In depth assessment of thyroid function is necessary. Addressing autoimmunity, if identified as the cause of thyroid dysfunction, is very important. Thyroid hormone therapy should be individualized with patient overall health goals included in treatment protocol and health planning.

 I encourage patients to try different therapy options, from readily available levothyroxine and liothyronine preparations, to compounded made-to-match special needs options.

It is important to guide therapy utilizing a combination of symptoms and laboratory results.

My Recommendations


initial assessment

  • Thyroid Peroxidase Antibodies
  • Thyroglobulin panel = Thyroglobulin and Thyroglobulin antibodies
  • TSH, free T4, free T3, reverse T3

treatment options

  • T4 levothyroxine : generic, Tirosint, Synthorid, Levoxil
  • T3+ T4 combinations: desiccated thyroid, compounded thyroid, two separate prescriptions for T4 and T3
  • T3, typically compounding is needed  for Sustain Release option

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