Natural Desiccated Thyroid: An Alternative to Synthroid

Written by Institute for Natural Medicine Staff

Medically Reviewed by Sarah Daglis, ND, MS

Published April 14, 2025
Last Updated April 14, 2025

The thyroid, a butterfly-shaped gland at the base of the neck, is like a control tower for your endocrine system. Producing hormones that regulate metabolism and influence nearly all of the body’s cells, your thyroid plays a role in everything from bone development and growth to reproductive, nervous system, and heart health.¹^,²

Thyroid hormones naturally fluctuate, but when levels become too high or too low, a cascade of metabolic symptoms can surge. An underactive thyroid, known as hypothyroidism, slows down bodily functions, while an overactive thyroid, called hyperthyroidism, speeds them up. Both conditions come with distinct symptoms and risks but can be controlled through a combination of natural and conventional treatments.

Effectively managing hypothyroidism starts with an accurate diagnosis and safe, patient-tailored therapy. Not all healthcare professionals are well-versed in natural alternatives to standard treatments.

Understanding hypothyroidism

The pituitary gland in the brain makes a hormone called thyroid-stimulating hormone (TSH), which tells the thyroid to release more hormones (triiodothyronine/T3 and thyroxine/T4) that help control the body’s energy and metabolism. The amount of these hormones can vary based on age and gender.³

Hypothyroidism affects mood, cognition, and metabolism.⁴ Symptoms range depending on age and sex, but fatigue, weight gain, cold intolerance, dry skin, constipation, and voice changes are common.⁵ Some people experience facial puffiness, decreased sweating, cramps, sleep disturbances, irregular menstrual cycles, and breast discharge.⁶ Depression and memory loss are often reported with Hashimoto’s disease, an autoimmune condition that causes hypothyroidism. Hashimoto’s symptoms include neck pain, sore throat, an enlarged thyroid, and feelings of fullness in the throat.⁶

Untreated hypothyroidism is linked to heart disease, nerve damage, infertility, and neurological and musculoskeletal issues.⁷

Subclinical hypothyroidism can be tricky because most people don’t notice or have symptoms, and their T4 hormone levels may appear normal. Over time, however, this condition can increase the risk of developing full hypothyroidism, heart disease, heart failure, and memory problems.⁸

Diagnosing hypothyroidism

Doctor or nurse advises patient in clinic office. Medical service. Female therapist consultation.

Primary hypothyroidism is diagnosed when high TSH levels and low T4 levels are accompanied by fatigue and other symptoms.⁹ Evaluating symptoms is challenging, as they vary widely and can be mild, non-specific, and sporadic.

Multiple issues complicate not only diagnosis but also treatment⁸:

Non-specific symptoms like weight gain and fatigue can be difficult to classify, as they may be unrelated to low TSH.
Symptoms are not always alleviated with thyroid hormone replacement therapy.
Patient satisfaction regarding symptom relief is often suboptimal, which reflects poorly on diagnosis and treatment.¹⁰
Plasma levels of TSH and T4 have come into question, as they may not accurately reflect thyroid health.

Although there are no established guidelines for general thyroid screening, the American Thyroid Association recommends testing for abnormalities at age 35 and rechecking every five years for the following high-risk groups⁶:

Women over 60
People with a family history of thyroid disorders or history of head and neck irradiation
Patients with autoimmune disorders or type 1 diabetes
People with positive thyroid peroxidase antibodies

Conventional treatment

Levothyroxine, also known as LT4 therapy, is commonly prescribed to alleviate hypothyroidism symptoms. In some cases, it’s combined with liothyronine (LT3). Research shows combination therapy is just as effective as levothyroxine alone. However, several meta-analyses suggest that patients with thyroid hormone deficiencies tend to prefer combination T4–T3 therapy over LT4 monotherapy.⁴

Despite its widespread use, levothyroxine is associated with a range of side effects, including weight fluctuations, headache, nausea, diarrhea, hair loss, and appetite changes.

Concerns have also emerged about overuse of levothyroxine. A 2021 study revealed that approximately 90 percent of the 23 million U.S. adults taking the medication may not actually need it.¹¹^,¹²

Up to 20 percent of patients taking levothyroxine continue to experience hypothyroidism symptoms. This condition—known as levothyroxine-unresponsive hypothyroidism—raises further questions about the adequacy of widespread LT4 monotherapy.¹³

Desiccated thyroid extract

Desiccated thyroid extract (DTE), a natural thyroid hormone preparation, was the standard treatment for hypothyroidism long before levothyroxine became the norm. Derived from dried and powdered pig thyroid glands, DTE contains both thyroxine (T4) and triiodothyronine (T3).

