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March 08, 2023 10 min read

Let's talk about a fancy term called the "sublingual route" - don't worry, it's not as complicated as it sounds! Basically, this just means taking medication by placing it directly under your tongue instead of swallowing it and waiting for it to be absorbed by your digestive system.

Now, you might be wondering why anyone would do this. Well, there are actually some significant benefits to taking medication sublingually. For one, it can work faster than traditional oral medications because the medication doesn't have to go through your digestive system first. This can be especially helpful if you're in a situation where you need fast-acting relief. But the question is, can you take your thyroid medication sublingually? Here's what you need to know.

What is the thyroid gland?

The thyroid gland is a tiny butterfly- gland found in the front of the neck that plays a crucial role in a number of important bodily functions. One of the main things the thyroid gland does is produce hormones, specifically thyroxine (T4) and triiodothyronine (T3). T4 is largely inactive, meaning it doesn't have much of an impact on your cells. That's why they're often referred to collectively as "thyroid hormone."

But here's where things get interesting - once your thyroid gland releases T4, certain organs in your body (like your liver and kidneys) actually transform it into T3. This is the active form of thyroid hormone, and it's the one that actually impacts your cells and helps regulate your metabolism. This is the process by which your body transforms the food you eat into energy.

What is hypothyroidism?

Hypothyroidism, also known as underactive thyroid or low thyroid function, is one of the most common thyroid problems. This thyroid disease occurs when your thyroid gland doesn't produce enough thyroid hormone. As a result, your metabolism slows down, and a range of symptoms appear. Some of the common symptoms are weight gain, dry skin, memory loss, fatigue, and cold intolerance.

There are various causes of hypothyroidism, such as Hashimoto's disease, thyroid removal surgery (thyroidectomy), radiation therapy, and ectopic thyroid tissue.

What are the common medications for hypothyroidism?

The medications to treat hypothyroidism are known as thyroid hormone replacement medications. These thyroid medications work by replacing the hormone your thyroid is not producing enough of. Aside from treating hypothyroidism, these medications may also be used to control goiters (growth of the enlarged thyroid gland), reduce the size of ectopic tissue,

1. Levothyroxine

Levothyroxine is a synthetic version of the hormone thyroxine (T4), which is produced naturally by the thyroid. In the United States, it's sold under the brand names Synthroid, Levoxyl, Unithroid, and Tirosint. It's the standard treatment for hypothyroidism, which means that you're likely to be prescribed this medication when you're just diagnosed with hypothyroidism.

2. Liothyronine

Liothyronine is the synthetic form of triiodothyronine (T3). You might have heard about this medication in passing, but it's not as commonly prescribed as levothyroxine. Liothyronine is usually used in combination with levothyroxine to help some thyroid patients who still experience symptoms despite taking T4 medication alone.

3. Natural desiccated thyroid (NDT)

Natural desiccated thyroid (NDT) is a type of medication made from dried and powdered animal thyroid glands, usually from pigs. It has been used for decades to treat hypothyroidism.

NDT is regaining popularity as an alternative to synthetic thyroid hormone replacement therapy. Studies have shown that many people prefer NDT over synthetic thyroid hormone replacement therapy because they experience more weight loss, have more stable levels of thyroid hormones, and feel better overall.

One of the reasons for this preference is that NDT provides both T4 and T3 hormones, while levothyroxine only provides T4. T4 must be converted to T3 in the body to be used properly, and some people have difficulty converting T4 to T3. NDT provides both hormones, which may be beneficial for those who have trouble converting T4 to T3.

NDT is made from natural sources and has a long history of use. It is considered safe and effective when used properly and under the guidance of a healthcare provider. It's also a good option for those who prefer natural therapies or have sensitivities to synthetic hormones.

While NDT offers numerous benefits, it can be challenging to find in traditional pharmacies. However, you can buy desiccated thyroid online from reputable sources, such as VitaliThy. It's an NDT supplement that contains Thyroid USP and is very effective in easing hypothyroid symptoms.

How do you usually take thyroid medication?

Taking thyroid medication may seem like a straightforward task, but there are a few things to keep in mind to ensure you're getting the most out of your medication.

First and foremost, it's important to take your medication on an empty stomach. This means you should wait at least 30 minutes after taking your medication before eating anything. Why is this important? Well, food can interfere with the absorption of your medication, which can lead to inconsistent thyroid hormone levels in your body. And that's the last thing you want when you're trying to manage your thyroid health!

