Treatments for Hypothyroidism

The majority of hypothyroidism cases are chronic and require lifelong treatment. The ultimate goals are to return blood levels of TSH and T4 to the normal range and to alleviate symptoms.In most cases, symptoms of hypothyroidism begin to improve within two weeks. However, those with more severe symptoms may require several months of treatment for full recovery. Most patients with hypothyroidism require lifelong treatment, but the dose ofT4 may need to be adjusted. Be sure to tell your doctor about any other medications that you take, because of the possibility of drug interactions.

Medication- The treatment for hypothyroidism is thyroid hormone replacement therapy. Doctors typically prescribe an oral form of T4. Generic and brand-name formulations are not equally effective. Always use brand-name products. The generic forms of T4 are not as effective or standardized and the price is not much different than the brand-name products. Also, one manufacturer´s brand should not be interchanged with another. This causes a difference in the amount absorbed and often requires a new dosage. In unusual cases, a doctor may prescribe another form of thyroid hormone, triiodothyronine (T3), or a combination of T3 and T4.

Routine Monitoring- Individual needs for T4 can vary widely and depend upon a variety of factors, including the underlying cause of hypothyroidism. Your doctor will prescribe an initial dose, retest your blood level of TSH (and sometimes T4) after about six weeks, and adjust the T4 dose accordingly. This process may have to be repeated several times before your hormone levels fall to normal. After the optimal dose is identified, your doctor may recommend monitoring blood tests once yearly.

Changes in dosage

Situations that may require an increased dose of T4 - Your doctor may increase your T4 dose if your thyroid disease worsens, if you gain weight, if you become pregnant, or if gastrointestinal conditions impair T4 absorption. A high fiber diet, calcium- or aluminum- containing antacids, or iron tablets can interfere with the absorption of T4, and therefore T4 should be given at a different time of the day. Color-coded tablets can help with dose adjustments.

***NOTE***

It is very important to work with your doctor to determine your optimal dose of T4 and to stick to that dose. Never increase or decrease your T4 dose without first consulting your doctor. Over-replacement with T4 can cause mild hyperthyroidism, with the associated dangers of atrial fibrillation (irregular heart beat)and, possibly, accelerated bone loss (osteoporosis). If you feel tired or gain weight, talk with your doctor about repeat thyroid testing and the other possible causes for these symptoms.