Many people with hypothyroidism take thyroid medicine every day for years. While these medicines are important and help keep thyroid hormone levels under control, some people still continue to feel tired, gain weight, struggle with brain fog or have low energy despite taking their tablets regularly. This often leaves them wondering whether their medicine has stopped working.
The answer is not always that simple. Thyroid health depends on several parts of the body working together. Nutrient deficiencies, liver health and even stress can influence how thyroid hormones are produced and used. This is why doctors often look beyond a single blood test before deciding whether a treatment needs to be changed.
Nutritionist Rashi Chowdhary shares an Instagram post explaining three common reasons why thyroid medicine may not seem effective. According to her, fixing these underlying issues may sometimes be just as important as taking the medication.
Here’s what she explains:
- Iron and selenium levels matter
According to Chowdhary, the thyroid gland needs both iron and selenium to make thyroid hormones properly. She says iron helps an important enzyme involved in hormone production, while the thyroid stores more selenium than any other organ in the body.
“If you’re running low on both of them, your thyroid gland has no raw material to function,” she explains. Instead of assuming the medicine is not working, she suggests checking iron and selenium levels.
- Your liver plays a big role
The nutritionist also points out that the liver converts T4, the inactive thyroid hormone, into T3, the active form that the body’s cells use. Chowdhary says around 80 per cent of this conversion happens in the liver. If someone has fatty liver disease, even in its early stages, this process may become less efficient.
In such cases, the medicine may not be the main problem. Supporting liver health could also make a difference.
- A normal TSH does not tell the full story
Chowdhary explains that TSH is produced by the pituitary gland in the brain, not by the thyroid itself. She says chronic stress, poor sleep and ongoing physical or mental strain can affect how T4 is converted into T3. As a result, a person’s TSH level may appear normal even if the body is not getting enough active thyroid hormone.
She recommends asking your doctor about a complete thyroid panel instead of relying only on TSH. This may include Total T3, Total T4, Free T3, Free T4, TSH, Anti-TPO, Anti-TG and Reverse T3.
That said, thyroid medicine should never be stopped or changed without medical advice. If you continue to have symptoms despite treatment, speak to your doctor. The issue may not always be the medicine itself, but other factors that deserve attention.
