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Is there an over-the-counter substitute for levothyroxine?

November 22, 2022 7 min read

If you're one of the hundreds of millions of people in the world who take levothyroxine, you may be interested in learning about a new over-the-counter substitute for the drug. But is there a Levothyroxine substitute you can get over the counter?

The good news is that levothyroxine is not the only thyroid hormone replacement therapy available out there. Many over-the-counter alternatives are available and work just as effectively.

Whether you have an allergy to the ingredients in levothyroxine, find that levothyroxine is not working out for you, or you just want to find a better alternative, here's what you need to know about over-the-counter products that may help support the function of your thyroid gland.

The basics of thyroid hormone replacement therapy

The thyroid is a butterfly-shaped gland in your neck. It produces two main hormones: inactive thyroid hormones thyroxine (T4) and active thyroid hormones triiodothyronine (T3). These hormones are responsible for regulating the body's metabolism.

Hypothyroidism, also known as underactive thyroid, is a condition that occurs when the thyroid gland doesn't produce enough thyroid hormone. This can lead to a number of symptoms, including fatigue, weight gain, and depression.

Treatment for hypothyroidism typically involves taking medications to replace the missing hormone. Thus, balancing the amount of thyroid hormone in your body, restoring your metabolism, easing the symptoms, and improving your quality of life.

The most commonly prescribed thyroid medication for an underactive thyroid is levothyroxine (the synthetic form of T4 hormone). Besides levothyroxine, other prescription thyroid medications are as follows:

Liothyronine (Cytomel)

Liothyronine, also known as Cytomel, is a synthetic form of the hormone T3. Since it contains the active thyroid hormone instead of the inactive thyroid hormone like levothyroxine, your body may be able to absorb it more quickly. Many people also found it to be more effective in helping them with their hypothyroidism symptoms.

Liotrix (Thyrolar)

Liotrix, or Thyrolar, is a type of thyroid medication that contains synthetic T4 (levothyroxine) and T3 (liothyronine).

Natural Desiccated Thyroid

Natural Desiccated Thyroid (NDT) is an alternative to synthetic thyroid medication. One of the most famous names for NDT is Armour Thyroid.

NDT contains natural forms of both T4 and T3 hormones. They are made of dried porcine thyroid glands.

NDT appears to be more effective than levothyroxine in hypothyroid individuals, according to several studies.

Can you get synthetic thyroid medication over the counter?

You generally can't get synthetic thyroid medication over the counter, whether it is synthetic forms of T4 (levothyroxine and Synthroid), T3 (liothyronine), or the combination of T4+T3 (liotrix). They are only available by prescription.

This may get you wondering why. Well, the short answer is that thyroid treatment requires careful monitoring and control to ensure that the medications are safe and effective.

Keep in mind that it's essential to keep stable levels of thyroid hormone in your body in order to treat hypothyroidism effectively. That's why using synthetic thyroid medication without proper monitoring is not a wise move.

When used incorrectly, these synthetic medications can have serious side effects. They may even lead to hyperthyroidism (a thyroid disease in which your thyroid gland produces too much thyroid hormones).

What about natural desiccated thyroid medications?

NDT is the oldest thyroid medication that has been used to treat underactive thyroid since the late 1800s. It's made from dried animal thyroid glands. In the past, NDT used to be made of cows, sheep, or pig thyroid glands. Today, however, this medication is only made of the thyroid gland of pigs.

NDT contains all of the hormones that are found in our thyroid glands, including T4 and T3. This is important because T3 is the active thyroid hormone that helps regulate metabolism.

In some countries, NDT drugs, like Armour Thyroid and NP Thyroid, are considered prescription medications.

So, what's your option?

Not all natural desiccated thyroid medications are available by prescription only. There are natural desiccated thyroid supplements, such as VitaliThy and Real Thyroid, that are available over the counter. These supplements are even available to purchase online.

Like Armour Thyroid, they are made of dried porcine thyroid glands. Thus, they contain all the hormones that a thyroid gland normally produces, including T4, T3, T2, T1, and Calcitonin. And since they contain T3, you may be able to feel the effects of the supplements almost right away.

Many patients who use NDT supplements experience fewer hypothyroid symptoms, even when their previous medications, like levothyroxine, were ineffective. Since these supplements contain all thyroid hormones, they don't rely solely on the conversion of T4 to T3. This is surely beneficial for people who can't convert T4 to T3 properly because the supplement gives their bodies the active form of thyroid hormone.

Moreover, many NDT supplements like VitaliThy are Gluten-free, Lactose-free, Eggs-free, and fish and shellfish-free. This means that these supplements lack ingredients that can cause allergies, making them great for people who are sensitive to common medicine.

