What Are The Complications Of Hypothyroidism
Hypothyroidism can contribute to high cholesterol. If you have high cholesterol, you should get tested for hypothyroidism. Rarely, severe untreated hypothyroidism may lead to myxedema coma, an extreme form of hypothyroidism in which the bodys functions slow to a life-threatening point. Myxedema coma requires immediate medical treatment.
You Like How Hyperthyroidism Makes You Feel
Hyperthyroidism can cause unwanted symptoms like anxiety and excessive sweating. But it can also cause weight loss and a reduced need for sleep, which some people actually welcome.
While you may experience some symptoms of overactive thyroid more than others, and you may even consider some of them beneficial, it is important to be aware of the strain this condition is putting on your heart, bones, and overall health.
What Are Clinical Trials For Hypothyroidism
Clinical trialsand other types of clinical studiesare part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future.
Researchers are studying many aspects of hypothyroidism, such as
- understanding how the disease progresses, its clinical presentation, and genetics
- investigating how effective and safe levothyroxine is for people with chronic kidney disease
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Practice Patience And Ask For Tests
Some people start feeling more energetic and alert within a week or two of starting thyroid hormone but not everyone. It could take a month or two to feel better. And you may have to see your doctor several times for tests of your blood levels of thyroid stimulating hormone and adjustments to your levothyroxine dose to get it just right.²
You Are Anxious And/or Depressed
If you are experiencing increasing anxiety and/or depression, this could be a sign that you need more thyroid hormone or antithyroid drugs. Anxiety can also be a sign of medication-induced hyperthyroidism, indicating that you may be on too high a dosage of thyroid hormone replacement medication. If you are taking a thyroid drug with T3, such as natural desiccated thyroid or liothyronine, you may need to reduce the dosage.
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Its Hard To Lose Or Gain Weight
If you are on a diet and exercise program that should result in weight loss, but you arent losing any weight you may need an increased dosage of thyroid hormone medication for your hypothyroidism, or a reduction in antithyroid drugs. If you are trying to gain weight, and despite increased caloric intake, you are not gaining or youre losing weight you may need to increase your dosage of antithyroid drugs to treat your hyperthyroidism.
What Medication Treats Hypothyroidism
The thyroid gland produces two hormones: thyroxine and triiodothyronine . Similarly, thyroid hormone replacement medication also comes in T4 and T3 formulations. In a healthy thyroid gland, the inactive T4 hormone is released into circulation and then converted by the body into the active T3 hormone. Often, treatment for thyroid replacement starts with T4-only formulations, assuming that the body can successfully do the conversion independently.
Suppose your body has a hard time converting T4 to T3, or you take an interfering medication. In that case, standard T4 medicines may not be sufficient for you. For the few patients who do not feel completely normal taking a synthetic preparation of T4 alone, the addition of T3 may be of benefit.
Those who are interested in a more natural approach may prefer combination therapies. There are two main types of combination thyroid medications – desiccated and compounded.
- Natural desiccated thyroid comes from the dried thyroid glands of pigs.
- Compounded thyroid medication is a personalized medication in which drug ingredients are combined, mixed, or altered to solve specific patient needs.
Each person is unique with individual sensitivities. Our bodies will not all react the same way to a specific medication or dosage. It usually takes a few weeks to see a remarkable improvement in your symptoms when you start thyroid hormone replacement therapy. Your doctor may need to adjust your dosing to reach a therapeutic level.
Titration
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What To Do If You Think Your Thyroid Hormone Medication Isn’t Working
Consider absorption
If you find that your thyroid medication is no longer helpful, absorption may be an issue. Unfortunately, many things can affect how your small intestine absorbs your medication. To increase your intestinal absorption, take your thyroid medication on an empty stomach with water. Avoid other beverages like juice, coffee, tea, etc. Also take your thyroid medication separately from other drugs and supplements. Certain medications and supplements contain ingredients that block thyroid hormone absorption, including calcium.
