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How Long Can You Go Without Thyroid Medication?

What happens to your thyroid when you go without prescribed thyroid medication?
How Long Can You Go Without Thyroid Medication?
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The thyroid gland is a butterfly-shaped organ at the base of your neck. Although small, this mighty gland controls essential functions all over your body, including regulating cellular metabolism and managing growth and development. Your whole body can be affected when the thyroid gland is not working correctly.

For this reason, people with an underactive thyroid require lifelong thyroid hormone replacement medication. And missing doses of your thyroid medication or stopping it altogether can adversely affect your body. Below, we will look at what happens when you don’t take your thyroid medication.

Why is thyroid medication necessary?

When you’re hypothyroid, your thyroid gland does not produce enough thyroid hormones naturally to help regulate essential body functions. Thyroid hormone medications replace the amount of thyroid hormone your body needs to run smoothly.

When thyroid hormones are low, you can experience many symptoms impacting your overall health and quality of life.

Symptoms of hypothyroidism

Those with an underactive thyroid can experience various symptoms, including the following:

What are the different kinds of thyroid medication?

The thyroid gland makes and secretes two types of thyroid hormone - thyroxine (T4) and triiodothyronine (T3). Thyroid hormone replacement medication also comes in T4 and T3 formulations.

Generally, providers start with a medication with only T4, assuming your body can convert T4 to T3. If you are still experiencing symptoms while on a T4-only medication, your provider might add a T3-only medication to your regimen.

There are also combination T4-T3 formulations that come in a single pill. In the United States, these come as natural desiccated thyroid (NDT), or you can have a medication compounded for you based on your specific needs.

What happens when you stop taking thyroid medication?

How long can you safely go without taking your prescribed thyroid medication? It varies, depending on the severity of your thyroid disorder and the medication prescribed.

You can expect your symptoms to return if you stop taking your thyroid medication and have overt hypothyroidism. Typically, the longer you go without your medication, and the more severe your thyroid disease is, the higher your risk is for developing severe and even life-threatening conditions.

Those with subclinical hypothyroidism, a mild form of hypothyroidism, can sometimes safely come off their thyroid medication. This should only be done under the supervision of your provider.

Short-term effects

The half-life of levothyroxine is 6-7 days, which means it takes about 4-5 weeks for your body to rid itself of levothyroxine. Cytomel has the shortest half-life, about three days; thus, the majority of Cytomel will be out of your body within two weeks.

Nonetheless, as thyroid hormone levels start to wane, you can experience symptoms such as feeling tired and sluggish and having a low mood within the first week of not taking your medication. The longer you go without a thyroid medication, the more intense your symptoms will become.

Not taking your thyroid medication could also worsen other health conditions you may have, including sleep apnea, depression, and type 2 diabetes. Therefore, you may develop not only hypothyroid symptoms but also symptoms related to other health conditions.

Long-term effects

People with moderate to severe hypothyroidism who stop taking their medication are at risk for extreme health events, including a myxedema crisis. Although rare, a myxedema crisis is a life-threatening complication of hypothyroidism. Typically, this condition arises when someone already has uncontrolled hypothyroidism and has a triggering event like an infection or surgery.

In the myxedema crisis, people can experience swelling all over the body, including the face, tongue, lips, and limbs. It also is accompanied by a thickening of the skin. A myxedema crisis may also cause other complications, including:

How long can you go without thyroid medication before symptoms?

A person can go for many years without thyroid hormones. Indeed, people often go undiagnosed for decades despite suffering from hypothyroid symptoms. However, without thyroid replacement medication, a person with overt hypothyroidism cannot function optimally and will suffer from the physical and mental symptoms of hypothyroidism.

It is essential to stay current with your thyroid blood tests and thyroid provider’s visits and maintain your prescription to prevent a recurrence of hypothyroid symptoms. Remember that it takes 4-6 weeks before a thyroid replacement medication reaches its peak therapeutic effect. Therefore, if you have a lapse in taking your medicine, such as forgetting to pack it on a trip or refill your prescription, it will take time for your symptoms to stabilize once you restart it.

How do you make sure you are on the correct dose?

If you have hypothyroidism, you must find the right type and dose of thyroid medication for you. Your provider will determine your starting dose based on your age, underlying health conditions, and blood test results. Starting doses may vary. For example, some people begin at a full replacement dose of 1.7 mcg per kg of body weight daily. Others start on the lowest dose of 25 mcg per day. In both cases, doses are titrated up as necessary based on thyroid test results and the symptoms you are experiencing.

Once you find the correct dose of thyroid medication, you should stay on that same dose and take it every day. You will also want to use the same brand continuously. Switching between generic and brand medications can change how your body responds to each type of medication and its potency. To remain stable on your thyroid medication, make sure that you know about the foods, drinks, medications, and supplements that can interfere with how you absorb your thyroid medication.

Symptoms of too high of a dose

Sometimes, the dose of your thyroid medication may be too high, causing symptoms opposite to those seen in hypothyroidism. This can happen for various reasons, including changes in your diet, medications, supplements, or titrating your dose too fast.

Signs and symptoms of an overactive thyroid due to high thyroid dose include:

If you notice you are experiencing any of these symptoms or have other symptoms of concern, call your healthcare provider’s office. Your provider will likely order lab work to test your thyroid biomarkers and adjust your dose if needed.

A note from Paloma Health

Because stopping your thyroid hormone can result in hypothyroid symptoms, staying current with your thyroid testing, provider visits, and maintaining your prescription is essential. You should never stop your thyroid medication without talking to your provider first.

Testing your thyroid biomarkers is the primary way to determine how well your thyroid functions. You can do this one of two ways - a blood draw at your local lab or using an at-home testing kit.

Paloma’s at-home testing kit measures the three thyroid biomarkers commonly used to measure thyroid function: TSH, T4, and T3. Based on these values, your provider may diagnose a thyroid disorder and adjust your medication dose.

Some find working with a provider that specializes in hypothyroidism helpful. Our providers at Paloma Health work with you to determine the best treatment plan for your specific needs, including medication, nutrition, and lifestyle modifications. Schedule a free consultation call today.

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Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS, et al. Guidelines for the treatment of hypothyroidism. Thyroid. 2014; 24(12): 1670 - 1751. doi:

Burgos N, Toloza FJK, Singh Ospina NM, Brito JP, Salloum RG, Hassett LC, Maraka S. Clinical Outcomes After Discontinuation of Thyroid Hormone Replacement: A Systematic Review and Meta-Analysis. Thyroid. 2021;31(5):740-751. doi:

Colucci P, Yue CS, Ducharme M, Benvenga S. A Review of the Pharmacokinetics of Levothyroxine for the Treatment of Hypothyroidism. Euro Endocrinol. 2013;9(1):40. doi:

Cytomel. Package Insert. In:Pfizer Inc;2019.

Mathew V, Misgar RA, Ghosh S, Mukhopadhyay P, Roychowdhury P, Pandit K, et al. Myxedema coma: a new look into an old crisis. J Thyroid Res. 2011;2011:493462. doi:

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Emilie White, PharmD

Clinical Pharmacist and Medical Blogger

Emilie White, PharmD is a clinical pharmacist with over a decade of providing direct patient care to those hospitalized. She received her Doctor of Pharmacy degree from Massachusetts College of Pharmacy and Health Sciences. After graduation, Emilie completed a postgraduate pharmacy residency at Bon Secours Memorial Regional Medical Center in Virginia. Her background includes caring for critical care, internal medicine, and surgical patients.

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