Most patients who are diagnosed with hypothyroidism are started on medication. People often have misconceptions about how these medications work. Some think of them as unnatural, others are worried about side effects, and few feel they will be dependent on the tablet forever.
These are all valid concerns. If you have been prescribed thyroid medication and ever had such questions, you're in the right place. This blog will cover the most common questions that people have about thyroid medication.
What does thyroid medication do in the body and why is it prescribed?
The medication used for the treatment of hypothyroidism is levothyroxine. Your body naturally produces two hormones - T3 and T4. When these are deficient, it is labelled as hypothyroidism.
Levothyroxine is the synthetic form of T4 that is naturally produced in the body. It is considered to be the best treatment option for thyroid disease. Once absorbed, it works exactly as T4 would. Most of it is converted to T3, which is the active form of the thyroid hormone. This hormone binds to specific receptors to perform its actions.
You may be wondering why you can't just take T3 directly. A lot of research has been conducted in this area with mixed responses. Even so, levothyroxine remains the only approved treatment. There are specific genetic conditions and enzyme deficiencies that may require T3 if your body is unable to convert the T4 hormone.
Your best bet is to consult a doctor who is experienced in treating thyroid disease. Then you can rest assured that if you do need T3 supplementation, your doctor will start it at the right time.
Here are a few important pointers to keep in mind about how the medication works:
- The effects will not be seen instantly. It can take up to six to eight weeks for you to see changes in your energy levels or mood. Just be patient.
- It is not advisable to keep switching brands. As far as possible, take the exact medication prescribed by your doctor.
- Store the tablets in a cool, dry, and dark place. You may be tempted to just keep the tablets at your bedside table. But if you keep tablets in a clear container in direct sunlight, it can directly affect their efficacy.
For the best outcome, make sure you don't skip your medication. Set a fixed time to take the tablet each day.
How do I know what dose of thyroid medication to take?
Well, you don't. That is the reason you need to visit a doctor you trust. Many patients continue to take the same dose of medication for years on end. However, that may not be the right approach.
There are a lot of reasons you may need to modify the dose of your thyroid medication. Regular follow-ups with your doctor can help ensure that you are taking the correct dose. Often, the tablets are started at a lower dose and gradually increased to optimal levels. This gives the body time to adjust to the medication.
Every few weeks, your TSH levels need to be monitored to check the response. The dose may be modified as per the results. If you are regular with your medication but you still face severe symptoms, let your doctor know instead of trying to adjust the dose yourself.
What is the best time to take thyroid medication?
The most important fact to take care of is that levothyroxine has to be taken on an empty stomach for best results. There can be two ways to do this:
- First thing in the morning when you wake up.
- Three to four hours after dinner at bedtime.
Morning doses are generally preferred as you are more likely to forget the dose at night or the tablet may not be absorbed well if you have a late dinner.
If you are having the tablet in the morning, ensure that you maintain a gap of 30 to 45 minutes until breakfast. Avoid caffeine in the morning as it affects the absorption of the tablet. In case you are having any supplements, it may be a better idea to have a gap of a couple of hours.
What are the most common side effects of thyroid medication?
Although thyroid medication is largely safe, some side effects can occur. The chances of these increase if you are taking an incorrect dose. Some of the possible side effects include-
- Palpitations or increased heart rate
- Hair loss
- Anxiety or difficulty falling asleep
- Weight loss
- Tiredness
- Loose stools
- Skin rash
- Intolerance to high temperatures
- Increased swelling of the thyroid gland
- Irregular menses
- Raised liver enzymes
A lot of these symptoms may sound familiar to you. That's because these side effects are usually the symptoms of hyperthyroidism. If you are taking medication in a higher dose than required, you may experience these symptoms even when your thyroid gland is actually underactive.
If you have any history of heart problems such as a previous heart attack or any other hormonal problems, always inform your doctor in advance.
If you face any problems after starting your thyroid medication, don't just Google it. You might find information that may worry you without good reason. Your doctor's clinical experience is a much better source of answers.
What will happen if I miss a dose of thyroid medication?
The good news is that if you have been taking the medication for a while, one missed dose will not affect you significantly. However, if you miss doses frequently, it will seriously hamper the treatment process.
Also, if you are just starting out with the medication it is even more important to take the medication each and every day. This is because you have not yet built a hormone reserve. Missed doses can affect your hormone levels and make it difficult for your doctor to set a regular dose for you.
Suppose you suddenly remember at lunchtime that you didn't take your medication that day. What would you do if you accidentally missed your morning dose of levothyroxine?
The right answer is, to take the tablet at the next best time. You can't take the tablet along with a meal or any other supplements. Hence, find a window of time that fits these criteria and take the tablet then. However, if it is too close to your next dose it is better to skip this dose and take the next one on time.
Will I have to be on thyroid medication for life once I start it?
Something that patients commonly say is that they are afraid if they start taking the medication, they will have to take it forever. They generally want options to treat their thyroid issues without medication.
Here's one thing you have to remember - your disease will always be present, whether you are treating it or not. Just because you don't start taking tablets, does not mean your body will fix itself. Conversely, just because you are regular with thyroid medication does not mean you will be healed completely.
What we tell our patients is that thyroid medication is just one of the steps in the treatment process, it is not the ultimate solution. Hypothyroidism is a complex medical condition and a holistic approach is the best one.
This means supporting your thyroid gland to function optimally. This requires a good diet, regular exercise, sleep, etc. Therefore, there is no clear answer to this question. It depends upon the cause of hypothyroidism, the severity of the disease, and what kind of lifestyle changes you make.
You may be able to reverse your thyroid disease and get off medication completely. This process takes several months to years and requires a commitment to better health. Our team consists of the leading thyroid experts in India and they can help you reach your goals successfully.
The bottom line
Thyroid medication is a safe and crucial part of the treatment of hypothyroidism. Consult well-trained experts to ensure that you are taking your tablets correctly. If you ever face any side effects after taking the tablets, get in touch with your doctor instead of suddenly stopping the tablet. Being consistent with your medication and other lifestyle changes will ensure that you get the results you desire.
