THYROID HORMONE THERAPY

 

The treatment of patients with thyroid hormone pills can be done safely and with great precision. Thyroid hormone, ("Levothroid," "Unithroid," "Levoxyl" and "Synthroid") is identical to the hormone your thyroid makes when your thyroid is working properly. Because ?thyroid hormone? is something which is normally present in your blood, there are no side effects when people are treated with the correct dose of thyroid hormone. It is also safe to take thyroid hormone during pregnancy and while breast feeding. Middle age and elderly adults are usually started on a low dose of thyroid hormone which is gradually increased to the full dose. Young adults can begin taking thyroid hormone pills at the full dose.

Thyroid hormone pills usually need to be taken once a day, every day. If you have a permanently under active thyroid, you will need to continue taking thyroid hormone pills for the rest of your life. You should try to remember to take your thyroid pill every day however, if you forget to take a pill, you should double your dose on the following day. Recently, generic forms of thyroid hormone pills have become available. It is the recommendation of the American Association of Clinical Endocrinology, the American Thyroid Association and the Endocrine Society that patients avoid taking the generic form of thyroid pills. Generic thyroid pills usually have the word "levothyroxine" written on the label of the pill box.

Several medicines will prevent your body from absorbing the thyroid pills, including iron pills, some antacids and calcium pills. It is best to take your thyroid pills first thing in the morning on an empty stomach. Defer taking your iron pills, calcium supplements, vitamins and antacids for at least 2 hours after taking the thyroid pill so that your body has time to absorb the thyroid medicine.

While you are being treated with thyroid pills, you will need to have your blood thyroid hormone level monitored. If you are treated with too large a dose, you may develop some of the symptoms of an overactive thyroid (hyperthyroidism.) Conversely, if your dose is too low, you may experience symptoms of an under active thyroid (hypothyroidism.) In most cases, the best way to ensure that you are being treated with the proper dose of thyroid hormone is to measure your blood TSH level. TSH (Thyroid Stimulating Hormone) is a hormone made by the brain (in the pituitary gland.) The amount of TSH in your blood is a reflection of whether or not the brain believes that there is the proper amount of thyroid hormone in your blood. This simple blood test will be done approximately 1-2 months after you begin taking thyroid pills and 1-2 months after the dose of your thyroid pill is changed. After I have determined that you are taking the correct dose of thyroid hormone, the blood TSH level will need to be measured, in most cases, only once a year.

Symptoms of an UNDERactive thyroid (HYPOthyroidism)
weakness, fatigue, loss of appetite, weight gain, always feel ?cold?, cold skin, slow heart rate, hair loss, constipation, shortness of breath, heavy periods, longer and more frequent periods, infertility, dry skin, coarse, brittle, dry hair, eye problems, muscle aches and cramps, loss of eyebrows, swelling, joint aches, slow speech, hoarseness/deep voice, high cholesterol, poor memory, slow thinking, numbness in your hands or feet, tingling in your hands or feet, fluid retention.

Symptoms of an OVERactive thyroid (HYPERthyroidism)
muscle weakness in the thighs and upper arms, fatigue, increased appetite, weight loss, always feeling hot, always sweating, fast heart rate, palpitations,frequent bowel movements, shortness of breath, irregular or missed periods, shorter and less frequent periods, irregular heart beat, hair loss, puffiness, redness, dryness or bulging of the eyes, tremor, nervousness, psychiatric problems, emotional problems

Hayward Zwerling, M.D., FACP is a Fellow of the American College of Physicians and of the American Association of Clinical Endocrinologists. Dr. Zwerling is board certified by the American Board of Internal Medicine in Internal Medicine and in Internal Medicine, Endocrinology and Metabolism.