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How Long Can You Go Without Thyroid Medication?

Learn out what happens to your thyroid the longer you go without thyroid medication.
How Long Can You Go Without Thyroid Medication?

In this article:

  • Why thyroid medication is necessary for hypothyroidism
  • Different kinds of thyroid medication
  • What happens when you stop taking thyroid medication
  • How long can you go without medication before symptoms?
  • Making sure you are on the right dose


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. 


Why is thyroid medication necessary for hypothyroidism?


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:

  • Fatigue
  • Increased sensitivity to cold
  • Constipation
  • Dry skin
  • Weight gain
  • Puffy face
  • Hoarseness
  • Muscle weakness
  • Elevated blood cholesterol level
  • Muscle aches, tenderness and stiffness
  • Pain, stiffness or swelling in your joints
  • Heavier than normal or irregular menstrual periods
  • Thinning hair
  • Slowed heart rate
  • Depression
  • Impaired memory
  • Enlarged thyroid gland (goiter)


What are the different kinds of thyroid medication?


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) or Thyrolar (Liotrix). While every person is unique in what will work best for them, synthetic T4 is usually the standard treatment method for hypothyroidism.


What happens when you stop taking thyroid medication?


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 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 compilation 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 causes other complications, including:


  • Difficulty breathing
  • Confusion
  • Hyponatremia (low sodium levels in your blood)
  • Hypothermia
  • Shock
  • Seizures
  • Coma  


People with hypothyroidism may also develop thyroid nodules. 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. 


How long can you go without medication before symptoms start? 


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 blood tests, 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. 

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Making sure you are on the right dose of thyroid medication


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 not intended to scare you, but instead empower you with the information you need to treat your condition and feel your best! Meet with a Paloma Health doctor to determine the best treatment plan for your specific needs, including medication, nutrition, and lifestyle modifications.

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