Thyroid Prescribing Information

Our Natural Thyroid capsules can also be prescribed in grains (gr) and are available in the many strengths:

• 16.25mg thyroid extract (¼ grain) contains 9.5mcg levothyroxine (T4) and 2.25mcg liothyronine (T3)
• 32.5mg thyroid extract (½ grain) contains 19mcg levothyroxine (T4) and 3.5mcg liothyronine (T3)
• 48.7mg thyroid extract (¾ grain) contains 28.5mcg levothyroxine (T4) and 6.75mcg liothyronine (T3)
• 65mg thyroid extract (1 grain) contains 38mcg levothyroxine (T4) and 9mcg liothyronine (T3)
• 130mg thyroid extract (2 grain) contains 76mcg levothyroxine (T4) and 18mcg liothyronine (T3)
• 195g thyroid extract (3 grain) contains 114mcg levothyroxine (T4) and 27mcg liothyronine (T3)

Dose Conversion:

Thyroid Extract 1mg contains T4 0.585mcg & T3 0.138mcg

The most common starting dose for patients with hypothyroidism is Desiccated thyroid, 90 mg a day which ideally is taken twice a day, 10 to 20 minutes after breakfast and dinner. (45mg twice a day). Taking it after meals also helps to reduce volatility of the blood-level of T3.
Taking the Desiccated thyroid twice a day overcomes traditional medicine's major objection and resistance to using natural thyroid preparations - its variability in its blood-levels. Most doctors using Desiccated thyroid are not aware that natural thyroid should be used twice daily and NOT once a day. The major reason is that the T3 component has such a short half-life and needs to be taken twice daily to achieve consistent blood levels.
Initial dose for hypothyroid states, 60 to 300 mg daily. Usual maintenance dose is 30 to 125 mg daily.
Note: Desiccated thyroid 60 mg is usually considered equivalent to thyroglobulin 60 mg, levothyroxine sodium (T4) 0.1 mg or liothyronine sodium (T3) 25 μg.

Combined Synthetic T4/T3:
Only recently have had the opportunity to compound a combined Synthetic Combination of T4/T3 into one capsule. This can allow for cost reductions and allows both hormones to be replaced in one capsule. Starting Combination 50mcg T4 / 12.5mcg T3

Dose Adjustments With Lab Monitoring:
Once on thyroid hormones, the dose should be increased until the TSH falls below 0.4. Then one needs to optimize the 2 thyroid hormones by using the Free T4 and Free T3 levels. It takes 4-6 weeks to see the maximal benefit once started.
Free T3 and Free T4 are used to monitor the treatment. They should be above the median (middle) but below the upper end of the laboratory normal reference range. The goal for healthy young adults would be to have numbers close to the upper part of the range, and for cardiac and/or elderly patients, the numbers should be in the middle of its range.
The Free T3 and Free T4 levels should be checked every 2 months and the hormone therapy readjusted until the FT3 and FT4 levels are in the therapeutic range described. Once a therapeutic range is achieved the levels should be checked at least once a year. A small number of large, overweight, thyroid-resistant women may need a larger dose of Natural Thyroid to see results.