Thyroid Medication Abroad: T3 Access | NicaSeeker

Welcome to Part 3 of a Three Part Series for people living with thyroid disease, especially those navigating care in Nicaragua, Central & South America, or New Zealand. 

In the last post, we focused on thyroid blood tests, and how they can look “normal” while you feel anything but normal. We explored the labs that matter, why timing changes results, and how to ask better questions.

Thyroid medication abroad becomes a survival issue when your treatment depends on T3 and borders suddenly matter. For many people with thyroid disease, access to thyroid medication abroad collapses the moment they leave their home country. This article explains why thyroid medication abroad is so restricted, what options exist in Central America, and how to plan ahead.

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Why This Post Exists

This post exists for people who are technically treated, yet remain unwell and suddenly unsupported when managing thyroid medication while overseas.

Many people have followed medical advice carefully, only to discover that access to thyroid medication abroad depends heavily on borders, residency status, whether compounding pharmacies can even make the much-needed medications—and local regulations.

⚠️ Important Medical Disclaimer

This article shares lived experience and patient-led education. It does not replace medical advice, diagnosis, or treatment. Thyroid disease is complex and individual. Always consult a qualified clinician before changing medication or sourcing thyroid medication abroad.

Why Thyroid Medication Abroad Is Restricted

Many people assume prescriptions travel with them. Unfortunately, thyroid medication abroad is regulated very differently. In the United States and Canada, pharmacies cannot legally dispense or ship T3 or Armour unless you are a resident or citizen.

Doctors also cannot prescribe across borders. As a result, people who rely on T3 often find thyroid medication inaccessible outside their home country despite long treatment histories.

Thyroid Medication Abroad in Nicaragua and Central America

After extensive inquiries, I confirmed that in Nicaragua, only levothyroxine (T4) is available nationwide. There is no synthetic T3 and no Armour. This reality makes thyroid medication abroad particularly challenging for people who cannot convert T4 to T3 efficiently.

This situation is common across Central America, where essential medicines lists often exclude T3-containing treatments.

For more general access to healthcare in Nicaragua, check out this article.

Why Levothyroxine Alone Is Not Enough for Everyone

For some people, levothyroxine works well. For others, it does not. If your body cannot convert T4 to T3, relying on levothyroxine alone while managing thyroid medication abroad can lead to rapid symptom decline.

When Telehealth Isn’t the Safety Net You Expect

For many people living abroad, telehealth feels like the obvious fallback when in-person care is no longer possible. In theory, it should allow continuity of care, especially when you already have a long-standing relationship with a doctor. In practice, this is not always the case.

In my situation, the integrative doctor in New Zealand who had managed my thyroid care for many years moved to an online telehealth practice. While this initially seemed reassuring, I soon discovered that the scope of what he was legally allowed to prescribe had changed.

In his new role, my General Practitioner was no longer permitted to practise integrative medicine. That meant he could not prescribe Whole Thyroid (also known as Armour Thyroid or desiccated porcine thyroid), nor could he prescribe synthetic T3. His prescribing authority was limited to standard pharmaceutical-only options.

When I contacted my former medical practice to ask whether any other doctors there practised integrative medicine, the response was revealing. I was told that the clinic was actively moving away from integrative approaches in favour of pharmaceutical-only care. The term “integrative medicine” was spoken with clear disdane by the receptionist, almost as though it were something outdated or inappropriate.

This experience reflects a broader shift occurring in New Zealand. Increasing regulatory oversight and administrative restrictions have made it progressively more difficult for doctors to practise integrative or holistic medicine. Many are no longer willing, or no longer permitted, to prescribe natural or compounded treatments alongside pharmaceuticals, even when those treatments are appropriate and effective for individual patients.

The result is that telehealth, which is often presented as a solution for people living abroad, can suddenly become a dead end. Long-standing care relationships can dissolve overnight, not because a patient’s needs have changed, but because the system has.

What to Do If You’re Running Out of Thyroid Medication When You’re Overseas

Emergency Option: Prescription-Free Access (Use With Caution)

In emergency situations, there is one additional option that some patients use as a temporary bridge when other pathways fail.

Inhouse Pharmacy Vanuatu (inhousepharmacy.vu) is an international pharmacy that compounds and ships medications worldwide and allows English-speaking phone support. They carry synthetic T3 and Whole Thyroid, also known as Armour Thyroid or desiccated porcine (pig’s) thyroid, without requiring a prescription.

This option should be approached carefully. Unless you already understand your dosage and response, a doctor’s evaluation is strongly recommended before using any prescription-free source.

Costs are significantly higher than most national compounding pharmacies. At the time of inquiry, pricing was approximately USD $480 for 100 tablets, compared with substantially lower costs through New Zealand compounding. Availability can also fluctuate. When contacted, T3 was temporarily unavailable until the following year.

For these reasons, this pathway is best viewed as an emergency or bridging option, not a long-term solution.

If you are running low on supply, act early. Gather recent lab results, prescriptions, and medical letters. Confirm exactly what thyroid medication abroad is available locally. Then explore neighbouring countries with broader access.

Costa Rica: A Practical Option for Thyroid Medication When You’re Abroad

Costa Rica has a more developed integrative medicine landscape. Through medical tourism networks, it is possible to access compounded T3 and T4 legally. This approach can make accessing thyroid medication from overseas more manageable for Central America–based expats.

The Medical Tourism Costa Rica Medical Directory was an excellent resource.  For me, they acted as an English-speaking intermediary and helped locate and liaise with an integrative doctor and a compounding pharmacy to confirm availability of medicines before facilitating the scheduling of an appointment for me.  All this was done free of charge.

Importing Thyroid Medication Abroad: Lessons Learned

Import regulations matter. Nicaragua has no postcodes, and medication imports require a licensed broker. I once had thyroid medication sent to Nicaragua from New Zealand seized by Nicaraguan Customs due to paperwork issues.  A USD $10 daily storage charge accrued while I tried in vain to resolve the issue by correcting paperwork retrospectively.  Ultimately, I had no option but to abandon my attempts to recover that medication (which cost NZD $500 to send through to Nicaragua), and restart the process using a US broker.

Always confirm broker requirements before shipping. Fixing mistakes afterward is costly and stressful.

Trusted Resources and Contacts

Preparaciones Magistrales Leisa
Comercial Farmacéutica Leisa SA
WhatsApp: +506 8730 3535 (Option 2)

Meditour Direct – Claire, a wonderful Irish lady in Costa Rica, was a fabulous support throughout the process.
WhatsApp: +506 8335 1737

Take the Next Step

If managing thyroid medication abroad feels overwhelming, take action now.  Send us your email using the form below and we’ll email you our Emergency Thyroid Checklist PDF.