Thyroid Hormones

What Are Thyroid Hormones?

The thyroid gland takes iodine from the food we eat and combines it with the amino acid tyrosine to make two thyroid hormones: thyroxine (T4) and triiodothyronine (T3). These hormones are released into the bloodstream and transported throughout the body to regulate metabolism.

T4 is the inactive form of thyroid hormone; it’s produced solely by the thyroid gland. T3 is the active form. The thyroid gland produces about 20% of the T3 in our bodies. Most people have enzymes called deiodinases in organs like the liver, brain, kidneys, and heart, which produce the other 80% by converting T4 into T3, as needed.

It is important that T3 and T4 levels are not too high or too low. The production and release of both thyroid hormones are controlled by a feedback loop involving the hypothalamus, pituitary gland, and thyroid gland. In the healthy body, the hypothalamus releases thyrotropin-releasing hormone that stimulates the anterior pituitary gland to secrete thyroid-stimulating hormones. These, in turn, signal the thyroid to release T3 and T4. When the levels of circulating T3 and T4 increase, they prevent the release of both thyrotropin-releasing hormone and thyroid-stimulating hormone, allowing the body to keep its level of thyroid hormones stable.

Low thyroid or hypothyroidism is a common condition, and many people who have it can take a commercial prescription hormone supplement that contains standardized amounts of T4 and/or T3. These can work well if the patient’s hormone levels remain stable. However, some patients need special strengths or ratios of T3 and T4. There are others whose hormone levels tend to fluctuate regularly, and they need medication that responds to changing needs. Compounding allows for customized dosages and easy dose adjustments based on current test results.

Who May Benefit From Thyroid Hormone Replacement/ Supplementation?

People with hypothyroidism

Hypothyroidism is a common endocrine issue in which the thyroid gland does not produce enough thyroid hormones. It is especially common in women over 60 but can occur in men, women, and children of all ages. In adults, Hashimoto’s disease is the most common cause of hypothyroidism in industrialized countries. In the rest of the world, iodine deficiency is the most common cause. In Hashimoto’s, the immune system attacks and damages the thyroid. Hypothyroidism can also be caused by radioactive treatment or surgery on the thyroid gland. Problems with the pituitary gland can also cause hypothyroidism by interrupting the feedback loop. Congenital hypothyroidism, present from birth, occurs when the thyroid gland does not develop properly.

Dosage and Form

Estradiol is often combined with other hormones to support a healthy balance of hormones in the body. The following dosage forms and strengths of estradiol and estradiol combinations currently fall within our formulary:

Medication Form Strength
T3 (Modified Release) Tablet 2.5mcg – 90mcg
T3/T4 Combinations Tablet Any
Armour Thyroid (commercial – Forest Pharmaceuticals) Tablet ¼ grain – 4 grains
Nature-Thyroid (commercial – RLC Labs) Tablet ¼ grain – 2 ½ grains
NP Thyroid (commercial – Acella) Tablet ¼ grain – 2 grains
Liothyronine (commercial) Tablet 5mcg
Levothyroxine Tablet 25-100mcg/tablet – 125-200mcg/tablet

How Belmar Can Help

If you’re a clinician interested in prescribing compound medications to your patients, contact us for information on how to get started and to access all of our clinical resources. If you are new to compounding, you may find our page on How to Write a Compounding Prescription helpful. You can also visit our Treatment Options page to find a formulary and learn more about all the medication solutions available from Belmar.

Contact Belmar Pharma Solutions

Learn More

If you’re a patient, we’re here to help you fill prescriptions or provide you the information you need to work with your doctor to help decide if a compounded prescription might be a good treatment for you.

Prescribers, for a complete formulary or access to our clinical resources fill out the form below and one of our Solutions Engineers will be in touch shortly. If you are new to compounding, you may also find our page on How to Write a Compounding Prescription helpful.


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Thank you for reaching out. A member of our team is reviewing your message and will reach out as soon as possible. In the meantime, below are a few links, including our formulary, that we think you might find helpful:

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Thank you for reaching out. A member of our team is reviewing your message and will reach out as soon as possible. In the meantime, below are a few links, including our formulary, that we think you might find helpful:

Formulary
Treatment Options
Clinician Blog