Do We Need New Thyroid Medication Treatments
When are we going to get new treatments and new thyroid medications to treat thyroid disease?
I have seen this question several times over the last few years in some form or another.
From their perspective, it makes sense that the problem is most likely related to their medication.
After all, shouldnt they feel better if they are taking their medication each and every day?
You would think so but this way of thinking is actually incorrect!
Would it surprise you to know that you already have plenty of options in terms of thyroid medications to use?
All prescription thyroid medications are exact replicas of the same hormone that your thyroid gland would produce if it was healthy.
This applies to Synthroid and levothyroxine!
The problem isnt in the medications that you are taking but in how you are taking them.
And this is the entire point of this article.
Today I want to explain what type of changes you can make to your thyroid medication to optimize your dose so you can feel better.
Lets jump in
Foods to Avoid if you Have Thyroid Problems:
Ive found that these 10 foods cause the most problems for thyroid patients. Learn which foods you should avoid if you have thyroid disease of any type.
Some Side Effects Can Be Serious If You Experience Either Of The Following Symptoms Or Those Listed In The Important Warning Section Call Your Doctor Immediately Or Get Emergency Medical Treatment:
- shortness of breath, wheezing, hives, itching, rash, flushing, stomach pain, nausea, or swelling of hands, feet, ankles, or lower legs
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .
Which Medications Are Available To Treat Hypothyroidism
Hypothyroidism is a lifelong condition. For many people, medication reduces or alleviates symptoms.
The medication is designed to return adequate levels of thyroid hormone to your blood. Once hormone levels are restored, symptoms of the condition are likely to disappear or at least become much more manageable.
Once you start treatment, it will take several weeks before youll begin feeling relief. Youll require follow-up blood tests to monitor your progress. You and your doctor will work together to find a dose and a treatment plan that best addresses your symptoms. This can take some time.
In most cases, people with hypothyroidism must remain on this medication their entire lives. However, the amount you take may need to be adjusted, especially if you have Hashimotos thyroiditis. To make sure your medication is still working properly, your doctor will likely test your TSH levels yearly.
If blood levels indicate the medication isnt working as well as it should, your doctor will adjust the dose until a balance is achieved.
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How Long Does It Take To Treat Hyperthyroidism
The amount of time it takes to treat hyperthyroidism can change depending on what caused it. If your healthcare provider treats your condition with antithyroid medications your hormone levels should drop to a healthy level in about six to 12 weeks.
Your healthcare provider may decide to give you high doses of iodine drops , which would normalize thyroid levels in seven to 10 days. However, this is a short-term solution, and you’ll most likely need a more permanent solution like surgery. Though you may need to wait to be scheduled for thyroid surgery , this is a very effective and definitive way to treat hyperthyroidism. Its considered a permanent solution for hyperthyroidism.
Is It Possible To Stop Taking My Thyroid Medication In A Safe Way
Yes, its possible. But you should always check with your healthcare provider first. Whether youre able to safely stop taking thyroid medication may depend on the reason you are taking it.
Research shows that some people can safely stop taking thyroid medications. In a review of over 17 individual studies, up to one-third of people were able to stop their thyroid medication. But this was mostly in people with borderline hypothyroidism, also called subclinical hypothyroidism. In subclinical hypothyroidism, only TSH is low. People with this condition sometimes dont even need thyroid medications at all.
Those who have clearer hypothyroidism may not be able to stop levothyroxine. Stopping levothyroxine usually leads to the return of hypothyroidism symptoms. In the review mentioned above, only about 12% of people with overt hypothyroidism were able to stop their thyroid medications successfully.
If youve had your thyroid completely removed, youll need thyroid medications for life. These medications will help your body function normally. If your thyroid was removed due to cancer, treatment may also lower the risk of your cancer coming back.
Talk to your healthcare provider before making changes to your thyroid medication. They can help make sure that you’re making the best decision for your health.
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How Should This Medicine Be Used
Levothyroxine comes as a tablet and a capsule to take by mouth. It usually is taken once a day on an empty stomach, 30 minutes to 1 hour before breakfast. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take levothyroxine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow capsules whole do not chew or crush them. Do not remove the capsule from the package until you are ready to take it.
Take the tablets with a full glass of water as they may get stuck in your throat or cause choking or gagging.
If you are giving levothyroxine to an infant, child, or adult who cannot swallow the tablet, crush and mix it in 1 to 2 teaspoons of water. Only mix the crushed tablets with water do not mix it with food or soybean infant formula. Give this mixture by spoon or dropper right away. Do not store it for later use.
