What does this Instagram post actually claim?
Ciria Velarde tells her 41.6K viewers there's "nothing wrong" with taking thyroid hormones and they shouldn't feel pressure to stop. She argues the real problem isn't taking thyroid medication, but continuing to feel unwell while on it.
The post targets people with thyroid conditions like hypothyroidism and Hashimoto's disease. Velarde positions herself as a health coach offering advice about hormone replacement therapy and thyroid healing.
Her message essentially boils down to: if thyroid hormones make you feel great, keep taking them. If they don't, that's when you need to investigate further.
Does the science support staying on thyroid hormones long-term?
For people with genuine hypothyroidism, yes. The American Thyroid Association's 2014 guidelines clearly state that levothyroxine therapy is typically lifelong for patients with overt hypothyroidism.
A 2012 study in the Journal of Clinical Endocrinology & Metabolism (Biondi & Wartofsky) found that patients with TSH levels above 10 mIU/L consistently benefit from thyroid hormone replacement. These patients showed improved cardiovascular outcomes and quality of life measures when properly treated.
However, the picture gets murkier for subclinical hypothyroidism. The TRUST trial (Stott et al., NEJM, 2017) followed 737 adults over 65 with subclinical hypothyroidism for 18 months. They found no significant improvement in quality of life scores between levothyroxine and placebo groups.
What did Velarde get wrong about thyroid treatment?
Her biggest miss is oversimplifying a complex medical decision. "Feeling great" isn't the only factor doctors consider when prescribing thyroid hormones.
The 2019 European Thyroid Association guidelines emphasize that treatment decisions should be based on TSH levels, symptoms, and individual risk factors. Some patients feel subjectively better on thyroid hormones even when their TSH levels don't warrant treatment.
Velarde also ignores potential risks. A 2020 meta-analysis by Lillevang-Johansen et al. in BMJ found that even slightly elevated thyroid hormone levels increase fracture risk by 16% and atrial fibrillation risk by 63%. These aren't trivial side effects.
When does thyroid hormone therapy actually make sense?
The clearest indication is overt hypothyroidism with TSH above 10 mIU/L and low free T4. Here, multiple randomized trials show clear benefits from levothyroxine replacement.
For Hashimoto's thyroiditis patients, the evidence is solid too. A 2013 study in Thyroid (Hu et al.) followed 394 patients for 20 years and found that early levothyroxine treatment slowed disease progression and reduced goiter size.
The gray area is subclinical hypothyroidism with TSH between 4.5-10 mIU/L. Young patients under 65 with symptoms may benefit, but older adults often don't according to the TRUST trial data.
What should you actually know about thyroid hormones?
Don't make treatment decisions based on how you "feel" alone. Thyroid function tests matter because they predict long-term health outcomes beyond just symptoms.
If you're not feeling well on thyroid medication, that's worth investigating. But the solution might be dose adjustment, switching from levothyroxine to combination T4/T3 therapy, or addressing other health issues entirely.
Most importantly, work with an endocrinologist who follows evidence-based guidelines. A 2016 survey in Thyroid found that 49% of patients were taking inappropriate doses of thyroid hormones, often because providers relied too heavily on symptoms rather than lab values.