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Mary Shomon

Should You Take Your Thyroid Medication Sublingually?

By May 3, 2011

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Patients regularly write in to ask: "I've been told by other patients that I should I take my thyroid medication sublingually because it works better. Is that true?"

Let's take a look at some of the issues behind the question.

First, by sublingual, we're referring to taking a thyroid pill and either crushing it and placing it under the tongue, or allowing it to dissolve.

Second, the question about sublingual use of thyroid medications is always related to natural desiccated thyroid (NDT) drugs like Armour, Nature-Throid or Erfa thyroid. That is because these drugs include the thyroid hormone T3 -- which is faster-acting and has a far shorter-half life than the synthetic T4 found in levothyroxine drugs like Synthroid, Levoxyl, and Eltroxin. Some people feel the effects of T3 very quickly, even within an hour or two, but a levothyroxine drug typically takes much longer to be converted into the T3 that is ultimately usable by the body.

Third, the argument that is made for taking thyroid medication sublingually is that by doing so, the thyroid medication is absorbed through the mucous membranes in the mouth, and goes straight to the bloodstream, which prevents the medication absorption from being affected by things like calcium supplements, iron supplements, food, coffee, or fiber -- which are all known to inhibit thyroid medication absorption.

To explore the issue further, Geri Rybacki, Executive Director of the Coalition for Better Thyroid Care and I both talked to a variety of doctors, drug companies and other experts, to get a sense of the professional perspective on the issue.

The consensus? The active ingredients in thyroid medication have molecules that are so large that it is difficult for them to pass through the mucous membranes. Most of the dissolved/crushed medication ends up swallowed, and moves through the digestive system in the usual way. Other factors also affect sublingual absorption, including oral pH, and salivary enzymes.

Thyroid expert Kenneth Woliner, MD in Boca Raton, Florida said that some medications are designed to be taken sublingually -- for example, drugs that need to be fast-acting, and when where seconds count (like nitroglycerine, used to treat angina and heart attacks) -- and have a molecular structure that lends itself to sublingual absorption. But thyroid is not one of them, according to Dr. Woliner.

Thyroid expert Kent Holtorf, MD, founder of the National Academy of Hypothyroidism, and the Holtorf Medical Center network of clinics in California and the Midwest, also agrees that thyroid medication was not designed for sublingual use, therefore the size of the thyroid hormone molecule means that sublingual use of thyroid medication may not be optimal for some patients as far as absorption, and may not prevent interactions that can reduce absorption of thyroid medications.

We also contacted several natural thyroid drug manufacturers, and while they all refused to go on the record publically, they concurred that they felt that sublingual administration of natural desiccated thyroid does not prevent other substances -- like iron, calcium, fiber, coffee -- from impairing absorption.

Still, a small subset of thyroid patients report anecdotally that they (1) feel better when taking NDT sublingually (2) are able to take their thyroid medications sublingually, along with coffee, breakfast, or supplements with iron and calcium, and still maintain good thyroid function or (3) feel better and have improved TSH, Free T4 and Free T3 levels when taking their thyroid medication sublingually. What could be going on?

Since there have not been any studies to evaluate the effectiveness of the sublingual route for natural thyroid, we can only speculate that perhaps these patients may have some sort of digestive malfunction, i.e. rapid digestion, which means that the pill may not even be fully dissolved before it leaves the stomach and goes into the intestines, or the insufficient enzymes to dissolve and digest the pill. By crushing/dissolving the pill in the mouth, perhaps this is allowing the pill to break down and begin to be digested.

It would be interesting to see a research study done to compare the two methods of taking natural desiccated thyroid -- sublingually versus swallowed -- evaluating the effectiveness of each method as far as TSH, Free T4, Free T3 levels, qualify of life and symptoms. An ideal study would also look at subgroups of patients swallowing their medication orally, vs. sublingual who, (1) drink coffee at the time of their medication, (2) take iron supplements at the time they take their medication, (3) take calcium supplements at the same time, and (4) eat at the same time as their medication.

(Don't hold your breath waiting for this research to be funded or performed, however. Few studies are ever done on natural thyroid drugs, or thyroid patient quality of life.)

In any case, while we're waiting for information, keep in mind that if you do decide to take your NDT sublingually you should:

  1. discuss this with your physician first, before making any changes
  2. keep track of your symptoms carefully
  3. have your thyroid levels carefully evaluated 6 to 8 weeks later -- including TSH, Free T4, Free T3, and ideally, also Reverse T3

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Comments
May 3, 2011 at 11:15 am
(1) Rhonda Lea Fries says:

For quite a long time, I have been concerned about those who believe that taking thyroid medicine sublingually prevents binding with other drugs and supplements. I have argued against it, without notable success.