Your doctor will probably start you on a low dose of levothyroxine and gradually increase your dose.
Levothyroxine controls hypothyroidism but does not cure it. It may take several weeks before you notice a change in your symptoms. Continue to take levothyroxine even if you feel well. Do not stop taking levothyroxine without talking to your doctor.
Should I Take Thyroid Hormone While I Am Pregnant
Since thyroid hormone is a hormone normally present in your body, it is absolutely safe to take while pregnant. In fact, it is especially important for pregnant women, or women who are planning a pregnancy, to have normal thyroid function for the health of their baby. If you are on thyroid hormone, you will likely need an increased dose of thyroid hormone during pregnancy. As soon as you know you are pregnant you should immediately increase your dose by 20-30% and contact your doctor. An easy way to increase the dose is to take double your usual dose two days a week. You should discuss the timing of thyroid blood tests with your physician, but often thyroid function is checked at least every trimester, and more frequently in the first half of pregnancy.
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What Causes Hyperthyroidism
Medical conditions and situations that can cause hyperthyroidism include:
- Graves disease: In this disorder, your immune system attacks your thyroid. This makes your thyroid create too much thyroid hormone. Graves disease is a hereditary condition . If a member of your family has Graves disease, theres a chance others in the family could have it, too. Its more common in people assigned female at birth than people assigned male at birth. Graves disease is the most common cause of hyperthyroidism, making up about 85% of cases.
- Thyroid nodules: A thyroid nodule is a lump or growth of cells in your thyroid gland. They can produce more hormones than your body needs. Thyroid nodules are rarely cancerous.
- Thyroiditis: Thyroiditis is inflammation of your thyroid gland, which may be painful or painless . It may happen within a year of delivering a baby . After you experience thyroiditis, your thyroid may be unable to recover, which would lead to hypothyroidism.
- Consuming excess iodine: If youre at risk for hyperthyroidism and consume too much iodine , it can cause your thyroid to produce more thyroid hormone. Iodine is a mineral that your thyroid uses to create thyroid hormone. Receiving intravenous iodinated contrast may also cause hyperthyroidism. Amiodarone, a medication that contains a high amount of iodine, may also cause hyperthyroidism.
What Is The Thyroid Gland
The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroids job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working properly.
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How To Take Your Medicine
To make sure your hypothyroidism stays under control:
Stick with the same brand. Different types of thyroid hormone medicine may contain slightly different doses. That could mess with your hormone levels.
Follow a schedule. Take your medicine at the same time each day. Aim for about an hour before a meal or at bedtime. Don’t take it when you eat. Food, as well as some supplements, such as calcium, can affect the way your body uses it.
Don’t skip doses. If you miss one, take it as soon as you remember. You can take two pills in one day if you need to.
Follow instructions carefully. Don’t stop taking your medicine without first checking with your doctor.
Drug Criteria & Outcomes: Drug Interactions With Thyroid Drugs
By Melissa Headrick, PharmD
Thyroid-replacement medications, such as levothyroxine , are used to treat a variety of medical conditions. The most common is hypothyroidism, but these agents also can be used to suppress pituitary thyroid-stimulating hormone and for diagnostic purposes. The optimal dose for hypothyroidism should be the minimum that restores normal serum TSH levels. The average maintenance dosage is 75-125 mcg/d orally, but dosages vary among patients and indications.
Many drug classes and individual drugs can interact with thyroid hormones by several different mechanisms. The most common interactions are with prescription agents, such as rifampin, anticonvulsants, certain antacids, warfarin, and digoxin.
If a patient taking thyroid hormone experiences symptoms of hyperthyroidism or hypothyroidism , a drug interaction could be occurring. Some possible management options include changing the dose of thyroid hormone, monitoring TSH levels, and separating the interacting agents. Clinical judgment should be used to evaluate these and other drugs for their potential to interact with thyroid hormones.
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Hypothyroidism In Young People
Babies may also be born lacking thyroid function, a condition called congenital hypothyroidism. Symptoms of hypothyroidism in infants may include:
- sleeping more than usual
- de Quervain thyroiditis
Can I Develop Hyperthyroidism During Pregnancy
During early pregnancy, your body needs to produce more thyroid hormones than normal to help the baby develop. These hormones are particularly important for your babys brain and nervous system. Having thyroid hormone levels that are a little higher than normal is alright, but if your levels increase dramatically, your healthcare provider may need to form a treatment plan. High levels of thyroid hormones can impact not only you but also your baby.
