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The thyroid gland is one of the most important organs of the human body as it helps in regulating various body functions. The thyroid is a butterfly-shaped organ which is present in the throat, below the Adam’s apple. The thyroid gland releases two hormones, T3 (thyroxine) and T4 (triiodothyronine) which are maintained with the help of the thyroid-stimulating hormone (TSH). 

Most of the time, thyroid dysfunctions in the body present as hypothyroidism, where there is reduced production of thyroxine hormone in the body, or hyperthyroidism, where there is an increased production of thyroxine hormone in the body. In hypothyroidism, one might gain weight and become unable to tolerate cold. In hyperthyroidism, one might lose weight and become intolerant to heat. Hypothyroidism is the more common form of thyroid dysfunction seen in people. 

Most people suffering from hypothyroidism require artificial thyroxine hormone, levothyroxine, to maintain the levels of thyroid hormones in their body. However, people tend to make some common mistakes while taking these medicines, some of which are listed below.

(Read more: Diet for hypothyroidism)

  1. Taking hypothyroidism medicines irregularly
  2. Discontinuing the medicine without consulting the doctor
  3. Using other medicines along with the hypothyroidism medication
  4. Improper storage of hypothyroidism medications
  5. Changing the brand or dose of the medication without consulting the doctor
  6. Taking too much hypothyroidism medication
  7. Taking hypothyroidism medications with meals and snacks
  8. Taking dietary supplements without consulting your doctor
Doctors for Hypothyroidism medication mistakes

If you want to manage your thyroid dysfunction successfully, you will have to take consistent doses of thyroid medicine. Thyroid medication should always be taken daily at about the same time on an empty stomach 30 to 60 minutes before breakfast. Skipping one dose or taking it at a different time is not extremely dangerous but regularly missing doses or skipping multiple days in a row can disrupt the thyroid levels in the body significantly. Set a special alarm so that you never forget taking your daily dose.

Some people tend to stop using their medication as soon as they start feeling better. This is a common mistake made by people taking not only hypothyroidism medication but also other treatments. Thyroid medications should not be stopped without consulting your physician as the levels of your thyroid-stimulating hormone can spike a little bit after you start taking the thyroid medications but your body still needs the medication regularly to maintain these levels. Medication for hypothyroidism is to be taken life-long usually, so consult your doctor before making any changes. 

(Read more: How to get pregnant with thyroid problems)

There are a number of drugs and supplements that can reduce the absorption of levothyroxine in the body if they are taken too close together. Some of these drugs include calcium supplements, antacids that contain aluminum, sucralfate (used to treat intestinal ulcers), iron supplements, cholestyramine (used to reduce cholesterol levels in the body), ciprofloxacin (antibiotic), raloxifene (osteoporosis drug) and some antidepressants. Discuss with your doctor if it’s possible for you to avoid taking these drugs and if these drugs are necessary, take them at least four hours before or after taking thyroid medications. 

(Read more: Thyroid problems in children)

Thyroid medications should be stored in a dry dark area with a consistent moderate temperature as if you store them incorrectly, they may lose their potency. This means you should avoid storing your thyroid medications in locations that are either exposed to a lot of natural light, such as near windows, or locations that fluctuate in temperatures like in cars or high-humidity environments like your bathroom.  

(Read more: Thyroid cancer)

While all the medications, be it branded or generic, contain the same drug, some endocrinologists believe that not all thyroid medications are the same. While the drug would be the same, the quantity of the hormone could differ in different brands. It has been noticed that a person’s body may react differently to different brands, so do not change the medication without consulting your doctor. Additionally, since thyroid medication takes a long time to show results, you should not make any hasty decisions yourself about your dosage. Reducing your dose will not help you wean yourself off and doubling it will not make the treatment go faster. Stay in touch with your doctor, tell them about the progress and how you feel and let them make any dosage recommendations if needed.

While most pharmaceutical companies say that taking an accidental extra dose of the artificial thyroxine hormone, levothyroxine, is not harmful, taking more thyroid medication than prescribed regularly and assuming it is harmless is wrong. Moreover, taking excessive amounts of thyroid medication frequently can cause other medical issues like fatigue, bone loss, sleep problems, irregular heartbeats, palpitations, anxiety and heart damage. It is best to stick to the prescribed dosage of medications. If you are following the prescribed dose and still experiencing these symptoms then consult with your doctor to find out if you need to tweak your treatment.

No matter which brand of thyroid medication you take, the synthetic thyroid hormone is supposed to be taken on an empty stomach and at least 45 to 60 minutes before any meals. If you take your thyroid medication too close to your meals or snacks or even if you take the medicines after your meals then it will lead to malabsorption. This may lead to complications and make your treatment ineffective. The best way to ensure that this never happens is to take your thyroid medications as soon as you wake up in the morning.

Taking dietary supplements may affect how your body absorbs your thyroid medications, especially if you are taking supplements that contain iodine. Iodine is a micronutrient that can make your thyroid hormone levels fluctuate, so it is important to keep a good eye on your iodine intake and report any dietary supplemental intake to your doctor. 

(Read more: Hyperthyroidism)

Dr. Narayanan N K

Dr. Narayanan N K

Endocrinology
16 Years of Experience

Dr. Tanmay Bharani

Dr. Tanmay Bharani

Endocrinology
15 Years of Experience

Dr. Sunil Kumar Mishra

Dr. Sunil Kumar Mishra

Endocrinology
23 Years of Experience

Dr. Parjeet Kaur

Dr. Parjeet Kaur

Endocrinology
19 Years of Experience

References

  1. Jonklaas, Jacqueline. et al. Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014 Dec 1; 24(12): 1670–1751. PMID: 25266247
  2. Barrett, Nicholas A. et al. Management of long-term hypothyroidism: a potential marker of quality of medicines reconciliation in the intensive care unit. Int J Pharm Pract . 2012 Oct;20(5):303-6. PMID: 22953769
  3. Ramadhan, Abdulaziz and Tamilia, Michael. Treatment-refractory hypothyroidism. CMAJ. 2012 Feb 7; 184(2): 205–209. PMID: 22158401
  4. Park, So Hyun and Hong, Song Hee. Identification of Primary Medication Concerns Regarding Thyroid Hormone Replacement Therapy From Online Patient Medication Reviews: Text Mining of Social Network Data. J Med Internet Res. 2018 Oct; 20(10): e11085. PMID: 30355555
  5. Clemens, Kristin and Uum, Stan Van. A pituitary mass as consequence of a decimal error in levothyroxine dose. CMAJ. 2012 Feb 7; 184(2): 210. PMID: 22249983
  6. Jonklaas, Jacqueline. Update on the Treatment of Hypothyroidism. Curr Opin Oncol. 2016 Jan; 28(1): 18–25. PMID: 26544166
  7. Ala, Shahram. et al. Dose administration time from before breakfast to before dinner affect thyroid hormone levels?. Caspian J Intern Med. 2015 Summer; 6(3): 134–140. PMID: 26644879
  8. Hoermann, Rudolf. et al. Individualised requirements for optimum treatment of hypothyroidism: complex needs, limited options. Drugs Context. 2019; 8: 212597. PMID: 31516533

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