Precautions
- antacids
- calcium supplements (these should not be taken for at least two hours after levothyroxine; be aware that some multivitamin and mineral supplements contain calcium)
- cimetidine
- colesevelam (levothyroxine should be taken at least four hours before or after this)
How to take levothyroxine when you take other medications?
To make sure levothyroxine is safe for you, tell your doctor if you have ever had:
- a thyroid nodule;
- heart disease, a blood clot, or a blood-clotting disorder;
- diabetes ( insulin or oral diabetes medication doses may need to be changed when you start taking this medicine);
- kidney disease;
- anemia (lack of red blood cells);
- osteoporosis, or low bone mineral density;
- problems with your pituitary gland; or
- any food or drug allergies.
Is Levoxyl a good hypothyroid medication?
diabetes – the dose of your diabetes medicine may need to change because levothyroxine can raise blood sugar levels. 4. How and when to take levothyroxine. Take levothyroxine once a day in the morning, ideally at least 30 minutes before having breakfast or a drink containing caffeine, like tea or coffee.
Why increase in levothyroxine medication?
The more common side effects of levothyroxine can include:
- increased appetite
- weight loss
- heat sensitivity
- excessive sweating
- headache
- hyperactivity
- nervousness
- anxiety
- irritability
- mood swings
What are side effects of levothyroxine?
How long does it take to feel better with levothyroxine?
When you start levothyroxine you won't feel better the next day. You may not feel better in two weeks. But symptoms should start disappearing within a month. After six weeks of treatment, you should be almost completely free of symptoms, assuming you're at the right medication level.
How long does it take for thyroid treatment to work?
You should start to feel better a few days after you begin taking medicine. But it may take a few months for your thyroid hormone levels to get back to normal. If your levels get better, but you still have symptoms like fatigue and weight gain, your doctor may need to change your treatment.
How long does levothyroxine treatment last?
Levothyroxine will stay in your system for around 4 to 6 weeks. It takes longer for people with hypothyroidism to eliminate levothyroxine (closer to 6 weeks) than those with normal thyroid function. Levothyroxine contains a synthetic version of T4, one of two hormones produced by the thyroid.
What is the downside to taking levothyroxine?
Tell your doctor if you have any of the following symptoms while you are taking levothyroxine: chest pain, rapid or irregular heartbeat or pulse, uncontrollable shaking of a part of the body, nervousness, anxiety, irritability, difficulty falling asleep or staying asleep, shortness of breath, or excessive sweating.
How do you know if levothyroxine is working?
Key facts. Levothyroxine is a synthetic version of a hormone called thyroxine. It replaces thyroxine if your thyroid gland cannot produce it and prevents the symptoms of hypothyroidism. Levothyroxine starts working straight away, but it may be several weeks before your symptoms start to improve.
What are the long term side effects of levothyroxine?
The long-term effects of thyroid medication include weight fluctuations, sensitivity to heat, joint pain, changes to your menstrual cycle, and possibly even autoimmune dysfunction.
Can hypothyroidism be cured permanently?
Hypothyroidism refers to an underactive thyroid gland. This can lead to all sorts of unwanted symptoms, like chronic fatigue, memory loss, and higher risk of heart disease. It is possible to cure hypothyroidism permanently for many of those suffering from Hashimoto's, which causes 90% of hypothyroidism cases.
Can hypothyroidism go away?
For those with particularly low levels of thyroid hormones, hypothyroidism is a life-long condition that will need to be controlled with medication on a regular schedule. It can be controlled very well and you can live a normal life with hypothyroidism.
What happens when you start taking levothyroxine?
About 1 to 2 weeks after you start treatment with levothyroxine, you will likely notice that your levels of fatigue have improved. It is important that you take your medication exactly as prescribed and not miss any doses as well as maintain routine checkups with your primary health care provider.
Why do you have to drink a full glass of water with levothyroxine?
