Synthroid Alternatives: 8 Options for Managing Hypothyroidism

If you've ever felt frustrated by Synthroid or worried you're not getting the results you want, you're not alone. Thyroid meds aren't one-size-fits-all, and there are plenty of reasons why someone might want to switch things up—maybe it's side effects, maybe it’s price, or maybe Synthroid just isn't doing the trick for you. Good news? You actually have choices.

There are several alternatives to Synthroid. Some are basically copies, but cheaper. Others use a slightly different formula that your body might like better—or they come in forms without certain dyes or fillers if you have allergies or sensitivities. And then there are the old-school 'natural' thyroid options, made from real animal thyroid. Some even switch out the usual T4 for T3 or a mix, which can help if you still feel tired no matter what your labs say.

This guide breaks down eight alternatives, giving you the facts, the pros, the cons, and the stuff that never seems to make it into the doctor’s office conversation. Let's get you the info you need to tackle your thyroid your way.

• Unithroid
• Levoxyl
• Euthyrox
• Tirosint
• NP Thyroid
• Nature-Throid
• Armour Thyroid
• Cytomel
• Choosing the Right Alternative

Unithroid

If you've ever been told you need a generic instead of brand-name Synthroid, Unithroid is probably what the pharmacist hands you. Unithroid is one of the first FDA-approved generic Synthroid alternatives, and it gives you levothyroxine—the same active ingredient. That means you’re getting the same thyroid-boosting power (T4), just without the brand-name price tag. Both Unithroid and Synthroid aim to keep your thyroid hormone levels steady, which keeps your energy, metabolism, and mood on track.

Doctors often say Unithroid works just as well as the big-name option for most people. That said, while the main ingredient is the same, the "other stuff" (like fillers or dyes) can be different. For anyone with allergies or really sensitive systems, this can actually matter. Fun fact: The FDA requires generic thyroid drugs like Unithroid to stay within 95% to 105% effectiveness compared to their branded cousins. So, they're tightly controlled, though some folks still say they "feel different" on a generic.

Pros

• Costs a lot less than Synthroid—great for anyone paying out of pocket or with high copays
• Contains the same active ingredient (levothyroxine) as Synthroid, so dosing is straightforward
• Easy to find at nearly any pharmacy in the U.S.
• Considered just as effective by most doctors and supported by studies

Cons

• Some people notice a difference in how they feel or how stable their thyroid numbers are when switching between brands or generics
• Some generics use different dyes or fillers that can trigger allergies or sensitivities
• Batches may vary slightly in absorption, according to some users

*Actual prices depend on location, insurance, and pharmacy. Generics like Unithroid are almost always the cheapest option for levothyroxine prescriptions.

Levoxyl

Levoxyl is another brand-name form of levothyroxine—the same main ingredient you'll find in Synthroid. It’s used by a lot of folks who need their thyroid medication to be consistent but have had issues with other brands because of fillers or reactions to dyes. If you’ve had weird side effects from Synthroid or generic options, especially itchy skin or swelling, your doctor might suggest Levoxyl as a swap.

One thing that makes Levoxyl different is its tablet formula. It skips some additives you find in other brands. People with allergies to food dyes or lactose often do better on it. Plus, it comes in pretty much every dose you can think of, so there’s flexibility to fine-tune your treatment without splitting pills or having to special order.

Pros

• Doesn’t have some common fillers—good for people with allergies or sensitivities.
• Reliable, consistent dosing since it’s a brand name (less batch-to-batch variation).
• Available in a wide range of doses, so your doctor can get your levels just right.
• Been on the market for decades, so doctors know what to expect with it.

Cons

• Costs more than generic drugs—especially if your insurance prefers generic.
• It’s still basically the same thyroid hormone as Synthroid, so you might not notice huge changes in how you feel.
• If you’re switching from another brand, you might need extra lab checks to make sure the dose still works for you.

Worth knowing: Years ago, Levoxyl was temporarily pulled from shelves because of an odor/smell issue with the bottles, not the pills themselves. That’s long resolved, so it’s back as a mainstream choice for hypothyroidism treatment.

