Levothyroxine May Interact With Other Medications
Levothyroxine oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.
To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs youre taking. To find out how this drug might interact with something else youre taking, talk to your doctor or pharmacist.
Examples of drugs that can cause interactions with levothyroxine are listed below.
Causes And Risk Factors
The primary risk factor for thyroid storm is having untreated Graves’ disease and/or hyperthyroidism.
Even when the Graves’ disease is identified and being treated, there are a number of other factors that raise your risk of thyroid storm:
- Infection, specifically lung infections, throat infections, or pneumonia
- Blood sugar changes, including diabetic ketoacidosis and insulin-induced hypoglycemia
- Recent surgery on your thyroid gland or trauma to your thyroid
- Abrupt withdrawal of your antithyroid medications
- Radioactive iodine treatment of your thyroid
- Excessive palpation of your thyroid gland
- Exposure to a large quantity of iodine
- Severe emotional stress
Complications of thyroid storm include stroke and heart attack, which can lead to death.
You Don’t Recognize The Symptoms Of Overmedication
If you end up accidentally on thyroid hormone replacement, you can experience many symptoms you may not realize are related to your thyroid medication.
Caroline spent two years in this situation.
“I had rushes of adrenaline, a thumping heartbeat, racing heart rate, sweating, feelings of extreme hunger, and high blood pressure. They put all these symptoms down to anxiety. After my prescription was accidentally lowered by 25 percent, all my symptoms have subsided!”
Some other symptoms of overmedication include diarrhea, weight loss, and insomnia. If you have any of these symptoms while on thyroid medication, be sure to consult your healthcare provider.
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Not Everyone On Thyroid Medication Actually Needs To Be
Another group of people who may be asking if they need to be on thyroid medication is those already taking it!
We have a number of recent studies which show that thyroid patients who were previously diagnosed with thyroid conditions in their early life may not actually NEED it later in life.
This is particularly true for people who are in nursing homes and who are elderly.
Studies have shown that a large number of people who fit this criterion can safely stop taking their thyroid medication.
How does it happen?
Well, its quite simple.
The conventional thought is that once you start taking thyroid medication you MUST be on it for the rest of your life.
So doctors never actually think to check if you can go off of it, they just keep prescribing it to you for decades and decades.
Researchers eventually thought to check if thyroid medication was necessary for these people and they ultimately found that many people who are elderly can actually stop taking their medication without any concerns.
I wouldnt say that this is common among younger women who are taking thyroid medication but it does apply to those who are much older in age .
Reasons Youll Probably Get Worse If You Stop Taking Your Medication
There will always be exceptions to these reasons, but most of you will probably feel worse if you stop taking your thyroid medication for the following reasons:
#1. Your Body May be Reliant upon the Medication
The first group of patients that should never stop taking thyroid medication includes those who do not have a thyroid or those who have had their thyroid removed.
This typically stems from conditions such as hyperthyroidism or thyroid cancer.
If you dont have a thyroid then you are REQUIRED to supplement with thyroid hormone indefinitely !
That means you will NEED to take thyroid medication for the rest of your life.
Remember, we said that thyroid hormone is required for you to function and for you to live.
If you cant produce it naturally then you have to take it in some other way.
This group of people should never make changes to their thyroid medication without physician supervision as it can be very dangerous.
Does that mean that you need to suffer from any existing symptoms?
No, but it does mean that you should be very thoughtful about any changes you make to your thyroid medication and dosing.
TSH is part of an important axis known as the hypothalamic-pituitary-thyroid axis .
In this axis, your body produces TRH which stimulates TSH which stimulates thyroid hormone production.
This normal axis is disrupted when you take any sort of thyroid medication .
Even some supplements, such as iodine, can alter this axis.
Imagine this scenario:
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What Does Thyroid Storm Feel Like
Since thyroid hormone affects many parts of your body, if youre experiencing thyroid storm, youll likely feel pretty bad all over. You may feel:
- Very hot and sweaty.
- Like you dont have control of your body.
Its essential to get to the nearest hospital as soon as possible if youre experiencing any of these symptoms.
How Long Can You Go Without Thyroid Medication
The thyroid gland is a butterfly-shaped organ at the base of your neck. Although small, this mighty organ controls several essential functions all over the body, including regulating cellular metabolism and managing growth and development. When the thyroid gland is not working correctly, the whole body can be affected.
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What Happens If I Eat Or Take Medication Too Soon
If you occasionally do not wait the full recommended time before eating or drinking, do not worry. This is not dangerous. Just do your best the next day.
