Taking thyroid medication is supposed to help with symptoms like fatigue, weight gain, and brain fog, but many people still feel unwell even when taking their prescribed dose. Thyroid medication may not be working as expected for several reasons, including improper testing, poor absorption, or underlying imbalances that need to be addressed. Understanding why medication isn’t working is the first step toward feeling better.
Incomplete Thyroid Testing
Many doctors only test TSH (thyroid-stimulating hormone) when checking thyroid function, but this does not provide a full picture. The thyroid also produces Free T3 and Free T4, the active hormones responsible for metabolism, energy, and brain function. Some medications only replace T4, but if the body isn’t converting T4 into the active T3, symptoms can remain. A full thyroid panel, including Free T3, Free T4, Reverse T3, and thyroid antibodies, is essential for understanding what is truly happening.
Poor Absorption of Medication
Thyroid medication needs to be absorbed properly to work. Certain foods, supplements, and gut imbalances can interfere with absorption. Low stomach acid, gut inflammation, and conditions like leaky gut can prevent the body from using thyroid medication effectively. Taking medication on an empty stomach and avoiding calcium or iron supplements around the same time can help improve absorption.
Other Hormone Imbalances
The thyroid does not work alone, it is connected to other hormones like cortisol and insulin. Chronic stress can lead to high cortisol levels, which interfere with thyroid function and slow metabolism. Insulin resistance can also make it harder for the body to use thyroid hormones properly. Addressing these imbalances through functional medicine can help improve how the thyroid responds to medication.
The Functional Medicine Approach
Functional medicine goes beyond just prescribing medication. It looks at the root cause of thyroid dysfunction, checking for nutrient deficiencies, inflammation, and gut health issues that may be preventing proper thyroid function. A personalized approach, including proper testing, dietary changes, and stress management, can help thyroid medication work more effectively.
If thyroid meds are not working, there is always a reason. Getting the right tests, improving absorption, and balancing other hormones can make a big difference. With the right support, it is possible to restore energy, improve metabolism, and start feeling better again.