43: Why Synthroid Isn’t Working – The Shocking Truth About T4, T3 & Thyroid Symptoms with McCall McPherson

Welcome to Modern Thyroid and Wellness, the podcast that explores the intricate dance between health, wellness and thyroid, unraveling the threads that weave our vitality together. I'm your host, McCall McPherson and I'm so thrilled to guide you on this journey to optimal wellness. Today we are talking about a topic that is near and dear to my heart. Why levothyroxine based medications like Synthroid, T rint, unithroid, Voxel often do not work for people and I was once this person and sadly 89% of people in America with a thyroid condition are on this class of med and this class alone. And I think the vast majority of people actually will never get well on them and they don't know why. They don't know. They think it's just the dose of their medication that isn't working. A whole slew of issues. So I want to spread this message far and wide. So if you have a friend on Synthroid, levothyroxine et cetera, share this with them because it is very, very powerful and can be life changing information. In my opinion, the treatment only approach with levothyroxine based medications will be one of the biggest medical failures of all time in my lifetime, especially in the world of hormones. I think the way that we diagnose and treat thyroid problems is the next Women's health initiative or the constructs and idea how medicine treated and looked at hormone replacement therapy for so long we now know has been wrong and millions and millions of women have paid the price. And I think that is the era that we are honestly in with thyroid. I'm hoping in my lifetime I can improve that to an extent and help shift the landscape of thyroid forever. So let's talk about the flawed premise of levothyroxine. So this is synthetic form, a man made form of T4 which is an inactive inert hormone. I give the analogy of crude oil. So we don't put crude oil in our car to make it run, but we need it to create gasoline to put in our car to make it run right. If we cannot convert that crude oil to gasoline, we're not going anywhere in our car. And sadly, the premise and promise of medicine with these T4 or levothyroxine based drugs is operating completely, completely and entirely under the assumption that we can efficiently and effectively convert that crude oil to gasoline to make this hormone usable in our physiology. The reality is many people cannot for a slew of reasons but conversion problems, difficulty converting T4 to T3 is a pervasive issue and in fact 100% of people at modern thyroid clinic are poor converters. So symptoms of poor conversion are simply, you're being treated for your thyroid condition and guess what, you still have a whole slew of thyroid hormones. So fatigue, brain fog, weight gain, dry skin, brittle nails, brittle hair, low sex drive, high cholesterol, cold intolerance, outer loss of the outer portion of your eyebrows, pre diabetes, elevations in blood sugar, diabetes, all of those things. And listen closely, because it doesn't matter how many times your clinician increases and decreases your dose of levothyroxine, if you are a poor converter, you will never have enough gasoline in your tank to effectively and efficiently work in terms of your physiology. The other issue that happens with levothyroxine is in a medical paradigm that largely relies on TSH or T4 to gauge your thyroid status, once someone is on a levothyroxine based medication, these labs are useless to a degree of 80%. So essentially, when you are on a T4 based medication like Levothyroxine, Synthroid, etc. The worse you are at using and activating that medication, the better your labs will look to your regular doctor that is just checking TSH or even TSH and T4. So if you are tuning in on YouTube or a video mechanism, I want you to check out the screen because I'm going to run through the physiology of this verbally, but also visually. So when you take Synthroid, levothyroxine, any one of these medications, TSIN, all of them, you're taking T4, T4 is uniquely effective at feeding back and telling your brain, oh my gosh, we have so much thyroid hormone. Lower this person's tsh. Okay, your TSH lowers, your doctor says, oh my gosh, your labs look great, or oh, you're over medicated, we need to reduce your medication, which is what happened to me. So your TSH stimulates your thyroid, your thyroid secretes T4, right? That T4 either activates and converts to T3 or it shunts to an inhibitory hormone called reverse T3. That's the physiology of all of this. When you have enough thyroid hormone, T3 or T4. But T4 is especially potent at communicating back and sending a message to your brain that says, we have so much thyroid hormone, reduce her tsh. What's the problem with that? Follow me. When you take a bunch of levothyroxine based medication and you are a poor converter, meaning the worse you are at using this medication, the better your labs