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You have totally optimized every aspect of your levothyroxine treatment, and you still have hypothyroidism symptoms and don’t feel well.



What if you have optimized your levothyroxine treatment in every way, and you’re still not feeling well? For some patients -- whether due to genetics or other factors – the best hypothyroidism treatment includes not just T4, but the addition of the T3 hormone. 

This means that some patients do better adding synthetic liothyronine – i.e., Cytomel – to their treatment, or feel best taking a natural desiccated thyroid drug that includes animal forms of both T4 and T3, like Nature-Throid, WP Thyroid, or Armour. 


There are also hypothyroidism patients who have underlying autoimmune disease like Hashimoto’s, or additional hormonal imbalances, such as perimenopause/menopause or adrenal dysfunction. 


Finally, even with fully optimized levels and medication, some hypothyroid patients continue to have symptoms because other factors are not being addressed, such as nutrition, sleep, and stress management.




You may be one of the patients who feels better on and/or needs a combination T4/T3 treatment. Talk to your health care provider about the possibility of testing your Free Triiodothyronine (Free T3) level, and potentially adding a T3 medication to your treatment. There are several ways to do this:

  • Add synthetic T3 (generic liothyronine, Cytomel) tablets to your levvothyroxine treatment

  • Add a natural desiccated thyroid drug (like Nature-Throid, WP Thyroid, Armour, or generic NP Thyroid)  to your levothyroxine treatment

  • Switch to a natural desiccated thyroid drug


Autoimmunity and Hormonal Imbalances

Work with your health care provider to evaluate and address issues regarding elevated antibodies, unchecked autoimmunity, and unresolved hormonal imbalances. My Thyroid Tuneup Program provides a detailed roadmap of all the facets of detailed troubleshooting of autoimmunity, antibodies, and other hormonal imbalances. 


If lifestyle factors -- including insufficient sleep, nutritional deficiencies and imbalances, and chronic stress are contributing to your continuing symptoms, work with your health care provider to evaluate and address these factors. 

The Thyroid Tuneup


For comprehensive guidance on combination T4/T3 treatment, evaluating and lowering antibodies, addressing sex hormone and adrenal imbalances, and modifying lifestyle factors for optimum health, I recommend you take my detailed three-part video webinar/ebook course, Thyroid Tuneup Program, which will quickly get you fully up to speed on these issues. 

You can learn more about the Thyroid Tuneup, and sign up for this life-changing program, at


The Levothyroxine Deep Dive program is copyright © 2020, Mary Shomon. All rights reserved.

Levoxyl®, Synthroid®, Tirosint®, Tirosint-SOL®, and Unithroid® are registered trademarks. Product images and logos used with permission. 


Mary Shomon does not provide medical advice, diagnosis or treatment.


The contents of this video and material contained on the website ("content") are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have learned from this video or site.

If you think you may have a medical emergency, call your doctor or 911 immediately. Mary Shomon does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned. Reliance on any information provided by Mary Shomon is solely at your own risk.

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