Monitor your weight
Thyroid medications are often prescribed based on your weight. Therefore, even subtle changes in your weight can affect your thyroid hormone levels. If you lose or gain weight, track your weight and symptoms so your doctor can adjust your dose accordingly.
Stay consistent with the brand and type of medication
There are subtle differences between thyroid medication brands. For example, there may be different fillers, coatings, preservatives, and coloring agents that may create inconsistencies. If you switch brands, check your thyroid levels every 4-6 weeks until they stabilize.
Practice patience and test regularly
Avoid over-the-counter thyroid glandular supplements
Make your medication part of your daily routine
Will I Have The Same Dose Of Medication For Hypothyroidism My Entire Life
The dose of your medication can actually change over time. At different points in your life, you may need to have the amounts of medication changed so that it manages your symptoms. This could happen because of things like weight gain or weight loss. Your levels will need to be monitored throughout your life to make sure your medication is working correctly.
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You Have Unexpected Weight Changes
Are you gaining weight without a change in your diet and exercise program? This can be a sign that you are not getting enough thyroid hormone to treat your hypothyroidism, or you are getting too much antithyroid medication for your hyperthyroidism. Similarly, if you are losing weight, you may be getting too much medication for your hypothyroidism, or too little medication to resolve your hyperthyroidism.
Youre Noticing Skin Changes
Skin changes can be signs that your treatment needs an adjustment. Very dry skin especially your hands, elbows, and feet can be a sign that you are not getting enough thyroid hormone when you are hypothyroid. Unusually smooth skin, a bumpy rash on your face called miliaria, or a patch of rough skin on your shins can all be signs that your hyperthyroidism treatment is insufficient, and you need an increased dosage of antithyroid medication.
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Who Is More Likely To Develop Hypothyroidism
Women are much more likely than men to develop hypothyroidism. The disease is also more common among people older than age 60.1
You are more likely to have hypothyroidism if you
- had a thyroid problem before, such as a goiter
- had surgery or radioactive iodine to correct a thyroid problem
- received radiation treatment to the thyroid, neck, or chest
- have a family history of thyroid disease
- were pregnant in the past 6 months
- have Turner syndrome, a genetic disorder that affects women
Your thyroid is also more likely to be underactive if you have other health problems, including
- lupus, a chronic autoimmune inflammatory condition
Warnings For Other Groups
For pregnant women: Studies of levothyroxine in pregnant women havent shown risk to the fetus. Talk to your doctor if youre pregnant or planning to become pregnant. It appears unlikely that this drug will harm a pregnancy.
Not treating hypothyroidism could cause problems for both you and your pregnancy. You should not stop taking this drug during pregnancy.
For women who are breastfeeding: Small amounts of levothyroxine may pass into breast milk, but this drug is usually safe to take while breastfeeding. Talk to your doctor about the best way to feed your child while taking levothyroxine.
For seniors: If youre older than 65 years, you may be at higher risk of developing negative heart effects while taking this drug. Your doctor may choose to start you on a lower dosage.
For children: Levothyroxine has only been approved for use in children for the treatment of hypothyroidism. The tablet can be used safely in children of all ages.
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Is It Normal To Feel Poorly After Taking Thyroid Medication
Its actually not common for thyroid patients to start taking thyroid medication but still feel poorly 2-3 months later. These symptoms usually stem from either an inadequate dose or because you are taking your thyroid medication incorrectly.
What happens when your thyroid levels go down?
A drop in thyroid hormones might trigger cold-like symptoms: sudden shivers, cold hands and feet, or a swollen throat. Thyroid hormones help maintain body temperature, and you might need them when transitioning between the warm and cold areas.
Fda Warning: Not For Obesity Or Weight Loss
- This drug has a black box warning. This is the most serious warning from the Food and Drug Administration . A black box warning alerts doctors and patients about drug effects that may be dangerous.
- Thyroid hormones, including levothyroxine, should not be used for weight loss or to treat obesity. Taking doses that are higher than recommended can lead to serious or even life threatening effects.
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Whats The Difference Between Hypothyroidism And Hyperthyroidism
In hypothyroidism, the thyroid doesnt make enough thyroid hormone.