It can be difficult to diagnose hyperthyroidism during pregnancy because your thyroid hormone levels naturally increase and the other symptoms of pregnancy mask signs of hyperthyroidism.
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You Don’t Feel Any Better
Thyroid medications usually do not work right away. It can take a few days to a few weeks for you to even start noticing a difference in how you feel. If you don’t feel better after taking your medication for several months, you may need a dose adjustment or a different medicationnot a complete stop of your regimen.
What Are The Medications For Hypothyroidism
Hypothyroidism is more common. The treatment involves the replacement of thyroid hormones. And in most cases, thats done with levothyroxine. Its a synthetic form of what the thyroid gland produces, says Dr. Celi.
Brand names for levothyroxine include Synthroid®, Unithroid® and Tirosint®. Other medications that your doctor may prescribe for hypothyroidism include liothyronine , liotrix and desiccated thyroid extract .
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Is Hyperthyroidism The Same Thing As Thyrotoxicosis
Hyperthyroidism is a type of thyrotoxicosis. Hyperthyroidism happens specifically when your thyroid gland both produces and releases excess thyroid hormone. Thyrotoxicosis happens when you have too much thyroid hormone in your body in general. You could have too much thyroid hormone by taking too much thyroid medication, for example. This would be thyrotoxicosis, not hyperthyroidism.
A note from Cleveland Clinic
Getting a new diagnosis can be stressful. The good news is that hyperthyroidism is a manageable and treatable condition. If youre experiencing symptoms of hyperthyroidism or have certain risk factors, such as a family history of Graves disease, be sure to contact your healthcare provider. They can have you undergo some simple tests to see if your thyroid is making too much thyroid hormone.
Last reviewed by a Cleveland Clinic medical professional on 10/19/2021.
Switching From Levothyroxine To Armour Thyroid
Armour Thyroid contains desiccated thyroid with a strength measured in grains. Levothyroxine is measured in micrograms . Therefore, the dose of levothyroxine needs to be converted to an appropriate dose of Armour Thyroid. One grain of Armour Thyroid is equal to 100 mcg of levothyroxine.
The following conversions may be used when switching from levothyroxine to Armour Thyroid:
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What Should I Know About Storage And Disposal Of This Medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture .
It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.
How Effective Are Overactive Thyroid Medications Long
You may have to take antithyroid medication for several weeks or months before your levels of T3 and T4 become normal. During that time, your healthcare provider may ask you to come in for periodic lab work to check your hormone levels.
The long-term effectiveness of antithyroid medications depends on your age, the underlying cause of your hyperthyroidism, and other factors. Your doctor may recommend taking propylthiouracil or methimazole in conjunction with another overactive thyroid treatment.
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How To Take Your Thyroid Hormone
When taken as a pill, thyroid hormone is absorbed in the small intestine like other common medications. However, absorption is usually only around 50% to 70%, and it can be even lower if you have certain foods or vitamin pills in your stomach. This is why most doctors recommend taking thyroid hormone , on an empty stomach, and waiting 30 minutes for any food or drink. Your doctor might also recommend timing your thyroid hormone apart from certain medications.
Porcine Derived Whole Thyroid Glandular Medication
A natural thyroid medication you can find is from the entire thyroid glands of pigs.
It contains all four essential thyroid hormones. These are the T4 , T3 , T2, and T1 hormones.
Whole thyroid glandular medication comes with iodine, glandular tissue content, and thyroglobulin protein. These benefit the wellbeing of the body.
T2 can help burn fat and increase metabolism. The glandular in this natural desiccated thyroid drug rebuilds your weak thyroid gland.
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The Role Of The Thyroid
The thyroid is a small gland in the front of your neck that controls your metabolism. The thyroid produces thyroid hormones, which control many activities in your body, including how fast you burn calories.
Thyroid diseases cause this gland to make too much or too little of the hormone. Depending on how much or how little hormone your thyroid makes, you may often feel restless or tired, or you may lose or gain weight. Women are more likely than men to have thyroid diseases, especially right after pregnancy and after menopause.
The most common cause of hypothyroidism in the U.S. is Hashimotos disease. In people with Hashimotos disease, their immune system mistakenly attacks the thyroid and damages it. Hypothyroidism also can be caused by:
- Hyperthyroidism treatment .
Your health care provider might prescribe thyroid hormone therapy for other conditions and reasons, such as:
- To control the growth of the enlarged thyroid gland .
- To control the growth of nodules on the thyroid gland.
- For treatment after the removal of the thyroid for cancerous or noncancerous disease.
- After treatment of hyperthyroidism by radioactive iodine ablation.