No More Thyroid Meds…Now What?, by Dr. Bob

At the request of a reader via e-mail, we will review the topic of thyroid disease from a survival perspective.  Levothyroxine is the most frequent medication that we are consulted about at Surviving Healthy.  Thyroid supplementation is the one of the most frequent prescription medications currently prescribed here in the US.  There is a huge debate about which supplementation is better, why some fail Synthroid, why some only respond to Armour thyroid, among other debates.  Those are beyond my scope as a Family Practitioner, and this article will not add to the confusion of these issues, but will instead address how to handle a life without thyroid supplementation if you find yourself in that spot and how you may be able to prevent being in that spot at all.

When the SHTF, we all expect that pharmacies will be quickly overrun by mobs and rioting and medications will simply be hoarded by gangsters and criminals or simply burned to dust.  In either case, you will not be able to head down to the corner drug and get a bottle of Synthroid after the crash.   You then run out within 89 days, and if you are anything like the rest of us, you will not have the good luck of filling a 90 day Rx the day before the crash!  Medications will certainly be something that the government is very likely to use as a control mechanism against our freedom, and we strongly recommend that all chronic medications be carefully planned now and that preppers are fully stocked for 3-5 years.  It may be longer than that without pharmacies on the corner, but at least that gives some time to rebuild and let the Patriots win back our country.  Certainly the experts have a much better predictive expertise than we do, and we defer to their books and articles for your education.

The first issue to address is abruptness of hypothyroidism.  If the crash hit when you had one single dose left, you are in trouble.  Acute discontinuation is a bad idea and will make the symptoms worse than a slower stopping of medication.  So, let’s say you are the typical non-prepping American, it all goes bad on the 20th day of your 30 day bottle.  You have 10 pills left.  You are still in trouble and thyroid is likely to be the least of your problems!  But, take the doses as you slowly stop over the next 30 days.  One pill on the 21st, then another maybe the 25th, then start with 1/2 pills every other day, then every 3rd day, then every 5th day, etc. until they are gone.  Same general formula applies if you are a good little prepper and you have 80 pills left in a 90 day bottle.  But, you can start to see that 80 pills is not going to really help you much.

This is why we do what we do!  If you have a filter and a 1,000 rounds of ammo, which you hope you do not have to use, why would you not have 1,000 of your thyroid pills?  It just doesn’t make sense.  If you are lucky enough to be on Levothyroxine generic, the cost is less than $200 per 1,000 to order 90+% of the time.  Take advantage of our consulting services and get your medication now, before you may not be able to.  We surely do not know the day and time, do you?  We do not mark up the cost of your medications a penny because we are truly trying to provide a service, use it!  There was no intent to start a commercial when writing this, but please plan ahead.  If you have another way to get your thyroid medication stockpiled, that is great.  Please just do it now.  The great thing about medication and food, you can always start using it and it doesn’t go to waste.

What happens to a person when they run out of their thyroid medication?  There are two major physiologic events that occur with lack of thyroid.  One is a general slowing of metabolism.  This will cause fatigue, tiredness, slow speech and thought, cold intolerance, constipation, some weight gain, and slowing of the heart.  Not exactly survival-friendly symptoms.  The second thing that happens is and accumulation of proteins (matrix glycosaminoglycans for you organic chemistry nerds) in the tissues.  This leads to coarse hair and skin, face puffiness, enlarged tongue, and hoarseness.  All of these symptoms are more easily identified in younger patients, as aging itself is blamed for all of the symptoms listed above.  We will now review each organ system in more detail to scare you into action.

The skin has decreased blood flow in hypothyroid patients and is cool and pale.  As the skin dies off on the surface from this lack of blood flow, the skin is rough.  Sweating decreases, skin can yellow, hair is coarse and can fall out, and nails are brittle.  When the hypothyroidism progresses, swelling of the legs can become quite marked due to the buildup of the proteins in the leg tissue compounded with the lack of blood flow.  Joint pains, aches, and even stiffness can occur; but are not common complaints.

The eyes can protrude if the hypothyroid develops with a condition that “burns out” the thyroid called Graves’ hyperthyroidism.  This protrusion can continue even after the person then becomes hypothyroid.  (This would occur after TEOTWAWKI, not previously).  The puffiness can develop around the eyes called periorbital edema, which is again caused by the protein buildup.  Staring and eye weakness can also develop, making a hypothyroid person not very helpful as a contributor to your groups’ survival efforts.