I would note, however, that there is some research involving rabbits and synthetic T4 (vaginal administration) which seems to indicate that the synthetic form (which is not bound by a protein) may pass the mucous membrane.

Thank you for addressing this very important topic.

July 28, 2011 at 4:40 pm
(2) maribella pappallardo says:

Rhonda, I find the rabbit study quite interesting. I was just reading on another site about possible vaginal administration and wondered if that had been studied.

As women administer HRT and contraceptives vaginally, it seems like a possibility. But would all formulas of thyroid dissolve appropriately?

If you have cites for the studies, please post! Thanks. MP

May 3, 2011 at 1:10 pm
(3) Janette says:

I have been swallowing my Armour Thyroid for over 3 years now. My TSH levels are normal as of last week. I take mine when I first wake in the morning before I get out of bed. By the time I let the dogs out and use the toilet & make breakfast, enough time has gone by that I can eat & drink alright. I have never dissolved them in my mouth before. I know things start to break down once they are placed in the mouth. Salavary glands break down stuff. I don’t really think it would make a lot of difference to just swallow them.

May 3, 2011 at 2:24 pm
(4) Priscilla says:

I take my Erfa sublingually. I started out using the old Armour sublingually, and then switched to Nature-Throid, which because it did not dissolve well under the tongue, I had trouble with. Eventually the NT reformulation made it worthless to me, so I switched to Erfa, which works beautifully sublingually.

In my case, my schedule and disability mean that there really is not a time when I can remember to take my pill when I have not either eaten recently or will soon need to eat again. Taking it sublingually works for me, much better than swallowing does, in that my symptoms are well-managed and my levels are great. In fact I prefer to keep my TSH very low.

May 6, 2011 at 11:24 am
(5) Jane Shields says:

I, too, don’t feel well unless my TSH is very low. I, also, have my doctor check my “Free T3.” “Free T3″ is a much better indicator of what is really going on in my body, and probably yours, too.

In Muncie, Indiana, the laboratory company, Lab Corp. does NOT include Free T3 as a part of the “Thyroid Profile” that most doctors order. The doctor has to ask for “Free T3″ in addition to the Thyroid Profile.

As I have read and learned a lot more about my hypothyroidism in the last 14 years, I have been apalled at how little knowledge doctors have regarding how poor a patient feels when undertreated. And, that includes endocrinologists.

May 6, 2011 at 4:39 am
(6) smgj says:

I’ve ben told my my Doc to chew my thyroid (ERFA). He suspects that the mecanical breakdown and subsequent mixing with enzymes from salvia may help the absorbtion later down the road. He believes that no sublingual absorbion occures, but that the process helps.

And of course to wait half an hour before eating og drinking anything other than water.

May 6, 2011 at 9:10 am
(7) Lynne says:

I have noticed a difference in crushing and taking my Armour sublingually, but I so still have to watch when I take it in relation to food and suppliments. I think there is a benefit for my body to crush the pills first…better absorption. I think whatever way you take your meds, be consistant.

May 6, 2011 at 10:21 am
(8) Hattie says:

I had been so sick before I finally took all of Mary’s papers to my dr. and convinced him that I had no thyroid at all and needed the “real” stuff. To be sure that nothing interferred with my Nature Throid, I began and continue setting an alarm for 3:30 am, crawling out chewing up my 3 naturethroid pills, taking them and back asleep in 10 minutes. Our breakfast is ready at 8:00 so I feel that I get the full value of the medicine.

May 6, 2011 at 10:40 am
(9) Christine says:

I don’t understand when people say their TSH is in range. If you are taking thyroid medication the feddback loop will eventually cause the pituitary to reduce TSH by the amount you are taking. so until you have completely taken pituitary control of TSH out of the loop (ie TSH approaching 0.0), you will not be increasing your T4/T3 in the long term. You will get a short term boost until the pituitary figures it out. That is why staying on a low dose thryoid medication will make you feel good at first, but eventually you feel crappy again.

May 6, 2011 at 7:45 pm
(10) Shelley says:

I have tried to tell the doctors for over 25 years that I had a thyroid problem and all said I didn’t since my TSH was normal. They told me that I just ate too much. I got a new family doctor who did further testing and again my TSH was normal, but my T4 was not. Went to and Endo who put me on a low dose of medication and at first I felt good and now I feel worse than I did before. He did blood word and says my tests are normal, but my basil temperature is running between 95 and 97. On top of this I have diabetes and all of a sudden, my numbers have gone sky high. Not sure what is going on or what to do. I see the doctor next week, but they keep telling me my temp is within normal range. I just know that I am hardly able to function and I am so tired of all of this. And my thyroid is under active, but I am always very hot and never cold. Go figure. I also get night sweats, but only my legs.

