Introduction
Hypothyroidism, or an underactive thyroid, occurs when the thyroid gland doesn’t produce enough thyroid hormones to regulate the body’s metabolism. This can lead to various symptoms that affect overall energy, mood, and body function. Common in both men and women but especially prevalent among women, hypothyroidism can have a significant impact on quality of life if left untreated or undertreated. Here, we explore the symptoms and signs of hypothyroidism, treatment options, and how supplements may support thyroid hormone conversion. We’ll also discuss why some people prefer naturally desiccated thyroid (NDT) over synthetic options like levothyroxine. Really it's why you shouldn't take levothyroxine and should take NDT instead. We have a thyroid optimization program you can check out here.

*You may be thinking, why is there a pig here? Good question. Naturally desiccated thyroid is typically derived from porcine sources.
Symptoms and Signs of Hypothyroidism
Symptoms of hypothyroidism can be wide-ranging and are often mistaken for other conditions due to their general nature. Some of the most common signs and symptoms include:
Fatigue and low energy levels
Weight gain or difficulty losing weight
Cold intolerance (sensitivity to cold temperatures)
Dry skin and brittle nails
Hair loss or thinning hair
Muscle weakness and joint pain
Brain fog or difficulty concentrating
Depression and mood swings
Constipation
Menstrual irregularities (e.g., heavy or irregular periods in women)
Slow heart rate and low blood pressure
These symptoms arise due to the slow metabolism resulting from low levels of thyroid hormone, particularly the active form, triiodothyronine (T3). Accurate diagnosis usually involves a blood test to check thyroid-stimulating hormone (TSH) levels, free T4, and T3.
The Role of T3 and T4 in Thyroid Health
The thyroid primarily produces thyroxine (T4), a precursor hormone that needs to be converted into T3, the active form that the body uses for metabolic processes. In hypothyroidism, low T4 levels or poor conversion to T3 can result in an imbalance that disrupts body function.
Factors affecting T4 to T3 conversion include chronic stress, poor liver health, nutritional deficiencies, and certain medications. Addressing these factors can help improve thyroid function, especially with the right support in place.
Natural Support for T4 to T3 Conversion
Supporting T4 to T3 conversion with targeted supplements can be beneficial for those with hypothyroidism. Here are some key supplements that may aid in this process:
Selenium: Selenium is crucial for converting T4 to T3 as it’s a key component of the enzyme that facilitates this conversion. Supplementing with selenium can help boost T3 levels in people with low selenium intake.
Zinc: Zinc is another mineral that supports thyroid hormone production and conversion. Studies have shown that zinc deficiency can impair thyroid function, making adequate zinc intake essential for thyroid health.
Vitamin D: Low levels of vitamin D have been linked to various thyroid disorders, including hypothyroidism. Vitamin D helps regulate the immune system, which can reduce inflammation and improve thyroid function.
Magnesium: Magnesium plays a role in over 300 enzymatic reactions in the body, including thyroid hormone production and conversion. Ensuring adequate magnesium levels may help support overall thyroid function.
Ashwagandha: This adaptogenic herb can help reduce cortisol levels, which can interfere with T4 to T3 conversion if elevated. Ashwagandha is also known to support energy levels and reduce stress.
B Vitamins: B vitamins, particularly B12, B6, and folate, support energy metabolism and hormone regulation. Vitamin B12 deficiency, in particular, is common in hypothyroid patients and can worsen fatigue and mood symptoms.
Why Naturally Desiccated Thyroid (NDT) May Be Preferred Over Levothyroxine
Traditionally, hypothyroidism has been treated with levothyroxine, a synthetic form of T4. While levothyroxine can work well for some, others find that their symptoms persist despite normal blood levels of TSH and T4. If a person does not have adequate nutrients to support T4 to T3 conversion, supplementing a bunch of T4 is ineffective. Here’s why some patients and practitioners are increasingly turning to naturally desiccated thyroid (NDT):
Contains Both T4 and T3: NDT is derived from animal thyroid glands and contains both T4 and T3, which can benefit those struggling with T4-to-T3 conversion. The presence of both hormones may help alleviate lingering symptoms that synthetic T4 alone does not fully address.
Closer to Natural Thyroid Composition: NDT is more similar to the body’s own hormone profile, containing not only T4 and T3 but also T1, T2, and other co-factors that may contribute to thyroid health. Many patients report feeling more balanced with NDT compared to levothyroxine.
Possible Symptom Improvement: Some people report improvements in energy levels, mood, and cognitive function when switching to NDT. This may be due to the immediate availability of T3, which the body does not have to convert from T4, thus delivering a quicker effect.
Consistency with Functional Medicine Approach: For those seeking a more holistic treatment approach, NDT aligns well with functional medicine’s focus on natural, bio-identical hormone replacement, addressing the underlying imbalance in thyroid function more comprehensively.
Conclusion
Hypothyroidism can significantly impact day-to-day life, but understanding the role of T4-to-T3 conversion and the variety of treatment options can empower patients to take a proactive approach. Supplements like selenium, zinc, and vitamin D may aid the conversion process, while naturally desiccated thyroid offers an alternative for those seeking a comprehensive thyroid support option beyond synthetic T4. Always consult with a healthcare provider before making changes to your treatment plan, and consider a functional medicine approach if conventional methods aren’t addressing your symptoms fully.
References:
Jonklaas, J., Bianco, A. C., Bauer, A. J., Burman, K. D., Cappola, A. R., Celi, F. S., Cooper, D. S., Kim, B. W., Peeters, R. P., Rosenthal, M. S., Sawka, A. M., & American Thyroid Association Task Force on Thyroid Hormone Replacement (2014). Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. Thyroid : official journal of the American Thyroid Association, 24(12), 1670–1751. https://doi.org/10.1089/thy.2014.0028
Khoshaba, L., & Patarkatsi, L. (2023). Switching from Natural Desiccated Thyroid to a Liquid Formulation of Levothyroxine for Hypothyroidism. Case reports in endocrinology, 2023, 4252894. https://doi.org/10.1155/2023/4252894
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