Levothyroxine alternatives: What can I take instead of levothyroxine?

Top levothyroxine alternatives | Comparison | Armour Thyroid | Cytomel | Thyrolar | Synthroid | Levoxyl | Natural alternatives | How to switch meds

Levothyroxine is a generic thyroid hormone medication used to treat an underactive thyroid (hypothyroidism). It is also approved for thyroid-stimulating hormone (TSH) suppression, which aids in treating certain types of goiters and thyroid cancer. Levothyroxine can be used along with surgery and radioiodine therapy to manage thyrotropin-dependent thyroid cancer. While levothyroxine is a commonly prescribed thyroid hormone medication, some people prefer to use an alternative thyroid medication. 

You may have an allergy to the ingredients in levothyroxine or you may find that levothyroxine is just not working for you. If you and your healthcare provider have decided levothyroxine is not right for you, you may be recommended a levothyroxine alternative, such as Armour Thyroid. You should not use an alternative medication without consulting your healthcare provider first.

Continue reading to learn more about levothyroxine alternatives, their possible side effects, and other important information. 

What can I take in place of levothyroxine?

Levothyroxine sodium is a generic medication that contains a synthetic form of thyroxine (T4), a natural thyroid hormone produced by the thyroid gland. The body converts T4 to triiodothyronine (T3), the more active form of the thyroid hormone. Alternatives to levothyroxine include natural and synthetic forms of T4 or T3. Some levothyroxine alternatives contain both T4 and T3. 

Other alternatives to levothyroxine

• Thyrolar (liotrix) but this medication has been discontinued.

Armour Thyroid (desiccated thyroid)

Armour thyroid is the brand name for desiccated thyroid made from animal thyroid glands. Armour thyroid is a natural alternative to levothyroxine that contains a dried thyroid extract from porcine (pig) thyroid glands. It contains both thyroxine (T4) and triiodothyronine (T3), and it can be used to treat the same conditions as those treated by levothyroxine, such as hypothyroidism and thyroid cancer. 

There are limited studies comparing the use of Armour Thyroid versus levothyroxine. Some studies suggest that hypothyroid patients feel better using Armour Thyroid instead of levothyroxine, although there may be an increased risk of side effects with Armour Thyroid. 

It’s important to note that Armour Thyroid is not currently approved by the Food and Drug Administration (FDA). Still, some doctors may recommend Armour Thyroid as a treatment option in some cases.

Cytomel (liothyronine)

Cytomel is the brand name for liothyronine. Like levothyroxine, Cytomel contains a synthetic thyroid hormone ingredient. However, it contains a synthetic version of the T3 hormone instead of the T4 hormone. 

Liothyronine is absorbed faster than levothyroxine, which may present an increased risk of toxicity and side effects. During treatment with Cytomel, hormone levels may need to be monitored with routine blood tests. Cytomel can be an appropriate thyroid hormone replacement option when taken as prescribed by a healthcare provider. 

Thyrolar (liotrix)

Thyrolar is the brand name for liotrix, and it contains a combination of synthetic T4 and T3. It can be used to help supplement thyroid hormones to treat hypothyroidism. Thryolar was discontinued by Allergan, according to an FDA announcement in 2018. It was discontinued due to a business decision and did not have reports of safety or efficacy concerns. 

Synthroid, Levoxyl, Unithroid, Tirosint, or other brand names

Levothyroxine is available under different brand names, including Synthroid, Levoxyl, Unithroid, and Tirosint. The brand-name versions of levothyroxine are FDA approved to treat hypothyroidism and provide TSH suppression for euthyroid goiters, thyroid cancer, and other thyroid problems. These brand-name medications contain the same ingredients as generic levothyroxine, and they are levothyroxine alternatives that are safe and effective when taken as prescribed. Tirosint differs from other brand names of levothyroxine in that it comes as a liquid gel capsule with no color additives or fillers. 

Natural alternatives to levothyroxine

The natural alternative to levothyroxine is a natural desiccated thyroid extract from animal sources. Armour Thyroid contains a natural form of thyroid hormone that comes directly from the thyroid gland of pigs. Certain vitamins and supplements are natural options that may help manage hypothyroidism. A healthy lifestyle that includes the right diet can also help support the thyroid gland and healthy thyroid hormone levels. 