May 6, 2011 at 11:50 pm
(11) Sharon says:

Iodine is a very important component of the thyroid function.
I take Iodoral every day which is 5mg of iodine and 7.5mg of iodide. This is very important for the breasts also. See David Brownstein MD book “Iodine, why you need it”. A great deal of research has been done on iodine and none of it seems to hit the mainstream (no surprise there). Another item recommended is Isocort for the adrenals. These 3 work together. If you have a hard time finding Iodoral right now, then try Iodine-Plu2 from Natural Living 702-430-8771 or http://www.progest50.com. One other thing I feel must be mentioned, and that is VitD3. If your levels are not at optimum, you are cheating yourself. See drmercola.com on the Vit D3 issue. All these things work together.

June 7, 2011 at 8:08 am
(12) Sherrie says:

Hi Shelley,
I have had your exact symptoms! I am on Nature Thyroid and have been for over a year! my weight goes up and down by about 10 lbs.
Are you taking any other hormones? I am almost 51 and have no hormones, recently went to a NAET specialist and she has helped me get my systom back I have severe allergies (food,grass, pollen) this I think got my hormones out of wack!! good luck to you!

June 7, 2011 at 3:48 pm
(13) Shelley says:

Thank you all for your help. I am really struggling as I also have uncontrolled diabetes which I know is due to my thyroid problem and I have a body full of yeast as well. I have found a new Endocrinologist and she and the other doctors in her practice sound like just what I need. They specialist in diabetes, thyroid, obesity among other things. I see her in July, so will let you all know how I make out. My last doctor said it wasn’t likely that my T4 was not converting to T3, but I beg to differ. I know my body and something is not right. I did have some hormone problems a couple of years ago, but don’t know how that is anymore. My last Endo sent the results of my blood work to me and said we will discuss this further at your next visit which was two months away. I had called him to let him know my sugar was running close to 400 and that was after taking major antibiotics for a health issue and only a month after starting Synthyroid. There is so much I don’t know or understand about any of my health issues and I am so tired. My family doesn’t understand and I feel very guilty. All I want to do is sit on my recliner. I love to read, but don’t even have the energy to do that. I am now on a gluten free diet and it requires much cooking and I hate doing that since I don’t have any energy. I haven’t even taken my Lantus for two days now as I am too tired to fill my needles. I am rarely on the computer as you can see due to my being slow to respond to your kind and helpful responses. I just pray that I can get the help I need as I also need to have two knee replacements, but my wound care specialist will not allow me to have them with my sugar being so high. I have been in terrible pain for over two years now, but not much I can do. Thank you all for your help and please stay in touch.

July 7, 2011 at 2:43 pm
(14) ciara says:

hi shelley-

i didn’t go as long as yourself in regards to being diagnosed (it was 5 yrs), but i had the same problems. it took me quite awhile to get to the right level of T4 medication, but i was still requiring at least 3 hour naps to get through the day. then i read up on how some people might require T3 medication on top of the T4, so i asked to try it. i now take 137mcg levothroid PLUS two 5mcg cytomel tablets a day. it has been my life saver. there are some days when my symptoms want to raise it’s ugly head, but for the most part, i can function somewhat normally.

August 3, 2011 at 12:45 am
(15) Kam says:

Hi,I had the same problem getting sick everyday than my gynacolgist send me a test for insulin resistance found out pcos .I am on erfa thyroid and taking homeopathy for pcos and dieting really work for me .Hopefully this will help you

May 7, 2011 at 2:27 am
(16) Kem says:

I take 50 mcg of cytomel with 1 gr naturethroid. I had the same thing happen to me and kept having to go higher and higher in grains until I got to 4 grains and felt like crap. I found out I had a Reverse T3 issue so I started taking cytomel for 3 months until the T4 had left. Taking cytomel alone can get a little bumpy so doc cut my T3 meds to 50 mcg and added 1 gr. nt. I split the meds up over the day, start with 25 mcg cytomel in morning, take 1/2 nt 3 hours later, 25 mcg cytomel 4 hours later and 1/2 nt 3 hours later. I have never felt better in my life, my RT3 is gone and all hypo symptoms have gone away. After messing with thyroid meds for 2 years and following bad doctors advice I found a good doc who understood me better and knew how to dose me correctly.

