How is hypothyroidism treated?
The treatment is to take thyroxine tablets each day. This replaces the thyroxine which your thyroid gland is not making. Most people feel much better quite quickly after starting treatment. Ideally, take the tablet on an empty stomach (before breakfast). This is because some foods rich in calcium or iron may interfere with the absorption of thyroxine from the gut. (For the same reason, dont take thyroxine tablets at the same time of day as calcium or iron tablets.)
What is the dose of thyroxine?
Most adults need between 50 and 200 mcg daily. A low dose is prescribed at first and is gradually increased over a period of time. Blood tests are usually taken every now and then over several months, and the dose may be adjusted accordingly. The blood test measures TSH (see above). Once the blood TSH level is normal it means you are getting the correct amount of thyroxine from the tablets. It is then common practice to check the TSH blood level once a year.
As you get into your 70s and 80s, you may need a reduced dose of thyroxine. Also, if your weight changes by more than 1 stone (about 7 kg) due to dieting, weight gain, or pregnancy, you should have a blood test sooner than the routine annual test as the dose may need to be adjusted.
Missed a tablet?
Everyone forgets to take their tablets from time to time. Don't worry as the odd forgotten thyroxine tablet will not make much difference. However, you should try to take thyroxine regularly for maximum benefit. Symptoms will gradually come back if you do not take the tablets for several days or more.
How long is the treatment for?
For most people, treatment is for life. Occasionally the disease process reverses. This is rare apart from the following:
Are there any side-effects or problems from treatment?
Usually not. Thyroxine tablets replace the body's natural hormone, so side-effects are uncommon. However, if you have angina, you may find that your angina pains become worse when you first start thyroxine. Tell a doctor if this happens.
If you take too much thyroxine it can lead to symptoms of an over-active thyroid, such as palpitations, diarrhoea, irritability, or flushing. This is why the initial treatment dose is small and gradually built up, and why you need blood tests to check that you are taking the correct dose of thyroxine.
Other medicines may interfere with the action of thyroxine. For example, carbamazepine, phenytoin, and rifampicin. If you start any of these medicines, or change the dose, then you may need to alter the dose of the thyroxine. Your doctor will advise. Also, if you take warfarin, the dose may need to be altered if you have a change in your dose of thyroxine.
Free prescriptions
If you have hypothyroidism, you are entitled to free prescriptions. This is for all your medicines, whether related to the hypothyroidism or not. Ask your pharmacist for details and for a form to fill in to claim this benefit.
In summary