Euthyrox

Euthyrox is another solid alternative when you’re looking beyond Synthroid alternatives. It’s actually one of the most prescribed brands of levothyroxine outside the U.S., but in 2019, it got FDA approval here too. So, you don’t have to travel just to try it out.

What sets Euthyrox apart? It comes in a huge range of dosage strengths (over 10 different options), so it’s easier for your doctor to fine-tune the right amount without having you split pills. Plus, the newer U.S. version uses a slightly different combination of inactive ingredients—some folks find this gentler if they’re sensitive to fillers.

Pros

• Wide range of dosage strengths, making adjustments simple
• FDA-approved in the U.S. since 2019—so it’s widely available at most pharmacies
• Similar, predictable effects as Synthroid because it’s pure levothyroxine
• Some patients say it dissolves quicker and feels more consistent with daily use
• Option for tablets in blister packs for extra shelf-life and easy travel

Cons

• Like any levothyroxine med, you need to stick to a daily routine—for example, always taking it on an empty stomach
• Switching brands (even to Euthyrox) can affect your thyroid levels, so expect more bloodwork at first
• Inert ingredient changes might help some people but could cause allergic reactions in others
• Not always covered by every insurance plan or assistance program

If you’re looking for a mainstream option that’s almost identical to Synthroid but want more flexibility in how your meds are packaged or what non-active stuff is in them, Euthyrox is worth bringing up at your next doctor’s appointment. Consistency matters—if you find a formula that feels right, stick with it, and double-check your thyroid numbers 6-8 weeks after a switch.

Tirosint

Feeling like regular levothyroxine pills aren’t working well for you? Maybe fillers or dyes are messing with your system? Tirosint could be a game changer. It delivers levothyroxine—the same active stuff as Synthroid—but in a gel capsule or even a liquid. So, if you’ve ever dealt with throat swelling, allergies to coloring agents, or stomach problems, this one’s worth checking out.

Tirosint skips the usual add-ons. No gluten. No lactose. No dyes or preservatives. That makes it popular with people who have celiac disease, trouble absorbing medication (like after weight loss surgery), or lots of sensitivities. For folks who hate swallowing pills or have irregular absorption, the liquid form can be especially helpful. In fact, a 2019 review in ‘Endocrine Practice’ pointed out that folks with malabsorption issues often get better control of their thyroid numbers with Tirosint compared to standard tablets.

Pros

• No fillers, dyes, gluten, or lactose—good for people with allergies or sensitivities
• Reliable absorption, even if you have gut problems or take lots of meds
• Available as a liquid—handy if you can’t swallow capsules or have absorption issues
• Same active ingredient as Synthroid, so most doctors know how to dose it

Cons

• Can cost more than generic levothyroxine or Synthroid, especially without insurance
• Not every pharmacy carries it, so you might need to order ahead
• The dosing is a little different between liquid, gel, and other forms—so switching forms might take a few adjustments

Here’s a look at how Tirosint compares to Synthroid and generic levothyroxine:

If stomach issues or allergies get in the way of taking your thyroid medication, talk to your doctor about Tirosint. Sometimes, paying more up front is worth it for better symptom control and peace of mind—especially if everything else has let you down.

NP Thyroid

NP Thyroid is one of the more popular "natural" thyroid medications out there. What sets it apart from Synthroid alternatives like generic levothyroxine is that it’s made from desiccated (dried) pork thyroid glands. That means you’re getting both T4 and T3 hormones, not just T4 like in standard meds. Some people who haven’t felt great on Synthroid find that NP Thyroid’s mix works better for their bodies.

Unlike synthetic-only options, this one is called "natural" not because it’s plant-based, but because it comes from animal tissue. It’s regulated by the FDA, but the exact amount of hormones in each pill can sometimes vary a little from batch to batch. The manufacturer, Acella Pharmaceuticals, tries to keep things consistent, but if you’re super sensitive to dose changes, this is worth keeping in mind.

Pros

• Includes both T4 and T3, which can help people who don’t convert T4 to T3 well on their own.
• No gluten, so it’s safe for those with celiac disease or gluten sensitivities.
• Lower in fillers and dyes than lots of other meds—great if you have allergies or want to avoid additives.
• Some users say their energy, mood, and metabolism improve on NP Thyroid when other meds have let them down.