The difference between hypothyroidism and hyperthyroidism is quantity. In hypothyroidism, the thyroid makes very little thyroid hormone. On the flip side, someone with hyperthyroidism has a thyroid that makes too much thyroid hormone. Hyperthyroidism involves higher levels of thyroid hormones, which makes your metabolism speed up. If you have hypothyroidism, your metabolism slows down.
Many things are the opposite between these two conditions. If you have hypothyroidism, you may have a difficult time dealing with the cold. If you have hyperthyroidism, you may not handle the heat. They are opposite extremes of thyroid function. Ideally, you should be in the middle. Treatments for both of these conditions work to get your thyroid function as close to that middle ground as possible.
Skip Natural Thyroid Medications And Supplements
Many supplements claim to support thyroid healthbut some are laced with thyroid hormones not listed on the label. Adding them to your medication could mean youre getting too much.
In a 2013 study of 10 top-selling thyroid-support products sold on the internet, researchers from Germanys Landstuhl Regional Medical Center and from the Walter Reed Army National Military Medical Center in Bethesda, MD, found that nine were laced with T3, T4, or both in a variety of amounts. Ingredient labels listed animal thyroid tissue for some while others only listed herbs such as ashwagandha, guggul, and Coleus forskohlii. The researchers concluded that drugs were added to the supplements. ¹²
Supplements, including types containing a seaweed called kelp, may also contain dangerously high levels of iodine. And natural thyroid supplements may contain gland tissue from the thyroid, liver, heart, pancreas and other animal organsraising a small but serious risk for exposure to prions, which are agents that could transmit the brain disease CreutzfeldtJakob. ¹³
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Talk With Your Doctor About Testing
You can develop hypothyroidism while pregnant. Some doctors routinely check thyroid levels during pregnancy to monitor for low thyroid hormone levels. If your levels are lower than they should be, your doctor may suggest treatment.
Some people who never had thyroid problems before they were pregnant may develop them after having a baby. This is called postpartum thyroiditis.
In many cases, the condition resolves within 12 to 18 months, and medication is no longer required. However, around 20 percent of people with postpartum thyroiditis will need long-term therapy.
Your Menstrual Cycle Is Unusual
Many women with hypothyroidism experience unpredictable menstrual cycles and other menstrual problems. Irregular periods, heavy bleeding and missed cycles are all connected to having too little of the thyroid hormones circulating.
Many women find, when they settle on the correct dose of thyroid medication, that their menstrual cycle becomes more regular and manageable. If you have started experiencing menstrual cycle irregularity or problems once more, this could be a sign that your thyroid medication needs checking.
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How Do Doctors Diagnose Hypothyroidism
Your doctor will take your medical history and perform a physical exam. A hypothyroidism diagnosis cant be based on symptoms alone because many of its symptoms are the same as those of other diseases.1 Thats why your doctor may use several thyroid blood tests and imaging tests to confirm the diagnosis and find its cause.
Because hypothyroidism can cause fertility problems, women who have trouble getting pregnant often get tested for thyroid problems.
Interactions That Can Make Your Drugs Less Effective
When levothyroxine is less effective: When you take levothyroxine with certain drugs, it may not work as well to treat your condition. This is because the amount of levothyroxine in your body may be decreased. Examples of these drugs include:
- The antidepressant sertraline. If you take sertraline with levothyroxine, your doctor might need to increase your levothyroxine dosage to keep it working well for you.
- Rifampin and anti-seizure drugs such as carbamazepine and phenobarbital.
- Calcium carbonate or ferrous sulfate. Take levothyroxine at least 4 hours before or after taking these medications to help make sure that levothyroxine works properly.
- Colesevelam, cholestyramine, colestipol, kayexalate, or sevelamer. Take levothyroxine at least 4 hours before taking these medications to help make sure that levothyroxine works properly.
- Simethicone and antacids such as aluminum or magnesium.
- Cancer drugs that belong to the tyrosine-kinase inhibitors class, such as imatinib.
