Have you thought about quitting thyroid medication or simply figuring out if you can quit thyroid medication?
It’s a question I get a lot.
Thankfully I’ve had decades of hands-on experience helping patients make sense of this question. Now, I want to help you.
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In 30 years of treating patients for natural thyroid care, a majority of those who’ve come to me – especially lately – have wanted to adjust their medication in some way. For some, it’s to take less.
For most though, it’s to see how to get off thyroid medication for good.
And that makes sense because nobody wants to feel beholden to their meds.
If you’re unsure if it’s worth doing, here is a good question to ask yourself (and even your current prescribing physician).
Are you healthier without needing medication?
There is a lot of evidence suggesting that thyroid medication raises other health risks.
One big study, performed in Korea, looked at people who were on thyroid medication compared to others who were in a similar health situation (but not on medication)1. What they found was that, for those on thyroid medication, the total risk of death was almost twice as high.
This gives rise to a super important concept: taking a hormone is not the same as making a hormone.
Even if it’s the same hormone in the same amount, we are simply unable to replace hormones as well as our bodies can produce them. That’s simply a fact.
Key Insight: A crutch is helpful, but it’s no substitute for a healthy leg. The same is true for thyroid medication – we need our bodies to produce hormones, rather than try to supplement it, to get the best results and our best health back.
There have also been a handful of studies looking at the cancer risks associated with thyroid medications.
Overall, thyroid medications raise the risk of cancer. It’s nearly any kind of cancer you might think of, and it’s by a substantial amount2.
In most cases, it is about a 50% risk increase. This is exactly why quitting thyroid medication is a totally valid goal, and in some cases, it is something you should be considering or should be pursuing. The data paints a very clear picture here.
How might success look when it comes to quitting your thyroid medication? There are two levels here that I quickly want to explore:
Truth be told, taking zero pills would be great, but it’s not always possible. Even a reduction in the amount of pills that we are taking can have an outsized impact on our overall health. As we dive deeper, I want to view that as a goal before jumping to taking no pills at all.
I want to outline a path to success when it comes to thyroid medications and quitting them for good. Here are the six steps to success that you should consider…
(Truth: You MUST do this with the help of a prescribing physician)
Let’s start by talking about who is not a candidate to quit their medication.
Key Insight: If you don’t have a thyroid or have almost nothing there at all, you can’t quit your thyroid medications.
Beyond that, we should also consider timing.
When might it not be an ideal time to quit your thyroid medications?
There are a couple of examples worth exploring, including:
The next thing to consider is having the right team in place. What you need is a team of professionals who can guide you and supervise you in the process – that person may or may not be your prescriber, either option can work.
In any case, though, your prescriber needs to be supporting you and think it’s a good idea to get their full support. That is going to help ensure that you are the best candidate possible for coming off or coming down from your current thyroid medication.
Could you reduce your thyroid medication by a little or by a lot?
The first thing to consider is how long you’ve been on treatment. There is a threshold that, beyond four years of being on medication, you may have become reliant on it (at least a little bit).
The next big factor that comes with this is overdosing.
If someone is put on too much thyroid medication, it can shut down the signal from the brain to the thyroid which helps the thyroid grow and repair itself (known as your TSH).
We also need to think about why you were put on thyroid medication in the first place.
This can be one of the most important considerations – in many cases, folks were not given a clear original diagnosis. Or, they were told it was for Hashimoto’s.
Let’s pull this one apart. Hashimoto’s is purely an immune attack, which can lead to hypothyroidism (a lack of thyroid hormone). They can overlap, but they are separate things – and the data is very clear on that.
If someone doesn’t have hypothyroidism to a marked degree, medications do not help with Hashimoto’s. Hashimoto’s alone is not a good reason, which means that if you were put on it for that reason you could benefit from winding down or ending your time on meds!
So, if Hashimoto’s doesn’t count as a reason, what are the degrees of hypothyroidism and how do they matter? Let’s consider three…
A couple of other factors that you may want to consider…
The first thing to know in this step is that you may feel worse before you feel better.
*Yes, this part can be no fun (short-term)…but I can’t stress it enough. And you should know what may happen.
Studies have shown that most folks fall into one of three pretty equal categories:
Most commonly, people will experience some kind of fatigue as part of their symptoms. And it tends to pass in short order, which is essentially like giving your thyroid a chance to get back online and get back to working again. You need to give it a chance.
Another good expectation to set is that coming off your thyroid medications may not resolve every last one of your symptoms.
You may have other things going on that are causing you harm, which is another reason why you need a good team in place.
Key Insight: This is a big one. Your lab test results are going to be very unreliable for a time – maybe for the first 3-6 months. During the taper, your TSH is supposed to elevate and it’s why it’s so important that your prescriber and your guide are on the same page.
A lot of the studies that revolve around deprescribing don’t do a whole lot to get people ready for the process, and yet they still do okay.
That said, the more you do to get ready, the better you can overall – and the faster you can feel better, too.
The first thing to do is to regulate your iodine intake.
That is what the Thyroid Reset Diet is all about, and some of the best studies that concern deprescribing tend to focus on helping people regulate their iodine intake to feel their best.
You can go as far as to measure your urinary iodine-to-creatinine ratios, which can ensure that you are at a therapeutic level and have the best chance of coming off your thyroid medications most successfully.
Additionally, you need to make sure that you have the right amounts and kinds of micronutrients.