The Levoxyl-branded tablet may rapidly swell and disintegrate, and cause choking or gagging if it becomes stuck in your throat. Take with a full glass of water, but talk with your doctor should you have difficulty swallowing it.
Do you have to take levothyroxine forever?
An underactive thyroid is a lifelong condition, so you'll usually need to take levothyroxine for the rest of your life. If you're prescribed levothyroxine because you have an underactive thyroid, you're entitled to a medical exemption certificate. This means you do not have to pay for your prescriptions.
Why was levothyroxine taken off the market?
Westminster Pharmaceuticals, LLC. Issues Voluntary Nationwide Recall of Levothyroxine and Liothyronine (Thyroid Tablets, USP) Due to Risk of Adulteration | FDA.
Why is levothyroxine used for thyroid?
Levothyroxine is generally taken life-long when used to treat hypothyroidism (low thyroid levels) unless the cause is transient. 2.
How does levothyroxine work?
Levothyroxine is a man-made form of thyroxine, a hormone that is produced naturally in the body by the thyroid gland. Levothyroxine replaces missing thyroxine in people whose thyroid glands do not produce enough thyroxine naturally.
What medications can affect levothyroxine absorption?
medications that can affect the absorption of levothyroxine, such as antacids, calcium carbonate, cholestyramine, iron, orlistat sucralfate, sevelamer, or proton pump inhibitors. rifampin. Note that this list is not all-inclusive and includes only common medications that may interact with levothyroxine.
What is the best medicine for hypothyroidism?
Levothyroxine replaces missing thyroxine and is the preferred medicine to treat hypothyroidism. The dosage of levothyroxine needs to be tailored for each individual and there is a fine line between taking too much thyroxine and toxic side effects, and having too little, resulting in compromised functioning.
What foods can decrease levothyroxine absorption?
Interacts with several other medications including amiodarone, anticoagulants, antidepressants, and digoxin. Foods such as soybean flour (found in infant formula), cottonseed meal, walnuts, and dietary fiber can decrease the absorption of levothyroxine.
What medications interact with levothyroxine?
Common medications that may interact with levothyroxine include: amiodarone or other medications that affect iodine, such as radioactive iodine. amphetamines, such as dexamphetamine or phentermine. anticoagulants, such as warfarin. anticonvulsants such as carbamazepine, phenobarbital, or phenytoin.
Where is levothyroxine absorbed?
40-60% of orally administered levothyroxine is absorbed; the majority from the jejunum and upper ileum of the gastrointestinal tract. Absorption is increased when levothyroxine is taken on an empty stomach.
How is levothyroxine given?
Levothyroxine oral is taken by mouth. The injection is given as an infusion into a vein. Levothyroxine is usually given by injection only if you are unable to take the medicine by mouth.
What is levothyroxine?
Levothyroxine is a thyroid medicine that replaces a hormone normally produced by your thyroid gland to regulate the body's energy and metabolism.
What other drugs will affect levothyroxine?
Many other medicines can be affected by your thyroid hormone levels. Certain other medicines may also increase or decrease the effects of levothyroxine.
How long after taking levothyroxine can you take calcium carbonate?
If you use any of the following drugs, avoid taking them within 4 hours before or 4 hours after you take levothyroxine: calcium carbonate ( Alka-Mints, Caltrate, Os-Cal, Oyster Shell Calcium, Rolaids Soft Chew, Tums, and others); cholestyramine, colesevelam, colestipol; ferrous sulfate iron supplement;
How long does it take for levothyroxine to work?
It may take several weeks before your body starts to respond to levothyroxine. Keep using this medicine even if you feel well. You may need to use this medicine for the rest of your life.
What happens if you are allergic to levothyroxine?
Get emergency medical help if you have signs of an allergic reaction to levothyroxine: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
What are the symptoms of allergic reactions to levothyroxine?
