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Hypothyroidism Treatment

Sunday, April 21, 2013 - 17:48

Contributing Author: Guy Slowik FRCS

Treatment of hypothyroidism is simple. It involves taking daily thyroid hormone replacement medication. This supplies the body with thyroid hormone to replace what isn't being produced by the thyroid gland.

The replacement thyroid hormone is artificially manufactured and is structurally identical to the thyroid hormone produced naturally in the body. It is a synthetic derivative of the thyroid hormone T4 and is calledlevothyroxine. Brand names include Synthroid, Levothroid, Levoxyl,Levo-T, as well as numerous generic preparations.

Synthetic thyroid hormone (T4) is made in a wide range of strengths so that dosage can be individually tailored to each person's needs.

An adult typically starts with 0.1-0.15 milligrams per day, and the dosage is adjusted over time to reach normal blood levels, reflected by normal blood levels of TSH. It is important that older adults, especially those with heart disease, start at a low dose and increase it slowly. This minimizes the risk that the increase in metabolic activity due to thyroid hormone replacement therapy will stress the heart.

Because T4 is converted into T3 (the other very important thyroid hormone) within the body, physicians are comfortable using T4 therapy alone. However, one recent study has suggested some persons may benefit from combined T3 and T4 therapy.

Need To Know:

People differ in how quickly they respond to the medication.

It is important to take the medication regularly as prescribed. Some hypothyroidism sufferers feel a marked improvement after only a couple weeks on medication. They find that their heart rate increases to normal range, they lose the weight they gained, and their skin and hair will return to normal. Some feel much improved in themselves only after a couple of weeks of treatment. It takes a little longer for the enlarged thyroid to decrease in size and for the "bad cholesterol" to return to normal levels.

But others may find they still have various symptoms at six months or longer after beginning medication. If it's taking that long, it's usually because the dose is inadequate to bring the thyroid hormone levels into the normal range. The doctor may need to increase the dose, or perhaps try a combination of drugs with T4 and T3. A person who frequently forgets to take their medication will also not benefit from improvement in their symptoms.If the symptoms persist even though the blood tests of thyroid function are normal, it is likely that the symptoms are not due to thyroid hormone deficiency.

It may be useful for an individual with newly diagnosed hypothyroidism to list their most distressing symptoms and to track changes in them over time after hormone therapy is begun.

Some people find that their physician will increase the dosage of their thyroid medication every year or two, in order to keep their blood levels of thyroid hormone within the normal range. This is because the inflammation of the thyroid gland may continue affecting more thyroid hormone producing cells, thus causing the thyroid to produce even less thyroid hormone than before.

Need To Know:

It is important not to take too much thyroid hormone, since this can cause symptoms of hyperthyroidism. These symptoms include a fast heart rate, tremor (shaking), excessive sweating, inability to tolerate heat, and abnormal heart rhythms.

For more information about hyperthyroidism, go to Hyperthyroidism.

Nice To Know:

Individuals diagnosed with subclinical hypothyroidism - when their TSH levels are high but thyroid hormone levels are normal, and they are not feeling any symptoms - are not always treated with replacement thyroid hormone. The decision is an individual one, made by the person and the physician. But up to half of such individuals will feel better after taking thyroid medication, and others will have improved cholesterol levels in the blood.

For more information about treatment of hypothyroidism in infants, children, and teens, see What is the Treatment for Hypothyroidism in Infants and Children?


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