will look. Essentially, what's happening is you are stockpiling your crude oil hormone in your garage. Your gas tank's on empty, right? The worse you are at converting, the higher this T4 will actually look. No one's checking your T3, so we're oblivious that you're not converting. So you have all this crude oil in your car. You've got a high level of T4. That high level of T4 feeds back and communicates to your brain to lower your TSH, right? So if your doctor checks your TSH, it appears low. It's.06. It's 0.3. It's less than.01. Your T4 again, also looks great. Oh, my gosh, look at this. You have all this T4, 1.49. Meanwhile, my range is 0.9 to 1.2, meaning this is too high. Anything above 1.2 is artificially suppressing your TSH. But if the only thing they're checking is your T4 and your TSH, oh, my God. Your medication is working beautifully. In fact, you have too much. We need to reduce it. Meanwhile, what's happening? Your T3 is low because again, this is your most important hormone. This is what is solving your health issues, your vitality issues, your energy issues, but you're not converting. You're not taking that crude oil and making it into gasoline. So you've got all this crude oil stockpiled in your garage, but your gas tank is on empty, but no one knows. So what that translates to you is your doctor says your symptoms of fatigue and weight gain and brain fog and depression and all these things, they're not due to your thyroid. Why? Because your TSH and your T4 look beautiful. Meanwhile, your T3 could literally be 2.2. Okay? In the gutter. My range is 3.6 to 4.2 for the bulk of your day of your waking hours. So no one knows if you're a poor converter, that your medication isn't working. And the worse you are at using it, the more your accumulating this T4, the more you're suppressing your TSH, the more likely your doctor will say, you have plenty of thyroid hormone. Your symptoms are totally unrelated, when in fact, they are solutely related to your thyroid. But no one is getting enough information to know otherwise. Okay, this is another reason what we never, ever believe someone when they tell us our thyroid labs are normal. This is the reason why I share my thyroid lab guide. What labs do you need to be actually checking? What are the ranges that we use at modern thyroid clinic that are optimal, not Normal. I freely share all this information with you so that you can effectively navigate the complex landscape of all of this with as many tools and objective resources as possible. You can always find my Thyroid Lab guide in any of my social media places under Thyroid Lab Guide. It's entirely free, so head there and get it. The next thing that I really want you guys to understand is something that I've coined and called the three stages of Synthroid, okay? Or the three stages of Levothyroxine. And this is the clinical pattern, the symptomatic pattern most people experience when they start to take Synthroid, okay, When they first start it, or Levothyroxine, rather. I should really say when they start levothyroxine or when they increase their dose, they get this acute, temporary increase. And T4, okay. That increase short term over the first few weeks is like, wow, I actually feel a little better. This might finally be working, right? Then what happens? What follows is that increase in T4 sends a message back to your brain and it lowers your tsh. It communicates again. Oh, my gosh, we have so much thyroid hormone. You can lower this person's tsh. You don't need to stimulate their thyroid as much anymore because we have adequate hormones. So over the next several weeks, three, four months, maybe even up to six, that TSH slowly settles, and then your T4, your. Well, your TSH settles. It stimulates your thyroid less. Your T4 drops in response. So it settles. Then your T3 drops and settles in response. So guess what? Slowly your symptoms come back and return. Okay, then, so we're about three to six months, and now initially we're good. Then we slowly get more tired. And then over the next six to 18 months, what usually ends up happening is there is a slow accumulation in your reverse T3. Reverse T3 is shaped like T3, very similar, but in an opposite orientation in reverse, which is why we call it reverse T3. What that allows reverse T3 to do is quite interesting. It allows it to land and bind in the same landing spot as T3. But instead of activating that landing spot, it simply binds, blocks, and doesn't let T3 bind and activate. So the higher your reverse T3 is, the lower T3 absorption you get. So what does that translate to? Clinically, symptomatically, slowly, over the next several months from that already worsening that you're feeling, you continue to get slowly and slowly worse. And then what happens a year later? You go back to your doctor, you get labs, and they're like, oh, well, we can bump it up again. You increase your T4, you get this artificial initial improvement in symptoms