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Dear Coach: Should I Take Thyroid Medication?

Dear Coach:

I have Hashimoto's (autoimmune thyroiditis). My doctor prescribed me levothyroxine, thyroid replacement hormone, but I'm afraid to take it because I want to take a natural approach. What should I do?


Dear L,

This is a GREAT question, and the answer is personal and unique to everyone (don't you hate when we say that?).

Levothyroxine, also known as synthroid, is a synthetic/man-made form of inactive thyroid hormone (called T4). Once you take it, eventually it gets converted into the active form (T3) that your body uses, mostly in your liver. I can understand why you would be nervous about starting hormone replacement and medications, especially when you want go the natural route with healing your thyroid and reversing your autoimmune condition.

First and most obviously, I have to point out that I'm not a doctor - so I can't give this out as medical advice. And, we're not really proponents of one way versus another. While this choice is completely up to you and no one else can tell you exactly what the right answer is, there are some factors you could take into account and things to consider.


Medication, no matter which form of thyroid meds, could help as support while you work on lifestyle factors and natural approaches to gaining your thyroid function back. So, even if you start, it still doesn't mean that you're doomed to a lifetime to prescription drugs.

As lifestyle changes start to take positive effect and the thyroid begins to work more efficiently, some people may be able to reduce their dosage of thyroid medication, or wean off of it completely. Work with your doctor on this, as close monitoring/testing may be necessary as you work your way down.

Personally, my Hashimoto's experience before thyroid medication: I wasn't able to function. I had a TSH over 150 (and I triple-checked to find that this was NOT a units-conversion issue!). I couldn't think clearly, was sleeping for 12 hours & still feeling exhausted, was experiencing aches and pains all over my body, and I couldn't find the energy to work. For me, medication helped me improve my baseline feelings of "ugh" so I could start working on things like diet and testing for/identifying other root causes.


Another point to think about is how you have felt in the past 2 weeks, and there's a quick exercise that might help you get to your personal answer.

  1. What are your symptoms? Write down your top 3 symptoms.

  2. On a scale of 1-10 (1 - best, 10 - worst) rate your three symptoms: how much does each symptom limit or obstruct your ability to live your life or perform your work?

  3. Add up your three ratings. Your total score indicates ways you could approach medication.

If your total is:

  • 12 or lower: You could potentially get by without medication as you make lifestyle changes. Watch yourself like a hawk, paying close attention to how you feel. If things start to feel different, go through this exercise again.

  • Between 13 and 18: This is that 50/50 grey area. Make some changes, and determine (for example, by lab testing) if the changes you made had any effect on antibody reduction or by symptoms-- do you feel any better? Go through this exercise again in 4 weeks and determine if anything has changed.

  • 19 or higher: Consider using medication to support at first, but also have a direct conversation with your doctor about your intentions to eventually wean off or reduce dosage as you address root causes & implement lifestyle changes.


Bottom line, don't think of medication as a failure, or even as the anti-functional medicine approach. Think of it as a tool to help you have the strength and stamina as you identify & address the root causes to get you to remission or symptom improvement.

I hope this helps!



If you'd like to learn more about lifestyle changes you can make to support your thyroid, join us for the Thyroid30, a free 30-day thyroid reboot program.

You'll receive daily inspiration and guidance in your inbox each day, plus recipes, tips, and action steps you can take today to start feeling better.

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