Get emergency medical help if you have signs of an allergic reaction to levothyroxine: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: fast or irregular heartbeats; chest pain, pain spreading to your jaw or shoulder; shortness of breath;
Why is levothyroxine less effective?
When levothyroxine is less effective: When you take levothyroxine with certain drugs, it may not work as well to treat your condition. This is because the amount of levothyroxine in your body may be decreased. Examples of these drugs include:
What is levothyroxine?
Levothyroxine is a prescription drug. It comes as a tablet or capsule you take by mouth. It also comes as an injectable solution that’s only given by a healthcare provider.
How does levothyroxine work?
Levothyroxine works by providing the thyroid hormone that your thyroid gland would produce if it were working normally.
What is the name of the drug that is used to treat thyroid cancer?
Brand names: Levoxyl, Synthroid, and Unithroid. Levothyroxine comes in three forms: an oral tablet, an oral capsule, and an injectable solution. Levothyroxine oral tablet is used to treat hypothyroidism. It’s also used to treat goiter and certain types of thyroid cancer.
What are some examples of drugs that can be taken with levothyroxine?
Examples of these drugs include: The antidepressant sertraline. If you take sertraline with levothyroxine, your doctor might need to increase your levothyroxine dosage to keep it working well for you. Rifampin and anti-seizure drugs such as carbamazepine and phenobarbital. Calcium carbonate or ferrous sulfate.
How long before taking levothyroxine?
Take levothyroxine at least 4 hours before or after taking these medications to help make sure that levothyroxine works properly. Colesevelam, cholestyramine, colestipol, kayexalate, or sevelamer. Take levothyroxine at least 4 hours before taking these medications to help make sure that levothyroxine works properly.
Can levothyroxine cause irregular heartbeats?
This may put you at risk for irregular heart rhythms ( arrhythmias ). Sympathomimetic drugs such as pseudoephedrine and albuterol. The effects of both the sympathomimetic drugs and levothyroxine may increase when you take these drugs together. This may put you at risk of serious heart problems.
What if Levothyroxine Doesn’t Work?
Levothyroxine is considered the preferred treatment for hypothyroidism ( 15 ).
What is levothyroxine sodium used for?
Levothyroxine sodium is an oral medication used to treat — not cure — hypothyroidism ( 2 ). Typically just referred to as Levothyroxine, it’s a synthetic drug that is biologically identical to T4, a prohormone produced by the thyroid ( 2, 3 ). Some of the trade names for levothyroxine sodium include ( 4 ):
What hormone is converted to T3?
Once in the body, levothyroxine (T4) is converted to triiodothyronine (T3), the most active thyroid hormone ( 6 ). Thyroid hormones increase basal metabolic rate and influence DNA transcription, protein synthesis and metabolism ( 7 ). Symptoms of hypothyroidism may reduce after several weeks of usage.
What is the best medication for hypothyroidism?
By Joe Leech, Dietitian (MSc Nutrition & Dietetics) [Last updated 26th October, 2019] Levothyroxine is the preferred medication of choice for treating an underactive thyroid (hypothyroidism). It’s typically taken for a long period of time, if not for life, so there are many important things you should know. This article looks at how it works, how ...
Why does my thyroid stop working?
It can result from insufficient thyroid hormone production or because thyroid hormones are inactivated before they have time to work ( 1 ).
What diseases interfere with levothyroxine absorption?
Diseases that interfere with levothyroxine absorption (e.g., celiac disease) Impact of other autoimmune diseases associated with hypothyroidism (e.g., type I diabetes and lupus) ( 17, 18 ). Drug interactions. Due to the risk of toxicity, doctors will not prescribe higher doses of levothyroxine.
Where is levothyroxine absorbed?
Summary: Taken by mouth, levothyroxine is absorbed in the small intestine and then converted to the biologically active thyroid hormone T3. Thyroid hormones influence several biochemical reactions in the body, including metabolic rate.
How long has animal thyroid been documented?