Other alternatives to help ease your hypothyroid symptoms

Consider doing the following things in conjunction with your thyroid medication or supplement to help you lead a healthy life with hypothyroidism.


A healthy diet may be beneficial in the treatment of hypothyroidism. Your overall health can be improved by ensuring that your diet contains a healthy balance of endocrine-boosting foods. On the other hand, eating foods that are high in sugar, processed foods, and fats may contribute to extreme fatigue, which is a symptom that is characteristic of hypothyroidism.

Vitamin D

Low levels of vitamin D are often associated with autoimmune hypothyroidism. Therefore, you should make sure that your body receives plenty of vitamin D. Moreover, vitamin D can help regulate the immune system and guard your body against the development of antibodies that can harm the thyroid.

According to the findings of a recent study, supplementing with vitamin D may assist thyroid medications or supplements in balancing thyroid hormone levels.

Essential oils

Essential oils can help reduce inflammation, reduce thyroid antibodies, promote cellular repair, and even enhance your tolerance to stress. Some essential oils you may want to try to include peppermint, lemongrass, lavender, spearmint, and frankincense.

Vitamin B12

Low levels of vitamin B12 have been linked to the development of a variety of thyroid conditions, including hypothyroidism. Thus, ensuring that your body has enough vitamin B12 can help support healthy thyroid function.

You can take vitamin B12 supplements or eat plenty of food that contains the vitamin, such as milk, animal liver and kidneys, beef, or clams.


Iodine is necessary for the production of thyroid hormones. That's why you should consider eating iodine-rich foods like seaweed, fish, and certain fruits. Doing this may help balance your thyroid hormone levels and normalize your thyroid function.


For those dealing with hypothyroidism, exercise may seem like the last thing on their mind. After all, when fatigue and weight gain are constant companions, who have the energy to work out?

But exercise can actually be a powerful ally in the fight against hypothyroidism. Regular exercise boosts energy levels by increasing circulation and oxygenation of the blood. A study reported that aerobic exercise helps to regulate hormones and metabolism by stimulating the release of thyroid-stimulating hormone (TSH).

In addition, exercise helps relieve stress and tension, which can exacerbate symptoms of hypothyroidism. It can aid in weight loss as well.


Minerals like selenium, zinc, and copper are important for activating deiodinases, which are the enzymes that convert T4 to T3. Without these minerals, the body cannot produce enough T3, leading to hypothyroidism.

Stress reduction

Stress can impact your thyroid health. When the body is under stress, it releases a hormone called cortisol. Cortisol has a number of effects on the body, one of which is to suppress the thyroid gland. This can lead to a decrease in hormone production, which can then impact the body's metabolism.

If you're already struggling with hypothyroidism, managing your stress levels is important to help keep your condition under control. There are a number of ways to do this, including relaxation techniques such as yoga or meditation.

Herbal Supplements

You can use some herbal supplements to support healthy thyroid hormone levels. However, more evidence is required to confirm their effectiveness.

The first herbal supplement you can consider is bladderwrack (fucus vesiculosus). Although not exactly a herb, bladderwrack (Fucus vesiculosus) is a species of seaweed and a significant source of minerals and dietary fiber. Iodine, which is present in bladderwrack, may aid in the treatment of thyroid-related issues.

Another herbal supplement that may help manage your thyroid problems is Ashwagandha. According to a study, 600 mg of ashwagandha root extract may help balance your thyroid hormone levels.

What you need to keep in mind

There is no one-size-fits-all approach to treating hypothyroidism. There are a number of different treatment options available for hypothyroidism. The best option for you will depend on a number of factors, including the severity of your condition, your age, and any other health conditions you may have.

A combination of medication, supplements, and lifestyle changes may help you manage your condition and feel your best.


There are many reasons why many people are actively searching for over-the-counter alternatives to levothyroxine. Some people have an allergy to the ingredients in levothyroxine, while others find that T4-only medications can't relieve hypothyroid symptoms. Fortunately, there are numerous over-the-counter alternatives for levothyroxine.

The main alternative to consider is NDT supplements, such as VitaliThy and Real Thyroid. These supplements are similar to prescription NDT like Armour Thyroid. They're made of porcine thyroid glands and contain both T4 and T3 thyroid medication. Therefore, many people find them to be more effective than levothyroxine. Plus, they're available to purchase online.

Besides NDT supplements, you may also consider eating foods that are rich in iodine, minerals, vitamin D, and vitamin B12. Taking herbal supplements and using essential oils may also help you lead a healthy life, even with hypothyroidism.

Lastly, you need to exercise regularly and manage your stress. Regular exercise has been shown to help normalize your thyroid function. And since stress can worsen your condition, managing it may help keep your condition under control.

Wojciech Majda
Wojciech Majda

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