“There is a common misconception that DTEs are unapproved prescription drugs,” says Angela Mazza, DO, ABAARM, FAAMFM, ECNU, a leading thyroid specialist at the Metabolic Center for Wellness in Oviedo, Florida. “However, DTE is the first thyroid replacement that existed way back in the 1800s, long before the FDA was created. Essentially, DTE was grandfathered in, and now prescription forms of [it] are closely monitored and regulated by the FDA.”

Also known as natural desiccated thyroid (NDT), DTE is available in tablet form and is often considered a safer and more tolerable alternative for people who don’t respond well to levothyroxine.

“DTE is natural versus synthetic, and it’s the closest thing to the thyroid hormone that we make ourselves,” explains Dr. Mazza. “This product is great for people who do not convert T4 to T3 very well because it has both forms of thyroid hormones in a ratio of about 4:1. It’s also effective for people who have sensitivities to synthetic forms of T4 and T3.”

Clinical research supports NDT use, showing it can significantly relieve symptoms and improve quality of life for patients with hypothyroidism—especially those who remain symptomatic on levothyroxine.¹⁴ A notable 2013 clinical trial found nearly 49 percent of participants preferred DTE over levothyroxine.¹⁵ In addition, in a review of online patient forums, about 90 percent of hypothyroidism patients reported DTE as more effective than other thyroid medications for improving symptoms and enhancing overall well-being.¹⁶

Dr. Mazza says DTE is considered safe, but use should be monitored by a qualified healthcare provider. “It’s important to remember that any thyroid hormone replacement, including DTE, should be taken on an empty stomach at least 30 minutes before meals and as far away as possible from supplements like iron and calcium,” she notes.

The gut–thyroid connection

A growing body of evidence links the gut microbiome to thyroid disorders, including hypothyroidism.¹⁷ GI health influences thyroid function by regulating absorption of essential minerals like iodine, selenium, zinc, and iron.¹⁸

“Micronutrients play a critical role in proper thyroid function because if the thyroid doesn’t have the nutrients needed to make thyroid hormones, there will be [hormonal] imbalances,” says Dr. Mazza. “For example, iodine is essential to T4 and T3. However, it’s important to note that too little or too much iodine can cause thyroid issues, either hypothyroidism or hyperthyroidism, especially in people with autoimmune thyroid disease.”

Beyond nutrient absorption, gastrointestinal health also contributes to thyroid hormone metabolism. The intestinal lining contains enzymes that help convert inactive T4 into active T3— the form used by the body. These enzymes significantly affect circulating T3 levels, making a healthy gut essential for balanced thyroid activity.¹⁸

Dr. Mazza, who talks about the gut–thyroid connection on the Natural Medicine Journal Podcast, describes this relationship as bidirectional. “Thyroid function primarily influences the gut via motility, as issues of constipation, bloating, reflux, and others can occur with hypothyroidism,” she says. “Once you get the thyroid functioning properly, these issues resolve.”

But the path from the gut back to the thyroid is more complex. “One example is that the gut helps the body recycle thyroid hormones so they can be used again,” notes Dr. Mazza. “In addition, dysbiosis, when there are more bad bacteria compared to good bacteria, can predispose patients to thyroid issues.”

Emerging studies now link dysbiosis to autoimmune thyroid conditions. Restoring gut health through targeted probiotics can improve thyroid function.¹⁹

“While probiotic product quality can vary, I’m hoping someday we will have a probiotic specifically designed for someone with hypothyroidism or Hashimoto’s disease, which I think is where the research is taking us,” Dr. Mazza says.

Dr. Mazza frequently recommends high-quality probiotics alongside thorough lab testing to assess micronutrient status. Additional strategies include screening for leaky gut, testing for food sensitivities, and addressing lifestyle factors such as diet and stress.

Healing the gut is a foundational part of treating thyroid disorders. “The good news is that the intestinal lining does heal,” says Dr. Mazza. “By using a comprehensive, individualized approach, I often see changes in just a few days.”