Another thing to keep in mind is the potential interaction between your medication and dietary fiber. High-fiber foods can also interfere with the absorption of your medication, so it's a good idea to wait a few hours after taking your medication before consuming any high-fiber foods. This includes things like whole grains, fruits, and vegetables. Other medications, such as cholesterol-lowering medications, can also interact with your thyroid medications.

When it comes to actually taking your medication, make sure to swallow it with a glass of water. Don't chew or crush the medication, as this can also affect its absorption.

What is sublingual drug administration?

Sublingual drug administration is a method of delivering medication through the blood vessels under the tongue. In this technique, the medication is placed under the tongue and absorbed through the mucous membranes, bypassing the digestive system and avoiding first-pass metabolism.

Sublingual administration is a popular choice for many medications, especially those that require rapid onset, high bioavailability, and precise dosing. Common examples of medications that can be administered sublingually include nitroglycerin for angina, opioids for pain relief, and some allergy medications.

One of the biggest advantages of sublingual drug administration is its fast onset. Because the medication bypasses the digestive system, it can quickly enter the bloodstream and produce its effects within minutes. This makes it an ideal choice for emergency situations or for medications that need to take effect quickly.

Another advantage of sublingual administration is its high bioavailability. When medications are taken orally, they must first pass through the liver, which can metabolize and reduce their effectiveness. By delivering medication directly into the bloodstream, sublingual administration can avoid this problem and deliver a more potent dose.

Sublingual administration is also a convenient and easy method of drug delivery. It doesn't require any special equipment or training and can be done anywhere, anytime. Plus, because it avoids the digestive system, it reduces the risk of nausea, vomiting, and other gastrointestinal side effects.

Can you take thyroid medication sublingually?

While it may seem like a convenient way to take your medication, not all medications are necessarily absorbed effectively if they are taken sublingually. And in the case of thyroid medications, the answer is a bit complicated.

Yes, thyroid hormones can be absorbed under your tongue, but not all of them are created equal. Some thyroid medications come packed with inactive ingredients that make it super hard for your tongue to dissolve them. So even though it's technically possible to absorb your thyroid meds under your tongue, it's not a guarantee that it will work.

So, which thyroid medications are good candidates for sublingual administration? Unfortunately, there aren't a ton of studies on this, so we have to rely on patient stories and experiences. But we do know that liquid formulations of thyroid medications, like Tirosint-Sol, work great under your tongue.

As for natural desiccated thyroid (NDT), well, that's a bit trickier. NDT is tough to break down, even for your stomach, so you might need to get a bit creative to make it work under your tongue. This could mean chewing or smashing up your NDT, warming up your mouth beforehand, or even taking it with B12 lozenges or sugar to assist with absorption.

While some patients have had success with taking NDT sublingually, absorption of non-liquid thyroid formulations can be hit or miss.

What are the benefits of taking your medication sublingually?

Drugs that are taken sublingually have various advantages over their more common pill or capsule counterparts. The benefits include:

1. Quick absorption

When compared to swallowing a pill or tablet whole, the body absorbs sublingual formulations far more quickly. When you take medicines through your gastrointestinal tract, it can take several hours for them to be fully absorbed. This can result in a delayed release of the medication and a slower onset of its effects.

However, some thyroid medications, especially those containing T3 thyroid hormone, can have an almost immediate impact on the body upon ingestion. And that's where the sublingual route comes in handy! By placing your medication under your tongue, you can experience a quick boost in your energy levels at the start of the day.

This is because the sublingual route allows for rapid absorption of the medication into your bloodstream, bypassing the digestive system and avoiding the delays that come with it.

2. Food and drug interactions are minimized

By taking your thyroid medication sublingually, you are not only bypassing the liver but also avoiding potential absorption issues that can occur in the gut, such as malabsorption, food interactions, and other medications interfering with absorption. This can be especially important for individuals who have gastrointestinal issues or are taking other medications that may interfere with thyroid hormone absorption.

3. A more consistent dose

Taking medication sublingually can also provide a more consistent and reliable dose. With oral medication, factors such as food, gastric acidity, and intestinal transit time can affect the rate and extent of absorption, leading to fluctuations in thyroid hormone levels in the body. By contrast, sublingual absorption is generally more predictable and consistent, leading to more stable thyroid hormone levels over time.