The recommendations provided here help your doctors to dose your thyroid medication more accurately and decrease the need for frequent blood tests. If you are having trouble taking your thyroid hormone consistently, please speak with your doctor.
What Happens If I Miss A Dose Of Thyroid Medication
If you miss a dose of thyroid medication, take it as soon as you remember. Its possible to experience symptoms of hypothyroidism after a missed dose. If you experience any symptoms, call your healthcare provider.
If you miss a dose and it’s almost time for your next dose, skip the missed dose. Take your next dose at your regularly scheduled time. Its usually not advised to take two doses of thyroid medication at the same time. Too much thyroid medication can cause symptoms like shakiness, sweating, and fast heartbeat.
But if you forget to take your medication for several days, let your healthcare provider know. They may want to adjust your dose for a few days.
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Reasons Why You May Need Thyroid Medication
There are several thyroid diseases and treatments that can alter thyroid hormone levels in your body. Most thyroid issues fall into two categories:
- Hyperthyroidism, a state where your thyroid produces too much thyroid hormone
- Hypothyroidism, a condition where your thyroid produces too little thyroid hormone
People with hyperthyroidism often get treatment to reduce the size of the thyroid gland. Sometimes, a doctor prescribes radioactive iodine to shrink the thyroid, whereas other times, surgery is required. Treatment for hyperthyroidism often leads to the state of an underactive thyroid. In that case, a patient needs to take thyroid hormone replacement to replace the hormones that their thyroid does not produce.
Individuals with primary hypothyroidism need to take thyroid hormone placement for the rest of their life. Hashimoto’s thyroiditis, an autoimmune condition where your immune system attacks thyroid tissue, is the leading cause of hypothyroidism.
Other situations may also warrant the need for thyroid medication, including surgical removal of the thyroid gland due to cancer, trauma, and congenital hypothyroidism.
What About Thyroid Pills And Other Meds
You should also let several hours pass between taking thyroid pills and some ulcer medications, such as sucralfate or certain cholesterol-lowering drugs, including cholestyramine and colestipol .
It’s important to discuss all possible medication interactions with your HCP. Certain antibiotics, for example, could increase or decrease absorption of your thyroid medicine.
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You Forget To Take Your Thyroid Medication
One of the most common mistakes is to forget to take your thyroid medication. Angie takes Synthroid.
“I forget to take it a lot! That is my biggest mistake. I tried writing myself a note, setting a reminder, getting a daily pill box, and leaving it out on the counter so I see it. I will be great for like two months, then forget two or three days in a row and wonder: ‘Why do I feel like crap?'”
Even a few days of forgetfulness can have an impact on your health. It is also particularly important to remember your thyroid medication if you are on a suppressive dose to prevent a recurrence of thyroid cancer.
Why Do Some People Feel Better When They Stop Taking Their Medication
If you spend any time researching on the internet you will always find someone who has a positive experience when they stop taking their medication.
But you have to ask yourself a very important question:
Are their experiences, medical conditions, circumstances, etc. the exact same as mine?
In most cases, you will find the answer to that question is no.
Its very possible that these patients may have been incorrectly placed on thyroid hormones, to begin with.
If you are taking thyroid medication, especially T4, and your body didnt actually need it, then stopping the medication may actually make you feel better.
This likely has to do with thyroid hormone conversion and metabolism in your body.
But, lets go back to the idea of incorrectly taking thyroid medication for a minute.
Its possible, that through incorrect testing of an isolated TSH test, patients can be placed on thyroid medication inappropriately.
Your TSH can fluctuate on a daily, weekly, and monthly basis and is sensitive to factors such as stress, supplements, sleep, and so on.
In addition, its estimated that up to 5% of lab tests are inaccurate .
Either of these conditions can set the stage for improper management in a patient with normal thyroid function.
The chances of this happening are slim, but the chances of stopping thyroid medication and feeling better are also slim.
Never make any assumptions about your body or your thyroid function based on someone elses experience.
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You Don’t Store Your Medication Properly
If you don’t store your medication properly, it can lose potency quickly and become less effective. Ideally, you should store your thyroid medication in a dry place, away from humidity and light.
It’s also important that your thyroid medication is not exposed to temperature extremes. Store your thyroid medication at no more than 80 degrees Fahrenheit. Be careful about leaving your thyroid drugs in a hot car or mailbox, or in areas without air conditioning when temperatures exceed 80 degrees.
A Note From Paloma Health
The information shared in this article is intended to empower you with the information you need to treat your thyroid condition and feel your best! Work with a thyroid doctor to determine the best treatment plan for your specific needs, including medication, nutrition, and lifestyle modifications.
