH test. This is not a measure 
of the function of the thyroid gland. TSH is produced by the 
pituitary. Using the TSH to diagnose poor thyroid function is 
a reverse approach. TSH can be elevated even if the thyroid 
gland is fine. For example, if you have a pituitary tumor, 
your TSH will be very high even if your thyroid gland is 
functional. In addition, TSH can be low even if you have 
thyroid disease. Dr. Barry Durrant-Peatfield discusses this 
effect; if your body is deficient in thyroid hormone, every cell 
in the body is affected---including the cells of the pituitary 
gland. Yes, even these cells cannot function well without 
thyroid hormone. So if your body is very hypothyroid, your 
TSH may actually be very low (and thus your doctor may 
refuse to treat your condition). In other words, there is 
absolutely no correlation at all between TSH and thyroid 
symptoms. And yet the TSH test is used almost exclusively 
to diagnose and treat this disease. Though there is much 
literature by thousands of doctors discussing the 
uselessness of the TSH test on patients taking oral thyroid 
hormone, almost every doctor out there continues to base 
our dosages on our TSH. Oral hormone can circulate in the 
blood, lowering TSH even if it is not used by the tissues. So 
the doctor measures your TSH, sees a 0.4, and declares 
you to be hypERthyroid even if your skin is scaly, you're 
depressed and in brain fog, and you're getting fatter by the 
minute. Once you are on oral thyroid hormone of any kind, 
the TSH test is nearly worthless and does not need to be 
performed.
Another little note about the TSH test: you know how the 
doctor will yank your medication when your TSH is too low 
even if you still are hypo? And you say "why?" and he says 
"because you are starting to become hyperthyroid." He is 
basing this solely on your TSH, which has nothing 
whatsoever to do with the actual use of thyroid hormone by 
the tissues, and you may very well be full of hyPO 
symptoms from head to toe. But he is all up in arms over 
your low TSH and wants it to move up to a nice "normal" 
level of at least 1 rather than a 0.3 so you won't be 
hypERthyroid. I take this opportunity to remind everyone out 
there that this is 100% NUTS. Doctors and patients alike 
MUST remember that millions of women are given TSH-
suppressive doses of thyroid hormone every single day in 
order to stop thyroid cancer. Are you familiar with this 
situation? If you have thyroid cancer, a treatment option can 
include high doses of oral thyroid in order to lower your TSH 
to 0; this stops the function of the thyroid gland, which stops 
the growth of the cancer. Read up on this treatment and 
you will find that these patients--with those 0 TSH levels due 
to oral thyroid hormone--are perfectly normal and not 
hyPERthyroid at all! And the doctors all think this is a fine 
treatment---and yet they will refuse to give a Hashimoto's 
hypo patient enough hormone to make her healthy if her 
TSH goes below 1, no matter how awful her hypo 
symptoms are.
What about other blood work? These tests are useful but 
should not be used alone to titrate your medication. Again, 
symptoms are the most important factor. When lab work is 
ordered, both free T3 and free T4 tests should be done, 
together, every time. Free T4 alone is not good enough; you 
need a free T3 test to see if you are converting the T4. And 
do not be in a huge rush to get these blood tests. Natural 
thyroid doses are adjusted upward every few weeks until 
symptoms are alleviated. If you are taking 2 grains (120 
mg) or less and feel good, you really don’t need any more 
labwork. If you are on 2 grains and still have mild 
symptoms, get a free T3 and free T4 test to see if the T4 is 
too low. If it is, add a small amount of unithroid and see if 
the last of your symptoms go away. If they do not, you can 
increase your Armour as well (and also check your 
adrenals; this topic is discussed in detail below).
If you are on 2 grains and have severe symptoms, you 
should keep increasing your Armour (as well as assessing 
your adrenals, discussed in detail below). Your body may 
very well have cellular resistance. Gradually increase to 3 
grains and see if your symptoms are alleviated. You may 
need 4 grains if you have extensive tissue damage. When 
should you get labwork? Go ahead and get a blood draw 
around 3 grains if you still have mild symptoms, to see if you 
should add a touch of Unithroid. But do not be surprised if 
your labwork is not in "normal" ranges. And do not be 
alarmed if it isn't. Why? Because if you have been hypo for 
many years and have a lot of tissue damage, you are no 
longer normal and you will not be healthy when you are in 
the normal range. My T3 levels, for example, are above the 
top of the normal range. But I am not even remotely 
hypERthyroid. I haven't the slightest symptom, in any form. 
Actually, I feel wonderful and if I take any lower dose, I 
become hypo again. My doctor says that my cells have a lot 
of resistance due to 5 years of untreated thyroid disease. 
We hope they recover in time, but for now I am not "normal" 
and do not fit on the reference range anywhere. This may 
very well be true for you too, so do not be surprised if your 
labwork does not fit on the "normal" range. The important 
thing to judge is how you feel. If you are not hyPER and all 
your hypO symptoms have been alleviated, you're probably 
on just the right dose, regardless of what your bloodwork 
says.
So please, do not depend on lab work to adjust your 
dosages! Too many doctors are already doing exactly that; 
we don't need the patients to start doing it as well! Go by 
your symptoms and find a doctor who will also do so. 
Forget about the TSH test; you won't need it anymore. Use 
the free T3 and free T4 tests only to determine if you need 
to add in some Unithroid. Beyond that, don't bother getting 
blood tests unless you start to feel bad again. Use the blood 
work solely to see if it is your T3 that is low or if it is your 
T4, so you know which medication to add or adjust. This is 
how my doctor is taking care of me and I am comfortable 
with this approach based on my research into thyroid 
disease.