May 8, 2011 at 6:27 pm
(17) Kim says:

Who is your doctor and where can I find him??

September 7, 2011 at 4:39 pm
(18) Anita says:

Why do u split up the doses into 4 times per day? Do u have Hashimoto’s?

May 7, 2011 at 8:28 am
(19) Cara Waits says:

This makes sense to me. I have yet to feel good on a regular basis. I am at a point where I just don’t care anymore. I have no energy and feel like crap most of the time. I have tried different doses and brands over the last five years. I now just wait and see what I feel like when I wake up in the morning.

I have a new doctor who says my TSH is a little low, but, my free T4 is perfect according to the charts – if this is true why do I feel depressed and have no energy – in general, I could care less about anything right now. I am tired of blood tests every three months, etc. etc. etc. My previous doctor just said it was a guessing game and we had to play around with everything. How long does that take?! Five years and I have tried Synthroid, Levoxyl, generic, Armour and Thyrolar. I finally switched doctors, but, I am not confident at this point that he knows a lot about it either. All I know is that I am not a chart.

May 12, 2011 at 9:08 pm
(20) JP says:

Your T4 might be fine, on paper, but if you’re not converting it well to T3 (the hormone that actually does the work) then you will not be getting the best treatment.

You need to get your Free T3 tested as well, to see what is actually available to get into your cells. It is possible that you are thyroid resistant (reverse T3) which requires getting your liver functioning better, and perhaps T3-only treatment for a while (although some do well on T3 only for a long time).

May 6, 2011 at 11:35 am
(21) alwayscold says:

I’ve been having a hard time getting my thyroid levels right, despite ever- increasing dosages in my compounded meds. I went to my holistic doctor who told me my digetive track was not allowing full digestion. This might be a problem for many people. lack of enzymes, overgrowth of bad bacteria, yeast, or parasites can block absorbtion. Since my meds are already crushed and in capsul form don’t think putting them under my tongue will help me.

May 6, 2011 at 1:27 pm
(22) Jean says:

After the reformulation of Armour, I switched to compounded Armour capsules. In order to take it sublingually, I dump the capsule contents into a pill container and divide up the dosage throughout the day. I get much better results that way than taking it orally. I feel the effects very quickly this way.

My digestive system seems to be impaired; this shows up in other ways. Perhaps it never recovered from damage before I discovered that I was gluten-intolerant.

Through discussion with my endocrinologist, I have recently added a small amount of oral Levothyroxine in the evening to bring the overall ratios of T4 and T3 ingested closer to the ‘natural human levels.’ That seems to help with the energy dip that I would start the day with.

June 29, 2011 at 3:57 pm
(23) Megzilla says:

Does anyone know about interactions between Protonix and NTH? I am on a small dose (20 mg) of protonix for GERD, I had my gastro reduce the dose from 40 mg recently. My doctors insist there is no interaction (or connection between weight gain and protonix) but I can’t see how something that affects stomach acid and digestion couldn’t have some effect somewhere on the body. The gut is so important to our overall health. There is even more serotonin there than in our brains!

This is all making me think that maybe I don’t have enough stomach acid to properly digest the NTH. Also I have suspected lactose intolerance, so there’s that to add to the digestive/damaged intestines issues. Chewing my pill instead of swallowing it may be a better option for me… I’ll try it.

May 6, 2011 at 10:23 pm
(24) Ginger says:

For 17 months I struggled to get my levels under control with
Westhroid. Finally after doing some research, I started dissolving it under my tongue, like I use to w/ the old Armour. My heart palpitations went away and I am able to keep increasing my dosages getting back up to what I normally took w/ the old Armour.I feel sooooo much better and my levels are coming into range again. I almost ditched Westhroid and switched to Erfa, but I am glad I gave Westhroid one last chance dissolving as much as possible, under my tongue.It has made a huge difference for me.

May 7, 2011 at 12:31 am
(25) Shelley says:

Sharon, thank you so much for your advice. I see my Endo next week and one of the questions I have listed to ask him is whether I should be taking iodine. You solved that for me and I will get right on it and try to find what you are taking. I also just purchased Vit D 3 and am going to start that tomorrow. I also have on my list of questions about having my adrenals tested and the level of cortisol in my body as well. I found a wed site called Women to Women and I read about all of that. I really like Dr. Mercola and get his daily email. I think if I am going to get well, I am going to have to help myself in so many ways. I also have a body full of yeast, but my family doctor is going to help me with that. I just got a new one and he really listens to what I have to say and spends time with me, so that is finally a good thing. I will keep you posted on how I am doing and again, I could just hug you for all of the info you have shared with me. I get so frustrated because I feel so very bad and have no energy at all. I also feel guilty since I can’t seem to get my work done, but that God my husband is very understanding and kind. He does so much for me since I am unable to do much. I don’t even have the energy to go anywhere. I told my husband that this isn’t even living. Thank you again so very much and I will do as you suggested.

