Changing your diet can affect how well your body absorbs thyroid hormone medication. For example, if you were eating a lot of fiber and then cut back on your intake, you may begin to absorb higher levels of thyroid medication. Certain supplements can add to the effects of your thyroid replacement and lead to overmedication. Pay close attention to supplements featuring the terms "thyroid support," "energy support," "thyroid glandulars," "adrenal glandulars," and "bovine glandulars.
Supplements that contain iodine , such as bladderwrack Fucus vesiculosus , kelp, bugleweed, Irish moss, or seaweed are also culprits. Too much iodine, in particular, can over-stimulate your thyroid and trigger hyperthyroidism.
Drugs that contain estrogens, such as hormone replacement medications and contraceptive pills, can interfere with thyroid hormone requirement. When you stop taking them , your body might require more or less thyroid medication than when you were taking them. With Hashimoto's disease , your thyroid hormone levels can fluctuate rapidly. Hashitoxicosis refers to the phase when your thyroid is over-functioning and producing more thyroid hormone.
Taking your thyroid hormone replacement medication when your thyroid is in hashitoxicosis can temporarily cause symptoms of hyperthyroidism. During pregnancy, your need for thyroid hormone increases, so you may need to be prescribed a higher dose of medication than usual. Once you have the baby, your need for thyroid hormone drops. Hence, the dose of thyroid hormone replacement you were taking during pregnancy could be too high for the postpartum period.
This can result in overmedication. Healthcare providers typically use your thyroid blood test results to see if you are getting too much medicine. In some cases, having a TSH level that is lower than normal or a T3 or T4 level that is higher than normal can be a sign of overmedication. You may become overmedicated with changes in the dosage or type of thyroid hormone replacement therapy you are taking. Certain health conditions and lifestyle changes can lead to overmedication, too.
Symptoms of being overmedicated with thyroid hormone replacement drugs are often uncomfortable, but rarely dangerous. Your healthcare provider will run periodic thyroid tests and adjust your dosage as needed until your symptoms resolve and your thyroid levels return to optimal levels. Losing weight with thyroid disease can be a struggle.
Our thyroid-friendly meal plan can help. Sign up and get yours free! Duntas LH, Jonklaas J. Levothyroxine dose adjustment to optimise therapy throughout a patient's lifetime. Adv Ther. The history and future of treatment of hypothyroidism. Ann Intern Med. Guidelines for the treatment of hypothyroidism: Prepared by the American Thyroid Association task force on thyroid hormone replacement. Oral liquid levothyroxine solves the problem of tablet levothyroxine malabsorption due to concomitant intake of multiple drugs.
Expert Opin Drug Deliv. Treatment for primary hypothyroidism: current approaches and future possibilities. Drug Des Devel Ther. Drugs R D. Thyroxine and triiodothyronine content in commercially available thyroid health supplements. Extracts are available by prescription only and shouldn't be confused with the glandular concentrates sold in natural foods stores.
These products aren't regulated by the Food and Drug Administration, and their potency and purity isn't guaranteed. You'll likely start by seeing your family doctor or a general practitioner. In some cases, you may be referred to a doctor who specializes in the body's hormone-secreting glands endocrinologist.
Infants with hypothyroidism need immediate referral to a pediatrics endocrinologist for treatment. Children or teens need to see a pediatric endocrinologist if there is any uncertainly about starting levothyroxine or proper dosing of the hormone. Here's some information to help you get ready for your appointment and know what to expect from your doctor.
Preparing a list of questions will help you make the most of your time with your doctor. For hypothyroidism, some basic questions to ask include:. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Diagnosis In general, your doctor may test for an underactive thyroid if you are feeling increasingly tired, have dry skin, constipation and weight gain, or have had previous thyroid problems or a goiter.
Blood tests Diagnosis of hypothyroidism is based on your symptoms and the results of blood tests that measure the level of TSH and sometimes the level of the thyroid hormone thyroxine. More Information Hypothyroidism diet Hypothyroidism: Can calcium supplements interfere with treatment?
Hypothyroidism: Should I take iodine supplements? Soy: Does it worsen hypothyroidism? Show more related information. Request an Appointment at Mayo Clinic. More Information Coconut oil: Can it cure hypothyroidism? Share on: Facebook Twitter. Show references AskMayoExpert. Rochester, Minn. Chaker L, et al. The Lancet. American Thyroid Association. Levothyroxine is available as a liquid for children and people who find it difficult to swallow tablets.
If you or your child are taking levothyroxine as a liquid, it will usually be made up for you by the pharmacist. It will come with a plastic syringe or spoon to help you measure out the right dose. If you do not have a syringe or measuring spoon, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not give the right amount.
If you forget to take a dose, take it as soon as you remember, unless it's almost time for your next dose. In which case just skip the forgotten dose. Do not take 2 doses together to make up for a missed dose. If you forget often doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
Your doctor will do regular blood tests to check the levels of thyroid hormones in your body before and after starting levothyroxine. At the start of treatment you can expect to have blood tests often. Once your hormone levels are stable, you'll usually have a blood test after 4 to 6 months, and after that once a year.
Like all medicines, levothyroxine can cause side effects, although not everyone gets them. Once you are on the right dose of levothyroxine, side effects should go away.
The common side effects of levothyroxine usually happen because the dose you're taking is more than you need. These side effects usually go away after you go on to a lower dose of levothyroxine or stop treatment. Common side effects are the same as the symptoms of an overactive thyroid. Talk to your doctor or pharmacist if these side effects bother you or do not go away. Drink plenty of water to prevent dehydration. If you're being sick try small, frequent sips.
Speak to a pharmacist if you have signs of dehydration , such as peeing less than usual or having dark, strong-smelling pee. If you get severe diarrhoea or vomiting from a stomach bug or illness, tell your doctor. Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking levothyroxine. Talk to your doctor if they last longer than a week or are severe.
These symptoms should improve as your body gets used to levothyroxine. If it does not go away, or if it's causing you problems, contact your doctor. Try cutting down on coffee, tea and alcohol. It might help to keep the room cool and use a fan. You could also spray your face with cool water or sip cold or iced drinks. The flushing should go away after a few days. If you get unusual muscle ache, which is not from exercise or hard work, talk to your doctor.
You may need a blood test to find the cause. In rare cases, it's possible to have a serious allergic reaction anaphylaxis to levothyroxine. These are not all the side effects of levothyroxine. For a full list see the leaflet inside your medicines packet.
It's important to carry on taking levothyroxine throughout your pregnancy. Having too low or too high levels of thyroid hormone in pregnancy can cause problems for you and your baby. You'll need to have regular blood tests during pregnancy to make sure you're on the right dose of levothyroxine for you and your baby.
Most women need to take a higher dose of levothyroxine than usual while they're pregnant. It's usually safe to breastfeed while you're on levothyroxine. Thyroid hormones pass into breast milk in very low levels that are too small to affect the baby. If you're breastfeeding, it's important that you continue to take levothyroxine. Your body needs good levels of thyroid hormones to make enough breast milk to feed your baby.
Some medicines can interfere with thyroid hormones, so the dose of levothyroxine may need to be changed. They include:. Levothyroxine can change how other medicines work, so their doses may need to be altered. These medicines include:. Some medicines should not be taken at the same time of day as levothyroxine as they can reduce the amount of levothyroxine your body takes in, including:.
Read the information leaflet supplied with these medicines or speak to your pharmacist for advice on how much time to leave between taking these medicines and taking levothyroxine. There's very little information about taking herbal remedies and supplements with levothyroxine.
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
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