Tablet
Armour Thyroid
Armour Thyroid, a desiccated thyroid extract used to treat hypothyroidism. Commercial formulation prescribed and dosed by a licensed physician.
30 tablets per month
Starting at $129/mo
ThyroidT4Standard
Thyroxine T4 Capsules
RxPrescription onlyTaken by mouth · Once a day · 50 mcg · Thyroid · T4 · Standard
Starting at $79/mo
Levothyroxine (T4): synthetic thyroid hormone, the standard first-line therapy for hypothyroidism and thyroid optimization. Oral capsule, once daily with breakfast.
How many capsules per month?
MonthlyEvery 3 months
30 capsulesper month
You'll receive 30 capsules per month. $99 billed monthly. Cancel anytime.
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- Synthetic T4, stable and predictable, the most studied thyroid hormone
- Long half-life allows once-daily dosing
- Precise dosing; FDA-approved for hypothyroidism
Every plan includes
- Personalized, physician-guided plan
- 30 capsules per month, monthly and 3-month
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
- Physician-guided care
- Ongoing, expert support
- 100% online
- Free, discreet shipping
What is levothyroxine (T4)?
(synthetic thyroxine)
Levothyroxine is synthetic T4, the hormone your thyroid makes. Your body stores it in the liver and converts it to T3, the active form, as cells need it. T4 has a long half-life (about 7 days), so one dose per day is enough. It is the most studied thyroid replacement and the first choice for most people with hypothyroidism.
- How it is taken
- Taken by mouth
- How often
- Once a day
- Dose range
- 50 mcg
- Form
- Thyroid · T4 · Standard
First-line
standard thyroid replacement, FDA-approved
T4 works for hypothyroidism when dosed to your TSH and Free T4 levels. Absorption depends on stomach acid, time of day, and some medications and foods.
How it works,
week by week.
Day 1
A US-licensed physician reviews your thyroid symptoms (fatigue, cold intolerance, weight, mood), medical history, and medications. Discusses how thyroid hormones work and the importance of lab-guided dosing.
Week 1
Start with an initial dose (usually conservative) of your prescribed thyroid hormone, taken once daily in the morning with water on an empty stomach.
Weeks 4-6
Thyroid hormones accumulate slowly; effects build over 4-6 weeks. Energy, temperature regulation, and mood may shift gradually. Keep a symptom journal.
Week 6-8
First lab check: TSH and Free T4 (or Free T3 if on T3). Your physician adjusts dose if needed. Repeat this cycle every 6-8 weeks until TSH and symptoms align.
Beyond
Thyroid hormones work best on a stable dose. Annual labs and check-ins ensure your dose stays right as your body and needs change.
What you may notice,
and when.
More energy
fatigue lifts as thyroid levels normalize
Better sleep quality
mood and sleep rhythm often improve together
Mental clarity
brain fog clears; focus and concentration return
Body temperature
cold intolerance eases as metabolism normalizes
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
Safety first:
what to know before you start.
Important safety information and common side effects
Thyroid hormones regulate metabolism and affect every cell. Overdosing causes tachycardia, palpitations, anxiety, insomnia, and heat intolerance; underdosing leaves fatigue and brain fog. Thyroid hormones are not for weight loss in people with normal thyroid function. Do not use if you have uncontrolled high blood pressure, active angina, or untreated adrenal insufficiency. Tell your physician about all medications, especially beta-blockers, stimulants, and any cardiac history. Stop and seek care for rapid heartbeat, chest pain, severe shortness of breath, or signs of thyroid storm (high fever, confusion, agitation).
The research behind
levothyroxine.
Levothyroxine (T4) is the standard treatment for hypothyroidism. Its use in overt disease is well established; the trials below concern older adults with only a raised TSH.
- GuidelineStandard of care
The 2014 American Thyroid Association guideline kept levothyroxine as the standard treatment for hypothyroidism. The panel found no consistent data to recommend another drug as the only treatment.
Jonklaas et al., Thyroid 2014 (ATA guideline) - Older adultsNo symptom benefit
The TRUST trial randomized 737 adults aged 65 or older with subclinical hypothyroidism to levothyroxine or placebo for one year. Levothyroxine lowered TSH but did not change hypothyroid symptom scores or tiredness.
