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Many people wish to find alternatives to taking traditional oral medications for hypothyroidism. Reasons for seeking alternative therapies vary and may include a preference for plant-based hormone regulation or ease of use. Sometimes, the desire for other thyroid hormone therapies can also be a response to problems like difficulty absorbing medications and struggling with unpleasant medication side effects. However, while there is intriguing research into alternative therapies for thyroid hormone replacement, there are several reasons why these therapies may not be ideal.
Ahead, we look at hormone pellet therapy as a treatment option for hypothyroidism.
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Pellet therapy is a type of treatment that places a small implant or "pellet" about the size of a grain of rice just below the skin. These pellets release hormones continuously within the body. The hormones released in this type of therapy are typically marketed as all-natural because they are made from plant sources and are also commonly considered bio-identical because they are the same structure as human-made hormones.
Most commonly, we see hormone pellet therapy for use in women during perimenopause and menopause to manage menopausal symptoms like hot flashes, temperature intolerance, sleep problems, or low sex drive. The hormones in these pellets are typically estradiol (a type of estrogen) and testosterone. The goal of taking these hormones is to stabilize the levels of these sex hormones. Estrogen, in particular, is known for fluctuating erratically during this period of life. Therefore, women can ward off unpleasant symptoms like hot flashes, vaginal dryness, and moodiness by using traditional hormone replacement therapy (HRT).
Some compounding manufacturers are looking into other ways to help women balance their hormones aside from traditional hormone replacement therapy, which is why pellet hormone therapy is now part of the conversation.
Beyond replacing estrogen and testosterone, pellet therapy is NOT commonly used for other hormone imbalances, including thyroid diseases.
History of hormone pellet therapy
Hormone pellet therapy has been around since the late 1930s, pioneered by Dr. George H. Gallup. However, the popularity of hormone pellet therapy declined in the middle of the century as the U.S. pharmaceutical industry and the availability of Premarin (a synthetic, oral hormone) grew. Pellet therapy never went away completely and is still considered as one method to manage symptoms of menopause.
The safety and efficacy of hormone therapy are complicated. When it comes to delivering medication in an implant just below the skin, we know that certain drugs are safe and FDA-approved. For example, there are FDA-approved birth control implants that are safe and effective, like the Implanon®. However, the hormones released in this medication have been rigorously studied for safety and efficacy.
One of the more misleading ideas surrounding bioidentical and natural hormones is that they are safer than traditional hormone therapy. Per Dr. Tatnai Burnett, M.D. of the Mayo Clinic, "the hormones marketed as 'bioidentical' and 'natural' aren't safer than hormones used in traditional hormone therapy, and there's no evidence that they're any more effective."
The problem with using the terms bioidentical and natural is that it makes people believe they are safer. To dispel any myths around these terms, it is essential to know that:
- "Bio-identical" means hormones are chemically identical to those produced in your body. Several hormone therapy products are FDA-approved and may not be different from traditional (synthetic) hormone therapy.
- "Natural" means that they come from plant or animal sources. However, they often have to be modified in a lab to go through commercial processing to make them bio-identical to the hormones in your body. These medications often have chemical binders in them, which also compromises the idea that they are entirely natural.
Dr. Burnett explains that marketers of compounded bioidentical hormone therapy offer their hormones in strengths and doses that differ from those that are FDA-approved. Yet, to get these doses, you have to go through a compounding pharmacy, many of which do not go through the rigorous testing and standards that provide quality assurance and safety. Furthermore, many compounded hormones are marketed as "custom-made" based on saliva tests. Still, these readings are not standardized nor reflective of what is going on in your blood.
So, even though many bioidentical hormones are used in FDA-approved products, know that just because something says "bioidentical" or "natural" does not mean it has been rigorously studied unless it has achieved FDA approval.
Lastly, it is important to note that hormone pellet therapy falls into the vitamins and supplements category, which means these products are not strictly regulated and evaluated by the FDA.
Your Guide To Thyroid Medication
Optimizing your thyroid levels with thyroid hormone replacement medication is usually the first step in minimizing symptoms.
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Hypothyroidism (underactive thyroid) is a condition in which your thyroid gland doesn't produce enough thyroid hormones. Hypothyroidism may not cause noticeable symptoms in the early stages. However, over time, untreated hypothyroidism can cause a number of unpleasant symptoms and complications like weight gain, joint pain, infertility, or heart disease. Treatment with thyroid hormone replacement therapy is usually simple, safe, and effective once you and your thyroid find the proper brand and dose for you.
Thyroid hormone pellet treatment is not supported by evidence at this time as a treatment for hypothyroidism, nor is it FDA-approved for this use. While it may be available on the market, it does not mean it is safe or medically endorsed. Indeed, according to Dr. Nanette Santoro, M.D., in an interview with EndocrineWeb, the FDA looks into pellet therapy products for safety only if there have been instances where a product has caused harm. Regrettably, that means there is little information on whether these treatments may be beneficial or harmful for people with hypothyroidism.
If you have hypothyroidism, you should development a treatment plan with your thyroid doctor before turning to alternative treatments that are unsupported by evidence or not recommended by your doctor. And, if you are interested in trying alternative treatment for hypothyroidism, it is essential to research what is available from credible sources and let your doctor know what you may be interested in trying.
The best treatment for hypothyroidism is the one that works safely and effectively for you, which varies from person to person. Therefore, it is crucial to have a complete thyroid function test and meet with a doctor who listens to your concerns and thoughts about your health.
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Most hypothyroid patients require thyroid hormones to help boost their low thyroid hormone levels. By taking the correct dose of thyroid hormone, many people can counter the unpleasant albeit common symptoms that accompany this condition. There are several different types of thyroid hormones you can take. Synthetic thyroid hormones are manufactured to mimic your body's exact chemistry of thyroid hormones. There are various brand and generic options, and some people may benefit from a combination of T4 and T3. Getting the proper dose of thyroid hormone is critical, and that's why it is important to see a thyroid specialist and be honest about your symptoms.
Being informed is vital, especially when discerning what thyroid treatment option is best for you. Paloma Health thyroid doctors work closely with you to decide the best treatment based on your symptoms, medical history, lifestyle, and thyroid lab results. If you are interested in trying alternative therapies for thyroid management, consult with your Paloma Health doctor.
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