and then slowly the exact same thing happens. So I again, my goal in this is for you all to be informed, empowered consumers of your health. Right? So what we've learned so far is when you're on levothyroxine, if you're really bad at using it, your labs will look fantastic to a person checking standard of care labs for We've also learned 89% of people are on this class of medication and this class of medication alone. And then lastly, we've learned the clinical pathway that most in trend that most people follow in terms of their symptoms. So let's talk about what the Data shows about T4 because it's really actually fascinating what we're trained in medicine and this myth that's passed around and around and around is, well, T3 is dangerous. If you put people on T3, you're going to give them a heart attack and stroke, they're going to get osteoporosis, osteopenia, they're at increased risk for cardiovascular events. All of these things fear based propaganda. What multiple studies actually show is number one, when someone is on a higher normal level of T3, they're less likely to die, full stop, period. When they are on a higher norm, when they are in a higher normal level of T3, they are less likely to develop osteoporosis and osteopenia. When they're on a high normal level or when they experience a high normal level of T3, they are less likely to be unemployed, they are less likely to retire early and they are of higher socioeconomic status. Inversely, when someone has higher levels of T4, which is the standard of care of medicine, they are more likely to have osteoporosis, osteopenia, they are more likely to have a lower socioeconomic status, they have a higher mortality, they are at an increased risk of early retirement and unemployment. And when we compare cardiovascular events between those two groups, there is no increased risk in the group that has higher normal levels of T3, which essentially turns upside down every single belief that medicine propagates and has propagated over the last almost 100 years. And who's paid the price for that? Millions. Tens of millions, if not hundreds of millions of people, sadly. Also, the increased risk of inadequate treatment with T3 is long term health consequences. Heart disease, elevated cholesterol, cognitive decline, Alzheimer's, blood sugar issues and diabetes. This isn't about feeling tired. This is about your long term Health, your health. Span your lifespan. Right. So what is the alternative? The alternative is balancing these hormones, creating a system within your physiology that accounts for both normal optimal levels of T4, not too much, not too little, but also incorporating in T3 that is essential for you to have a quality of life, to enjoy your life, to be gainfully employed, to function as your in your family, with your spouse, to enjoy your life and then protect your long term health. Right, so what do I normally do if someone comes into me on a high dose of levothyroxine based medication? I don't switch them to desiccated thyroid, I don't switch them to armor, I don't switch them to ren, thyroid or NP. No, that's not what I do. I add T3, cytomel or lyothyrenine into what they are already taking. So if they're on way too much love with thyroxine, I'll bring that down little by little.12.5 micrograms at every appointment until it's between 0.9 and 1.2. I will layer in T3, cytomel or lyothyronine to what they are already taking from day one in little bits over time until their level is Perfect, until their T3 sits for the bulk of their day between 3.6 and 4.2. Which means if you are checking labs at your peak, you will peak above that range because t3 is very short acting, especially lyothyrenine and cytomab. So what does that translate to? People get better. Honestly, most of the time on day one, they start to feel improvement when it's done effectively and correctly. Whereas if you try to transition them from levothyroxine to something like armor run thyroid, np, they usually get worse before they get better. And guess what? That's the last thing we wanna do to these people is make them worse before they get better. Because life is already hard enough, right? So it is so important to me that you guys understand this, that you know how to navigate it and that you share it with your friends and family. Because we a society filled to the brim with people who are on levothyroxine based medications, who will never get well, and they are constantly and chronically being told that their thyroid is not the cause of their symptoms, that thyroid symptoms are non specific, and it could be a million other things, when in fact the data is very clear. If someone runs a full thyroid panel and compares that to optimal ranges with certainty, it is these people's thyroid with certainty they can be helped with certainty. We can create balance in the hormones that need to be balanced to give them back their lives. So thanks so much and see you next time.