What Are Compounded Thyroid Medications?

Your thyroid: if you’re like the average person, you don’t give it a second thought. It sits in your throat quietly producing the TSH hormone needed to keep you alive. It’s only when something goes wrong with the thyroid’s production that most of us (including doctors) take notice of it, and often, issues creep up and don’t become obvious on lab tests until they’re firmly entrenched.

By that time, most patients feel symptomatic. These thyroid symptoms can include:

• abject exhaustion (feeling bone-tired all the time)
• nervousness
• anxiety
• palpitations
• flutters in the throat
• racing heartbeats
• blood pressure issues
• and in serious cases, cardiac complications

This article discusses the possible causes of thyroid issues and the benefits of treating them with compounded thyroid medications.

What Causes Thyroid Problems?

When the thyroid produces too much or too little TSH, or an unreliable amount of TSH, you’re experiencing a thyroid condition. The most common of these conditions are hypothyroidism and hyperthyroidism, low or high thyroid production respectively. But these are from the only conditions that can interfere with thyroid hormones; these generally fall into one of three additional categories:

• Structural abnormalities
• Genetic disorders and diseases
• Medication side effects and/or toxicity

Certain cancers and tumors may also interfere with the thyroid, even if they aren’t on the thyroid itself. That tiny little gland is immensely sensitive, if a bit finicky sometimes!

The good news is that treating the average thyroid condition is no longer difficult. While it can take some time to get the treatment just right (we’ll cover that a bit later), for the most part, all that’s needed for most patients to regain balance and eliminate symptoms is medication.

The Need for Individual Treatment Approaches

We’ve mentioned that the thyroid can be finicky; this is the main reason many patients and physicians go through a period of trial and error with medication. Generally, doctors will treat patients for thyroid problems by using one of these two methods:

1. supplementing certain hormones the thyroid naturally produces
2. blocking overproduction

Exactly how each patient reacts to each dose can vary dramatically; sometimes even a few milligrams is enough to make two patients with the same levels feel completely different.

We still don’t fully understand exactly why this happens, so the most common approach is to slowly tweak the medication in either direction until both lab results and patient reports indicate success. Very often, what reveals the success of treatment isn’t just the lab reports, but the fact that the individual patient feels so much better, too.

Commercial Vs. Compounded

Commercial Thyroid Medication

Many brands have their own form of commercial thyroid medication, including:

• Synthroid – Synthroid is best known for being a synthetic (man-made)
• Armor Thyroid – Armor is derived from pigs and is therefore natural.

Patient response to synthetics versus natural hormones can also vary unpredictably.

Compounding Thyroid Medication

Then there are compounded thyroid medications. Unlike commercial thyroid treatments, compounded treatments are individualized for each patient on a personal basis. The pharmacist takes the base compounds and creates a brand-new, custom-made medication based on the patient’s lab reports, how the patient feels, or what the physician believes is best. Often, this is the best way to find the exact correct substance and dose to treat particularly finicky conditions.

Bioidentical Thyroid Hormones

Compounding also allows patients to access bioidentical hormones. These substances are virtually identical to your own hormones in molecular structure, and research shows they may be easier for the body to recognize and utilize. Certainly, some patients seem to respond to bioidenticals much more readily than synthetics or natural hormones.

In comparison, synthetic and pig-derived hormones both differ ever-so-slightly from the human body’s own natural hormones. Researchers theorize that in some cases, this may cause the human body to fail to properly “recognize” the hormone for what it is, leading to poorer treatment outcomes for patients.

Bioidentical hormones aren’t available in commercial standardized doses or formats, so every prescription is hand-made. This customization may also benefit patients who don’t fit within normal dosing ranges.

Why are Compounded Thyroid Treatments Better?

Compounded thyroid medications open up a world of possibilities for patients and their physicians. It’s especially beneficial for patients who haven’t responded to (or who have responded poorly to), standard commercial thyroid treatments in the past.

Because each compounded prescription is individualized in both dose and contents for the patient, and because the pharmacist works with base compounds rather than predesignated doses, it’s possible to adjust the dose by as little as a microgram or grain at a time.

Dosage micro-adjustments and changes to delivery format may also make it possible for physicians to respond to thyroid issues long before they become serious.

Up until the last decade, most physicians lived by a “wait and see” approach. If the patient was borderline low thyroid (or high), but wasn’t especially symptomatic, they’d hold off treatment. If the patient was symptomatic, but lab results only showed a slight elevation or lowering of TSH, they’d often suggest lifestyle changes before medication.

Through research, we now know that many patients hover somewhere along the “borderline” level before thyroid hormones range far enough out of whack to necessitate medications. Lifestyle changes like eating a good diet and getting enough exercise certainly can help, but they’re simply not a cure for a thyroid that’s just not working correctly.

Thanks to compounding, physicians can begin with infinitesimally small doses of thyroid hormone (or hormone blockers) in an effort to alleviate symptoms. They can also adjust the dose by a fraction until the right blood serum levels are achieved. If overt hypothyroidism is detected, this may make it easier to treat at lower doses early after diagnosis.

Compounded thyroid medications also make it safer and more effective for physicians to treat cases of subclinical hyperthyroidism and hyperthyroidism when they believe treatment is warranted (though treatment isn’t warranted in every instance).

Compounding may also be preferred in cases of cancer, severe allergies, and other life-threatening conditions where issues with fillers or additives could cause the patient more harm than benefit.

Are Compounded Thyroid Medications Right for Me?

Every patient is different, especially when it comes to hormones. Exactly which approach is right for you is best answered by your physician or endocrinologist. But research does show that patients who require thyroid medication do often respond more quickly, more evenly, and with a lower dose when using compounded bioidentical thyroid hormones. Your pharmacist can also address questions about thyroid treatments and whether compounded hormones may be right for your needs.