Selenium

Selenium is a natural mineral that can play a role in thyroid functions. Studies have found that low levels of selenium may be associated with thyroid diseases, including hypothyroidism. Therefore, maintaining adequate levels of selenium may help reduce the risk of thyroid problems. Adequate clinical trials are needed to determine the effectiveness of selenium for reducing this risk, however. 

Vitamin B12

Low vitamin B12 levels may be associated with thyroid problems, including hypothyroidism and autoimmune thyroid diseases, such as Hashimoto’s disease. Vitamin B12 supplements may help support a healthy thyroid gland. 

Vitamin D

Vitamin D is an essential nutrient, often taken with calcium, for the proper development and maintenance of bones. However, it has been shown that low levels of vitamin D are associated with thyroid diseases. Some studies have found that vitamin D supplementation may help manage thyroid problems in people treated with levothyroxine. Clinical trials are needed to confirm the exact effects of vitamin D on the thyroid. 

Essential oils

There is some anecdotal evidence that essential oils help manage the symptoms of hypothyroidism. No clinical trials have proven these claims. Some essential oils that are used to manage hypothyroidism include:

• Lavender
• Peppermint
• Rosemary
• Sandalwood
• Cedarwood
• Lemongrass

Herbal supplements

Certain herbal remedies are sometimes used to help support healthy thyroid hormone levels. However, these remedies are not FDA-approved or proven by clinical trials. More evidence is needed to confirm the use of herbal remedies. Herbal remedies may include:

• Bladderwrack (Fucus vesiculosus): Although not technically an herb, bladderwrack is a type of seaweed that is a good source of dietary fibers and minerals. Bladderwrack contains iodine, which may help manage thyroid-related problems. 
• Ashwagandha: This herb may help manage thyroid hormone levels in people with early-stage hypothyroidism. One study found that 600 mg of ashwagandha root extract may be beneficial for normalizing thyroid hormone levels. 

Diet

The right diet may help manage symptoms of hypothyroidism. A diet rich in fruits, whole grains, vegetables, and lean proteins can help support overall endocrine health. On the other hand, foods that are high in saturated fats, processed ingredients, and sugar may contribute to fatigue, a common symptom of hypothyroidism. Studies have found that celiac disease may be linked to hypothyroidism. Therefore, a gluten-free diet may help support a healthy thyroid. 

Exercise 

A slowed metabolism and weight gain are common symptoms of hypothyroidism. A healthcare provider may recommend a consistent exercise regimen to help manage weight gain or obesity. Exercises like walking, jogging, and swimming may help keep the body’s metabolism in check.

Stress reduction 

Stress can affect the thyroid gland and cause an imbalance of thyroid hormone levels. For this reason, managing stress can be an important part of regulating hormone levels. Yoga, meditation, and other relaxation techniques can help reduce stress. 

How to switch to a levothyroxine alternative

Switching to or from a levothyroxine alternative should only be done after seeking medical advice and guidance from a healthcare provider. Dosages are generally based on weight, age, and gender. The process for switching to a levothyroxine alternative will depend on the thyroid medication levothyroxine is switched to.

Switching from levothyroxine to Armour Thyroid

Armour Thyroid contains desiccated thyroid with a strength measured in grains. Levothyroxine is measured in micrograms (mcg). Therefore, the dose of levothyroxine needs to be converted to an appropriate dose of Armour Thyroid. One grain of Armour Thyroid is equal to 100 mcg of levothyroxine. 

The following conversions may be used when switching from levothyroxine to Armour Thyroid:

Switching from levothyroxine to Cytomel

Cytomel contains a synthetic version of T3 called liothyronine. T3 is three to four times more potent than T4, which is found in levothyroxine. A healthcare provider would recommend a dose of liothyronine that is lower than that of levothyroxine to account for the increased potency. 

The following conversions may be used when switching from levothyroxine to Cytomel:

Switching from levothyroxine to Thyrolar

Thyrolar contains a mix of synthetic T3 and T4. The following conversions may be used when switching from levothyroxine to Thyrolar:

Switching from levothyroxine to Synthroid, Levoxyl, Unithroid, Tirosint, or other brand-name equivalents

Both the brand name and generic versions of levothyroxine contain the same active ingredients. When switching from the generic to the brand-name version, the dosage typically remains the same. 

Consult with an endocrinologist or other healthcare provider when switching to or from a levothyroxine alternative. In some cases, dosages need to be adjusted based on your medical condition and response to therapy.