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If you live with hypothyroidism, you probably take daily thyroid medication. These thyroid hormone medications include levothyroxine drugs like Synthroid, T3 drugs like Cytomel, or natural desiccated thyroid medications like Armour Thyroid. Thyroid hormone replacement drugs supplement your naturally produced thyroid hormone when your thyroid can’t make enough on its own. Because of this, thyroid medication is usually taken for life.
You may have heard stories, however, of how some people have been able to stop taking thyroid hormone replacement medication safely. Is this something that you can – or should do? If so, what are the steps in safely stopping your thyroid medication?
Before we explore these questions, let’s be clear: it’s a terrible idea to stop taking your prescribed medication for hypothyroidism unless directed by your doctor. Before considering this option, here’s what you need to know about the process.
You may be a candidate to stop taking your thyroid medication if you have a form of underactive thyroid known as subclinical hypothyroidism. Subclinical hypothyroidism (SCH) is defined as slightly increased TSH levels with normal Free T4 levels. You may or may not have hypothyroidism symptoms, and SCH is considered a mild form of hypothyroidism.
A 2021 study showed that about 40% of those initially diagnosed with SCH remained euthyroid – normal thyroid function – after stopping their thyroid medication. Their thyroid hormone levels remained within the normal range.
If you were prescribed medication to treat subclinical hypothyroidism or a slightly sluggish thyroid, you should know that there are differing opinions on whether even to treat SCH in the first place. Some patients with SCH take thyroid medication but appear to gain no benefit from taking it. Others find that low-dose thyroid hormone replacement helps relieve mild symptoms of subclinical hypothyroidism. Once on thyroid medication for SCH, the only way to know if you can safely stop taking it is through trial and error.
SCH differs from overt hypothyroidism, which involves an elevated thyroid stimulating hormone (TSH) level at diagnosis, with a low free thyroxine (Free T4) level. Patients with overt hypothyroidism or who developed elevated TSH and low Free T4 after stopping medication in the past are usually not good candidates to stop taking thyroid medication. According to studies of patients with overt hypothyroidism, only 12% remained euthyroid and asymptomatic after stopping thyroid medication.
Also, note that some thyroid patients will never be able to stop getting treatment for hypothyroidism and shouldn’t try. These include people who are hypothyroid due to surgical removal or total ablation with radioactive iodine (RAI) of the thyroid gland – or longstanding Hashimoto’s that has atrophied the thyroid gland. These patients either have no thyroid gland or a gland incapable of producing essential thyroid hormones they need to survive.
If you are subclinically hypothyroid and want to stop your medication, your first step is to talk with your thyroid care provider. Together, you will develop a plan to reduce your thyroid medication dose over time safely.
Under the supervision of your thyroid doctor, you will slowly cut back on your dose. As you cut back, symptoms of hypothyroidism – such as fatigue, cold intolerance, brain fog, or changes in your mood – may start to occur. This is normal, as the body adjusts to making thyroid hormone again. If the symptoms become more debilitating, your doctor may reduce your dosage more slowly, giving your body more time to adjust. Your thyroid specialist will test your thyroid function frequently during this process.
If your symptoms don’t resolve or worsen noticeably, this is a sign that you may be unable to stop your medication. Be sure to communicate with your doctor about your symptoms during this process.
If you are borderline or subclinically hypothyroid, several other approaches may also help you normalize thyroid levels, resolve unrelieved thyroid symptoms, and potentially allow you to stop taking thyroid medication. These include:
Selenium supplementation: This mineral can help reduce thyroid antibodies and aid in T4 to T3 conversion. These changes may be enough to allow patients with mild hypothyroidism to safely stop taking thyroid medication without a return of symptoms.
Iodine supplementation: In some thyroid patients, iodine deficiency can cause SCH. In those patients, testing for and supplementation with iodine may restore thyroid levels to normal and allow patients to safely stop taking medication.
Low-dose naltrexone (LDN): Naltrexone – an anti-addiction medication – is prescribed off-label at low doses for autoimmune diseases. In some cases, treatment with LDN can reduce antibodies and improve thyroid levels to the extent that a patient can safely stop taking medication.
Autoimmune Protocol (AIP) diet: For some patients, carefully following the AIP diet may relieve symptoms and reduce antibodies, allowing a subclinically hypothyroid patient to stop taking thyroid medication.
Gluten-free diet: Some thyroid patients with celiac disease or gluten sensitivity have had a reduction in thyroid antibodies and normalization of thyroid levels after following a gluten-free diet. This may allow for stopping thyroid medication in some cases.
You should never attempt to stop taking your thyroid medication on your own. Suddenly stopping your thyroid medication can lead to worsening hypothyroidism, with adverse reactions and hypothyroid symptoms that include rapid weight gain, fatigue, and depression, as well as heart problems. In rare cases, failure to treat a thyroid condition can result in a life-threatening coma.
We recommend you work with one of Paloma’s knowledgeable thyroid doctors to map out your personalized plan for optimal wellness and thyroid health. Schedule an appointment with one today.
Also, remember that if you are working with your healthcare provider to get off your thyroid medication, you should have your thyroid levels checked. Typically, a thyroid panel is done before you start tapering down your medication dose and periodically after that to assess your thyroid health and unmedicated thyroid function over time. You may find this testing process easier by using a comprehensive home test kit from Paloma Health, which evaluates TSH, Free T4, Free T3, and TPO antibodies as part of a complete thyroid panel.
Finally, if you want to try the AIP diet for your thyroid health, download the free Paloma Health App. The app includes a 12-week Hashimoto’s Protocol, featuring the AIP diet. With guidelines, tips, recipes, and other information, you can help support healthy thyroid function with diet and lifestyle changes.