Cons

• Hormone content can slightly vary from pill to pill—great for some, but problematic if you need exact dosing control.
• Because it’s derived from pork, it’s not an option for vegetarians, vegans, or people with pork allergies.
• Insurance might not cover it, and it can be more expensive than the generic synthetic options.
• Not all doctors are experienced prescribing natural thyroid medications, so you may run into resistance.

There was a temporary recall of NP Thyroid in 2020 due to some lots being sub-potent (not enough hormone), but the manufacturer has since fixed those issues. Still, it shows the importance of monitoring your labs regularly if you make the switch from Synthroid or other alternatives.

Nature-Throid

Nature-Throid is a prescription medication made from desiccated (dried) animal thyroid—usually pork thyroid gland. It’s one of the main Synthroid alternatives that’s actually been around for decades, long before today’s synthetic meds showed up. It contains both T4 and T3 hormones, so it’s a different ballgame compared to the pure T4 found in Synthroid and most generic levothyroxine.

If you’re someone who just isn’t feeling great on straight T4 meds like Synthroid, your provider might suggest trying Nature-Throid. Some people say they feel better (more energy, less brain fog) on this kind of combo hormone, especially if their body doesn't convert T4 to T3 efficiently. Nature-Throid is also free from gluten, soy, and some common dyes, making it an option for people with food sensitivities.

Pros

• Contains both T4 and T3, which can help if you don’t fully convert T4 into active T3 on your own.
• Considered “natural”—made from real animal thyroid tissue rather than being purely synthetic.
• No gluten, soy, or corn, and minimal additives—good if you have allergies or want a cleaner ingredient list.
• Can be ideal for people who experience ongoing symptoms on Synthroid despite having normal lab results.

Cons

• Strength of each batch can vary slightly, since it’s made from natural sources—not as standardized as pure synthetic meds like Synthroid.
• Some doctors are reluctant to prescribe it, usually because of concerns about dosing precision or long-term data.
• Not suitable for strict vegetarians or vegans since it’s made from pig thyroid.
• On-and-off manufacturing issues have caused supply shortages in recent years—not always easy to find at the pharmacy.

Want to see how Nature-Throid compares side-by-side? Here’s a quick look at the hormone content per grain (approx. 60 mg):

Bottom line: If you’re struggling on regular levothyroxine or just want to try a more natural thyroid medication, Nature-Throid could be worth discussing with your doctor. Just keep in mind the supply hiccups and batch-to-batch variations that can make it trickier to manage your numbers. Always check with a healthcare provider before making any changes.

Armour Thyroid

If you’re not seeing results from typical levothyroxine and want to try a more natural route, Armour Thyroid might catch your attention. It’s a natural desiccated thyroid (NDT) medication, which has been around for decades—actually, long before Synthroid hit the shelves. Armour Thyroid comes from dried pig thyroid glands, so it contains both T4 and T3 hormones. Some people swear by the energy boost they get from the natural combination, saying it finally helps them feel "normal" again when other thyroid medication options fall short.

Doctors sometimes prefer to stick with synthetic meds like Synthroid or generic levothyroxine because Armour's T3 levels can cause your hormone numbers to swing around a bit. But real talk: if you’ve tried everything and still feel sluggish, Armour could be a game-changer. You’re still going to need regular lab monitoring, though, because the mix of T4 and T3 can make dosing trickier and might affect your heart if you have certain risks.

Pros

• Includes both T4 and T3 hormones, unlike most synthetic options.
• Some find improved mood, energy, and metabolism compared to T4 alone.
• Available in various strengths for easier dose adjustments.
• Preferred by some with persistent symptoms despite normal labs on Synthroid alternatives.

Cons

• Animal-derived (not suitable for those with pork allergies or certain dietary preferences).
• Dose can be less predictable and may need frequent adjustments.
• Some insurance plans won’t cover it, making out-of-pocket costs higher.
• Potential for increased side effects (like palpitations) due to the added T3.

A quick peek at some numbers: In a 2018 review, about 15% of patients on NDT like Armour Thyroid reported feeling "markedly better" than on pure T4 meds alone. Not a huge group, but for those few, the benefit was big enough to be worth the switch.