There are a lot of key ones that you need across the entire journey. This is something I thought about a lot as I was developing my Thyroid Specific Formulations.
When it comes to deprescribing, the three I’d focus on the most include:
These are all made to support the restoration of normal thyroid function and better utilization of thyroid hormones in your body. I’d love for you to consider any of them.
Along the lines of preparation, we may have medical conditions that make us less apt to be successful.
We should keep these three top of mind:
A lot of folks have come off their thyroid medication with these conditions and done fine.
But, you’re more likely to see more success if you address these conditions at the outset.
Now it’s time to make a plan.
The first thing to remember is that you are in charge of this entire journey. Ultimately, how quickly or how slowly you proceed is based on you, your preferences, and your symptoms. You should rely on your experience and not lab tests.
Keep in mind: Any level of reduction you make is better for your body, and your body will thank you for it. As you are preparing, we need to focus on potency.
This is going to rely on a lot of work with your prescriber.
In my experience, what I have found helpful is to have a lot of pills at a low potency. As you go through the process, you can take fewer and fewer pills.
If you are on T4-based medications, it is often a matter of simply having enough pills. That’s because, with those, you can skip days.
If you are on medicines that include T3 (like natural thyroid), you will need some different potencies as you go through the process.
Key Insight: As part of this, some may choose to switch to slower-acting medications because they can be simpler for you. It can be easier to schedule, but a new medicine may not make the process as clear (it’s a bit of a trade-off).
The next thing to keep in mind is knowing when you are going to re-test.
Generally speaking, the best time frames for that are going to be roughly three months after you have completed the taper process. Before that, it simply won’t be as meaningful.
Finally, as part of the preparation, you’ll want to choose a taper schedule.
There are a couple of options that I want to quickly run you through…
This is often done for those on T4 medication. It can be done over two weeks, and one protocol is to take half a dose for one week – and then half a dose every other day for the second week. Fast and easy!
This is the one that I use the most. It occurs on a two-month timeframe, for those on T4 medicine, or a ten-week timeframe if T3 is included. If someone is on a T4 medication with 150 mcg as an example, it looks like this:
If T3 is involved (with 90 mg NDT as an example), you’ll want to take things a bit more slowly. Here’s how that might look:
While these are the most common timeframes, a big question I get is people asking if they can take things more slowly.
If you do it too slowly, I have seen a reduction in success – this is because you need a certain amount of elevation to bring your thyroid back.
Key Insight: On principle, there is nothing wrong with going slowly. Practically speaking, though, it simply doesn’t work as well for some people. It’s important to go with a timeframe where we know we can get the best results possible.
It’s time to kick your plan into action.
And, as we get started, it helps to think about troubleshooting and some of the most common issues we might come up against.
The first concerns iodine.
This can be addressed by checking your urinary iodine-to-creatinine ratio and taking steps accordingly. You want to see it at less than 100.
There are also other comorbidities to consider.
Things like your adrenal health, iron levels, or your liver. Those are three out of many that you may need to address.
What if things aren’t working?
You may also need to consider stopping your taper and doing a bit of a reset. Revisit three to twelve months down the road and try again.
And, when/if should you consider going back on your meds?
Here’s why you might:
Key Insight: There’s a lot at play here, which makes it all the more important to partner with professionals and prescribers who will accompany you on this journey. It is so important to work with people you trust and who know the full story.
Now that you’ve gone through all of the steps, what do you do next? I’d recommend considering any of the following…
I hope this guide helped set you on the right path to thinking through deprescribing and quitting your thyroid medications. When it makes sense, it can be a benefit to your health while cutting down on potential risks down the line.
If you want to learn a bit more about the current state of your thyroid, I would highly recommend taking the Thyroid Quiz today. In addition to the steps above, it can give you a deeper understanding of the state of your thyroid and what you can do to help it feel its best.
1 – Jung KY, Kim H, Choi HS, An JH, Cho SW, Kim HJ, et al. Clinical factors predicting the successful discontinuation of hormone replacement therapy in patients diagnosed with primary hypothyroidism. PLoS ONE. 2020 May 29;15(5):e0233596. DOI: 10.1371/journal.pone.0233596. PMID: 32469958. PMCID: PMC7259697.
2 – Burgos N, Toloza FJK, Singh Ospina NM, Brito JP, Salloum RG, Hassett LC, et al. Clinical Outcomes After Discontinuation of Thyroid Hormone Replacement: A Systematic Review and Meta-Analysis. Thyroid. 2021 May;31(5):740–51. DOI: 10.1089/thy.2020.0679. PMID: 33161885. PMCID: PMC8110016.
P.S. Whenever you are ready, here is how I can help you now:
1. Schedule a Thyroid Second Opinion with me, Dr. C, Click Here for Details
2. Need A Thyroid Supplement Recommendation? Take My Thyroid Specific Formulations Quiz Now
3. Need a Personalized Supplement? Check out My Thyroid Specific Formulations
4. Download and use my Favorite Recipes Cookbook Here
5. Check out my podcast Medical Myths, Legends, and Fairytales Here
Dr. Alan Glen Christianson (Dr. C) is a board-certified Naturopathic Endocrinologist, and the author of The NY Times bestselling Adrenal Reset Diet, Metabolism Reset Diet, Thyroid Reset Diet, and the Healing Hormone Cookbook.
Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, diabetes, and regain energy. Learn more about the surprising story that started his quest.
