Do you also feel tired all the time? Do you feel weak, gain weight, and sometimes feel very sluggish? These can often be signs of a decrease in the functioning of the thyroid gland in our body. Doctors call this condition (Hypothyroidism). So, a medicine that doctors often recommend and that many people use is Levothyroxine. Today, let's talk about this medicine and the things to be careful about while using it, in a very simple and friendly way.
Simply put, what is Levothyroxine?
Levothyroxine is a synthetic hormone made in a laboratory, similar to the thyroid hormone produced naturally by the thyroid gland in our neck. If for some reason your body does not produce enough thyroid hormone, your doctor will prescribe this medicine to make up for the deficiency.
Think of the thyroid hormone as a little manager that controls everything in our body.
- Our body controls metabolism, the rate at which the food we eat is converted into energy.
- It helps keep things like our heart rate and body temperature at the right level.
- This hormone is essential for maintaining our energy levels and mental state.
So when this hormone is low (Hypothyroidism), all of these processes slow down a bit. What Levothyroxine pills do is restore those slowed down processes.
Things you need to tell your doctor before taking this medicine
Before starting Levothyroxine, it is very important to inform your doctor about any other medical conditions you have and any other medications you are taking, as some conditions require special care when using this medication.
| If you have one or more of the following conditions, be sure to tell your doctor: |
|---|
| • Addison's disease or other adrenal gland problems |
| • Heart disease or heart pain (Angina) |
| • Conditions such as bone weakness or osteoporosis |
| • Diabetes |
| Pituitary gland problems |
| • If you are taking medication to prevent or treat blood clots (e.g. Warfarin) |
| • If you are on a weight loss program |
| • If you have fertility problems |
| • If you are pregnant, trying to get pregnant, or breastfeeding |
| • If you have an allergy to any other medicine, food, or dye. |
How exactly do you use this medicine?
This is where many people go wrong. To get the most out of this medicine, you need to know exactly how to take it.
Most importantly: Always take Levothyroxine tablets on an empty stomach , at least 30 minutes to an hour before breakfast, with a glass of water.
Why do we say that? Because if we take this medicine with food, it will interfere with the food and the medicine will not be absorbed properly. Then the benefits of taking the medicine will be reduced.
Also, avoid taking the following things close to the time (within 4 hours) of taking this medicine:
- Antacids for gastritis (especially those containing aluminum or magnesium)
- Calcium tablets (Calcium carbonate)
- Iron tablets (Ferrous sulfate)
- Some cholesterol-lowering medications (e.g. Cholestyramine)
- Some other medications (e.g. Sucralfate, Sevelamer)
Get into the habit of taking your medicine at the same time every day. Only take the dose your doctor tells you to take. Don't take more.
If you give it to small children...
This medicine may also be given to newborn babies. In such cases, crush the tablet well and dissolve it in 1-2 teaspoons of water, breast milk, or soy-free infant formula, and give it as directed by your doctor. Never mix it with soy-based formula , as this may reduce the effectiveness of the medicine.
What to do if you miss a dose of medication?
If you forget to take a dose, take it as soon as you remember. But if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take a double dose.
What if I take too much medicine?
If you think you have overdosed, go to the nearest hospital Emergency Department (ETU) immediately . Alternatively, call the National Poisons Information Centre at the Colombo National Hospital .
Other things that can interact with Levothyroxine
Levothyroxine can interact with many medications, vitamins, and even some foods, so it's important to tell your doctor about everything you're taking.
| Medicine / substance category | Examples |
|---|---|
| Medicine for heart disease | Amiodarone, Digoxin |
| Vitamins and minerals | Calcium, Iron Supplements |
| Medicine for gastritis/acid reflux | Antacids, Sucralfate |
| Medicines for epilepsy | Carbamazepine, Phenytoin, Phenobarbital |
| Types of hormones | Birth control pills, Estrogen, Testosterone |
| Diabetes medication | Insulin or diabetes pills |
| Some medications for depression | Especially tricyclic antidepressants |
| Types of steroids | Prednisone, Cortisone |
This is not a complete list. Tell your doctor about all the over-the-counter medications, vitamins, and traditional medicines you take, as well as if you smoke or drink alcohol.
Other things to consider when taking the medicine
- Drink plenty of water: Some Levothyroxine pills are quite large, so swallowing them without enough water can cause them to get stuck in your throat. So always take the medicine with a glass of water.
- Do not switch brands: Do not switch the brand of Levothyroxine you are using without your doctor's approval. Sometimes, the way the medicine is absorbed into the body can vary slightly from brand to brand.
- Regular tests: While taking this medication, your doctor will often order a blood test (TSH test) to check if your thyroid hormone levels are correct. Don't skip it.
- Lifelong: Most people have to take this medication for the rest of their lives. Do not stop taking the medication without your doctor's advice.
- Hair loss: Some people may experience a little more hair loss when they first start taking the medication. But don't worry, most of the time it will go away on its own over time.
- Before surgery: If you are going to have any surgery, tell your medical team in advance that you are taking Levothyroxine.
What are the possible side effects?
Side effects often occur when the dose of medication exceeds the amount needed by the body. Therefore, it is important to be aware of these symptoms.
| Side effect |
|---|
| Side effects that should be reported to your doctor immediately |
| • Allergic reactions (swelling of the face, lips, tongue, skin rash, difficulty breathing) |
| • Feeling like your heart is beating fast, chest pain |
| • Excessive sweating, inability to tolerate heat |
| • Severe restlessness, irritability, insomnia |
| • Tremors |
| • Severe diarrhea |
| • Irregular menstrual cycles in women |
| Things that are usually not serious, but should be reported to the doctor if they persist |
| • Changes in appetite |
| • Headache |
| • Nausea/vomiting |
Take-Home Message
- Take the Levothyroxine tablet every morning, on an empty stomach, with water, at least 30 minutes before meals.
- Avoid stopping the medication or changing the dosage without your doctor's advice.
- Inform your doctor about all other medications, vitamins, and supplements you are taking.
- Get your blood tests (TSH test) done on time and maintain the correct medication dosage.
- If you experience symptoms such as chest pain, rapid heartbeat, or extreme restlessness, call your doctor immediately.
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