Hypothyroidism

Hypothyroidism is usually treated with levothyroxine, a synthetic (man-made) version of thyroid hormone that you swallow.

If your healthcare provider prescribes levothyroxine, tell them about the other prescription and over-the-counter drugs, vitamins, and other supplements you take. Also tell them whether you eat certain foods, such as soy, in large amounts. Levothyroxine can interact with certain medications. Soy, vitamins and other supplements, and over-the-counter and prescription medications can affect the way your body responds to levothyroxine.

Your healthcare provider will start you on a low dose of levothyroxine and increase the dose gradually if necessary.  You should take this medication on an empty stomach and at least an hour before you take any other drugs or supplements.

In adults with dementia and hypothyroidism, thyroid replacement therapy may improve cognition, functional status, and mood.

Hyperthyroidism

Hyperthyroidism treatments include:

Anti-thyroid Medicines

Anti-thyroid medications can stop the thyroid gland from making too much hormone. Medications don’t work for everyone and they don’t work forever. Usually medications come before treatment with radioactive iodine.

Radioactive Iodine Therapy

Treatment with radioactive iodine involves swallowing the iodine, which your thyroid absorbs. Over time, the iodine shrinks the gland so it produces less hormone. Side effects generally don’t occur. After treatment, hormone levels can take up to 6 months to become normal.

After treatment, your healthcare provider may need to lower the amounts of your other medications because your body may process these medications more slowly.

Sometimes, the treatment reduces your thyroid levels too much, and you develop hypothyroidism. If this happens, you will need to take medication for hypothyroidism on a daily basis.

Surgery

Thyroid surgery (thyroidectomy) removes most of the thyroid gland. It can be an alternative to radioactive iodine treatment for some people. Risks of the surgery include damage to vocal cords and parathyroid glands. These glands help control blood levels of calcium.

If you have this surgery you’ll need to take synthetic thyroid on a daily basis for the rest of your life.

Benign Nodules

If nodules aren’t cancerous or too big, a healthcare provider may monitor the nodules. If they continue to grow, you may need another biopsy. 

If the nodules cause problems, treatment may be needed. Surgery may be needed when nodules cause difficulty swallowing or breathing. Nodules that produce too much thyroid hormone may need radioactive iodine to shrink them or an anti-thyroid medication to lower hormone levels.  If these approaches don’t work, surgery may be needed.

Cancerous Nodules

If a thyroid nodule is cancerous, surgery is usually necessary. Typically, most or all of the thyroid gland is removed. After surgery, daily thyroid medication is needed.

Levothyroxine Dose Levels

Doses of levothyroxine that are too high can cause side effects such as:

• Increased appetite
• Difficulty sleeping
• Heart palpitations (racing or rapid heartbeat)
• Jitters or shakiness

A healthcare provider may need to lower your dose if you have any of these symptoms.

Let your health care provider know about any medications, supplements, or vitamins you take because levothyroxine can interact with some of them. Also, this drug can interact with certain foods, such as soy. Let your provider know about your diet and if you change it in a major way.

Last Updated December 2022