Ingestion of animal thyroid derived preparations has been long described but only scientifically documented for the last 130 years. Refinements in hormone preparation, pharmaceutical production and regulation continue to this day.
Is levothyroxine good for hypothyroidism?
The emergence of levothyroxine as a treatment for hypothyroidism. The evolution of thyroid hormone therapies has been significant over an extended period of time. Thyroid hormone replacement is very useful in the treatment of those with hypothyroidism. All of the most recent guidelines of major endocrine societies recommend levothyroxine ...
What is levothyroxine used for?
Levothyroxine is the standard therapy for patients with hypothyroidism, a condition that affects up to 5% of people worldwide. While levothyroxine therapy has substantially improved the lives of millions of hypothyroid patients since its introduction in 1949, the complexity of maintaining biochemical and clinical euthyroidism in patients undergoing ...
How long does levothyroxine last?
Due to its long half-life of about 7 days, in patients in the clinically euthyroid state, levothyroxine is the preferred first-line treatment for primary hypothyroidism and has been the most commonly prescribed treatment since the 1980s [8]. Initial Dosing and Dose Adjustment of Levothyroxine During Therapy.
What are the conditions that affect levothyroxine absorption?
These conditions include gastritis, coeliac disease, and lactose intolerance. Helicobacter pylori-associated gastritis is associated with increased levothyroxine requirement, with the increased requirement resolving with treatment of the gastritis [58, 59]. Similarly, untreated coeliac disease is associated with a high levothyroxine requirement that is remediated by dietary treatment of the coeliac disease [60, 61]. The same pattern has been demonstrated with lactose intolerance [62]. While each of these conditions remains in the untreated state, it appears that levothyroxine absorption is better when liquid levothyroxine is utilised for patient therapy [63–65]. Nephrotic syndrome is another medical condition associated with a need for an increased dose of levothyroxine, presumably due to urinary losses of thyroid hormones, accompanying the urinary losses of thyroxine-binding globulin [66].
How is thyroxine secreted?
Thyroxine is secreted by the thyrocytes and is the main thyroid hormone in the circulation. Thyroxine is actively transported to the various organs where it is converted to triiodothyronine by the activity of the deiodinases [6]. Triiodothyronine, the active form of thyroid hormone, is secreted in small amounts by the thyroid but is mainly generated via extrathyroidal conversion of the prohormone thyroxine. Hypothyroidism is a common endocrine disease that requires timely and lifelong treatment since, if left untreated, it can contribute to hypertension, dyslipidaemia, and heart failure and induce reversible dementia and infertility, as well as neurosensory, musculoskeletal, and gastrointestinal symptoms [7]. There is currently no other treatment for hypothyroidism, other than providing thyroid hormone replacement. Due to its long half-life of about 7 days, in patients in the clinically euthyroid state, levothyroxine is the preferred first-line treatment for primary hypothyroidism and has been the most commonly prescribed treatment since the 1980s [8].
Why is levothyroxine needed during pregnancy?
The dramatic increase in levothyroxine dose requirements associated with pregnancy, and the subsequent decrease in requirement post-partum are perhaps the best documented alterations in levothyroxine requirement [34]. The reason for the increased requirement is the need for an increased total body thyroxine pool associated with increased thyroxine-binding globulin concentrations and increased plasma volume. Increased levothyroxine doses are required in approximately 50–85% of pregnant women, and the need for an increase occurs early in the first trimester. Requirements tend to stabilise as the patient progresses into the second and third trimester, with few changes generally being required in the third trimester. The percentage increase in levothyroxine dose needed can be as high as 30–50% and is highest when the cause of the hypothyroidism is a thyroidectomy or ablation of the thyroid gland [35]. Achieving a serum TSH < 1.2 mIU/l preconception seems to reduce the percentage of patients requiring a dose increase [36]. Studies show that serum TSH can be maintained at goal during pregnancy by either increasing the levothyroxine dose by 29% by increasing from 7 to 9 tablets of levothyroxine weekly when conception is confirmed [37] or ongoing titration based on serum TSH [38]. The latter method had the advantage of resulting in fewer patients having a suppressed TSH during pregnancy [38]. Women undergoing in vitro fertilisation have similar needs for increased levothyroxine dosages, with 83% of women requiring an increase and the average increase being 33% [39].