Back to the medications…. If your doctor absolutely 
REFUSES to let you have anything but Synthroid, go to this 
link about Synthroid and the FDA.
http://thyroid.about.com/blsynthroid.htm
Read through each of the links about Synthroid and print 
them out for your doctor.  BE SURE to include the actual 
letter from the FDA to Knoll Pharmaceuticals which denies 
them "Generally Recognized as Safe and Effective" status. 
And if that doesn’t work, fire your doctor and get a new 
one. If your mechanic won’t fix your car properly and keeps 
charging you for bad work, you go to a new mechanic. Well, 
your body is more important than your car, so fire your 
doctor if he won’t fix you! You can feel good again! There 
are over a dozen different thyroid preparations on the 
market so there is no reason for your doctor to force you to 
use a medication that isn’t working on you.
Most of you are well aware of this: Synthroid is now in big 
trouble. Synthroid is prescribed to about 60% of thyroid 
patients and has been in use for almost 40 years. Knoll 
Pharmaceuticals was allowed to bypass the FDA drug 
approval process by grandfathering it in with Armour even 
though the two products are totally different (Armour got in 
because natural desiccated thyroid has been used 
successfully for more than a century). Well, since then 
synthroid has had so many potency and stability problems 
that it has been recalled numerous times. So in 1997, the 
FDA announced that all sodium levothyroxine products 
would have to submit New Drug Applications by August 
2000! This is an unusual step, but it was taken due to the 
problems with Synthroid. Knoll Pharmaceuticals responded 
by protesting and delaying. They delayed as long as 
possible and did manage to get the FDA to extend the 
deadline to August 2001. Meanwhile, Jerome Stevens Labs 
submitted their application by Aug 2000 and their product 
Unithroid was given FDA approval. Unithroid is now the 
reference drug for all sodium levothyroxine products.
But Knoll continued to whine and delay. They insisted that 
there was no reason for THEM to submit this NDA. To drum 
up support for their cause, they began sending letters to 
doctors and pharmacists all over the country. In this letter, 
Knoll actually claims that they successfully petitioned the 
FDA for "Generally Recognized as Safe and Effective" 
status! This is a blatant lie; the FDA did NOT grant such 
status to Synthroid and is still requiring a New Drug 
Application. The FDA rebutted with a scathing letter which 
denied all of Knoll’s requests and clarifies that Synthroid 
does NOT have "generally recognized as safe and effective" 
status. http://thyroid.about.
com/health/thyroid/library/weekly/aa050301a.htm
On 25 May, King received FDA approval for their 
levothyroxine product Levoxyl. http://thyroid.about.
com/library/weekly/aa052501a.htm
WRAP UP
To finalize, I want to emphasize that I’m not a thyroid expert 
nor am I in the medical profession. I’m just a thyroid patient 
who had to do her own research to save her own life. In 
addition, I haven’t had thyroid cancer. And my Hashi’s has 
been atrophic thyroid disease. This means that my thyroid 
gland has atrophied; it has shrunken and disappeared. I 
never had glandular swelling or nodes like the majority of 
Hashi’s patients have had. And I haven’t gotten hyPER on 
my medications---no palpitations, sweating, anxiety, etc. So 
I haven’t experienced many of the problems that other 
women have dealt with.
But I have had fibromyalgia, CFS, depression, skin cancer, 
dry skin, hair loss, menstrual complications, libido issues, 
and a host of other symptoms common to all of us, no 
matter what form our disease takes. I’ve done a lot of 
research to figure out a solution and I feel WONDERFUL. 
And I have found information that is being ignored by nearly 
every doctor out there: the metabolic effect of T2 is not 
even recognized by any doctors (not even my wonderful Dr. 
Dean) because the research is so new. And for some 
reason I can’t comprehend, nearly every doctor on the 
planet is ignoring the adrenal function of their thyroid 
patients. The physician’s desk reference clearly states that 
patients must have their adrenals tested PRIOR to thyroid 
treatment, but the doctors aren’t doing it.
So, while I know nothing about thyroid cancer, goiter, and 
glandular nodes, I do hope I can help as many as possible 
with this vital information that should be applicable to every 
thyroid patient regardless of how she came into her 
disease. I’m no expert and am not seeking any glory or 
recognition. I just want everyone to feel better!
Hope this helps!
Gail
Thyroid Avenger
"Man cannot live on T4 alone."
 
            NOTE: I am not a doctor 
or medical professional, 
nor do I play one on TV 
(ha ha). The following 
information is the story of 
how I came to achieve 
wellness, and the 
information I found 
during that process. No 
warranty is expressed or 
implied (ha ha again).
NOTE: If you think you 
might use the information 
contained in the various 
links I’ve listed here, go 
to the link and print out 
the article immediately. 
Some of these sources 
archive their articles over 
time and you cannot 
access the links again. 
This is especially true of 
the New England Journal 
of Medicine articles. I 
have printouts of all these 
articles. If an article has 
been archived so you 
cannot get it, post me at 
admin@freebohemia.com 
and I can scan my copy 
for you.
                      This info is on many 
levels; there is basic info 
many of you will already 
know but I include it 
because many of you 
are newly diagnosed and 
just learning about this 
disease. Other info is so 
scientific you need a 
medical dictionary! In 
addition, I started 
compiling this info after 
being contacted by 
Americans, but now 
have requests from as 
far away as Australia. I 
do not know the 
international policy of 
Great Smokies 
Diagnostic Laboratory!
I also recommend that 
you subscribe to Mary 
Shomon's newsletter 
(www.thyroid.about.com
) so you can keep up to 
date on all the latest 
thyroid news from a 
reputable source (rather 
than some of the hearsay 
that goes around the 
forum; all sorts of 
unfounded rumors 
abound in the forum, in 
addition to the 
wonderful support and 
helpful hints offered).