4. More flexibility

One benefit of taking thyroid medication through the sublingual route is that you have more flexibility in terms of when and what you can eat or drink after taking it. Normally, patients are advised to wait several hours before eating or drinking anything after taking their medication, as certain substances can interfere with absorption. However, with sublingual administration, this is not a concern, and you can also take supplements like calcium or iron at any time of the day. Additionally, you can take your medication at any time, although morning is still recommended.

What are the drawbacks of taking your medication sublingually?

But aside from the benefits, there are also some drawbacks to taking your thyroid medication sublingually. These include:

1. You have a higher risk of an overdose

Here's something to be aware of when taking your thyroid medication sublingually: It's easy to accidentally take more than your body needs. This can be scary, but fortunately, it's not usually harmful in the long term.

You might experience some heart palpitations or anxiety, but no worries, your body will eventually metabolize the excess thyroid hormone, and you'll be back to normal. Just remember that this is an extension of the absorption changes we talked about earlier, so keep an eye on your dose.

2. You may need to adjust your dose

Switching to the sublingual route may require a change in your total dose of thyroid medication as absorption changes. You may need to alter or change your dose accordingly.

3. Not all medications can be taken through the sublingual route

It's also important to note that not all of your thyroid medication may be absorbed sublingually. This can happen for various reasons, just like with other hormone medications. Some people may not respond well to topical creams and require pills instead, for example. If you are one of the unlucky ones who doesn't respond to sublingual doses of thyroid medication, don't worry – there are other options available.

Should you take thyroid medications sublingually?

The sublingual route involves placing medication under your tongue and allowing it to dissolve and absorb directly into your bloodstream. It's not a new concept, but it's gaining popularity among thyroid patients looking for alternative options to traditional thyroid medications.

While not all thyroid patients can do it, there are certain groups of people who could benefit from it. Here are some examples:

  • If you've tried multiple types of thyroid medications without success, sublingual could be worth a shot.

  • If you've had surgery or changes to the anatomy of your gut, such as gastric bypass or surgical removal of parts of your intestines, sublingual could be a good option.

  • If you have known gut issues or malabsorption problems, such as SIBO, yeast overgrowth, or inflammatory bowel disease, sublingual could be easier on your gut.

  • If you have a physician who can monitor you during the transition, sublingual may be worth considering.

  • If you're sensitive to the inactive fillers and binders found in many thyroid medications, sublingual could eliminate these unnecessary ingredients.

It's important to note that this is not an exhaustive list, and everyone is different. If you think sublingual could be beneficial for you, it's important to discuss it with your doctor before making any changes to your medication regimen.

Other things to consider before taking your thyroid medication sublingually

Are you struggling to find relief from your thyroid medication and considering taking it sublingually? Before you do, here are some things to consider:

1. Dose adjustment

If you're not feeling better with your current medication, talk to your doctor about adjusting your dose. They may order thyroid lab tests to determine your optimal dose. It's essential to take the right amount of medication for your body, and sublingual administration won't fix an incorrect dose.

2. Medication switch

If you're taking levothyroxine and not seeing results, consider switching to Natural Desiccated Thyroid (NDT). Many patients have reported better symptom relief with NDT than with synthetic T4 medication. Since NDT contains both T4 and T4 medications, it may be more effective in restoring normal thyroid function. One great option is VitaliThy, a natural desiccated thyroid you can buy online.

3. Take your medication properly

Taking your medication on an empty stomach is crucial for proper absorption. The ideal time to take your medication is first thing in the morning, at least 30 minutes before breakfast, or 2-3 hours after eating. If you take other medications or supplements, speak to your doctor about how to take them in relation to your thyroid medication.

Conclusion: Sublingual route maybe beneficial for some hypothyroid patients

Although it is unlikely that all thyroid drugs would be effective if given sublingually, there are several that may be taken this way safely, and doing so provides significant advantages for many thyroid treatments.

Taking medication sublingually can be an alternative administration method for some thyroid patients, but it's important to exhaust all other options and speak to your doctor before making any changes. Don't hesitate to ask your doctor about the sublingual route and discuss whether it's a viable option for you.

Before diving in, it's also important to weigh the benefits and drawbacks thoroughly. You should be aware of the downsides, even if they are unlikely to have any lasting effect.

Curious to learn more about the food you need to avoid while taking thyroid hormone replacement medication? Take a look at our guide of the foods that interfere with your thyroid medication.

Wojciech Majda
Wojciech Majda

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