Stott et al., N Engl J Med 2017 (TRUST) - Pooled trialsNo clear benefit
A 2019 BMJ meta-analysis of 21 randomized trials (2,192 adults with subclinical hypothyroidism) found that thyroid hormone treatment did not help adults with mildly abnormal thyroid tests. An earlier Cochrane review of 12 trials (about 350 people) found no effect on quality of life or symptoms.
Bekkering et al., BMJ 2019 (summary by NIHR Evidence); Villar et al., Cochrane 2007 (CD003419)
What the studies found
- Treats overt hypothyroidism and is the guideline standard (ATA, Thyroid 2014)
- Lowers TSH in older adults with subclinical hypothyroidism (TRUST, NEJM 2017)
- Earlier pooled trials showed some effect on blood lipids and heart measurements, but no clinical outcome (Villar, Cochrane 2007)
The trials used regulated levothyroxine tablets, dosed under medical supervision. Thyroxine capsules compounded here are not the studied product.
What this does not say
- TRUST covers older adults with subclinical, not overt, hypothyroidism.
- Dosing is guided by blood tests and needs medical supervision.
- Compounded capsules differ from the tablets used in trials.
The research
behind it.
Levothyroxine has decades of clinical use and safety data. It corrects TSH and Free T4 reliably when dosed properly and absorbed well.
Some people feel better on T4 alone; others need a small addition of T3 or prefer a natural desiccated thyroid. Your physician adjusts based on your labs and how you feel.
Getting started
takes a few minutes.
- 1
Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
- 2
Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
- 3
Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Frequently asked questions
Contact supportHow do I take Thyroxine (T4) Capsules?
Taken by mouth, once a day, in the morning. The starting prescription is 1 capsule (50 mcg) each time. Your physician sets your own dose and it is printed on your label.
How much arrives in each shipment?
30 capsules at the starting strength, shipped to your door from a licensed US pharmacy.
Why start with T4 instead of natural thyroid?
T4 has the most clinical data, the most predictable absorption, and the easiest dose adjustment. It is the standard first choice. If T4 alone does not improve your symptoms after 6-8 weeks at the right dose, your physician can add T3 or switch to a combination.
Why can't I feel my dose immediately?
Thyroid hormones accumulate in your tissues and bloodstream over weeks. The half-life of T4 is about 7 days, so it takes 4-5 half-lives (1 month) to reach steady state. Be patient; your physician will adjust if needed at your 6-8 week check.
Will thyroid hormone help me lose weight if my thyroid is normal?
No. Thyroid hormones are not weight-loss drugs. They work only in people with low thyroid function. Overdosing a person with normal thyroid function causes dangerous side effects (tachycardia, heat intolerance) without weight loss.
Can I adjust my dose myself?
No. Thyroid dosing requires lab values (TSH, Free T4, Free T3) to be safe and effective. Too much causes palpitations and anxiety; too little leaves you fatigued. Your physician adjusts by the numbers and your symptoms, never by guessing.
What if T4 alone does not work for me?
Some people need T3 added or prefer a T4/T3 combination or natural desiccated thyroid. Your physician will try adjusting the T4 dose first, then explore other formulations if needed. This takes patience and close communication.
Levothyroxine educational content reviewed by our physician
Scott Nass, MD Doctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
More options
in this area.
Capsule
Liothyronine (T3) Capsules
Liothyronine (T3) slow-release capsules, used to support thyroid hormone levels and metabolic function. Prescribed and dosed by a licensed physician.
30 capsules per month
Starting at $89/mo
Capsule
T3 / T4 Capsules
Combination of T3 (Liothyronine) and T4 (Thyroxine) in slow-release capsules for comprehensive thyroid hormone replacement. Prescribed and dosed by a licensed physician.
30 capsules per month
Starting at $79/mo
Injection
Tirzepatide + B12
A weekly dual-action GLP-1/GIP injection for meaningful weight loss and appetite control, paired with vitamin B12 for energy.
Starting at $198/mo
References
- 1.Hypothyroidism: evidence-based diagnosis and management in adults. N Engl J Med, 2017
- 2.Levothyroxine replacement in primary hypothyroidism: a clinical update. J Clin Endocrinol Metab, 2012
Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.