There can be some increased risk of bleeding and anemia due to changes in the blood.  Pernicious anemia can develop at higher rates in hypothyroid patients also (see Vitamin review for details).  Women that are in their childbearing years are at higher risk for the anemia.

The heart is not able to pump as effectively, due to decreases in both heart rate and muscle effectiveness.  Why the rate slows is still a mystery physiologically.  (Doesn’t science know everything now?).  Due to these changes, exercise capacity and shortness or breath are both decreased.  For patients that already have heart disease, usually symptoms worsen when they are then additionally hypothyroid.  Some people can suffer from other cardiovascular abnormalities such as a mild buildup of fluid around the heart, hypertension, and high cholesterol.

The respiratory system is impaired itself, besides the effects of the cardiovascular system.  Exercise capacity decreases, along with fatigue, shortness of breath, and runny nose.  Muscle weakness can eventually affect the respiratory muscles causing hypoventilation.  This then can cause a buildup of CO2 and decreased O2.  Obese folks are at a higher risk for this when also hypothyroid.  Sleep apnea can occur, mostly due to the large tongue that may develop.

The gastrointestinal system can experience gut motility decreases which then causes constipation, which is usually the most common symptom that hypothyroid patients complain of.  This can usually be used by the majority of hypothyroid patients to track the effectiveness of their supplementation, which is very helpful if there is no lab to check their levels.  With this decrease in digestive force, cramping and bloating can also occur.  Taste can decrease, stomach muscle weakness, absorption problems, and sometimes even fluid buildup around the liver.

Reproductive problems in both men and women can result from hypothyroidism.  This is due to hormonal changes that result from the lack of thyroid.  Women have menstrual problems that affect their cycles and therefore fertility.  Men have ED, decreased libido, and sperm abnormalities when hypothyroid.

Neurologically, the most serious symptom that affects survival is the slowing of general thinking abilities with prolonged hypothyroidism.  There are also sensation problems that can occur that affect the hands and feet, due to not only the effect on the nerves but also the decreased blood flow mentioned above.  Carpal tunnel syndrome is common with decreased thyroid.

Metabolically, many different problems can occur when a deficient person goes without thyroid supplementation.  Low sodium, increased creatinine, cholesterol increases, homocysteine increases, and decreased drug clearance all occur.  This decrease in drug clearance can affect the dosing of simple medications, especially any pain medications.  Also affected are epilepsy meds and anticoagulant meds (even aspirin).  The flip side of this is the problem that medications can also be less effective for hypothyroid patients at their standard doses.

Those of you with hypothyroidism are probably scared out of your mind right now, so do something about it.  Get your meds stockpiled now.  You may have gotten that message already, but it deserves repeating.  Also important, if you have someone in your survival family or group, make sure they are supplied so they can continue to effectively contribute to the group.  Remember to taper any doses of thyroid medication available over as long a period of time possible when facing that reality.  Thanks again to our readers and the readers of SurvivalBlog for continuing to request articles like this to make all of us better prepared.

JWR Adds: Dr. Bob is is one of the few consulting physicians in the U.S. who prescribes antibiotics for disaster preparedness as part of his normal scope of practice. His web site is:


  1. Hi,

    Quick question; thyroid pills have an expiration date. How might one prolong the usage date? Freezing? What are your thoughts?

    Kind regards,

  2. How do you purchase that many at one time without a prescription and with that what doctor would write a prescription for that many? I would like to know so I can buy them!! Thanks for the above information

  3. Thyroid medication has a short shelf life. You couldn’t stockpile it for 3-5 years. In terms of prepping, learn to farm or hunt animals that have a thyroid and desiccate (dehydrate) your own. You would have to essentially make thyroid jerky – dehydrated at a low temp to ensure it retains the thyroxine and then take bits of it to survive. Wouldn’t be an exact dose and you’d have to adjust based on how you are feeling, but better than the alternative….

  4. After surgery to remove my cancerous thyroid, I was inadvertently prescribed Levothyroxine by my family doctor as well as my thyroid specialist. Our family doctor sent the prescription to our regular supplier and I directed my specialist to send the prescription to grocery store that I frequently shop. At the grocery store, I pay cash so it won’t go through my health insurance. I am currently taking Levothyroxine that is 3 years outdated. I have my blood work tested in 6 month intervals and my thyroid levels are normal to date.

  5. Hello,

    I had a thyroidectomy in 2011 and currently on Armour. I’m concerned that when there is a natural disaster and medicine is no longer available, how can I stay alive? Are there any educational books that you can recommend to help me prepare?

    Thank you!

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