Cytomel

If you’ve ever heard about T3 medications or wondered why you still feel sluggish despite taking your thyroid meds, Cytomel might come up in the conversation. Cytomel is the brand name for liothyronine sodium, which is a synthetic form of the thyroid hormone T3 (not T4, like Synthroid or levothyroxine). Since T3 is the active form your body uses, some people find it perks up their energy and mood when T4-only meds don’t cut it.

Doctors usually use Cytomel to treat hypothyroidism if you’re not responding well to T4 drugs like Synthroid, or if blood tests show your body isn’t converting T4 into T3 efficiently. It’s also sometimes used short term to prep for certain thyroid tests or surgery, but a lot of patients use it daily alongside their standard T4 med.

Where Cytomel really stands out is speed. T3 medication kicks in much faster than T4. Some folks notice a difference within hours or days, compared to waiting weeks for T4 to build up in your system. But with more power comes a bit more responsibility—mistiming or overdosing can make your heart race or bring on anxiety, so careful dose adjustments matter a lot.

Pros

• Provides direct T3 for people who don’t convert T4 well
• Works fast—can boost energy and mental sharpness quickly
• Can be used in combo with T4 meds for customized dosing
• No animal or glandular ingredients (fully synthetic)
• Often helps if depression or fatigue persists on T4-only meds

Cons

• Too much T3 can cause rapid heartbeat, anxiety, or insomnia
• Requires more frequent dosing—often more than once a day
• Price can be higher than generic T4 drugs
• Blood levels can fluctuate more, so careful monitoring is key
• Not for everyone—people with certain heart conditions need extra caution

If you’re curious about where Cytomel sits in the big picture, here’s a quick comparison:

Switching to Cytomel isn’t something to DIY at home—always talk it out with your provider. And if you’re struggling on T4 alone, bringing up Cytomel at your next appointment could open up new options.

Choosing the Right Alternative

Finding the best thyroid med isn’t about grabbing whatever’s on sale or chasing the latest trend. Your body, your needs, and your thyroid numbers all play a role. But if you’re wondering how to pick between Synthroid alternatives like levothyroxine, natural thyroid, or even Cytomel, here’s what actually matters.

First, know your type of hypothyroidism. Some folks just need a steady dose of T4 (what’s in drugs like Synthroid, Unithroid, or Levoxyl), others feel better with combo meds that add T3—like Armour Thyroid or NP Thyroid. There's no "right" answer, except what your labs and energy say.

If you have allergies, look at the inactive ingredients. Capsule-based meds like Tirosint have almost no fillers or dyes, so they can be a lifesaver if tablets make you itchy or bloated. If you’re vegan or have strict dietary needs, skip the animal-based ones like Armour and Nature-Throid.

Tight on cash? Generic levothyroxine (found in Unithroid, Levoxyl, and Euthyrox) works just as well as the pricier brands for most people. But for those super-sensitive to small changes, even these little differences might cause problems, so staying consistent with one brand or generic version can help a lot.

And about real-world results: A lot of people on T4-only meds (like Synthroid) feel great. But around 10-15% still deal with low energy or brain fog, even though numbers look normal. These folks sometimes benefit from adding in T3 (that’s Cytomel or combination thyroid meds). There’s real research showing this can help, but it’s not the standard first step.

Choosing your next move isn’t a guessing game. Here’s a straightforward list to help narrow things down:

• If you want something nearly identical to Synthroid, try another brand of levothyroxine (Unithroid, Levoxyl, Euthyrox).
• If you’ve got allergies or can’t handle fillers, check out Tirosint. It’s pure and simple with just T4.
• Want an extra boost with T3 for persistent symptoms? Combo meds like Armour Thyroid, Nature-Throid, or adding Cytomel might help.
• If budget is king, go for the generic—just stick with the same pharmacy when you refill, so the brand doesn’t keep switching.
• If you have a heart condition or are older, slow changes and T4-only meds might be safest. Too much T3 can push your heart too hard.

Here's a quick comparison:

No single thyroid medication fits everyone. Bring up these options with your doctor at your next visit. Tell them what’s working—and what’s not. The best choice is the one that leaves you actually feeling like yourself again.