May 12, 2011 at 9:13 pm
(26) JP says:

Your endo may not be at all pleased that you’re taking iodine. But that’ doesn’t mean that you shouldn’t!

There’s a good iodine users’ group at yahoo.com which is very helpful. Iodine did not cure my thyroid, but I sure do feel better when I’m taking it!

May 7, 2011 at 2:17 am
(27) Kem says:

I have a lapband and absorption has always been an issue for me. My good doc had never heard of taking Naturethroid or cytomel sublingually but he had a baseline of my TSH, free T3 & T4 along with RT3 and the improvement was dramatic with later testing. The meds are definitely getting into my system. This is how I’ve always taken my NT and T3, all I can say is it works for me. Not everybody fits into the cookie cutter mold. My doc first thought I only needed to take them once a day but I found I felt better if I split my NT into 2 doses and my cytomel into 2 to 3 doses. Now doc’s prescription says multi dose because it works for me.

May 8, 2011 at 12:52 am
(28) Myra Healey says:

You are talking about thyroid med sublingly, what about cytomel, I take my cytomel under my tongue a couple hours after I get up after I had swallow my synthroid. Is that okay to do ?
Myra

May 9, 2011 at 12:34 pm
(29) April says:

How did you get your doctors to listen to you? My internist is still swearing I do not have a thyroid issue. I was finally feeling well again, but my Endo took me off Armour and lowered T3 (Cytomel) to non-existent dose (5mcg) b/c TSH was suppressed to .12 and she found that unacceptable. Now all symptoms of hypo have returned, I feel awful, can’t function! I don’t know what to do.

May 10, 2011 at 8:20 am
(30) Geri Rybacki says:

April, a recent study in the UK suggests that TSH can be safe for patients even when it’s as low as 0.04 mU/L0.4 mU/L. A new doc may be in your future.

http://www.endocrinetoday.com/view.aspx?rid=62295

May 10, 2011 at 12:33 pm
(31) April says:

Thanks for the reference/article…yes, I am seeking new docs….

May 10, 2011 at 8:54 am
(32) Vanilla says:

The original article stated that it was always natural thyroid hormone that people took sublingually. However, a couple of comments have mentioned taking Cytomel sublingually. It would be interesting to have the experts comment on whether there is in fact a benefit in taking Cytomel under the tongue. Presumably it would have a different molecular structure; the molecules might be smaller and therefore absorbable by the mucous membrane of the mouth.
Yoohoo, Mary! Please ask the experts on our behalf.
I am currently taking T3 alone (= Cytomel, Tertroxin) in an effort to deal with excess Reverse T3, and I am taking it sublingually. Years ago I also took T4 (thyroxine) in the same way, assuming that by-passing the digestive system would be a good thing.

May 11, 2011 at 5:08 pm
(33) Diane Carlisle says:

I used Armour Thyroid and I chew it first thing in the morning and wait 30 minutes before I have my coffee and a fibre bar before my moring walk and it seems to be okay with me. I take my calcium at the evening meal. I just learned that people with Thyroid problems should not eat grapefruit. Is this true? Thanks, Diane

May 24, 2011 at 3:35 pm
(34) Ima says:

Diane,
I’m with you. Been doing this routine since 1988 (old Armour) up to this a.m. I had Hashi’s, gland totally nuked due to CA nodules but not removed for a number of reasons and low-dose chemo. I’ve had a great medical team for 23 years and I feel really blessed especially being a faithful follower of Mary’s for a number of years and reading the horror stories of others.
BTW: My biggest nemsis is STRESS. ‘Nuff said.

July 9, 2011 at 6:06 pm
(35) Leigh says:

There’s a fundamental problem with the assertion that the thyroxine molecule is too large to pass through the mucous membrane: the matter of SIZE. The size of just a single skin cell is SO MUCH LARGER than a single molecule of thyroxine, it strikes me as absurd that any scientist could fail to take note. I’ll have to go back and find some exact numbers to prove my point, but it doesn’t take much more than common sense even without exact measurements to understand what I’m saying. When I took Armour sublingually (before it was reformulated), I did fine. Now I swallow Nature-throid because it’s too much of a hassle to grind it up and endure the slow dissolution of that chalky dust under my tongue (blech!). Ultimately, as long as a thyroid patient has the right medication, enough of it, and a smart and open-minded doc, it doesn’t matter how the drug is administered: just take it! Like the sneaker commercial says :-)

January 23, 2012 at 10:37 am
(36) Carol says:

(16) Kem – who is your Doctor? Where are you located?

