Issue #248  October 23, 2014  

Welcome to KnowYourThyroid.

Today, Dr. Theodore Friedman is going to dispel some of the common myths about thyroid disease. If you have thyroid problems, you have more than likely to have heard some of these myths. I am going to try #7 since I take Armour Thyroid.




 7 Common Myths About Thyroid Disease You Probably Believe


By Dr. Theodore Friedman



1) Myth: Patients on thyroid medicines need cortisol to support the thyroid 

Fact: A very small percentage of people with autoimmune thyroid disease have Addison’s disease or other reasons for adrenal insufficiency and need cortisol prior to starting thyroid medicines. Patients with symptoms of adrenal insufficiency (weight loss, nausea, vomiting, diarrhea, joint pain, abdominal pain) should be evaluated by an endocrinologist. Those without those symptoms can safely take thyroid medicine without taking cortisol.

2) Myth: Thyroid disease is easy to treat.

  Fact: For the lucky ones, thyroid disease is easily remedied with thyroid hormone. But for some people, blood tests don’t match how you feel. While your TSH may appear normal, you may have symptoms of hypothyroidism. Determining the dosage and type of treatment then, can be difficult and should be done under close supervision of a knowledge of an endocrinologist familiar with different thyroid preparations.


3) Myth- Armour thyroid is unreliable and its pills vary in potency depending on whether the pig has hyperthyroidism or hypothyroidism.

Fact: The health status of the pig has nothing to do with the quality of the pills you take. Forest Pharmaceuticals, which makes Armour, has a rigorous quality control process that ensures that all lots are consistent.


4) Myth: You can use iodine instead of thyroid medication because it’s safer and more natural. 

Fact: Iodine can make hypothyroidism (and hyperthyroidism) worse and should not be taken as a supplement in patients without first discussing it with your endocrinologist. But the amount of iodine in salt or a multi-vitamin is low enough that it’s safe to take.


5) Myth: All patients with Hashimoto’s hypothyroidism need to be on a gluten-free diet.

 Fact: Both celiac disease (in which one needs to be on a gluten-free diet) and Hashimoto’s hypothyroidism are autoimmune diseases and if you have Hashimoto’s hypothyroidism, you are more prone to getting celiac disease. Yet the overwhelming majority of patients with Hashimoto’s hypothyroidism do not have celiac disease and do not need to be on a gluten-free diet.


6) Myth: There is no need to measure a free or total T3 in patients treated with levothyroxine (L-T4) preparations for hypothyroidism. 

Fact: A recent study found that about 15% of patients with hypothyroidism treated with L-T4 had low freeT3 levels even with a normal TSH. These patients may benefit from desiccated thyroid preparations or L-T4/L-T3 combination treatment.


7) Myth: All patients with hypothyroidism can safely be treated with once a day Armour thyroid.

 Fact: Armour thyroid has both L-T4 and L-T3 (liothyronine) in it of which L-T3 has a short half-life and should be given twice a day. Otherwise patients will have low free T3 levels in the afternoon, evening and next morning before their dose. Armour thyroid has too much L-T3 and not enough L-T4, so some extra L-T4 is often needed for patients on Armour thyroid.


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