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The thyroid gland is a butterfly-shaped organ at the base of your neck. Although small, this mighty organ controls several essential functions all over the body, including regulating cellular metabolism and managing growth and development. When the thyroid gland is not working correctly, the whole body can be affected.
Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormones naturally to help regulate essential body functions. For this reason, people with overt hypothyroidism require lifelong thyroid hormone replacement medication. When thyroid hormones are low, you can experience several unpleasant symptoms that impact your overall health and life quality.
Symptoms of hypothyroidism include:
- Weight gain
- Puffy face
- Muscle weakness
- Elevated blood cholesterol level
- Muscle aches, tenderness and stiffness
- Heavier than normal or irregular menstrual periods
- Thinning hair
- Impaired memory
- Enlarged thyroid gland (goiter)
To combat hypothyroidism, you must take a daily thyroid hormone replacement medication. Thyroid medication typically works by increasing circulating thyroxine (T4) levels. T4 is responsible for regulating your weight, heart rate, temperature, muscle strength, and overall energy and mood. Levothyroxine (commonly known by the brand names Synthroid and Tirosint, among others) provides synthetic T4 to replenish low thyroid hormone levels.
There are also thyroid medications that increase triiodothyronine (T3), the other primary hormone produced by the thyroid gland. Examples of T3 drugs include Cytomel and Triostat.
There are also combination T4/T3 formulations that come in a single pill. In the United States, these come as natural desiccated thyroid (NDT). While every person is unique in what will work best for them, synthetic T4 is usually the standard treatment method for hypothyroidism.
If you stop taking your thyroid medication, you can expect your hypothyroid symptoms to return. Typically, the longer you go without your medication, and the more severe your thyroid disease is, the higher your risk for severe and even life-threatening conditions.
In the immediate period, after stopping your thyroid medication, you may begin to feel tired and sluggish and have a low mood. The longer you go without a prescription, the more intense your symptoms are likely to become. Not taking your thyroid medication could also worsen other health conditions you may have, including sleep apnea, depression, and type 2 diabetes.
People with moderate to severe hypothyroidism who stop taking their medication are at risk for extreme health events, including a myxedema crisis. Although very rare, a myxedema crisis is a life-threatening complication of hypothyroidism. Typically, this condition arises when someone already has uncontrolled hypothyroidism, and a precipitating event occurs, like infection or pregnancy.
In 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:
- Difficulty breathing
- Hyponatremia (low sodium levels in your blood)
People with hypothyroidism may also develop thyroid nodules, solid or fluid-filled lumps that form within your thyroid. About 5% of thyroid nodules become cancerous. Managing your thyroid by taking your medication as prescribed can help reduce your risk of developing cancerous and non-cancerous thyroid nodules.
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.
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. Nonetheless, as synthetic T4 levels start to wane, you can begin to experience symptoms within the first week of not taking your medication.
It is essential to stay current with your thyroid blood tests, thyroid doctor’s visits, and maintain your prescription to prevent a recurrence of hypothyroid symptoms. Keep in mind that it takes between 4-6 weeks before 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.
If you have hypothyroidism, you must find the right type and dose of thyroid medication for you. Your doctor 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/kg/day. In contrast, others are started at low doses between 25mcg-50mcg/day and titrated up as necessary. It can take several weeks to determine if the amount is therapeutic or not.
Once you find the right dose of thyroid medication, is it essential that you 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. To remain stable on your thyroid medication, make sure that you know about things that can affect thyroid medication absorption.
A note from Paloma Health
The information shared in this article is intended to empower you with the information you need to treat your thyroid condition and feel your best! Work with a thyroid doctor to determine the best treatment plan for your specific needs, including medication, nutrition, and lifestyle modifications.