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Can You Get Off Thyroid Medication?

Four steps to healing your thyroid and reducing (or eliminating) the need for medication.

Yes, it’s possible, but it depends on your situation! Here are four steps to follow to improve your thyroid physiology and reduce (or remove) the need for thyroid medication.

Video Transcript

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Today we’re answering another listener question: can you get off thyroid replacement therapy, and what are the steps? 

Overall, I would say my answer is “maybe, but it depends.” 

It would probably depend on how long you’ve had a thyroid condition. If it’s only been a few years, it’s going to be probably easier to recover from that. 

But if you’ve been dealing with a hypothyroid condition for decades, and you’ve been taking a thyroid hormone replacement that the gland would typically make, it may be a little bit harder. That gland may have really been atrophied. 

Or if you have hypothyroidism because you had a thyroidectomy or had your thyroid gland radiated, that gland may not come back. (Although I have seen people who’ve had thyroidectomies or have had their thyroid gland damaged, have tissue regrow and be able to have normal thyroid physiology without medication! I think it’s pretty remarkable what the body can do.)

Whether or not you can come off thyroid medication probably depends on how long you’ve had hypothyroidism, how much damage and what type of damage has been done, and whether you can identify and eliminate what triggered the whole process to begin with. 

For example, if the issue is an iodine deficiency and you replace iodine, you might be able to recover. But I don’t think that’s the vast majority of the cause for most of those people who are struggling with chronic hypothyroidism, especially when they don’t feel well on their current dose of medication. 

So what you have to do is identify what the things are that triggered the initial change in thyroid physiology from homeostasis to allostasis. See if those things are still there. If they are, you need to reduce or eliminate them as much as possible.

That can take some work, but if you can find those stressors and address them, then yes, you can recover. I’ve seen it over the last, almost three decades now, people needing less and less thyroid medication and people being able to come off of their thyroid medication in time. 

But are you willing to make changes? I just did a Thyroid Thursday about this. You have to be willing to make changes to diet, lifestyle, thoughts, behaviors, habits, sleep, relationships, whatever was the major trigger. 

Because if the same stressors are constantly there, why would you expect your body to do anything different than it’s currently doing?

But an important question to ask is are you willing to get help? (Probably outside of the insurance-based model.) 

If you’re going to an allopathic physician, trying to get you to recover from a thyroid condition is not in their wheelhouse. Their wheelhouse is managing your condition with a medication. 

If it’s hyperthyroidism, they’re trying to radiate it or cut it out and then put you on a thyroid medication. If you’re hypothyroid from the start or have Hashimoto’s, it’s all kind of the same beast. They’re just managing it. They’re just trying to tinker with the thyroid medication dose that they might think is best for you in the moment, and that may change in their model over back and forth because of different things that are going on with your physiology. So they’ll increase it, they’ll decrease it. 

In functional medicine, our thing is trying to help people understand what’s creating their health challenges, what’s causing their body to behave the way it is, and what can we do through diet, lifestyle, and supplementation strategies to help this person not manage a condition, but recover from a condition.

So many of the people that I know who are practicing true functional medicine just aren’t in an insurance-based model because it just doesn’t fit with what insurance wants to cover. 

Okay, so what are the steps? 

Step one, you can evaluate your own habits, your own behaviors, your own environment, your own relationships, your sleep patterns, and your physical status.

These are the things that Dr. Kelly Halderman and I talk about in the book, The Thyroid Debacle.

Part 3 of the book is all about what we call “The Fitness Factors,” all these aspects of your life that if you have a high level of fitness, it’s probably going to be beneficial. If you have a low level of fitness in these categories, it’s probably going to be problematic. 

The goal is to raise your level of fitness in each of these fitness factors or categories we talk about in the book.

Need 1-1 help with your thyroid? Schedule a free discovery call with me here.

But something in your history, health history, in your health timeline created who you are today and the challenge you’re struggling with.

So we have to go back through that and start looking at, “how did I get here? What are the things that led up to my diagnosis and the conditions I’m trying to recover from?”


Step two is to reduce or eliminate unhealthy habits and behaviors. 

Yeah, I eat a terrible diet, well change that. I stay up all late at night watching movies and TVs and on Instagram and Facebook. Don’t do that, right? I have terrible personal relationships. Change that. I have financial issues. Change that, right? 

If you have those habits and behaviors that are not healthy, drink too much drugs, whatever, eliminate them, and that’s huge.


Step three, start working to improve your level of fitness in each of the categories that we talk about in The Thyroid Debacle Book.

Once you identify that you have poor physical fitness, then work with somebody to start improving your level of physical fitness. If you have poor sleep fitness, then work on improving your sleep habits and your sleep physiology, and you may need a physician to help you. Maybe these are things you can just simply do on your own. If your room is super hot, you’ve got lots of blankets, you got dogs, kids, whatever in the room sleeping with you, your spouse snores, you got bright lights in the room, even in the dark, change that stuff. 

In the book, we talk about a whole bunch of easy strategies that you can use to improve your level of fitness in all these categories.

Step four is to find a functional medicine practitioner, and not all functional medicine practitioners are the same.

Not everybody in functional medicine actually practices the philosophy of functional medicine. They just use different drugs or lots of supplements to manage or treat conditions and symptoms, and that’s really not what the foundation of functional medicine should be. 

The foundation of functional medicine should be to look for those stressors that are causing the body to act from a defense perspective and reduce or eliminate those so the body can actually heal and repair. 

Too many people are trying to heal and repair when their body is still in defense mode, and that’s a challenge. You can have short-term success with supplementation strategies, but you’re probably not going to have long-term success, especially once those copious amounts of supplements go away. 

Your functional medicine practitioner should make the process of trying to identify some of these causes easier. They should be helping you identify it. They’re going to be able to help you run the labs. They can look at which systems are struggling, what are the potential areas where problems might be contributing to your stress load, and then give you strategies to help address those things, whether that’s supplements, diet, or lifestyle modification.

They should be able to help you understand, especially in thyroid physiology, when it’s time for a potential medicine change, and you need to go back to your prescribing doctor and say, “Hey, I think I need to have my dose change. I’ve lost 15 pounds. My TSH is really low. Now my T4 is really high. I don’t feel good.”


So the functional medicine practitioners should be able to help you with that, and they’re going to help keep you accountable and keep you on the path. 

It would be nice to say that once you address your gut physiology, it’s never going to be problematic again. Or once you improve that immune inflammatory system, it’s never going to be a problem again. 

Unfortunately, that’s not the case.

When you’re on a path of working on your health, and then maybe you get diverted with a cold or virus or whatever it is, a functional medicine practitioner should be able to help keep you on that path over time or help you get back on that path quicker.…

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Hi, I’m Dr. Eric Balcavage, owner and founder of Rejuvagen. If you’re struggling with health issues or have questions, let’s chat. You can schedule a 15-minute call with me to get started.