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About Treatment Options

There are many different thyroid hormone replacements available globally. There are branded replacements and generic replacements (generics are copies of the original drug).  They come in tablets, capsules and liquid form. Some are lactose-free and you can also get some with minimal inactive ingredients. Some are synthetic and some are made from the glands of pigs.

Some people find one particular brand or generic better for them than another, probably due to an intolerance to one of the inactive ingredients.

Some patients have found that when a pharmaceutical company changes the ingredients in a thyroid hormone replacement, they start to have adverse effects or that their symptoms return such as when Merck substituted mannitol for lactose in their levothyroxine in France.

We would urge any patients having side effects from any brand of levothyroxine to contact the MHRA and make a report via their Yellow Card Scheme.

Medications and manufacturers

Thyroid UK collates information such as ingredients on many brands of generic thyroid medications including levothyroxine, NDT and T3 to ensure that antigens or intolerances can be found before asking for a particular brand. This also includes manufacturers’ contact details should you need to contact them about adverse effects or supply issues, and ingredients.  Download the thyroid hormone replacement information document.

Levothyroxine (T4)

Levothyroxine is the first-line treatment for hypothyroidism. It comes in various dosages and you will start off at a lower dose and then your dosage will be increased or decreased depending on your blood test results and symptoms.

Read more about Levothyroxine (T4).

Liothyronine (T3)

Liothyronine (T3) is a thyroid hormone that some patients require as well as levothyroxine to resolve all symptoms of hypothyroidism.  It can only be initiated by a thyroid specialist endocrinologist.

Read more about Liothyronine (T3).

Natural desiccated thyroid (NDT)

Natural desiccated thyroid (NDT) is a thyroid medication that was used until levothyroxine was produced.  Some people have unresolved symptoms on levothyroxine and/or T3 but find NDT improves their symptoms.

Read more about Natural desiccated thyroid (NDT).

Thyroid glandulars

Glandulars are a medication made from the thyroid glands of either pigs or cows. Glandulars should not contain any hormones.  Some people find them helpful in their treatment for hypothyroidism.

Read more about thyroid glandulars.

Access to thyroid medications

Some people have unresolved symptoms on levothyroxine either due to the excipients (inactive ingredients) or due to non-conversion of T4 issues. Find the information you need to access a different medication.

Food and drug interactions

There is a multitude of things that can interfere with your thyroid medication including food and drug interactions.


A thyroidectomy is a procedure for removing part or all of the thyroid gland.  This is usually done due to benign or cancerous nodules or due to uncontrolled overactivity of the thyroid gland.

Read more about Thyroidectomy.

Date updated: 17.08.21 (V1.4)

Review date: 08.04.22

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