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Footnotes

1
Allen E, Fingeret A. Anatomy, head and neck, thyroid. StatPearls. 2023;Jul 24. https://www.ncbi.nlm.nih.gov/books/NBK470452
2
Armstrong M, Asuka E, Fingeret A. Physiology, thyroid function. StatPearls. 2023;Mar 13. https://www.ncbi.nlm.nih.gov/books/NBK537039
3
Walsh JP. Thyroid function across the lifespan: do age-related changes matter? Endocrinol Metab. 2022;37(2):208-219. https://doi.org/10.3803/EnM.2022.1463
4
Bianco AC. Emerging therapies in hypothyroidism. Annu Rev Med. 2024;75:307-319. https://doi.org/10.1146/annurev-med-060622-101007
5
Chaker L, Bianco AC, Jonklaas J, Peeters RP. Hypothyroidism. Lancet. 2019;390(10101):1550-1562. https://doi.org/10.1016/S0140-6736(17)30703-1
6
Patil N, Rehman A, Anastasopoulou C, Jailal I. Hypothyroidism. StatPearls. 2024;Feb 18. https://www.ncbi.nlm.nih.gov/books/NBK519536
7
Chiovato L, Magri F, Carle A. Hypothyroidism in context: where we’ve been and where we’re going. Adv Ther. 2019;36:47-58. https://doi.org/10.1007/s12325-019-01080-8
8
Gosi S, Kaur J, Garla VV. Subclinical hypothyroidism. StatPearts. 2024;Feb 15. https://www.ncbi.nlm.nih.gov/books/NBK536970/?report=reader#_NBK536970_pubdet_
9
Jansen HI, Boelen A, Heijboer AC. Hypothyroidism: the difficulty in attributing symptoms to their underlying cause. Front Endocrinol. 2023;14. https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1130661/full
10
Mitchell AL, Hegedüs L, Žarković M, Hickey JL, Perros P. Patient satisfaction and quality of life in hypothyroidism: an online survey by the British Thyroid Foundation. Clin Endocrinol (Oxf). 2021 Mar;94(3):513-520. https://doi.org/10.1111/cen.14340
11
Brito JP, Ross JS, El Kawkgi OM, et al. Levothyroxine use in the United States. JAMA Intern Med. 2021;181(10):1402-1405. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2781311
12
El-Khoury JM. Seasonal variation and thyroid function testing: source of misdiagnosis and levothyroxine over-prescription. Clin Chem. 2023 Apr 28;69(5):537-538. https://doi.org/10.1093/clinchem/hvad017
13
Casula S, Ettleson MD, Bianco AC. Are we restoring thyroid hormone signaling in levothyroxine-treated patients with residual symptoms of hypothyroidism? Endocrine Practice. 2023;29(7):581-588. https://www.endocrinepractice.org/article/S1530-891X(23)00380-4/abstract
14
Heald AH, Taylor P, Premawardhana L, et al. Natural desiccated thyroid for the treatment of hypothyroidism. Front Endocrinol. 2024;14. https://doi.org/10.3389/fendo.2023.1309159
15
Hoang TD, Olsen CH, Mai VQ, et al. Desiccated thyroid extract compared with levothyroxine in the treatment of hypothyroidism: a randomized, double-blind, crossover study. J Clin Endocrinol Metab. 2013;98(5):1982-90. https://doi.org/10.1210/jc.2012-4107
16
Heald AH, Premawardhana L, Taylor P, et al. Is there a role for natural desiccated thyroid in the treatment of levothyroxine unresponsive hypothyroidism? Results from a consecutive case series. Int J Clin Pract. 2021;75. https://doi.org/10.1111/ijcp.14967
17
Xie L, Zhao H, Chen W. Relationship between gut microbiota and thyroid function: a two-sample Mendelian randomization study. Frontiers Endocrinol. 2023;14. https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1240752/full
18
Shulhai A, Rotondo R, Petraroli M, et al. The role of nutrition on thyroid function. Nutrients. 2024;16(15). https://doi.org/10.3390/nu16152496
19
Sessa L, Malavolta E, Sodero G, Cipolla C. The conspiring role of gut microbiota as primer of autoimmune thyroid diseases: a scoping focus. Autoimmun Rev. 2025;24(5). https://doi.org/10.1016/j.autrev.2025.103780

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