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What Is The Prognosis For Thyroid Storm
Thyroid storm is a medical emergency that is fatal if its not treated. Causes of death from thyroid storm can be heart failure, heart arrhythmias or multiple organ failure. However, with treatment, most people experience improvement within 24 hours.
Risk factors for poor prognosis include:
- If youre of advanced age.
- Having neurological issues upon admission to a hospital, such as decreased sensation and mental function issues.
- If your healthcare provider is unable to use beta-blockers and antithyroid medications to treat your thyroid storm due to other health conditions.
- If you need dialysis and/or mechanical ventilation due to thyroid storm.
You Fail To Check Your Prescription Carefully When You Receive It From The Pharmacy
When you pick up or receive your thyroid medication, you should:
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Check to make sure it’s the correct medication, at the correct dosage.
-
Count the pills or capsules to make sure you received your full prescription.
-
Ensure that a has not been substituted for your brand-name medication.
Linda had a similar experience, getting a generic instead of the brand-name medication she usually took. In her case, it wasn’t the pharmacy’s fault. “It was the insurance company that made the switch,” says Linda.
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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.
You Don’t Take Your Medication Correctly
Thyroid medication should generally be taken in the morning, an hour before eating any food, drinking coffee, or drinking milk, and at least three hours apart from taking any calcium or iron supplements or calcium-fortified drinks. If you take it in the evening, you should wait at least three to four hours after eating.
Some thyroid medications, however, have specialized instructions. Levoxyl brand levothyroxine, for example, needs to be taken with a full glass of water, according to prescribing instructions from the manufacturer. According to Anne: “One of my worst thyroid medication mistakes was taking Levoxyl without plenty of water. Once I started drinking a full glass of water after taking the pill, I started losing weight and my pill worked effectively.”
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What To Do Instead Of Stopping Your Thyroid Medication
If you feel like you are stuck with your current thyroid medication and arent sure what to do then this is the section for you.
Before you consider stopping your thyroid medication make sure you at least look at these potential options which tend to help MOST people.
#1. Get a Complete Thyroid Lab Panel
The first step is to get a complete thyroid lab panel.
Ive discussed, at length, what is included in this panel, and you can find more information in this post.
The reason that this is so important is that, without it, you are really flying blind.
Ordering and obtaining all of the thyroid lab tests will help give you information about how well you are absorbing thyroid medication, how well you are utilizing it in your body, how your body is metabolizing/converting it, and so on.
This step is the MOST important for ensuring that you feel better because you cant treat without it.
If your current doctor is unwilling to order these tests then you may need to seek out a second opinion and look for someone who specializes in thyroid care.
This lab panel includes the following tests: TSH, free t3, free t4, reverse T3, thyroid antibodies, and sex hormone-binding globulin.
You can read more about what each test tells you, including optimal ranges, in this post.
#2. Consider Altering your Medication or Dose
The next step, which hopefully follows #1, is to take a hard look at which medication you are currently using.
Supplements allow you to do just that.
#4. Improve your lifestyle
When Medication Is And Isnt Required
Standard blood tests for TSH and free T4 are very reliable indicators of who needs thyroid hormone replacement :
- TSH levels are abnormally high, and your free T4 levels are abnormally low: This means you have true hypothyroidism. T4 medication is required.
- Slightly elevated TSH levels and normal free T4: This is called subclinical hypothyroid. This is an early form of hypothyroidism and requires monitoring but not T4 medication.
- Low free T3: This is a sign of inflammation, digestive issues, or a diet too low in carbs or calories. T3 medication is not normally required.
- Elevated thyroid antibodies with normal thyroid hormone levels: In this case, you do not need thyroid hormone replacement. Hashimotos disease does not always lead to hypothyroidism.
- Low free T4 and normal TSH: This is a sign of dysfunction in the pituitary gland. Consult an endocrinologist.
Whether your thyroid condition requires medication or not, many thyroid conditions can be improved through better gut health.
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Combining Your Synthetic Thyroid Hormone With Other Medication
Just as there shouldnt be food in your stomach when you take your hypothyroidism medication, its also important to avoid taking any other medication at the same time.
Specifically, antacids, calcium, cholesterol drugs, and iron supplements can each interfere with the way the thyroid hormone is absorbed. So, you should take these particular drugs four hours before or after taking your thyroid medication, according to the U.S. National Library of Medicine. Most other medication can typically be taken 45 minutes to an hour after your hypothyroidism treatment, Bianco says.
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