How long does it take to discontinue levothyroxine?
If there is a suspicion for levothyroxine treatment having been prescribed unnecessarily, this can be investigated via a test period incorporating 6- to 8-week therapy discontinuation, followed by TSH testing.
What is the best treatment for hypothyroidism?
The medication most used to treat hypothyroidism is levothyroxine, a compound that acts as a replacement for a person’s thyroid hormone. People with hypothyroidism will often need to take levothyroxine for a long time, typically for the rest of their life, so it is important that their treatment is monitored closely and the dose is adjusted for the best effect as needed. As a person progresses through life, their dose may need to be adjusted because other diseases or medications can affect the dose needed for effective treatment. Pregnancy or weight gain can also affect the dose of levothyroxine needed by the patient, so patients and physicians need to work in partnership to ensure that the treatment is working as well as it can. The goal of this partnership is to maintain normal thyroid hormone levels without the patient experiencing any side effects or negative health consequences of taking too much or too little levothyroxine.
How It Works
Levothyroxine is used to treat an underactive thyroid (hypothyroidism).
May Treat: Hypothyroidism · Adjunct to surgery or radiotherapy for thyroid carcinoma · Myxedema coma
Brand Names: Levothroid · Levoxyl · Synthroid · Unithroid · Tirosint and more
Drug Class: Thyroid Hormones - Synthetic T4 (Thyroxine)
Availability: Prescription sometimes needed
Pregnancy: Consult a doctor before using
Lactation: Does not adversely affect lactation
- Not recommended to cause weight loss.
- Take daily, at least 30 minutes before breakfast
- Do not change brands without checking with Dr.
- Not recommended to cause weight loss.
- Take daily, at least 30 minutes before breakfast
- Do not change brands without checking with Dr.
- Tell MD now of chest pain or irregular heart rate.
- Call doctor if you missed 2 or more doses
- Review all drugs you are taking with your doctor
- Lab tests may be ordered to monitor therapy
- Swallow capsules whole.
- For capsule products : Do not chew or crush.
- For solution, oral products : If available, read the patient package insert.
- For tablet products : Do not miss any doses.
Upsides
Downsides
Bottom Line
Tips
Response and Effectiveness
- If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include: 1. May increase heart rate, cause arrhythmias (palpitations), precipitate angina, and have other adverse effects on the heart. 2. A headache, hair loss, flushing, diarrhea, and menstrual irregularities in women are also reaso…
Interactions
- Levothyroxine replaces missing thyroxine and is the preferred medicine to treat hypothyroidism. The dosage of levothyroxine needs to be tailored for each individual and there is a fine line between taking too much thyroxine and toxic side effects, and having too little, resulting in compromised functioning.
Further Information
- Take on an empty stomach, at least 30 to 60 minutes before food. Several foods, fiber, soy, coffee, and grapefruit juice can interfere with absorption. Supplements that contain iron and calcium may...
- Dosages should be titrated every 6 to 8 weeks under a doctor's advice.
- Take thyroxine EXACTLY as directed by your doctor. Taking too much can result in toxicity a…
- Take on an empty stomach, at least 30 to 60 minutes before food. Several foods, fiber, soy, coffee, and grapefruit juice can interfere with absorption. Supplements that contain iron and calcium may...
- Dosages should be titrated every 6 to 8 weeks under a doctor's advice.
- Take thyroxine EXACTLY as directed by your doctor. Taking too much can result in toxicity and potentially fatal side effects; taking too little may mean that you are not taking enough to supplement...
- Swallow capsules whole; do not cut, crush, or attempt to dissolve in water.