March 29, 2012 at 2:01 pm
(37) Aerin says:

I’m going to try this as well I just switched to Nature-Throid I think my dose is too low I was fine on generic but couldn’t lose weight, now I’m really tired so trying to chew my medicine because I think it doesn’t get absorbed as well. I also read that another issue with problems could be adrenal so I’m going to start taking Licorice Root everyday which helps assist adrenal gland. Has anyone else switched to Nature-Throid and had to move to higher grain/prescription? Maybe it’s not as strong as the Generic I’m going to give it couple more weeks and get tested again to make sure proper grain.

May 17, 2012 at 2:26 pm
(38) Soni says:

Kem. I have high Rt3. I am wondering the name of your doctor and location. I may be able to consult with him no matter how far I will have to go. Please respond. Thanks

June 10, 2012 at 7:56 pm
(39) Mary says:

After spending more years than I can remember getting thyroid checks and being told I was ‘just fine’ because my TSH was ‘just fine’, they finally figured out I have secondary thyroid issues so they finally medicated me and I have been just fine until Armour changed their formula. Now I’m not fine so I am doing research again.
They say secondary thyroid is rare. I think from what I read it is grossly under diagnosed. If you feel like you have all symptoms, push, push push.
Dr love to claim you’re depressed, imaginating maybe even a bit psycotic.
I heard it all. Not a one of them ever said sorry.
Just keep asking…what’s the worst thing that will happen if you try my thyroid meds and let’s see what happens.

September 4, 2012 at 7:12 am
(40) Helen Thomas says:

I find that my thyroid medication is better absorbed at night. After changing to taking at night ny tiredness disappeared AND I lost half a stone! I had heard a couple of years ago that studies have found that we absorb thyroxine better at night. What amazes me is that it doesn’t seem to be being picked up on. I tried to post about it on this site before in the weight loss sectuon but the post wasn’t accepted for some reason. I take my med just before I go to sleep with a littke water and make sure I haven’t had any food or drink for an hour before I take it.

September 4, 2012 at 10:40 am
(41) Ed Arnold says:

Sublingual administration of thyroid is not always about natural desiccated products. I take T3 (as Cytomel) and T4 (as Levoxyl). It works great! I believe that coating the mouth and esophagus with the dissolved pills leads to excellent and quicker absorption.

September 4, 2012 at 2:38 pm
(42) Charlotte says:

I am now taking NP by Acella. I started out just swallowing my meds then read where they would be more effective if I did them sublingually. I take 3 gr. When I was just swallowing my pills my Free T3 and Free T4 were within range but not optimized. After doing my 3 gr. sublingually for 6 weeks…I retested and both my Free numbers were way over range. My doc lowered my dose by 1/2 gr and I started having symptoms again. I have now gone back up to my 3 gr…but am swallowing my meds again and not doing them sublingually. I will retest in 2 weeks but already know that my numbers will be back down again. I usually dose by symptoms so I know that 3 gr..not taken sublingually is best for me. Doing my meds sublingually definitely raised my numbers up and put my symptoms into the hyper range.

September 4, 2012 at 8:36 pm
(43) Steve says:

Don’t take armor thyroid Sublingually! I did for a year or so and got tongue cancer . its a powerful hormone just a few drops can feed and stimulate every cell in your body but when you take it under the tongue only a small amount go’s directly into your bloodstream the rest saturates your tongue while slowly flowing down to your stomach.

Your stomach with ample fluid is a much better place to distribute the hormone evenly .

it was forth stage and they gave me 50/50 odds , I beat the odds but I suffered like never before and they say there’s a 30% chance it will come back so please dont make my mistake just take your meds with a good amount of water and call it a day.

November 19, 2012 at 12:59 pm
(44) DStewart says:

Steve – That is a scary story, but I suspect your experience in coincidental.
There are a lot of people who have been taking natural Thyroid sublingually for many years before us, and yours is the first I have heard of anyone making this connection. If you have any evidence of direct causation that could possibly be backed up by someone like your Oncologist or Endocrinologist, then PLEASE share that information as it would be of excellent use to many people here! Thanks!