When other drugs are less effective: When certain drugs are used with levothyroxine, they may not work as well. This is because the amount of these drugs in your body may be decreased. Examples of these drugs include:
All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:
- how severe your condition is
- other medical conditions you have
- how you react to the first dose
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Symptoms Of An Underactive Thyroid
Many symptoms of an underactive thyroid are the same as those of other conditions, so it can easily be confused for something else.
Symptoms usually develop slowly and you may not realise you have a medical problem for several years.
Common symptoms include:
Elderly people with an underactive thyroid may develop memory problems and depression. Children may experience slower growth and development. Teenagers may start puberty earlier than normal.
If you have any of these symptoms, see a GP and ask to be tested for an underactive thyroid.
Signs That Your Thyroid Medication Is Not Working
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If you are on thyroid medication for an underactive thyroid, it is routine procedure to have your blood work done every 2-3 months to monitor your thyroid hormone levels. Most practitioners will measure TSH and T4. TSH is a pituitary hormone that signals the thyroid to increase production of both T4 and T3. Thyroid medication such as Synthroid is a synthetic version of T4 . When T4 is administered, TSH level decrease. This is what leads to your labs appearing normal. Unfortunately, this is not where the tale of thyroid hormone ends. This article will discuss some important concepts with respect to thyroid hormone conversion.
A healthy thyroid mostly makes T4. In fact, the thyroid makes 90-95% T4 and 5-10% T3. T3 is the metabolically active thyroid hormone. It has a much shorter half life and is used up within a few hours. T4, on the other hand, has to be converted into T3 in the liver, kidneys, and by the gut bacteria. One iodine molecule is removed from T4 to convert it into T3. The enzyme requires both zinc and selenium to function optimally. Zinc is one of the most common nutrient depletions we see clinically in thyroid patients. In fact, taking thyroid medication , can further deplete both zinc and selenium levels since it calls for increased activity of the converting enzyme .
Your doctor swears everything is fine and life goes on. Sadly, many women trust that everything is okay and this is as good as it gets. This could not be further from the truth.
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Can Thyroid Cause Neck And Shoulder Pain
D. For some people, hypothyroidism can add to joint and muscle problems. Specifically, hypothyroidism may lead to: Muscle aches, tenderness and stiffness, especially in the shoulders and hips.
What happens if there is a mismatch in thyroid medication?
Consequentially, you can have a mismatch between the medication dose you were prescribed and what your body currently needs. Having a chronically under or overactive thyroid, or swinging between the two states, can have long-lasting effects on your body. 1. You feel pumped Your heartbeat is stronger than usual or irregular.
Does Birth Control Affect My Thyroid
When youre on birth control pills, the estrogen and progesterone inside of the pills can affect your thyroid-binding proteins. This increases your levels. If you have hypothyroidism, the dose of your medications will need to be increased while youre using birth control pills. Once you stop using birth control pills, the dosage will need to be lowered.
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How To Adjust Or Make Changes To Your Thyroid Medication
What if you have waited the appropriate amount of time but are still feeling poorly?
Its time to make some changes to your thyroid medication.
In order to do this, you need to follow two steps:
#1. Get your thyroid tested
#2. Make changes to your thyroid medication
Why do you need to get your thyroid tested first?
Because you need to see how well your previous dose of thyroid medication was working.
You should have a baseline set of labs that you received in which you were diagnosed with a thyroid condition.
When you re-test your thyroid you can compare your new set of labs to the old one.
Did your TSH go down? If you are taking thyroid medication you should see it drop .
Did your free T3 increase? If you are taking the right type of thyroid medication you should see your free T3 increase.
Did your free T4 increase? If you are taking levothyroxine then you should see your free T4 increase.
After comparing your old lab tests to your new ones, you should be able to see if your thyroid medication was working and how well it was working.
If all of your lab tests are going in the wrong direction then you know you need to make dramatic changes .
Alternatively, if your lab tests are trending in the right direction but just not quite there yet then you know you just need to make some small changes to your medication .
There is no one size fits all pattern that you can apply when it comes to your thyroid which makes getting these lab tests all the more important.