January 26, 2013 at 1:20 pm
(45) Tamra says:

First, I should mention that I had a thyroidectomy due to TC in 2010. You may have hit the nail on the head re digestive issues and sublingual NDT. While taking 225 mg of compounded NDT for over a year I was never able to get my free T4 up to a normal range and never felt *well*. Because all of my illness started after a severe intestinal infection (c.diff) which led to chronic IBS, I thought I’d humor all the advice-givers and give sublingual NDT a try. After all, what I was doing wasn’t working and was very $$$. When I first switched over to Erfa my doc thought it best to give me the same 225 mg dosage as the compounded I had been taking. But that ended up making my free T3 8.1!!! I was extremely hyper! Now I take 125 mg of Erfa sublingually. My labs look better, but most important, I feel better. So many people with thyroid issues, especially those with fibromyalgia, also have digestive issues like IBS as they seem to go hand in hand. This might be a better option for that subset of folks.

May 22, 2013 at 6:24 am
(46) cheap nhl jerseys online says:

Should You Take Your Thyroid Medication Sublingually?

June 5, 2013 at 11:48 am
(47) Francesca Whitaker says:

I took armour thyroid meds.from 2004 to 2009… In 2009 I started having severe pain in my lower back muscles….Next 3 years were spent in spinal injections, many X-rays ,cat scans, physical theraphy, hydrocodone , Tramadol, percocet taken daily for the pain. Extreme severe pain…The only medication I take daily is my thyroid meds and vit D…

On day I just stopped taking everything….my pain was gone in 3 to 4 days…completely gone….I stayed off or 3weeks.. Went to Dr. Did thyroid test. Dr. Put me on Tirosint .. I have been on it for 31 days. After 3 weeks on Tirosint my pain slowly started returning, now the pain is stronger…

Has anyone else experienced severe pain in there lower back and hip muscles…unable to turn over in bed, unable to get out of chair, unable to get out of bed without assistance….unable to wipe after going to bathroom…pain so severe I would scream in agony….

I am desperate. I do not know who to see about this..told this story to Endo she had no idea what to do…
If it is all thyroid meds doing this what will I do for myself?

Dr. Said after thyroid tests I need to be on thyroid meds for life…

June 24, 2013 at 4:11 pm
(48) Patricia says:

I had a total thyroidectomy April 2009 for papillary CA. I was on Synthroid alternating days 175 and 200mg. My #s were where my endo wants them to keep me suppressed but I was miserable. Zero energy, yada, yada. I found a doc from Mary Shoman’s site and went to him. I was also on Methotrexate for mild psoriasis and Cymbalta for depression and fibromyalgia. This doc had me discontinue them and put me on Armour. I developed a raging itch that migrated all over my body as well as bowel issues. I was going out of my mind. He changed it to Naturethroid and the bowel issues have subsided although since I had my gall bladder out in `97 I’ve always had some problems and this has made them worse. I passionately hate this “1 hour before and 4 hours” after business for taking the Naturethroid (or Armour). My hours and intake are irregular. I’m hungry in the afternoon, mean as a snake now, and depressed as hell. My back & knee hurt just like a recent poster’s. I don’t want to go back to Synthroid and my old endo won’t entertain my taking Cytomel. After all, the numbers are good. :-( I was hoping to find that taking the dessicated thyroid sublingually would stop the garbage about counting hours between food, etc., but it doesn’t seem that is a solution either. I’m positively miserable and at my last wit’s end. There should be an easier solution to this mess.

August 13, 2013 at 8:49 am
(49) Fordhammsw says:

For Francesca Whitaker: I have had pain as severe as what you describe. I believe there can be a connection between GI problems and back pain – at least there is for me. I’ve discovered that when my back starts to hurt, if I pay attention to what is going on in my gut, I can sometimes alleviate it. I first made the connection to the gut when I was hospitalized for five days with such excruciating back pain that I could not stand or sit – literally, my lower back muscles could not “grab” and hold me up. I was howling like an animal….This was preceded by my very first acupuncture session, which focused on addressing my “irritable bowel” symptoms. Of course, they thought I was crazy at the time , because acupuncture “shouldn’t” have caused this, but an allergist later traced it to my being allergic to stainless steel, and the acupuncture needles were SS. And the nerves the needles were stuck into were gut nerves, and all the agony was in my back. I think it is what they call “referred pain”. So, why don’t you check out what’s going on with your gastrointestinal system, including the possibility that your thyroid meds are upsetting it – to see if that makes a difference?

August 16, 2013 at 11:15 am
(50) Liz Oppo says:

I recently stopped taking Synthroid sublingually because I was concerned that it might be absorbed by tissue in my throat, neck etc. that shouldn’t be getting a large dose of levothyroxin. It just doesn’t make sense so I prefer to have it be absorbed through my stomach so that it will not affect any one area, but go through my blood system more evenly.

September 6, 2013 at 12:53 am
(51) Marg says:

I too have started to feel very poorly on my Erfa Thyroid, taken sublingually. I do really feel that it’s not about dosage anymore, but absorption, I am always a “have to have coffee” first thing sort of person, so would neglect to take my Thyroid, but then take it later. But then was told that sublingual bypasses the need to wait so longer after coffee (and creamer)! But I really do think I am having absorption issues this way. I would almost have to say that the 2gr I am on, is NOT enough right now due to absorption issues, tho would it be enough if I could absorb more? My endo said to split my dose, 1/2 first thing in morning, another half around lunchtime due to the T3 half life. I haven’t done that, though I think I will try that, because waking up with stiff and painful hands and feet, plus gaining weight, something definitely not right anymore. And my endo only agreed with the dose I was taking already (as a new patient), I have never been able to get a doctor to dx me as hypo. I started on it myself, then because it was so expensive to purchase online, I went to dr and told them I was taking it (no one asks what doctor gave it to me), and blood work confirmed if they felt it was the correct dose. Which they did. (Surprise). So I have no faith really that the doctors will ever be able to adjust my medication themselves, I will have to do that myself and see how I feel. So for now I am going to try to split the dose in half, and if that does not offer improvement (sublingually that is), I will do my best to hold off on my coffee and start taking it orally, or titrate the dosage upwards.

September 19, 2013 at 12:32 pm
(52) Angie says:

The conditions that need to be met to take thyroid meds (for me,levothyroxin)really don’t fit into my morning routine. I too, need my morning coffee and I end up not taking my meds, thinking that I’ll take them later in the day. Now, I read something on the internet about how caffeine can affect the absorption of the meds for six hours ! I actually took the medication sublingually this morning but now after what I read, doing that may not be a good thing. I have read that taking the meds at night is good. Good luck

November 22, 2013 at 5:08 pm
(53) Ren says:

I’ve recently started Armour Thyroid and was advised in Kent Holtorf’s forum to take it sublingually. I’m also a coffee drinker. I usually put it under my tongue early am and drink coffee while waiting for it to dissolve. I’m careful not to mix the two in my mouth. It takes about 1-2 hrs for it to dissolve. I had taken it orally for about three weeks, then switched to sublingual. I noticed a change (decrease) in muscle pain within 36 hrs of sublingual. Have been just bumped up to 90 mgs. Hopefully, this will take care of rest of symptoms…

November 24, 2013 at 5:43 pm
(54) julie says:

I have been reading through all the entries on this thread and feel compelled to share what has changed my life. I found out that my thyroid problems were caused by an autoimmune response triggered by gluten exposure. No gluten, no thyroiditis episodes. I still take modest amounts of Armor, but no more rollercoaster caused by bouts of thyroiditis. Also, I got rid of fatigue, anxiety, body aches and other nagging symptoms by getting a Dr. that tests for low grade levels of bacteria like strep, clostridia, and fungi like Candida. We treated for these and the change was remarkable. Finally, I decided to get tested for other food intolerances and food allergies and got quite a list. We also added vitamin and other supplements that my tests indicated I was deficient in. My body feels so much calmer, arthritic pain is gone, and my stamina is much improved. Great plains Labs Organic Acids Test was one of the significant ones we used worth noting. The most important thing to remember is our bodies are very intricate machines that we have unwittingly damaged in many ways. We have to correct for antibiotic overuse, modified plant foods(gluten), and many other insults modern life provides. Looking for only one reason for our health issues is one of the biggest mistakes we can make. Be persistent, ask questions, read as much as you can, and be willing to accept that you may need to make some lifestyle changes that may be inconvenient at first, but become comfortable habits in the end. They have changed my life, and the results have amazed some of my other doctors.

March 15, 2014 at 12:52 pm
(55) Kerby Criss says:

I have chewed my Levothyroxine every morning for two years. I keep them refrigerated because half way through the bottle they start to get soft (and stale?) and this helps slow the process. This has helped me feel better more consistently. I just received a refill and the pill is so chalky and soft that it practically melts in my mouth. I am afraid that I have received a bad batch. Who can I ask about this? Both my pharmacist and my doctor look at me like I am nuts. They have no idea what it is like to suffer with hypothyroidism.

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